Patients with coronavirus disease 2019 (COVID-19) were shown to have reduced serum testosterone levels compared to healthy individuals. Low testosterone levels are linked with the development of erectile dysfunction (ED). In this case-controlled study, 20 healthy controls and 39 patients with ED 3 months after recovering from mild-to-moderate COVID-19 pneumonia were studied. The patients ranged in age from 31 to 47 years. To identify early and late COVID-19 infections, real-time polymerase-chain reaction (RT-PCR) and COVID-19 antibody testing were done. The levels of luteinizing hormone (LH), follicular stimulating hormone (FSH), total testosterone (TT), free testosterone (FT), free androgenic index (FAI), and sex hormone-binding globulin (SHBG) were measured. The sexual health inventory for patients (SHIM) score was used to measure the erectile function of the patients and controls. When compared to the controls, the TT serum level in long COVID-19 (LC) patients with ED was low (p = 0.01). In contrast to controls, FT and FAI were both lower in LC patients with ED. (p = 0.001). FSH serum levels did not significantly differ (p = 0.07), but in ED patients, LH serum levels were elevated. SHIM scores were associated with low TT (p = 0.30), FT (p = 0.09), and high LH (p = 0.76) in LC patients with ED. Male patients with decreased serum levels of LH and testosterone may have hypothalamic-pituitary–gonadal axis dysfunction, which could lead to the development of LC-induced ED. Therefore, an in-depth research is necessary to confirm the causal link between COVID-19 and ED in LC patients.

Background: Ulcerative colitis (UC) is an idiopathic chronic inflammation of colonic and rectal mucosa. The peroxisome proliferator-activated receptor α (PPARα) has been identified as having protective effects in UC. Aim: The study aimed to investigate the efficacy of fenofibrate, a PPARα agonist, in UC. Methods: A total of 70 patients with mild to moderate UC were allocated randomly and assigned to two groups (n = 35 each) from Gastroenterology Department, Faculty of Medicine, Menoufia University. The mesalamine group received a placebo along with 1 g of mesalamine three times daily, while the fenofibrate group received 1 g of mesalamine three times and fenofibrate 160 mg once daily. The study duration was for six months. A gastroenterologist assessed patients by non-invasive Partial Mayo Score (PMS) and the Inflammatory Bowel Disease Questionnaire (IBDQ) to evaluate clinical response and remission. The serum levels of silent information regulator 1 (SIRT1), NOD-like receptor protein 3 (NLRP3), and adenosine monophosphate activated protein kinase (AMPK), as well as fecal calprotectin levels were examined to determine the biological effect of fenofibrate. Results: After treatment, the fenofibrate group showed statistically significant reductions in PMS (p = 0.044) and improved digestive domain of IBDQ (p = 0.023). Additionally, there were significant decreases in serum NLRP3 (p = 0.041) and fecal calprotectin (p = 0.035), along with significant increases in SIRT1 (p = 0.002) and AMPK (p = 0.0003). The fenofibrate group also had higher response and remission rates compared to the mesalamine group. Conclusion: Fenofibrate may be a promising adjunct for improving clinical outcomes, quality of life, and modulating inflammation in mild to moderate patients with UC. Trial Registration Identifier: NCT05781698.

Individual differences in IBD illness severity, behavior, progression, and therapy response are evident. Since a break in the intestinal epithelial barrier causes IBD to begin, mucosal gene expression in IBD is crucial. Due to its high sensitivity and dynamic nature, molecular analysis of biomarkers in intestinal biopsies is feasible and provides a reliable means of evaluating localized inflammation. The goal of this investigation was to discover alterations in gene expression in the inflamed mucosa of IBD patients undergoing treatment with 5-amino salicylic acid (5ASA) (N = 39) or anti-TNF drugs (N = 22). The mucosal expression of numerous IBD-related genes was evaluated using qPCR. We discovered that the levels of the proteins Lipocalin-2 (LCN2), Nitric Oxide Synthase 2 (NOS2), Mucin 2 (MUC2), Mucin 5AC (MUC5AC), and Trefoil factor 1 (TFF1), which are overexpressed in untreated IBD patients compared to non-IBD subjects, are decreased by both therapy regimens. On the other hand, anti-TNF medicine helped the levels of ABCB1 and E-cadherin return to normal in IBD patients who were not receiving treatment.

