Saudi Cases Research Articles

Determinants Impacting Audit Delays: The Case of Saudi Listed Firms

Objectives: We examined the determinants that influence the timeliness of audit reports. Methods: We used 532 observations that were collected over four years (2019 - 2022) from 133 Saudi listed firms, which were analysed using ordinary least squares (OLS) regression and relevant statistical tests (e.g. multicollinearity, autocorrelations, R-squared, adjusted R-squared, and F-value tests). Agency theory was used as a theoretical framework to gain insights about the results. Results: Audit firm size and auditee size were significant attributes that affected the timeliness of audit report lag (ARL) among financial and non-financial Saudi listed firms. Conclusion: This study provides useful insights into the determinants of ARL, as well as timely empirical evidence that complements existing literature in terms of relationships between an audit firm’s attributes and the timeliness of financial reporting.

Tools of regime stability: the political economy of sovereign wealth funds in Gulf rentier states

Why have Gulf resource-dependent countries transformed the role of their sovereign wealth funds (SWFs) from passive global investors to ubiquitous drivers of economic development? How does this role-change operate amidst fiscal scarcity, confounding macroeconomic expectations of commodity-based SWFs? Beyond a narrow view of funds as apolitical economic actors, this article puts forward the logic of SWFs as tools of regime stability to explain SWF development in Gulf rentier states. This logic advances that SWFs are adaptive strategies through which rentier states respond to evolving external pressure without compromising the fundamental pillars of regime stability underpinning allocative frameworks. Drawing on the Saudi case, the article finds that SWFs create de-risking pathways to mobilize private finance capital through environmental, social and governance (ESG) practices and market-based instruments like green bonds. Simultaneously, SWFs allow incumbents to revisit rentier governance by enhancing economic steering capacity while upholding, but restructuring, patronage networks. By shedding light on the political role of SWFs, this article contributes to debates surrounding rentier states and financialization literatures. It highlights how the elasticity of rentierism as financialized forms of state-led economic development does not erode state capacity but rather empowers ruling elites with a new range of tools and resources to upgrade rentier governance in times of economic transitions.

Unusual presentation of congenital chloride diarrhea mimicking colovesical fistula: a case report and literature review

Background: Congenital chloride diarrhea (CCD) is a rare autosomal recessive condition characterized by lifelong watery diarrhea. CCD is challenging to diagnose because of its severe clinical presentations and differentials. Therefore, it is crucial to be diagnosed early and receive appropriate management as it causes early death if left untreated or due to complications. Case Report: A Saudi newborn baby boy was passing a large amount of urine through the anal canal and was otherwise healthy. He was referred to our center with a high suspicion of a colovesical fistula. Diagnosed with CCD by the exclusion of fistula after confirmation with contrast study. Conclusion: This case highlights an unusual presentation of CCD mimicking a colovesical fistula. To the best of our knowledge, no similar case has been reported in the literature, and we believe this is the first Saudi case of CCD mimicking a colovesical fistula. It underscored the diagnostic challenges of this rare disorder and emphasized the importance of early recognition and accurate diagnosis to prevent such complications.

Unusual presentation of congenital chloride diarrhea mimicking colovesical fistula: a case report and literature review

Background: Congenital chloride diarrhea (CCD) is a rare autosomal recessive condition characterized by lifelong watery diarrhea. CCD is challenging to diagnose because of its severe clinical presentations and differentials. Therefore, it is crucial to be diagnosed early and receive appropriate management as it causes early death if left untreated or due to complications. Case Report: A Saudi newborn baby boy was passing a large amount of urine through the anal canal and was otherwise healthy. He was referred to our center with a high suspicion of a colovesical fistula. Diagnosed with CCD by the exclusion of fistula after confirmation with contrast study. Conclusion: This case highlights an unusual presentation of CCD mimicking a colovesical fistula. To the best of our knowledge, no similar case has been reported in the literature, and we believe this is the first Saudi case of CCD mimicking a colovesical fistula. It underscored the diagnostic challenges of this rare disorder and emphasized the importance of early recognition and accurate diagnosis to prevent such complications.

