Background: Research activity represents an important process conducted to address an issue in a precise and systematic manner. Data of this kind regarding the methodological difficulties encountered by healthcare practitioners in conducting clinical research in Saudi Arabia are scarce. This study aims to assess the methodological difficulties encountered by healthcare practitioners in conducting clinical research in Saudi Arabia. Materials and Methods: This cross-sectional survey was conducted among healthcare practitioners who conducted or who were involved in research in Saudi Arabia from June 2018 through August 2018. Data were collected through SurveyMonkey, using a modified version of a questionnaire from a previous similar study. Results: Overall, 236 respondents participated in the study, more than half, that is, 131 (55.50%) had conducted research as principal investigators, 41 (17.40%) had never attended a research workshop, and 57 (24.20%) were members of research committees. Respondents identified “formulating the research title” and “cooperation between research partners” as the easiest research steps by 58 (24.58%) for each. “Receiving funds and financial resources to complete the research project” ranked the highest difficult step by 124 (52.54%) of the respondents. Attending >2 clinical research workshops was significantly associated with lower methodological difficulty scores. Specifically, those who attended scored 35.28 ± 12.86, while those who did not scored 42.34 ± 12.64, with a highly statistically significant difference ( P = 0.001). Conclusion: These findings show that securing funding and finding an available biostatistician contributed greatly to the methodological difficulties of conducting clinical research. The difficulty score decreased significantly with increasing the number of clinical research workshops attended by the researchers.

Background: We performed a meta-analysis to determine whether a consistent relationship exists between the use of angiotensin converting enzyme inhibitors (ACEIs) and the risk of lung cancer. Accordingly, we summarized and reviewed previously published quantitative studies. Methods: Eligible studies with reference lists published before June 1st, 2019 were obtained from searching several databases. Random effects’ models were used to summarize the overall estimate of the multivariate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) Results: Thirteen observational studies involving 458,686 ACEI users were included in the analysis, Overall, pooled risk ratios indicate that ACEIs use was not a risk factor for lung cancer (RR 0.982, 95% C.I. 0.873 – 1.104; P = .76). There was significant heterogeneity between the studies (Q = 52.54; P < .001; I2 = 86.07). There was no significant association between ACEIs use and lung cancer in studies with over five years of ACEIs exposure (RR 0.95, 95% C.I. 0.75 – 1.20; P = .70); and ≤ 5years of exposure to ACEIs (RR 0.98, 95% C.I. 0.83 – 1.15; P = .77). There were no statistically significant differences in the pooled risk ratio obtained according to the study design (Q = 0.65; P = .723) and the comparator regimen (Q = 3.37; P = .19). Conclusions: The use of ACEIs was not associated with an increased risk of lung cancer. Nevertheless, well-designed observational studies with different ethnic populations are still needed to evaluate the long-term (over 10 years) association between ACEIs use and lung cancer.

Objectives: To evaluate the prevalence and the factors associated with recurrence of myasthenia gravis following thymectomy. Methods:Six electronic databases which reported on recurrence of myasthenia gravis following thymectomy and/or its risk factors from 1985 to 2018 were searched. Summary prevalence and risk values obtained based on the random effect models were reported. Systematic ReviewResults: Seventy (70) papers containing 7,287 individuals with myasthenia gravis who received thymectomy as part of their management were retrieved. The patients had a mean follow-up of 4.65 years post-thymectomy. The prevalence of myasthenia gravis recurrence post-thymectomy was 18.0% (95% CI 14.7-22.0%; 1865/7287). Evident heterogeneity was observed (I 2 =93.6%; p<0.001). Recurrence rate was insignificantly higher in male compared with female patients (31.3 vs. 23.8%; p=0.104). Pooled recurrence rates for thymomatous (33.3%) was higher than the rate among non-thymomatous (20.8%) myasthenia gravis patients (Q=4.19, p=0.041). Risk factors for recurrence include older age, male sex, disease severity, having thymomatous myasthenia gravis, longer duration of the myasthenia gravis before surgery, and having an ectopic thymic tissue. Conclusion:A fifth of individuals with myasthenia gravis experience recurrence after thymectomy. Closer monitoring should be given to at-risk patients and further studies are needed to understand interventions to address these risks.