Obstructive sleep apnea (OSA) is a disorder characterized by repeated episodes of partial or complete obstruction of the airway during sleep. OSA can lead to serious long-term complications if left untreated. This study aims to assess the prevalence of OSA symptoms among the adult population in Al-Ahsa, Saudi Arabia. This is a cross-sectional study including the adult population living in Al-Ahsa, Saudi Arabia. A self-administered questionnaire was distributed to the targeted population using an online survey. The questionnaire was divided into two sections, where the first part was about the characteristics of the participant (i.e., age, gender, marital status, etc.), and the second part was the Epworth Sleepiness Scale (ESS) questionnaire to evaluate OSA symptoms. Three hundred and sixty adult subjects participated in this study by responding to the questionnaire (58.1% males vs. 41.9% females). The respondents' median age was 30 years old. The prevalence of OSA symptoms was 26.9%. In terms of OSA symptom severity, mild, moderate, and severe excessive daytime sleepiness were found among 12.5%, 8.3%, and 6.1%, respectively. The prevalence of OSA symptoms was significantly higher in the older group (>30 years; p=0.004), married participants (p=0.008), and obese or overweight (BMI ≥25 kg/m2; p=0.002). Multivariate regression estimates showed that being obese or overweight (BMI ≥25 kg/m2) was the sole independent significant predictor associated with increased odds of OSA symptoms. The prevalence of OSA symptoms among Al-Ahsa residents was 26.9% with prevalence being higher in males than females. Further investigations are needed to establish the prevalence of OSA and understand its influence on the adult population in our region. People who were suspected to have OSA in this study should be reassessed using polysomnography to confirm the diagnosis. Patients with suspected OSA should be encouraged to adopt lifestyle modifications specifically targeted to/focused on weight reduction and smoking cessation.

Introduction: Nutrition threatens the quality of life (QOL) in end-stage kidney disease (ESKD) patients on haemodialysis (HD). The aim of the study is to assess which nutritional parameters associate with the health-related QOL category score using Arabic translated, adapted, and validated version of the Kidney Disease Quality of Life Short-Form 36 (KDQOL-36). Methods: We carried out a cross-sectional study with a total of 60 ESKD patients in one haemodialysis centre in Al-Ahsa, Saudi Arabia. The health-related QOL of the five components of the KDQOL-36 are as follows: physical component score (PCS), mental component score (MCS), the burden of kidney disease (BKD), symptoms and problems of kidney disease (SPKD), and effects kidney disease (EKD) which were grouped into three categories (good, average and poor) based on the score. Results: Of the 60 HD patients, 43 (71.7%) were between 19 and 59 years old and 41 patients (68.3%) were males. This study revealed that high haemoglobin impact PCS, MCS, SPKD, and EKD in favour of poor health-related QOL, but normal haemoglobin impacts BKD in favour of good QOL. In addition, patients who had a normal serum albumin level had good scores for MCS, BKD, SPKD, and EKD. Also, there was a significant association between Kt/V value with EKD (p=0.001). Conclusion: According to the findings of this study, patients with HD have poor health-related QOL outcomes than those with good nutritional status. This finding demonstrates the critical need for further articles to study this particular group of population.

Background: In heart failure with preserved ejection fraction (HFpEF) and decreased ejection fraction (HFrEF), LA strain, an indicator of the filling and discharge of the left atrium (LA), was recently identified as a sign of diastolic dysfunction. Our objective was to examine the significance of left atrial (LA) strain relative to tissue Doppler echocardiography and the left atrial volume index (LAVI) in evaluating left ventricular (LV) diastolic performance in individuals with chronic kidney disease (CKD). Methods: A prospective cross-sectional study was conducted on 220 outpatients with CKD who fulfilled the inclusion criteria and were referred to the cardiology clinic at Tanta University for routine echocardiographic assessment during a period of 6 months (April to September 2024). Based on their estimated glomerular filtration rate (eGFR), patients were divided into five groups: GFR ranges from 90 to 120 mL/min/1.73 m² in Group 1, 60 to 90 mL/min/1.73 m² in Group 2, 30 to 60 mL/min/1.73 m² in Group 3, 15 to 29 mL/min/1.73 m² in Group 4, and less than 15 mL/min/1.73 m² in Group 5. All participants were evaluated using echocardiographic measurements, such as the E/e ratio, left ventricular systolic and diastolic volumes, left atrial strain, left atrial volume index (LAVI), and ejection fraction (EF). Results: LA strain conduit and reservoir strain can significantly diagnose LV diastolic function in CKD patients (p < 0.001; AUC = 0.819 and 0.869, respectively) using cutoffs of ≤36 and ≥23, with 86% and 95.5% sensitivity, 65% and 60% specificity, 96.1% and 96% PPV, and 31.7% and 57.1%, NPV respectively. An AUC = 0.926 was observed with LAVI among grade 1 vs. grade 0 (0.9 is considered excellent in diagnosing patients with and without the disease). Other markers had AUC values of 0.5–0.6 among the grades of the diastolic function, suggesting no discrimination in diagnosing the disease. Conclusions: LA conduit strain and reservoir strain are independent markers that represent a superior and more sensitive approach than LAVI and tissue Doppler echocardiography for evaluating LV diastolic dysfunction in patients with CKD, even in the early stages.