Regionalism indicators and assessment approach of recent trends in Saudi Arabia’s architecture: The Salmaniah architectural style and the King Salman Charter initiatives as a case study

This study explores recent regionalism trends in the Kingdom of Saudi Arabia. The research positions the argument within a broader context of critical regionalism concepts and theories. It draws insights from the Saudi case on how regionalism approaches holistic yet applicable criteria. The literature review discusses the broader perspectives of critical regionalism and the history of regionalism progress in Saudi Arabia. The review positions the research's framework on how the global and local nexus are compared. A contribution of research methodology is provided on how to study regionalism architecture in societies and to provide regionalism indicators to compare with and conduct an assessment. This research employed a methodological approach using key expert interviews and surveys (building assessments and evaluations) applied to three cases that represent the six core values of the King Salman Charter. The study found that although the King Salman Charter for Architecture and Urbanism demonstrates six core values for contemporary, traditional architecture in Saudi Arabia, it is not at the level of detail of providing detailed implementation criteria. Rather than responding to a global regionalism trend or deriving core values from a selective but not exhaustive list, the Charter should craft its principles and methodological criteria based on studying Saudi Arabia’s historic, traditional settlements, and the Kingdom’s extant built heritage.

Incidence of Lymphoma Among Adult Patients in the Eastern Province of Saudi Arabia – A Single-center Study

BACKGROUND: Lymphoma is a cancer of the lymphatic system with two main types, namely Hodgkin lymphoma (HL) and non-HL (NHL). Within these, there are many subtypes. Based on data from the National Cancer Institute, NHL accounts for 4.2% whereas HL accounts for 0.5% of all cancers in the United States. The treatment strategy depends on the type and the stage of the lymphoma. In this study, we are studying the incidence rate of lymphoma in a military-nononcology center for better understanding and recording of the condition. METHODS: We conducted an observational, analytical, retrospective study in a tertiary care hospital on 56 patients admitted to the hospital between January 2016 and the end of December 2021, with lymphadenopathy or body mass, who were diagnosed with lymphoma. The modality of diagnosis was tissue histopathology. All data including demographics, details of lymphoma lesions, and laboratory and histopathology results were obtained from health informatics or manual records. RESULTS: In this study, we found that 67.9% of the cases were male, with a significantly higher rate among Saudi patients in comparison to non-Saudi (94.6% and 5.3%, respectively). Among Saudi cases, we found that a significantly higher percentage of lymphoma cases were originally from the Eastern and the Southern provinces (47.1% and 35.8%, respectively), and 46.5% of them were living in Dammam at the time of diagnosis. The percentage of NHL was significantly higher than Hodgkin type (80.3% and 19.6%, respectively). The majority of the cases belonged to B-cell NHL (73.2%). Moreover, the incidence rate increased from 2016 to 2021 with an accumulative rate of 25.14 / 100,000 person-years. CONCLUSION: Our data indicate that the incidence rate of lymphoma increased in the last 5 years at a tertiary care center. We found evidence for associations between the original province and the rate of the lymphoma. Moreover, the rate of B-cell NHL was significantly higher with superior mortality rate in comparison to other types of lymphoma in our cohort, which supported previous studies in the Kingdom of Saudi Arabia. There was no increase in incidence of lymphoma in our study cohort of military personnel, and it matches the incidence data of other local studies. Further national studies and initiation of lymphoma registry may add a value for future researches.

Harmonic Analysis of Large Grid-Connected PV Systems in Distribution Networks: A Saudi Case Study

The increasing penetration of grid-connected PV rooftops at the distribution level still entails significant technical challenges affecting seriously the power quality indices such as harmonics and voltage fluctuations. Owing to the intermittent nature of renewable resources, the changing incident energy from renewables can generate considerable amounts of harmonics. Moreover, power electronic devices and nonlinear loads that are used frequently in the industry may exaggerate the harmonic distortions as well. Accordingly, utilizing suitable filtration techniques for harmonic reduction is crucial. In order to evaluate the impacts of grid-connected PVs in modern grids, a case study on power quality and voltage profile is conducted with a large grid-connected PV microgrid of 9570 kW, feeding a large hospital project in Saudi Arabia as an initial phase of implementing this project in the future. For eliminating the possible increase in harmonic distortion, a single-tuned filter is used to cope with the permissible limits according to the known IEEE standards. This filtering technique is chosen due to its advantages including the simplicity, suitability for significant integer harmonic orders, and low cost. For evaluation tests, a detailed simulation is developed by the ETAP program for the overall selected project as well as the aimed PV subsystem. Several simulation tests are conducted to investigate the harmonic distortion problem. The results show a significant reduction in the individual harmonic distortion (IHD) and the total harmonic distortion (THD) below 8% according to considered IEEE standards for LV networks. Both 6 and 12 pule inverters are considered. This is considered an important step in the realization of such large PV projects in the field.

