RESUMO
Primary hyperparathyroidism is characterized by excessive production of parathyroid hormone. As the condition progresses, bone loss primarily occurs due to resorption. A complication of this condition is the formation of fibrotic and cystic changes in the bone, known as brown tumors. These lesions occur in areas of significant bone resorption, where fibrovascular tissue and giant cells replace bone tissue, often accompanied by hemorrhage and hemosiderin deposits. These brown lesions are rare, with an occurrence rate ranging from 1.5% to 4.5%. We present two cases of middle-aged women who had presentations consistent with hyperparathyroidism and presented with complications such as bone pain and numbness. Both underwent parathyroidectomy to manage the cause and recovered after the surgery. These cases emphasize the importance of recognizing primary hyperparathyroidism as a potential cause of abnormal lesions and highlight the diverse presentations associated with this condition.
RESUMO
Background The first years of college, notably the first and second, are challenging and time-intensive, frequently characterized by substantial pressure that can lead to dissatisfaction among new students. Such an environment may precipitate adjustment difficulties, potentially resulting in depression, anxiety, and stress. This phenomenon is particularly pronounced among medical students. Despite the widespread nature of these challenges, research focusing on the prevalence of adjustment disorder among medical students in Madinah, Saudi Arabia, is notably scarce in the literature. This study aims to evaluate the prevalence and identify predictors of adjustment disorder among a substantial cohort of first- and second-year medical students in Madinah. Methodology An institution-based, quantitative, cross-sectional study was conducted from April 2022 to August 2022. The study encompassed a total of 273 first- and second-year medical students from the Madinah region. To measure stressor exposure and symptoms of adjustment disorder, the Adjustment Disorder-New Module 20 (ADNM-20) scale was employed. Results Our study, comprising 273 participants from Taibah University and Al-Rayan Colleges, revealed a higher prevalence of adjustment disorder among Al-Rayan students: 54.8% (n = 63) compared to their counterparts at Taibah University 41.8% (n = 66), with a p-value of 0.033. However, no significant association was found with other demographic factors. Utilizing the ADNM-20 questionnaire, the study identified prevalent symptoms of adjustment disorder among participants. Key findings included 47.6% (n = 130) of participants feeling low and sad, 41% (n = 112) experiencing repetitive stressful thoughts, approximately one-third (n = 81) exhibiting avoidance behaviors and intrusive thoughts, 38.1% (n = 104) reducing enjoyable activities, 29.3% (n = 80) encountering increased anxiety, 30% (n = 80) reporting irritability, 31.1% (n = 85) facing concentration issues, 23.4% (n = 64) having sleep disturbances, and 28.2% (n = 77) observing impacts on personal and leisure activities. Conclusions The study concludes that adjustment disorder is prevalent among new university students, particularly at Al-Rayan University, where it manifests in various symptoms including mood disturbances and anxiety.
