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20 March 2026
Saudi Medical Journal was established in 1979 through the vision and initiative of His Royal Highness Prince Sultan bin Abdulaziz, Second Deputy Prime Minister, Minister of Defense and Aviation, and Inspector General, whose support laid the foundation for the journal’s continued development. Since its inception, the Journal has been published regularly and has maintained a strong commitment to scientific rigor and editorial quality.
Over the years, Saudi Medical Journal has evolved in scope, reach, and operational efficiency. Its editorial and publishing activities have been continuously refined to ensure timely publication while upholding high standards of peer review and content quality. The journal has attracted submissions from both within and outside the Kingdom and serves a broad readership across the Middle East and beyond.
The Editorial Office has been led by distinguished editors and supported by dedicated staff who have contributed to building the journal’s international reputation and credibility. Ongoing improvements in editorial processes and publishing practices reflect the journal’s commitment to excellence and continuous development.
As the longest-running medical journal in the Kingdom, Saudi Medical Journal plays an important role in bridging medical scholarship between the Middle East and the global research community. In addition to publishing original scientific research, the journal actively supports capacity building by offering medical publication workshops aimed at junior doctors and health researchers.
Current Issue
Volume 47, Issue 4 (2026)View issue
Featured Content
- Clinical Practice Guideline20 March 2026
Chronic Total Occlusion Percutaneous Coronary Intervention: A Consensus of the National Heart Center in Collaboration With the Saudi CTO Club of the Saudi Arabian Cardiac Interventional Society
Objective: Chronic total occlusion (CTO) is one of the most complex and technically demanding percutaneous coronary interventions (PCI). Over the last two decades, technological and procedural advancements have significantly improved clinical outcomes. However, CTO-PCI practice and outcomes remain suboptimal with a lack of standardized approaches. Methods: The Saudi CTO Club has been actively working to enhance collaboration among CTO operators throughout the region. The National Heart Center (NHC), in collaboration with the Saudi Arabian Cardiac Interventional Society (SACIS), convened national experts to develop a consensus document and workflow for integrating CTO-PCI into clinical practice in Saudi Arabia. This consensus document consolidates current evidence from international guidelines and the recommendations are tailored to address region-specific considerations. The document delineates clear protocols for clinical indications, procedural techniques, and the mitigation of complications in CTO-PCI. Results: In this consensus, 14 statements are discussed considering scientific evidence and agreed upon for CTO-PCI. These statements covered four pillars: i) Indications; ii) Evaluation; iii) CTO-PCI technical principles; and iv) Safety and complications. Conclusion: This consensus provides a framework for recommendations to guide the treatment of patients, the development of CTO programs, and the training of new CTO-PCI operators.
Current Articles
Most Popular Articles
- Clinical Practice Guideline7 February 2026
National Heart Center Perfusion Guidelines
Objectives: To establish the[-28pc]AU: Add abbreviated academic degree for authors Fareed A. Khouqeer and Yasser A. Alheraish. first national standards and guidelines for best practice in perfusion for patients undergoing cardiothoracic surgery in Saudi Arabia. Cardiopulmonary bypass (CPB) enables complex cardiac surgeries; however, it poses risks of potential complications. Methods: We used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to develop these guidelines and assess the certainty of evidence through a collaborative process. A panel of 16 Cardiovascu- lar perfusion experts across Saudi Arabia formulated 22 key clinical questions relevant to local practice. PubMed, Scopus, and Embase databases were searched for each question to identify relevant systematic reviews, randomized controlled trials (RCTs), non-randomized trials, post hoc analyses, and pooled analyses published from 2010 to 2024. The guideline panel voted for every question using the GRADEpro system, requiring a minimum consensus of 70% for approval. Results: A total of 16 conditional recommendations and 6 good practice statements were finally approved, categorized into 5 key domains. Of these, 4 addressed guidelines, protocols, and general practices; 2 focused on surgical techniques; 8 covered heart-lung machine hardware; 3 centered on cardioplegia and Priming Solutions; and 5 emphasized monitoring and perioperative management. Six statements were based on expert opinion due to insufficient supporting evidence. Using a standardized pre-bypass checklist to enhance safety and implementing perioperative glycemic management to control glucose levels and reduce complications were strongly recommended by the panel. Conditional recommendations focus on pump selection, biocompatible oxygenators, and continuous cerebral oxygenation monitoring. Anticoagulation, myocardial protection, and transfusion management were also highlighted. Conclusion: These Saudi guidelines provide evidence-based recommendations to enhance the care of patients undergoing cardiac surgery with CPB, offering clear guidance for clinicians to achieve optimal outcomes. Nevertheless, future locally relevant research and regular updates are essential to bridge existing evidence gaps. - Clinical Practice Guideline20 March 2026
Chronic Total Occlusion Percutaneous Coronary Intervention: A Consensus of the National Heart Center in Collaboration With the Saudi CTO Club of the Saudi Arabian Cardiac Interventional Society
