Mohammed Saad Alqahtani

The aim of this study is to assess the ability of ultrasound to identify and estimate the normal cross-sectional area (CSA) of the great auricular nerve (GAN) at a defined landmark in healthy adults. The study sample included 80 GANs in 40 participants (11 males, 29 females), mean age 36.5 years, mean height 160.1 cm, mean weight 63 kg, mean body mass index 24.4 kg/m ² . Two radiologists separately obtained sonographic images of the bilateral GANs. Each participant was scanned 3 times bilaterally to assess for intraobserver reliability. The mean CSA of the bilateral GANs was 0.8 mm ² (range 0.4–2.7 mm ² ). The GAN CSA positively correlated with weight, height, and body mass index. This study confirms the ability of ultrasound to reliably assess the GAN at a defined landmark and estimate its normal CSA. Knowledge of how to identify and measure the GAN would be expected to help decrease complications during procedures and help establish normal reference values.

The rapidly advancing field of gut microbiota research has revealed its pivotal role in human health, with growing evidence implicating microbial dysbiosis in the development of metabolic diseases, particularly type 2 diabetes mellitus (T2DM). This narrative review synthesizes recent findings on the complex, bidirectional relationship between the gut microbiota–metabolic axis and T2DM, drawing upon data from human and experimental studies published in the past decade. Patients with T2DM consistently demonstrate marked gut dysbiosis, characterized by reduced microbial diversity and depletion of beneficial butyrate-producing taxa such as Faecalibacterium prausnitzii and Roseburia intestinalis. In contrast, increases in pro-inflammatory bacteria including Escherichia-Shigella and Lactobacillus are commonly observed. Such compositional changes are linked to metabolic dysfunction through altered microbial metabolites, including elevated trimethylamine N-oxide (TMAO), which has been associated with insulin resistance and increased diabetes risk. Moreover, gut microbiota imbalances correlate with systemic inflammation, as indicated by higher levels of cytokines such as IFN-γ and IL-6. These findings underscore the gut microbiota’s central role in energy metabolism and inflammation in T2DM. Understanding these mechanisms could inform novel therapeutic and preventive strategies—such as microbiota-targeted dietary, probiotic, or pharmacologic interventions—to improve metabolic outcomes and enhance clinical management of diabetes.

Gastric cancer traditionally affects older adults, and its precursor lesions and risk factors are well-documented in this population. Helicobacter pylori (H. pylori) infection remains highly prevalent in Saudi Arabia and contributes to gastric pathology. However, early-onset gastric cancer (EOGC), diagnosed in individuals aged ≤ 45 years, presents unique challenges and remains poorly understood in young populations. Therefore, we conducted an observational cohort study using a prospective longitudinal design (2021–2024) involving 1823 Saudi nationals aged 18–45 years who underwent zoom high-definition chromoendoscopy to evaluate the prevalence of premalignant gastric lesions (PGLs) and EOGC. We found a high H. pylori prevalence (78.0%) with PGLs in 1.9% of participants and EOGC-adenocarcinoma in 0.7% of patients. All EOGC cases arose from dysplasia, with most PGLs being classified as OLGA/OLGIM stage II/III. Multiple risk factorswere significantly associated with PGLs and EOGC, including H. pylori infection (p = 0.022), increasing age (p < 0.001), a family history of gastric cancer (p < 0.001), poor dietary habits (p < 0.001), obesity (p < 0.001), and smoking (p < 0.001). Additional EOGC risk factors include dage of 36–45 years (p = 0.018), EBV infection (p = 0.016), and diabetes mellitus (p = 0.001). These findings demonstrate the notable presence of PGLs and EOGC in young Saudi adults and emphasize the importance of early detection and risk factor management in this vulnerable population.

Background: Subclinical systolic dysfunction due to diabetic microangiopathy and its impact on left ventricular (LV) function remains unclear. Myocardial deformation (strain) imaging can detect LV systolic dysfunction earlier than conventional ejection fraction evaluations. Thus, this study aimed to examine the relationship between uncontrolled diabetes and impaired LV global longitudinal strain (GLS) in patients with diabetes mellitus (DM) compared to non-diabetic individuals. Methods: A total of 76 asymptomatic patients with uncontrolled type 2 DM and 76 age- and gender-matched healthy controls underwent transthoracic echocardiography imaging. Patients with coronary artery disease, an LV ejection fraction <55%, atrial fibrillation, or inadequate echocardiographic quality were excluded. The presence of proliferative retinopathy, microalbuminuria, nephropathy, or peripheral neuropathy defines diabetic microvascular complications. Results: The absolute GLS% was significantly lower in the uncontrolled diabetic group (–18.4 ± 1.7) compared to controls (–22 ± 1.9, p < 0.001). Diabetic patients with complications had lower absolute GLS% values of –18.9 ± 1.7 for no complications, –17.5 ± 1.3 for one complication, and –16.8 ± 1.3 for two or more complications (p-value = 0.001). Regression analysis showed a positive association between complications and lower absolute GLS% (β = 0.41, p < 0.001). No significant difference was found in LV mass between hypertensive (155.1 ± 40.4) and non-hypertensive individuals (139.8 ± 44.3; p-value = 0.19). Conclusion: Uncontrolled diabetes and the presence of complications were associated with lower absolute GLS% values, suggesting impaired myocardial deformation. These findings highlight the importance of monitoring GLS% as a potential marker for cardiac involvement in diabetic patients.