Institutional Ownership Types and ESG Reporting: The Case of Saudi Listed Firms

The main aim of this study is to investigate the influence of institutional investors’ ownership (INOW) on firms’ environmental, social, and governance (ESG) reporting in Saudi Arabia. Using data on ESG reporting from the Bloomberg database for 206 Saudi-listed firms spanning the period from 2010 to 2019 and employing ordinary least squares regression (OLS), the results show a significant and positive association between INOW and ESG reporting. When institutional investors are classified into government and privately managed institutions, the research findings clearly show that only government-managed institutional investors (Govt_IO) are linked to ESG reporting in a positive and significant way, whereas there is no significant association between privately managed institutions (Prvt_IO) and ESG reporting. In addition, when the ESG score is disaggregated by individual pillars, we find Govt_IO is positively associated with environmental score and social score. These results suggest that the association between INOW and ESG varies depending on the types of INOW, as well as the ESG components. Even after several additional analyses, including tests for endogeneity, the main results of this study still hold.

Malarial Epidemiology among Patients in Al-Medina Al-Munawara, KSA

Worldwide, malaria is the most important disease caused by parasites and responsible for a yearly estimation of 225 million clinical cases. The risk of the disease covers almost half of the world’s population and the annual death has been estimated as 800.000. Children under five years of age are mainly affected. Pregnant women and adults with immunosuppression become victims of cerebral manifestations or anaemia and frequently die. Almost 40% of the world's population is at risk to acquire the infection. Human malaria is caused by four Plasmodium species among which the most prevalent is Plasmodium falciparum. Because of the higher global prevalence, morbidity and mortality rate of P. falciparum, most research efforts on malaria pathogenesis have been focused on this species. Recent studies have reported the clinical outcomes that originate from regions where P. falciparum and P. vivax are equally prevalent. This in turn could make the clinical tools inappropriate for use in managing vivax mono infections. Thus, the present study was aimed to identify the epidemiology and clinical features of the malarial cases of the Referral laboratory, Al Madinah, Saudi Arabia. A retrospective case series study was conducted among the patients reported from January 2016 to December 2016 using a specially designed data collection form. Out of the 182 confirmed cases, 143 were non-saudi and 39 were Saudi cases. Most of the cases reported in the month of September due to seasonal change. Gender distribution showed a higher dominance of male patients compared to females. No cases were reported to be caused due to P.malariae. The predominant species was found to be P.Vivax (87%) while P.falciparum with only 13% incidence. Further investigations in large sample sizes are recommended to explore the other aspects in reducing the malaria burden.

Acute Pancreatitis Secondary to Hypertriglyceridemia during Pregnancy

Abstract Introduction Hypertriglyceridemia (HTG) (triglycerides > 1,000 mg/dL [11.3 mmol/L]) has been associated with a high risk of developing acute pancreatitis (AP) in pregnant women, but this condition is rare. We present the case of a pregnant Saudi with AP secondary to HTG. Case Report A 27-year-old Saudi female presented at 30 weeks' gestational age with abdominal pain, nausea, and vomiting of 4 days' duration. AP was diagnosed based on clinical presentation, high lipase, and abdominal ultrasound findings. Her triglyceride level was 58 mmol/L. Fenofibrate and intravenous regular insulin infusion with dextrose were started, which decreased triglycerides by the third day from 58.8 to 29 mmol/L (50% reduction) with a further reduction to 11 mmol/L (81%) by day 7 of her admission. Labor was induced at 37 weeks of gestation, and she delivered a healthy neonate. Conclusion We report successful treatment of AP in pregnancy with intravenous insulin and fenofibrate. Several case reports have discussed the therapeutic option of AP induced by HTG in pregnancy. Lipid-lowering agents are category C in pregnancy. However, few case reports indicate their safety. Insulin, heparin, and apheresis have also been used during pregnancy without any complications.

Mathematical COVID-19 model with vaccination: a case study in Saudi Arabia.

