The epidemiological and clinicopathological features of breast cancer in Riyadh, Saudi Arabia.

OBJECTIVES: To investigate the epidemiological and clinicopathological features of breast cancer (BC) in Saudi Arabia to improve decisions regarding resource allocation, disease control, and management. METHODS: We retrieved the records of all patients who presented with histologically proven BC at King Fahad Medical City between 2019 and 2020. The data were analyzed quantitatively, and the results were expressed as percentages and frequencies. RESULTS: This study comprised 419 patients. The mean age was 50.13 (± 10.96) years. The majority of the patients were obese (56.6%), and approximately a quarter had a history of oral contraceptive pill use, breast biopsy, or an affected family member. Most cases were from the central region (80.1%), followed by the southern provinces (12.7%). Breast lumps were the most common complaint (89%), whereas hypertension and diabetes mellitus were the most common comorbidities. Invasive ductal carcinoma was the most common pathologic type (89.7%). Most patients presented with TNM stages II and III (55.2%), and 27.7% had metastasis. The main therapeutic modalities included radical mastectomy (63.8%), neoadjuvant chemotherapy (60.4%), and adjuvant radiotherapy (82.9%). CONCLUSION: In Saudi Arabia, a trend of BC incidence migration towards older patients may be ensuing. However, prediction of an advanced and aggressive presentation requires the enhancement of screening programs and standardized protocols for disease management.

Is thyroid dysfunction a common cause of telogen effluvium?: A retrospective study.

Telogen effluvium (TE) is a common cause of hair loss characterized by excessive resting hair shedding. Thyroid dysfunction is one of the possible causes of TE. On the other hand, the link between thyroid disorder and TE is still being debated. The aim of this retrospective is to investigate the link between thyroid dysfunction and TE. This retrospective study included 500 female patients with TE who had thyroid function testing between January 2012 and December 2022. Patients were eligible if they had a confirmed TE diagnosis and thyroid function tests within 3 months of being diagnosed with TE. The thyroid function of the participants was classified as euthyroid, hypothyroidism, or hyperthyroidism. The severity of hair loss was determined using the severity of alopecia tool (SALT) score. The study included 500 TE females, 248 of whom were euthyroid, 150 had hypothyroidism, and 102 had hyperthyroidism. The hypothyroid group had a significantly higher mean SALT score than the other 2 groups. Furthermore, patients in the hypothyroid group had a higher proportion of severe hair loss. The mean SALT score did not differ significantly between groups with normal thyroid function and those with hyperthyroidism. A common cause of TE is thyroid dysfunction, particularly hypothyroidism. Patients with hypothyroidism have more severe hair loss than those with normal thyroid function or hyperthyroidism. To effectively identify and manage such cases, thyroid function testing should be included in the diagnostic workup of patients with TE.

Impact of Thyroid Dysfunction on Hair Disorders.

Hair loss is a problem for everyone, regardless of their age or sex. The three most prevalent types of hair loss, telogen effluvium, alopecia areata, and androgenetic alopecia, have been associated with a variety of risk factors. Strong evidence links thyroid hormones (THs) to hair loss. THs control the growth, differentiation, metabolism, and thermogenesis of body cells. The skin is a significant target organ for THs; however, the cellular and molecular causes of thyroid dysfunction-related skin diseases remain unknown. Hyperthyroidism, hypothyroidism, and drug-induced hypothyroidism can induce widespread hair shedding. Little information is available regarding the incidence and effects of thyroid dysfunction on hair problems. This study aimed to review the impact and prevalence of thyroid disorders on hair loss. The conclusions drawn from this study highlight the underestimated prevalence and impact of thyroid disorders on hair loss. The review of scientific articles, including original research, review articles, and a case report, provides a comprehensive understanding of the topic. This research adds to the existing literature by enhancing our understanding of the relationship between thyroid dysfunction and hair disorders. It contributes to the body of evidence by reviewing relevant studies and summarizing the impact of thyroid disorders on hair loss. The study also highlights the gaps in knowledge and the need for more research in this area to improve the diagnosis and management of hair disorders associated with thyroid dysfunction.