Catheter-associated urinary tract infections (CAUTIs) cause serious complications among hospitalized patients due to biofilm-forming microorganisms which make treatment ineffective by forming antibiotic-resistant strains. As most CAUTI-causing bacterial pathogens have already developed multidrug resistance, there is an urgent need for alternative antibacterial agents to prevent biofilms on catheter surfaces. As a trial to find out such a potential agent of natural origin, the bark of Tamarix ericoides Rottl., a little-known plant from the Tamaricaceae family, was examined for its antibacterial and antibiofilm activities against one of the major, virulent, CAUTI-causing bacterial pathogens: Enterococcus faecalis. The methanolic T. ericoides bark extract was analyzed for its antibacterial activity using the well diffusion method and microdilution method. Killing kinetics were calculated using time–kill assay, and the ability of biofilm formation and its eradication upon treatment with the T. ericoides bark extract was studied by crystal violet assay. GC-MS analysis was performed to understand the phytochemical presence in the extract. A in vitro bladder model study was performed using extract-coated catheters against E. faecalis, and the effect was visualized using CLSM. The changes in the cell morphology of the bacterium after treatment with the T. ericoides bark extract were observed using SEM. The biocompatibility of the extract towards L₉₂₉ cells was studied by MTT assay. The anti-E. faecalis activity of the extract-coated catheter tube was quantified by viable cell count method, which exposed 20% of growth after five days of contact with E. faecalis. The anti-adhesive property of the T. ericoides bark extract was studied using CLSM. The extract showed potential antibacterial activity, and the lowest inhibitory concentration needed to inhibit the growth of E. faecalis was found to be 2 mg/mL. The GC-MS analysis of the methanolic fractions of the T. ericoides bark extract revealed the presence of major phytochemicals, such as diethyl phthalate, pentadecanoic acid, methyl 6,11-octadecadienoate, cyclopropaneoctanoic acid, 2-[(2-pentylcyclopropyl) methyl]-, methyl ester, erythro-7,8-bromochlorodisparlure, etc., that could be responsible for the antibacterial activity against E. faecalis. The killing kinetics of the extract against E. faecalis was calculated and the extract showed promising antibiofilm activity on polystyrene surfaces. The T. ericoides bark extract effectively reduced the E. faecalis mature biofilms by 75%, 82%, and 83% after treatment with 1X MIC (2 mg/mL), 2X MIC (4 mg/mL), and 3X MIC (6 mg/mL) concentrations, respectively, which was further confirmed by SEM analysis. The anti-adhesive property of the T. ericoides bark extract studied using CLSM revealed a reduction in the biofilm thickness, and the FDA and PI combination revealed the death of 80% of the cells on the extract-coated catheter tube. In addition, SEM analysis showed extensive damage to the E. faecalis cells after the T. ericoides bark extract treatment, and it was not cytotoxic. Hence, after further studies, T. ericoides bark extract with potential antibacterial, antibiofilm, and anti-adhesive activities can be developed as an alternative agent for treating CAUTIs.

The aim of this study is to estimate the normal cross-sectional area and diameter of the stellate ganglion (SG) by ultrasound (US) in healthy adults. The study sample included 80 stellate ganglia in 40 participants (15 males, 25 females), mean age 38 years, mean height 162.5 cm, mean weight 67.8 kg, mean body mass index 25.4 kg/m². Two radiologists separately obtained US images of the bilateral SG. Each participant was scanned 3 times bilaterally to assess for intra-observer reliability. The mean diameter of the SG was 1 mm (range: 0.1–2). The mean CSA of the bilateral SG was 1.3 mm² (range: 0.6–3.9). The SG diameter positively correlated with age. Our study demonstrates the ability of US to image the SG and estimate its normal diameter and CSA. Knowledge of how to identify and measure the SG during ultrasound-guided procedures would be expected to decrease the risk of associated complications and help establish normal reference values.