The discovery of a new form of corona-viruses in December 2019, SARS-CoV-2, commonly named COVID-19, has reshaped the world. With health and economic issues at stake, scientists have been focusing on understanding the dynamics of the disease, in order to provide the governments with the best policies and strategies allowing them to reduce the span of the virus. The world has been waiting for the vaccine for more than one year. The World Health Organization (WHO) is advertising the vaccine as a safe and effective measure to fight off the virus. Saudi Arabia was the fourth country in the world to start to vaccinate its population. Even with the new simplified COVID-19 rules, the third dose is still mandatory. COVID-19 vaccines have raised many questions regarding in its efficiency and its role to reduce the number of infections. In this work, we try to answer these question and propose a new mathematical model with five compartments, including susceptible, vaccinated, infectious, asymptotic and recovered individuals. We provide theoretical results regarding the effective reproduction number, the stability of endemic equilibrium and disease free equilibrium. We provide numerical analysis of the model based on the Saudi case. Our developed model shows that the vaccine reduces the transmission rate and provides an explanation to the rise in the number of new infections immediately after the start of the vaccination campaign in Saudi Arabia.

Enterprise Risk Management and Firms’ Value Nexus: A Case of Saudi Emerging Market

Enterprise Risk Management and Firms’ Value Nexus: A Case of Saudi Emerging Market

Mindfulness in Strategic Decision-Making Process and its Impact on Organizational Performance: A case of Small and Medium Saudi Based Businesses

The prompt response to market changes, demands managers and employees to be flexible and perform multiple tasks, simultaneously. Mindfulness encouraged companies to be goal-oriented by improving attention to the present moment. Unexpected events faced by firms should be approached wisely to achieve organizational objectives. Hence, a strategic decision process should be coupled with mindfulness to make effective decisions that result in increased performance. There is limited empirical mindfulness research in the management discipline, particularly on whether mindfulness foster or impedes task performance in the workplace. Therefore, the purpose of the study was to develop a view as to “how do small and medium firms react in uncertain conditions by employing mindfulness in predicting and comprising problems in their strategic decision process to achieve objectives and enhance performance in the context of Saudi Arabia”. The findings enriched the comprehension of the effect of mindfulness in the strategic decision process on organizational performance.

Tricky Presentation of Multisystem Inflammatory Syndrome in Children (MIS-C) with in Pediatric

Introduction: In emergence a COVID patient with multisystem inflammatory syndrome in children (MIS-C), associated with SARS-CoV-2, has shown increasing number among pediatric. Even the same presentation of Kawasaki disease we have to keep in mind MIS-C, in order to reach a consensus on this new disease in the future. Three variations of the disease patterns were reported: a group of children with increase in inflammatory activity and persistent fever, without criteria for Kawasaki disease, a second group with Kawasaki disease criteria, and a third group with shock, coronary aneurysms, severe cardiac dysfunction, and gastrointestinal symptoms. Classic Kawasaki disease is self-limited vasculitis which affects medium-sized vessels, almost occurred in children under five years old. Here, we bring a Saudi case, present to emergency department in Prince Sultan Military Medical City. Case report: 10 years old female, medically free, presented with abdominal pain, fever and skin rashes. Patient had history of COVID-19 infection 1 month before presentation. Initial investigations showed acute kidney injury with elevated inflammatory markers. Conclusion: Further evidence of the increase in the incidence of pediatric MIS-C, temporarily is associated with SARS-CoV-2. Physician should give more attentions to this new diagnosis with more fatal outcomes than Kawasaki cases.

Identification of RPL5 gene variants and the risk of hepatic vein thrombosis in Saudi patients

Objectives:To identify ribosome protein L5 gene variants and the risk of hepatic vein thrombosis in Saudi patients.Methods:A case-control study was conducted during the period of May 2018 to September 2019. Sixty-five patient cases of hepatic vein thrombosis (HVT) were chosen, and 50 healthy individuals of the same ages and both gender were set as a control group. The genotype of the gene RPL5 was determined by PCR please provide abbreviation in full and capillary electrophoresis. Sanger sequencing for genetically screened variants was applied for the RPL5 gene.Results:Alleles A at variant rs182018447 and T allele at variant rs559377519 were strongly corelated (p=0.009 and p=0.037, respectively) with the risk of HVT. The genotype frequencies of the RPL5 gene, the A/A genotypes at rs182018447 and T/T at rs559377519 were associated with HVT (p=0.000 and p=0.004; respectively) and an increase in risk for HVT among these patients. Please rephrase the highlighted text without using the word respectively.Conclusion:Our findings indicate that the 5 genetic novel variants examined in the RPL5 gene were associated with a risk of HVT in all our Saudi cases. Additionally, the A/A at rs182018447 and T/T at rs559377519 genotypes were substantially susceptible to HVT in all these patients.

