Background and Objectives: Helicobacter pylori (H. pylori) infection is common worldwide and may cause gastroduodenal complications, including cancer. In this review, we examine the prevalence and distribution of various H. pylori genotypes and the risk factors for H. pylori infection, particularly in the Middle East and North Africa (MENA) region. We also introduce different global screening methods and guidelines and compare them to those currently in use in the MENA region. Materials and Methods: We searched the Google Scholar, PubMed, and Saudi Digital Library (SDL) databases for clinical trials and articles published in English. The data collection was mainly focused on MENA countries. However, for H. pylori genotypes and diagnostic methods, studies conducted in other regions or reporting global practices and guidelines were also included to allow a comparison with those in the MENA region. We also included studies examining the prevalence of H. pylori infection in healthy participants. Results: H. pylori infection is highly prevalent in the MENA region, mainly because of the accumulation of risk factors in developing countries. Herein, we highlight a lack of good quality studies on the prevalence of various H. pylori genotypes in the MENA region as well as a need for standard diagnostic methods and screening guidelines. Due to the complications associated with H. pylori, we recommend routine screening for H. pylori infection in all gastroenterology patients admitted in the MENA region. Conclusion: Concerted effort will first be required to validate affordable, non-invasive, and accurate diagnostic methods and to establish local guidelines with adapted cut-off values for the interpretation of the test results.

Background Breast cancer is the most common cancer in women and accounts for 14.7% of cancer-related deaths among females worldwide. Its core management includes surgical removal of the tumor either by breast-conserving surgery (BCS) or mastectomy. Choosing between these two procedures may be influenced by factors that are not studied in our region. We aimed to determine the prevalence of BCS and mastectomy and the factors that may influence the choice of procedure. Methods This retrospective study was carried out by reviewing the records of female breast cancer patients who underwent BCS or mastectomy at between 2009 to June 2017, excluding those with metastasis or recurrence. Frequencies and multivariate tests were used for detecting correlations between procedures and demographic, clinicopathological, and radiological factors. Results Of 335 patients (mean age 52.75 ± 12.2 years), 62.4% had mastectomy and 37.6% had BCS. Modified radical mastectomy accounted for 70.8% of mastectomies. Multivariate analysis showed non-Saudi nationality (P = 0.002), multifocal (P = 0.0001) and multicentric tumors (P = 0.0001), large tumor size (P = 0.0001), tumor stages IIIA (P = 0.005) and IIIB (P = 0.014), positive HER2 (0.009), and triple-negative receptor status (P = 0.010) significantly correlated with mastectomy. Conclusion Mastectomy has a much higher prevalence than BCS in our study mainly due to advanced tumor stage at the time of diagnosis. This emphasizes the urgent need for early detection of breast cancer to move towards BCS, with education and increasing awareness of breast cancer and the surgical options, especially that it is more common in a significantly younger population in our area.

Background: Knowledge of ear health and hearing loss is essential for early intervention and treatment, but the state of public knowledge of such in Jeddah, Saudi Arabia, remains unknown.Objectives: To measure public knowledge of ear health and hearing loss.Method: This cross-sectional study was conducted during August 2018 in Jeddah, Saudi Arabia. An electronic survey questionnaire was distributed to 2372 residents of various districts in Jeddah. The survey was created in 2013 by adopting previously published World Health Organization material, designed to assess knowledge and perception of ear health. All males and females aged 10 years or older living in Jeddah had the chance to participate in this study. A total of 2372 people participated. Percentages mean ± standard deviation, one-way analysis of variance (ANOVAs) and independent t-tests were applied to determine the significant difference. p-values of 0.05 or less were considered significant.Results: The overall mean number of correct responses on the survey’s true/false questionnaire was 10.66 ± 1.92 out of 14. Female participants gave a higher mean number of correct answers than did male participants (10.73 ± 2.03 vs. 10.54 ± 2.03, respectively). Participants with a family history of hearing loss gave a higher mean number of correct answers compared with participants who reported a negative family history (10.89 ± 1.82 vs. 10.53 ± 1.97, respectively).Conclusion: Overall awareness of ear health and hearing loss management is fair. However, the results indicate a need for more integrated educational materials to be made available both to the general population as well as to hearing loss individuals and their families.

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Objectives: To improve the understanding of the association between electrocardiographic)ECG(abnormalities and clinical outcomes of patients with all types of intracranial hemorrhage)ICH(. Methods: A retrospective cohort study was conducted in a tertiary healthcare hospital on patients with ICH without cardiac disease or renal disease requiring dialysis. Demographic and clinical data were collected from hospital records. ECG record were Original Article obtained within 24 hours of presentation and prior to treatment. Records were interpreted for this study by a cardiologist blinded to other data. Results: Assessment of 291 patients)228 adults and 63 children(showed that subdural hemorrhage was the most common type of ICH)31.6%(followed by intraparenchymal hemorrhage)23.0%(. ECG records were available for 98 patients. ECG abnormalities were most commonly nonspecific ST-segment changes)32.6%(. In adults, history of neurological disease was associated with atrioventricular block)p=.004(and QTc prolongation)p=.041(. Pediatric patients exhibited associations between ST-segment changes)p=.045(and sinus tachycardia)p=.027(and type of ICH. However, ECG changes were not statistically associated with clinical outcomes in adults or children. Conclusion: Significant ECG changes frequently occurred in patients with all types of ICH but did not consistently predict the outcome in this study. Close observation of patients is still recommended to detect ECG changes that could affect the treatment.