ISSN: 2961 - 4295
Effect of Preoperative Lugol’s Iodine on Intraoperative Blood Loss in Thyroidectomy in Euthyroid Patients: A Systematic Review and Meta-Analysis
Abdel-Sattar Elshory¹, Fakhry Sanhory², Salma Ismail², Qasem Elotiby¹
Background: Although Lugol’s iodine is routinely used in hyperthyroid patients before thyroidectomy to reduce gland vascularity, its role in euthyroid patients remains controversial.
Aim: This study aims to evaluate the effectiveness of Lugol’s iodine in reducing intraoperative blood loss in euthyroid patients undergoing thyroidectomy.
Methods: A systematic search of PubMed, Embase, Web of Science, and Scopus was performed up to May 2025. Randomized controlled trials (RCTs) comparing preoperative Lugol’s iodine to placebo or no intervention in euthyroid patients were included. The primary outcome was intraoperative blood loss. Meta-analysis was conducted using a random-effects model, with mean difference (MD) and 95% confidence intervals (CI).
Results: Out of 487 screened records, 3 RCTs with 250 euthyroid patients (125 Lugol’s, 125 control) were included. Lugol’s iodine significantly reduced intraoperative blood loss compared to control (MD: –18.22 mL, 95% CI: –21.53 to –14.92; p < 0.00001). Moderate heterogeneity was observed (I² = 85%). All included studies had moderate-to-high methodological quality. No consistent data on adverse effects were reported.
Conclusion: Preoperative Lugol’s iodine significantly reduces intraoperative blood loss in euthyroid patients undergoing thyroidectomy. While findings support its use as a blood-conserving adjunct, further large-scale trials with standardized protocols are warranted to confirm efficacy and assess safety.
Mapping the Burden of Restless Legs Syndrome across Saudi Arabia: A Systematic Review and Meta-analysis
Hyder Mirghani¹, Osama Hamdi Asiri², Khaled Abdulrahman Alshehri², Maitha MohammedAlthawy³, Amnah Ali Alharbi⁴, Maryam Mohammed Abdulaal⁴, Munia Ghassan Alqahtany⁵, WahbiIbrahim Alnazawi⁶, Dhuha Abduallah Alhuthaily⁷, Raghad Shami Alsharidi⁸, Shroog Ibrahim AlQurashi⁹, Abdulaziz Jameel AlOtaibi¹⁰, Abdulmajeed Albalawi¹¹
DOI:10.64039/djms.2025.2101Background: Restless Legs Syndrome (RLS) is a common but underdiagnosed neurological disorder that negatively affects sleep quality, mood, cardiovascular health, and quality of life. Aim: This systematic review and meta-analysis aimed to estimate the pooled prevalence of RLS among adults in Saudi Arabia and explore variation across population subgroups.
Methods: A comprehensive search was conducted across PubMed, Scopus, Web of Science, and Ovid databases up to October 2025. Observational studies that reported RLS prevalence among adults (≥ 16 years) were considered. The pooled prevalence was calculated using a random-effects model (DerSimonian–Laird method), with heterogeneity assessed by the I² statistic and subgroup analyses conducted by population type and diagnostic criteria.
Results: Twenty studies with a total of 22,383 participants were included.The pooled prevalence of RLS in the general adult population of Saudi Arabia was 12.13% (95% CI, 8.13-16.79%) with high heterogeneity (I² = 98.3%). Subgroup analyses revealed markedly higher prevalence rates in specific clinical groups: 26% among patients with chronic conditions, 26% in pregnant women, and 18% among students. Studies using the International RLS Study Group criteria reported a pooled prevalence of 22%. Heterogeneity persisted within subgroups.
Conclusion: RLS is relatively common among adults in Saudi Arabia, particularly among highrisk and pregnant populations. These findings highlight the need for increased awareness, standardized screening, and further research to improve diagnosis and management of RLS across the Kingdom.
A 50-Year-Old Female with Hypertension Revealing Cushing’s Disease: A Case Report
Khaled Mejahed¹, Abdel-Qader Fakhr¹, Khalid Salman², Salma Emad¹, Ayham F. Reweey²
Hypertension is a common condition frequently managed in primary care. However, secondary causes such as Cushing’s syndrome may be overlooked, leading to delays in diagnosis and treatment. We present the case of a 50-year-old female with a 5-year history of hypertension who presented for routine medication adjustment. A systematic clinical assessment revealed features suggestive of hypercortisolism. Subsequent biochemical testing confirmed Cushing’s disease, and MRI imaging revealed a pituitary adenoma with associated visual field defects, previously unnoticed by the patient. This case highlights the importance of comprehensive evaluation in hypertensive patients to identify secondary causes and prevent complications.