Probability of Winning the Tender When Proposing Using BIM Strategy: A Case Study in Saudi Arabia

The procurement process is one of the most important phases in any project life cycle, particularly when it comes to selecting the right contractor for the job. Awarding the contract to the best bid proposal is a critical step to ensure the greatest value. BIM has been recognized as not only a geometric modelling of buildings, but also, it facilitates the different stages in management of construction projects. The purpose of this paper is to study the impact of using Building Information Modeling (BIM) in the tendering process from the contractor’s perspective, based on a probability model able to predict winning probability, regardless of relative weight. The main objective of this research is to measure the likelihood of winning a tender in the case of implementing BIM strategy, compared with contractors who do not use BIM. The research uses a literature review, surveys, and interviews with experts to develop a model that predicts the probability of winning a contract; this is determined by measuring the BIM impact on each selection criterion in a multicriteria selection process using the Analytical Hierarchy Process (AHP) to develop a probability-based model. The results of the survey and the interview show that BIM strategy has a variant influence on the score the contractor could have on each of them raising the probability of winning the tender. The main result of this paper is the property-based model, which is able to predict BIM winning probability regardless of relative weight, which can be applied in any country. Nonetheless, the Saudi case study shows that utilizing BIM when proposing could increase the winning probability by up to 9.42% in the case of Quality-Based Selection (QBS), and to 5.5% in the case of Cost-Based Selection (CBS).

Alpha-2 beta-adrenergic receptor (301-303 I/D) gene polymorphism in hypertension and type 2 diabetes mellitus diseases among Saudi cases in the Qassim region.

The hypertension (HTN) and type 2 diabetes mellitus (T2DM) are a common multifactorial disease due to genetics and environmental factors. The alpha 2B adrenergic receptor (α2B-AR) has relationship with secretion of insulin and mediates the vasoconstriction that elevate blood pressure. This study aimed to determine the association between α2B-AR gene polymorphism with HTN and T2DM in Saudi cases. 200 cases and 100 healthy controls from Saudi population were recruited from the Internal Medicine clinic, Qassim University. The patients were grouped into: 72 HTN without T2DM; 62 HTN with T2DM and 66 T2DM only. Full medical history, examination and biochemical assays were performed for all participants. Genomic DNA was isolated from blood lymphocytes of all subjects for detection of α2B-AR gene polymorphism by using polymerase chain reaction (PCR). The results found a significant association between D carriers genotype and HTN with T2DM cases (p < 0.05) as well as with T2DM-only cases, (p < 0.05) compared to control. Regardless of HTN status, only cases with HTN and T2DM as well as those with T2DM were significantly associated with the recessive model DD versus II+ID (p < 0.05). So, D carriers genotype was significantly associated with total cases of HTN and T2DM (p < 0.05) compared to controls. Our results suggested that there is a relationship between the α2B-AR I/D gene polymorphism and the risk for T2DM with or without HTN, but no such comparable relationship is evident with HTN-only cases among Saudi population in Qassim region.

COMPARISON between COVID-19 and MERS demographic data in Saudi Arabia: a retrospective study