Validity of the motivated strategies for learning questionnaire in Saudi Arabia.

OBJECTIVES: To assess the construct validity and reliability of the motivation section of the Motivated Strategies for Learning Questionnaire in Saudi Arabia. METHODS: A cross-sectional study using the Motivated Strategies for Learning Questionnaire (MSLQ) was conducted.  The MSQL has essentially two sections: a motivation section and a learning strategies section.  The motivation section, which consists of 31 items, was used.  A total of 146 medical students who were all male completed the questionnaire.  Confirmatory factor analysis was used to test the hypothesised factor structure, and to identify the validity and reliability of the motivation section of the MSQL. RESULTS: A selected group of fit statistics showed that the hypothesised model did not fit the sample data fairly well.  The Intrinsic Goal Orientation subscale consisted of 4 items (α = 0.75), the Extrinsic Goal Orientation subscale consisted of 4 items (α = 0.78), the Task Value subscale consisted of 6 items (α =0.86), the Control of Learning Beliefs consisted of 4 items (α =0.78), the Self-Efficacy for Learning and Performance consisted of 8 items (α =0.89), and the Test Anxiety consisted of 5 items (α =0.77). CONCLUSIONS: It is concluded that the hypothesised model did not fit the data well. This may suggest that the motivation section of the MSQL may not work for Saudi Arabian students. However, this could be due to the fact that the sample data available on this study did not represent female students. Further work is required to establish this. Limitations of the study are discussed.

Failure of alefacept in the treatment of vitiligo.

BACKGROUND: Vitiligo is a common acquired pigmentary disorder with a profound psychosocial impact. The exact pathogenesis of vitiligo is not fully understood; however, vitiligo appears to be an autoimmune disease involving T-cell-mediated melanocyte destruction. Recently, complete clearance of coexisting vitiligo without recurrence over 2 years was reported in 2 psoriasis patients treated with alefacept. OBJECTIVE: To evaluate the safety and efficacy of alefacept in the treatment of vitiligo. METHODS: After providing informed written consent, 4 adult patients with widespread vitiligo (covering a body surface area ≥5%) were treated with weekly intramuscular injections of 15 mg alefacept for 12 weeks. All patients were monitored clinically, by laboratory investigation, and by digital image analysis. All patients were followed up with for 24 weeks. RESULTS: All patients tolerated alefacept well, without any adverse events. None of the patients showed any repigmentation. However, 1 patient developed new depigmented patches during treatment with alefacept. LIMITATIONS: A pilot study with a small number of patients. CONCLUSION: Alefacept as a monotherapy for vitiligo treatment did not result in any patient improvement, and further evaluation in larger studies may be required.

Treatment of reticulated acropigmentation of Kitamura with Q-switched alexandrite laser.

BACKGROUND: Reticulated acropigmentation of Kitamura (RAPK) is a pigmentary disorder of autosomal dominant inheritance, occurring predominantly within the Japanese population, for which no successful treatment has been described. OBJECTIVE: The objective was to describe a 23-year-old Saudi woman with reticulated acropigmentation of Kitamura (RAPK), who was successfully treated with a 75-nm Q-switched alexandrite laser. METHOD: To report a 23-year-old Saudi woman with reticulated acropigmentation of kitamura (RAPK) who was treated with two sessions of the Q-switched alexandrite laser, six weeks apart with no recurrence after two years. RESULTS: Cutaneous pigmentation of reticulated acropigmentation of kitamura (RAPK) almost resolved completely in two laser sessions. Side effects were limited to transient post inflammatory hypopigmentation. CONCLUSION: Cutaneous pigmentation of reticulated acropigmentation of kitamura (RAPK) can be effectively treated by Q-switched alexandrite (755-nm) laser, which shows a promising result, and it can be considered as treatment option, although further studies are required to confirm the effectiveness of this treatment modality with other Q-switched laser; e.g. Q-switched ND:YAG or Q-switch Ruby.