The introduction of direct-acting antivirals (DAA) to treat the hepatitis C virus (HCV) overcame many drawbacks of interferon-based therapy. DAA achieved sustained viral response (SVR) rates above 90% and overcame many drawbacks of pegylated interferon regimens.The HCV genotype (GT) distribution varies by geographical area, with GT-4 being most prevalent in the Middle East region, including Saudi Arabia. Yet, the real-world evidence about using DAAs in the Saudi population is limited.Thus, the aim of this study to investigate the effectiveness and safety of DAAs in Saudi patients with HCV infection. A retrospective cohort study included patients treated with DAAs from 2015 to 2017 at a tertiary care hospital in Riyadh, Saudi Arabia. All patients with HCV treated with either ledipasvir plus sofosbuvir (LDS/SOF) ± ribavarin (RBV) or ombitasvir-paritaprevir-ritonavir (OBV/PTV/r) ± dasabuvir (DSV) ± RBV were included. Using a per-protocol analysis, the effectiveness outcome was the end-of-treatment response (EOTr) and Sustained virologic reponce12 weeks after competing the regimen (SVR12). The secondary safety outcome was the adverse event related to the therapy reported by the patients. A total of 97 patients were included; with the majority infected with GT-4 (64 %), followed by GT-1 (18 %), in addition to 8 % having a mixed GT (1 + 4). The EOTr and SVR12 rates were 98 % and 96 %, respectively. SVR12 was 94.4 % within the LDS/SOF ± RBV group and 97.7 % within the OBV/PTV/r ± DSV ± RBV group. Only 4 % had a response failure due to relapse or breakthrough, and all were infected with mixed GT1 + 4. Medications were well tolerated with minimal side effects, including vomiting, nausea, and weakness. DAAs regimens are associated with high rates of SVR12 and are well tolerated with a good safety profile in Saudi HCV-infected patients.

Background and Objectives: Obesity and type 2 diabetes (T2D) are closely linked and associated with a higher risk of complications. This study aims to evaluate the effectiveness of once-weekly semaglutide in achieving a composite endpoint of A1C and weight reduction. Materials and Methods: This retrospective cohort study assessed the effectiveness of semaglutide in obese patients with T2D at a tertiary care hospital in Saudi Arabia. This study included patients who received semaglutide treatment for 12 months, and the endpoint was reducing A1C by ≥ 1% and body weight by ≥ 5% after 12 months of starting semaglutide. Secondary endpoints include predictors of achieving the composite endpoint and the effect on the lipid profile. Results: The present study enrolled 459 participants, with dyslipidemia and hypertension being the most common comorbidities. After 12 months of treatment with semaglutide, 42% of the patients achieved the composite endpoint. Semaglutide significantly reduced weight, BMI, A1C, FBG, total cholesterol, LDL, and triglycerides. The subgroup analysis showed that patients who achieved the composite endpoint were younger and had significantly lower use of insulin. Females in the study had significantly higher BMI, A1C, and HDL levels and lower levels of triglycerides compared to males. Multivariate analysis revealed that baseline BMI (aOR = 0.953; 95% CI: 0.915 to 0.992; p = 0.02), baseline A1C (aOR = 1.213; 95% CI: 1.062 to 1.385; p = 0.004), and receiving insulin (aOR = 0.02; 95% CI: 0.001 to 0.343; p = 0.007) were significant predictors of composite endpoint achievement. Conclusions: Semaglutide is a valuable option for the treatment of obese patients with T2D. This study found that semaglutide is effective in reducing weight and A1C and improving the lipid profile. The predictors of achievement of the composite endpoint were lower baseline BMI, higher baseline A1C, and insulin non-use.

Objectives: To compare the effectiveness of providing telepharmacy anticoagulation to on-site clinics in achieving optimal outcomes for patients newly starting warfarin. Methods: This single-center retrospective cohort study included adult patients who started warfarin for the first time and were monitored by clinical pharmacists either on-site or via telepharmacy anticoagulation clinics between January 2017 and March 2024. The primary outcome is to compare the time in therapeutic range (TTR) between the 2 groups. The secondary outcome is the occurrence of anticoagulation therapy–related complications. Results: We included 191 patients, with 77 in the telepharmacy group and 114 in the on-site group. The baseline characteristics were similar for both groups. The primary outcome— time in therapeutic range (TTR)—was not significantly different between thetelepharmacy and the on-site groups (50% versus 53.8%, p=0.455) and remained so after univariable and multivariable adjustments (OR [odd ratio]= 0.63, p=0.14 and OR=0.58, p=0.102). Additionally, there were no significant differences in secondary outcomes, including thromboembolism and bleeding (p=1 for both). Conclusion: This study demonstrates that patients who receive warfarin for the first time at an anticoagulation clinic can use the telepharmacy method without the fear undesirable outcomes. Results of this study support the continued use and expansion of telepharmacy services in Saudi Arabia. However, further research larger sample sizes and multiple centers is needed to confirm these findings.