A Case of Cushing's Disease Presenting with Isolated Suicidal Attempt.

Cushing's disease is an abnormal secretion of ACTH from the pituitary that causes an increase in cortisol production from the adrenal glands. Resultant manifestations from this excess in cortisol include multiple metabolic as well as psychiatric disturbances which can lead to significant morbidity and mortality. In this report, 23-year-old woman presented to mental health facility with history of severe depression and suicidal ideations. During evaluation, she found to have Cushing's disease, which is unusual presentation. She had significant improvement in her symptoms with reduction of antidepressant medications after achieving eucortisolism. Cushing syndrome can present with wide range of neuropsychiatric manifestations including major depression. Although presentation with suicidal depression is unusual. Early diagnosis and prompt management of hypercortisolsim may aid in preventing or lessening of psychiatric symptoms The psychiatric and neurocognitive disorders improve after disease remission (the normalization of cortisol secretion), but some studies showed that these disorders can partially improve, persist, or exacerbate, even long-term after the resolution of hypercortisolism. The variable response of neuropsychiatric disorders after Cushing syndrome remission necessitate long term follow up.

Cetuximab Conjugated with Octreotide and Entrapped Calcium Alginate-beads for Targeting Somatostatin Receptors.

There is a need to formulate oral cetuximab (CTX) for targeting colorectal cancer, which is reported to express somatostatin receptors (SSTRs). Therefore, coating CTX with a somatostatin analogue such as octreotide (OCT) is beneficial. Alginate was used to coat CTX to facilitate delivery to the gastrointestinal tract (GIT). This study aimed to deliver CTX conjugated with OCT in the form of microparticles as a GIT-targeted SSTR therapy. Both CTX and OCT were conjugated using a solvent evaporation method and the conjugated CTX-OCT was then loaded onto Ca-alginate-beads (CTX-OCT-Alg), which were characterized for drug interactions using differential scanning calorimetry (DSC), and Fourier transform infrared spectra (FTIR). Moreover, the morphology of formulated beads was examined using a scanning electron microscope (SEM). The drug content and release profile were studied using UV spectroscopy. Finally, in vitro cytotoxicity of all compounds was evaluated. The results showed homogenous conjugated CTX-OCT with a diameter of 0.4 mm. DSC showed a delay in the OCT peak that appeared after 200 °C due to small polymer interaction that shifted the OCT peak. Moreover, FTIR showed no prominent interaction. SEM showed clear empty cavities in the plain Ca-alginate-beads, while CTX-OCT-Alg showed occupied beads without cavities. CTX-OCT-Alg had a negligible release in 0.1 N HCl, while the CTX-OCT was completely released after 300 min in phosphate buffer pH 7.4. All formulations showed good antiproliferative activity compared with free drugs. The formulated CTX-OCT-Alg are a promising platform for targeting colorectal cancer through GIT.

Prevalence and trends of overweight and obesity amongst Saudi school children, a study done by using three noninvasive methods.

UNLABELLED: Obesity has become a global epidemic. It's level in the Middle Eastern and Asian countries have reached to an alarming level. Rapid transition of life style and urbanization has not only affected adults but also the younger population. OBJECTIVE: This study records the trends of prevalence of obesity and over weight in the school children of both genders of Al Qassim region by employing three different non-invasive methods and recorded their differences. SUBJECTS AND METHODS: This cross-sectional study was conducted on Saudi students of secondary and intermediate levels between 12-14 years of age. The total number of the students who participated in the study was 242, 129 males and 113 females. A self-administered pre-coded questionnaire was used. Body mass index, skin fold thickness and bioelectrical impedance analyzer (BIA) readings were recorded. Data was analyzed on SPSS version 11. Descriptive statistical analysis was performed. Chi square test with a P value <0.05, was used to compare the prevalence rates. RESULTS: Prevalence of obesity and over-weight recorded were higher in the boys but the rates recorded by three methods have shown a wide variation. Several factors, such as change in dietary habits, socioeconomic status and the family history of obesity have shown association but physical inactivity and father's obesity were found significant contributory factors. There is an urgent need for intervention to prevent and control obesity and its consequences amongst children in Saudi Arabia.

Multiple pulmonary and systemic ectopic emboli following endoscopic injection sclerotherapy for gastric fundal varices.

We report a case of a 40-year-old female with cirrhosis, hepatocellular carcinoma, and upper gastrointestinal bleeding who developed multiple pulmonary emboli after endoscopic injection sclerotherapy for gastric variceal bleeding. The patient did not have any respiratory symptoms after the sclerotherapy. A chest radiograph obtained one day after the procedure for the evaluation of fever showed few small nodular radio-opacities in both hilar regions. Computed tomography (CT) demonstrates the existence of multiple radio-opaque emboli within the pulmonary and left common iliac arteries with no evidence of associated pulmonary parenchymal changes. She had no further symptoms, and the radiologic opacities persisted on CT obtained 4 months later.