ABSTRACT The outbreak of corona virus disease (COVID-19) caused by the new severe acute respiratory syndrome corona virus 2 began in Wuhan, China, resulting in respiratory disorders. In January of 2020, the World Health Organization declared the outbreak a pandemic owing to its global spread. Because no studies have investigated COVID-19 in Saudi Arabia, this study investigated similarities and differences between demographic data during the COVID-19 and Middle East respiratory syndrome (MERS) outbreaks in Saudi Arabia. A retrospective trend analysis was performed to assess demographic data of all laboratory-confirmed MERS and COVID-19 cases. Patients’ charts were reviewed for data on demographics, mortality, citizenship, sex ratio, and age groups with descriptive and comparative statistics; the data were analyzed using a non-parametric binomial test and chi-square test. Of all COVID-19 patients in Saudi Arabia,78%were male patients and 22% were female patients. This proportion of male COVID-19 patients was similar to that of male MERS patients, which also affected male patients more frequently than female patients. The number of COVID-19-positive Saudi cases was lower than that of non-Saudi cases, which were in contrast to that of MERS; COVID-19 appeared to be remarkably similar to MERS with respect to recovered cases. However, the numbers of critical and dead COVID-19 patients have been much lower than those of MERS patients. The largest proportion of COVID-19 and MERS cases (44.05% and 40.8%, respectively) were recorded in the Western region. MERS and COVID-19 exhibited similar threats to the lives of adults and the elderly, despite lower mortality rates during the COVID-19 epidemic. Targeted prevention of and interventions against MERS should be allocated populations according to the areas where they inhabit. However, much more information regarding the dynamics and epidemiology of COVID-19 in Saudi Arabia is needed. Abbrevation : MERS: Middle East Respiratory syndrome; COVID-19: Corona Virus Disease 2019.

Evaluation of irisin, retinol-binding protein 4, and leptin serum levels as biomarkers of macrovascular complications involvement in Saudi type 2 diabetes mellitus. A case-control study.

Objectives:To evaluate adipokine serum values of irisin, retinol-binding protein 4, and leptin in Saudi cases with type 2 diabetes mellitus (T2DM) for providing markers of T2DM macrovascular complications.Methods:This case-control research was carried out at Erfan Hospital, Jeddah, Saudi Arabia. The study included 138 subjects, classified into 3 groups: 46 T2DM patients with macrovascular complications, 46 T2DM without macrovascular complications, and 46 controls. Participants evaluated clinically and some biochemical parameters were measured.Results:Diabetic with and without macrovascular complications showed elevation of retinol-binding protein 4 (RBP4) and leptin; decreased irisin serum levels versus controls. Serum irisin was lower (p=0.007), while RBP4 was higher (p<0.0001) in T2DM patients with macrovascular complications versus without. Irisin showed negative correlations with fasting blood glucose (FBG), insulin, homeostatic model assessment of insulin resistance (HOMA-IR), RBP4, hemoglobin A1C (HbA1C), triglyceride, cholesterol, and low-density lipoprotein cholesterol. While RBP4 showed positive correlations with fasting blood glucose, insulin, HOMA-IR, leptin, and HbA1c; but a negative association with high-density lipoprotein cholesterol.Conclusion:Type 2 DM patients had raised RBP4 and leptin, but lower irisin levels versus controls. Irisin was lower, but RBP4 was higher in T2DM patients with macrovascular complications versus without, suggesting T2DM patients in pro-inflammatory conditions. These results suggested that irisin is protective, while RBP4 is a risk factor for T2DM macrovascular complications.

Multinational security coalitions and the limits of middle power activism in the Middle East: the Saudi case

Abstract This article examines Saudi Arabia's decision in recent years to use novel and hitherto unexplored informal alliance formats, which we term multinational security coalitions (MSCs). This development was initiated by the new Saudi political leadership under King Salman and Crown Prince Mohammad bin Salman, who have a much greater inclination to pursue proactive foreign and security policies than their predecessors. However, it will be highlighted that beyond the priorities of individual personalities, this shift in Saudi Arabia's behaviour occurred against the backdrop of significant changes in the existing security environment, including the perceived withdrawal of the United States from the security affairs of the region during the presidency of Barack Obama, and crucially also Saudi Arabia's frustration over the failure of the Gulf Cooperation Council (GCC) to develop into a viable security mechanism. The article begins with the introduction of the key ideas relating to institutional design, the conceptual framework for this study. Section two outlines the most important reasons for Saudi Arabia's choice of the MSC format. The third section examines the strengths of the MSC format—especially informality, the resulting low entry-thresholds and the low risk of entrapment—that provided Saudi Arabia with partial and temporary success in recruiting coalition partners and thus bolstering its leadership role. The final section demonstrates, however, that ultimately MSCs are not a panacea. The informality of MSCs that makes it easy for the pivotal state to assemble a coalition also makes it hard for it to forge, and enforce, a common vision.