No abstract

Cytomegalovirus (CMV) is a human herpes-type virus with variable clinical manifestations. Infections in immunocompetent patients are usually asymptomatic or mild, and severe infections are generally seen in immunosuppressed individuals. CMV colitis is not uncommon in patients with ulcerative colitis (UC) and is mostly associated with the use of steroids, immunomodulators like azathioprine, and biologics like infliximab, which have systemic immunosuppressive effects. Vedolizumab is an anti-integrin antibody that is gut-selective without any systemic effects. We report an unusual presentation of a female patient with UC who had concomitant CMV colitis and erythema nodosum, who was on vedolizumab, and not on any steroids or other immunosuppressants. She responded well to anti-viral treatment and steroids.

Gastrointestinal basidiobolomycosis (GIB) is a rare, emerging fungal infection caused by Basidiobolus ranarum, which requires a high index of clinical suspicion for early diagnosis and management. It is prevalent in hot and humid regions, and its clinical manifestations may mimic inflammatory bowel disease (IBD), malignancy, and tuberculosis (TB). This often results in the disease being missed or incorrectly diagnosed.We present the case of a 58-year-old female patient from the southern region of Saudi Arabia who presented with persistent non-bloody diarrhea for four weeks and was found to have GIB. This condition is associated with significant morbidity and mortality if not diagnosed and treated in a timely manner. The optimal therapeutic strategy for managing this rare infection has not yet been established. Most patients described in the literature have received a combination of pharmaceutical and surgical therapy. Including GIB in the differential diagnosis of gastrointestinal disorders that do not fit the diagnosis may help with its early diagnosis and management.

Background: Inflammatory bowel disease (IBD) disk is an easy tool to use in clinical practice to measure IBD-related disability, with a score >40 correlating with high daily-life burden. Its use has been limited mainly to the western world. We aimed to estimate the prevalence of IBD-related disability and evaluate the associated risk factors in Saudi Arabia. Methods: In this cross sectional study conducted at a tertiary referral center for IBD, the English IBD disk was translated into Arabic, and patients with IBD were approached to complete it. Total IBD disk score (0 = no disability; 100 = severe disability) was documented and a score of >40 was set as a threshold to estimate the prevalence of disability. Results: Eighty patients with a mean age of 32.5 ± 11.9 years and disease duration of 6 years, including 57% females, were analyzed. The mean IBD-disk total score was 20.70 ± 18.69. The mean subscores for each function within the disk ranged from 0.38 ± 1.69 for sexual functions to 3.61 ± 3.29 for energy. The overall prevalence of IBD-related disability was 19% (15/80 scoring >40) and was much higher in active disease, in males and in IBD of long duration (39%, 24%, and 26%, respectively). A clinically active disease, high CRP, and high calprotectin were strongly associated with higher disk scores. Conclusion: Although the overall mean IBD disk score was low, nearly 19% of our population had high scores signifying a high prevalence of disability. As demonstrated by other studies, active disease and high biomarkers were significantly associated with higher IBD-disk scores.

Background: Inflammatory bowel disease (IBD) is common among different age groups worldwide, Including the gulf region. It is categorized into Crohn's disease and Ulcerative colitis. Early diagnosis and treatment of inflammatory bowel disease can improve patients' outcomes and reduce the incidence of complications. However, early diagnosis is highly dependent on patients' awareness of the disease to seek medical advice. This study aims to survey the awareness IBD in the general population of the western region of Saudi Arabia. Methods: A self-administered structured questionnaire was translated into Arabic and distributed to the general public above 16 years old. The questionnaire included questions about Crohn's disease and Ulcerative colitis and their treatment, in addition to the respondents' demographic data. Results: 1304 participants responded to this survey. 29% had not heard or read about Crohn's disease, while 19% of the responders had not heard or read about Ulcerative colitis. The mean awareness level score was 1.72±1.19, with a minimum score of 0 and a maximum score of 3. Females showed a significantly higher average score compared to males (p-value < 0.001). Also, the age group between 31 to 40 had the highest average score (p value=0.002). Moreover, responders, who had a Ph.D., showed significantly higher mean scores than the other educational degrees (p value<0.001). Responders who dealt with Crohn's disease patient or ulcerative colitis patients, showed significantly higher scores than their peers, with p values < 0.001 for bothConclusion: The general population in Saudi Arabia has an unacceptable level of awareness of inflammatory bowel disease. Males, young adults, highly educated individuals who dealt with patients previously had better awareness compared to the rest of the population. National acts are essential to improve public awareness towards the disease.

Introduction: Inflammatory bowel disease (IBD) is common worldwide, including the gulf region. Early diagnosis of IBD can improve patients' outcomes. However, early diagnosis is dependent on patients' awareness of the disease to seek medical advice. This study aims to survey the awareness of IBD in the the general population of the western region of Saudi Arabia. Methods: A questionnaire about Crohn's disease (CD) and Ulcerative colitis (UC) was distributed to the general public. A score of 1 was given for the right response and 0 for an incorrect response giving a maximum of 3 and a miminum of 0 for the three questions in the questionnaire. Results: 1304 participants responded. 29% had not heard or read about CD, while 19% had not heard or read about UC. The mean awareness level score was 1.72±1.19. Females showed a significantly higher score compared to males (p < 0.001). Age group 31 to 40 had the highest score (p =0.002). Moreover, responders, who had a Ph.D., showed significantly higher scores than other educational degrees (p <0.001). Responders who dealt with CD or UC patients, showed significantly higher scores than their peers (p < 0.001) for both. Conclusion: The general population in Saudi Arabia has an unacceptable level of awareness of IBD. Females, young adults (age group 31-40 years), educated individuals (with a PhD) and those who had dealt with IBD patients previously had better awareness compared to the rest of the population. National acts are essential to improve public awareness towards the disease.