Objective: Chronic total occlusion (CTO) is one of the most complex and technically demanding percutaneous coronary interventions (PCI). Over the last two decades, technological and procedural advancements have significantly improved clinical outcomes. However, CTO-PCI practice and outcomes remain suboptimal with a lack of standardized approaches. Methods: The Saudi CTO Club has been actively working to enhance collaboration among CTO operators throughout the region. The National Heart Center (NHC), in collaboration with the Saudi Arabian Cardiac Interventional Society (SACIS), convened national experts to develop a consensus document and workflow for integrating CTO-PCI into clinical practice in Saudi Arabia. This consensus document consolidates current evidence from international guidelines and the recommendations are tailored to address region-specific considerations. The document delineates clear protocols for clinical indications, procedural techniques, and the mitigation of complications in CTO-PCI. Results: In this consensus, 14 statements are discussed considering scientific evidence and agreed upon for CTO-PCI. These statements covered four pillars: i) Indications; ii) Evaluation; iii) CTO-PCI technical principles; and iv) Safety and complications. Conclusion: This consensus provides a framework for recommendations to guide the treatment of patients, the development of CTO programs, and the training of new CTO-PCI operators. - Clinical Practice Guideline10 March 2026
National Heart Center – Saudi Health Council Acute Myocardial Infarction-Related Cardiogenic Shock Consensus Document
Objective: Cardiogenic shock (CS) remains a serious complication of acute myocardial infarction (AMI) with persistently high mortality and significant variability in management across centers. Methods: A multidisciplinary panel convened by the National Heart Center used the GRADE framework to review evidence and develop consensus recommendations tailored to AMI-related CS. Results: The document emphasizes standardized CS definition and staging, prioritizing the SCAI classification. Key components include early recognition, haemodynamic assessment, lactate monitoring, and the central role of echocardiography. Recommendations support rapid culprit-vessel revascularization, early consideration of mechanical circulatory support, and structured Heart Team activation. The document also highlights the need for protocolized care pathways and CS registries. Conclusion: These consensus recommendations provide a unified approach to AMI-related CS aimed at reducing practice variation and improving clinical outcomes. - Review10 March 2026
Clinical Significance of IKBKB Mutations: A Focus on IKBKB-Related Immunodeficiency
Inhibitory kappa B kinase beta (IKBKB, IKK2, or IKKβ ) acts as an activator of the nuclear factor (NF)-κ B signaling cascade that is involved in regulating normal physiological processes and is dysregulated in several pathological processes including immunological disorders. Mutations in IKBKB have been found to cause immune deficiency syndromes. Inherited loss-of-function mutations in IKBKB lead to severe or lethal immune deficiency. In this review, the clinical significance of IKBKB mutations will be reviewed in the context of immune deficiency syndromes. All published clinical cases of IKBKB mutations relevant to immune deficiency, either caused by loss- or gain-of-function mutations will be presented to provide a comprehensive overview of the genetic, clinical, and immunological patterns of these mutations. Finally, the challenges and future perspectives in the diagnosis and management of affected patients with this rare condition will be discussed. - Original Study20 March 2026
An Investigation of the Correlation Between Total Intracranial Volume and Body Mass Index
\looseness-1 Objective: Total intracranial volume (TICV) is an important covariate in brain volumetric analysis that can vary significantly between participants. This study aimed to investigate the association between body mass index (BMI) and TICV. Methods: 152 healthy volunteers were recruited. The BMI was calculated, and T1-weighted images were acquired to estimate brain volumetric values. The data were analyzed using volBrain software. Results: Male participants have significantly higher GM, WM, CSF, TICV, cerebellum GM, cortical GM, subcortical GM and cerebrum GM volumes compared to female. There were significant differences in GM, TICV, cerebellum GM, cortical GM, subcortical GM and cerebrum GM volumes between BMI subgroups. Dunn-Bonferroni tests revealed that participants with a normal BMI had significantly higher volumes of GM, TICV, cerebellum GM, cortical GM and cerebrum GM compared to individuals with overweight and obese. In addition, subcortical GM volume was significantly higher in participants with normal BMI compared to individuals with obesity. Pearson's correlation analysis revealed that age and BMI are significantly negatively correlated with GM, cerebellum GM, cortical GM, subcortical GM and cerebrum GM. Moreover, BMI was found to be significantly negatively correlated with TICV. The GLM analysis revealed that the association between age, biological sex and BMI had a significant influence on TICV. Conclusion: Brain volumetric measurements were found to be influenced by age, biological sex and BMI and need to be regressed out from volumetric analysis. - Review7 February 2026
Artificial Intelligence in Radiology: Hidden Fragilities and the Path to Resilience
Radiology artificial intelligence (AI) is advancing however its adoption faces fragile foundations that threaten sustainability. Despite bold promises of efficiency and accuracy, current deployment is undermined by weaknesses in economics, evidence, infrastructure, human factors, regulation, security, and environmental impact. Nearly 90% of radiology AI studies report process metrics rather than patient outcomes, while hidden costs elevate ownership to 400% to 500% of subscription fees. Technical fragilities include 25% or greater performance loss with routine protocol or scanner shifts, compounded by vendor consolidation that has eliminated 63% of companies since 2020, creating migration costs averaging 180,000 dollars per exit. Human factor challenges, including automation bias and progressive deskilling, intersect with regulatory requirements that mandate continuous evidence generation. Security risks and environmental costs remain underrecognized. This review introduces frameworks including risk assessment matrices, compliance guides, procurement checklists, evidence standards, lifecycle calculators, and implementation protocols to enable sustainable, patient centered, value driven integration.