Introduction: Calciphylaxis, also known as calcific uremic arteriolopathy (CUA), is a rare and potentially fatal condition primarily affecting patients with end-stage renal disease (ESRD) on hemodialysis (HD). It is characterized by calcification in small blood vessels, leading to painful skin ulcers and high mortality rates. Case Description: This is a case of a 42-year-old female with ESRD on HD who developed calciphylaxis, presenting with non-healing ulcers on her thighs. Discussion: Despite initial treatments, including wound care and pain management, her condition did not improve. A skin biopsy was inconclusive, highlighting the diagnostic challenges associated with calciphylaxis. Based on clinical judgment, warfarin and calcium-based therapies were discontinued, and the patient’s HD regimen was adjusted. Due to the persistence of symptoms, sodium thiosulfate (STS) therapy was initiated, leading to significant improvement in her ulcers after six months of treatment. Conclusions: This case highlights the importance of clinical judgment in the diagnosis and management of calciphylaxis, particularly when histopathological diagnostic methods yield inconclusive results. Clinical criteria, alongside a thorough assessment of the patient’s history and presentation, are vital for achieving a timely diagnosis in such challenging cases. The successful use of sodium thiosulfate in this patient adds to the growing body of evidence supporting its use as a potential treatment for calciphylaxis, especially in cases that do not respond to conventional therapy.

Background: The left atrium's (LA) filling and discharge is quantified by LA strain. LA strain has been established as a metric for diastolic dysfunction in heart failure with preserved and reduced ejection fraction (HFpEF and HFrEF, respectively). We sought to address the role of LA strain value versus tissue Doppler echocardiography and the left atrial volume index (LAVI) in the left ventricular (LV) diastolic function evaluation in chronic kidney disease (CKD) patients. Method: A prospective cross section study was conducted on 220 outpatients of CKD that fulfilled the inclusion criteria and referred to cardiology clinic at Tanta University for routine echocardiographic assessment during a period of six months (April to September 2024). Patients were divided into subgroups based on their estimated Glomerular Filtration Rate (eGFR) into 5 groups; Group 1: GFR 90-120 mL/min/1.73 m2, Group2: GFR 60-90 mL/min/1.73 m2, group 3: GFR 30-60 mL/min/1.73 m2, group 4: GFR 15-29 mL/min/1.73 m2, group 5: GFR <15 mL/min/1.73 m2. Echocardiographic parameters including systolic and diastolic volumes of left ventricle, LA strain, LAVI, ejection fraction (EF), and E/e ratio were measured in all participants. Results: LA strain conduit and reservoir strain can significantly diagnose LV Diastolic Function in CKD Patients (P -23, with 86% and 95.5% sensitivity, 65% and 60% specificity, 96.1% and 96% PPV and 31.7% and 57.1% NPV respectively. AUC=0.926 was observed with LAVI among grade 1 vs grade 0 (0.9 is considered excellent in diagnosing patients with and without the disease). While other markers among the grades of the diastolic function had AUC of 0.5-0.6, which suggests no discrimination in diagnosing the disease. Conclusions: LA conduit strain and reservoir strain are independent markers that is superior and more sensitive approach than LAVI and tissue Doppler echocardiography for evaluating LV diastolic dysfunction in patients with CKD even in the early stages.

Background and Objectives: Blood transfusion is a key component of sickle cell disease (SCD) management, and ABO and Rh compatibility is essential to minimize transfusion-related complications. This study investigated factors associated with blood transfusion history and examined the relationships of ABO and Rh blood groups with clinical and laboratory markers of disease severity. Materials and Methods: A cross-sectional study was conducted among 309 patients attending a hematology outpatient clinic in Saudi Arabia between October and December 2025. Clinical data were collected through patient interviews, and laboratory results were obtained from medical records. Results: Overall, 89.9% of patients had a history of blood transfusion. Older age, chronic disease, higher platelet count, MCV, MCH, and HbA2 levels were associated with blood transfusion history. In contrast, higher hemoglobin and HbF levels were associated with fewer transfusions. Patients with blood group O had lower odds of transfusion than those with non-O blood groups (OR = 0.340, 95% CI: 0.135–0.856; p = 0.022). Hydroxyurea use was associated with lower LDH levels, while G6PD deficiency and higher MCV were independently associated with higher LDH levels. ABO and Rh blood groups were not associated with acute chest syndrome or LDH levels. Conclusions: Blood transfusion history in SCD was associated with several clinical and hematological factors. These findings support further investigation of G6PD status and reinforce the known benefits of hydroxyurea. Further studies are needed to clarify the role of ABO and Rh blood groups in disease progression and transfusion practices.