Bi-allelic variants in HCRT cause autosomal recessive narcolepsy.

Narcolepsy with cataplexy is a complex disease with both genetic and environmental risk factors. To gain further insight into the homozygous HCRT-related narcolepsy, we present a case series of five patients from two consanguineous families, each harboring a novel homozygous variant of HCRT c.17_18del. All affected individuals exhibited severe cataplexy accompanied by narcolepsy symptoms during infancy. Additionally, cataplexy symptoms improved or disappeared in the majority of patients over time. Pathogenic variants in HCRT cause autosomal recessive narcolepsy with cataplexy. Genetic testing of the HCRT gene should be conducted in specific subgroups of narcolepsy, particularly those with early onset, familial cases, and a predominantly cataplexy phenotype.

A bibliometric analysis of the top 100 cited articles for hemangioblastoma of the central nervous system.

Hemangioblastoma is a rare benign tumor that can affect the central nervous system sporadically or in association with von Hippel-Lindau (VHL) syndrome. Despite the advances in the medical field, hemangioblastoma still has a significant morbidity and mortality burden. This review gathered and analyzed this entity's top one hundred cited articles. The Scopus database was screened using the following keywords ("Hemangioblastoma" OR "Haemangioblastoma" OR "Hemangioblastomata"). The results were sorted by citation count, highest to lowest. Articles discussing hemangioblastoma of the central nervous system were included. Two independent reviewers extracted the article-, author-, and Journal-based data. Articles were classified into four categories: clinical features/ natural history, treatment, histopathology, review, or radiology. The location, brain, spine, or both, and type, sporadic, VHL-associated, or both, were used to classify the articles. The search query resulted in 4023 articles, and the top 100 most cited articles were included. The number of citations totaled 8781, averaging 87.81 CC per article. The included papers were published in 41 different journals between 1952 and 2014 by more than 11 departments from 65 institutions and 16 countries. The number of citations ranged from 46 to 333. The peak publication activity was before the 2000s, contributing to 62% of all articles, and the most prolific decade was 1990-2000, with 37 publications. We conducted a comprehensive bibliometric analysis of data from the most influential publications on central nervous system hemangioblastoma. We identified publication dynamics and research gaps. More high-impact studies are warranted to enhance disease comprehension and management.

Herpes simplex encephalitis with normal brain magnetic resonance imaging and normocellular initial cerebrospinal fluid.

Introduction: Herpes simplex virus (HSV) is associated with one of the lethal diseases, Herpes simplex encephalitis (HSE). Diagnosis is confirmed using MRI and CT scan imaging techniques and more sensitive DNA PCR from cerebrospinal fluid analysis and brain biopsy.Case presentation: However, after four days, the patient's HSE diagnosis was confirmed by the detection of herpes simplex virus type 1 (HSV1) via polymerase chain reaction (PCR) testing. This case highlights the importance of utilizing multiple diagnostic aids and not solely relying on initial test results, as infections may not appear in CSF analysis or MRI scans initially. Furthermore, this case also emphasizes the necessity of initiating empirical treatment based on clinical signs and symptoms, even in cases where diagnostic tests initially appear negative. Prompt and efficient diagnosis and treatment are crucial in managing HSE and preventing long-term neurological damage.Conclusion: This case of HSE underscores the significance of a multifaceted diagnostic approach and timely intervention in managing this potentially severe and life-threatening condition. As mentioned, sometimes the infection does not appear in CSF analysis initially, nor does its effects appear in MRI. HSV PCR remains the golden test to confirm the diagnosis of HSE.

Cardiac Surgery-Associated Acute Kidney Injury (CSA-AKI) in Adults and Pediatrics; Prevention is the Optimal Management.

BACKGROUND: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a significant and severe complication that affects morbidity and mortality. We studied both pediatric and adult patients using the Acute Kidney Injury Network (AKIN) definition. METHODS: This was an observational retrospective cohort study done at King Abdulaziz University Hospital in Jeddah, Saudi Arabia, and approved by the ethical committee. The exclusion criteria were baseline serum creatinine (SCr) ≥ 4 mg/dL or preexisting renal failure requiring dialysis, reoperation, death within 24 hours postoperatively, and operative mortality or missing data. We included 941 patients in the analysis using statistical software SPSS, version 15.0. RESULTS: Of the total number of patients, 28.68% in the adult group and 20.07% in the pediatric group developed CSA-AKI. Adult risk factors included the age group 60-69 years, cardiopulmonary bypass (CPB), number of grafts, and hypertension. In the pediatric group, CPB, aortic cross-clamping (ACX), and the lower preoperative SCr were the main risk factors Conclusion: Conventional conservative management and preoperative identification of predictor risk factors are essential for preventing CSA-AKI, constituting the primary strategy for optimal management.

A novel variant of RBCK1 gene causes mild polyglucosan myopathy.

Homozygous or compound heterozygous pathogenic variants of the RBCK1 gene can result in a systemic disorder characterized by the accumulation of complex carbohydrate molecules, namely polyglucosan bodies in the muscular tissues. The role of this gene in the pathophysiology of the disorder at the molecular level remains unclear. Being a very rare disorder, the medical knowledge is based on just a few reported cases. Here we report a 7-year-old girl who presented with exercise intolerance and hepatosplenomegaly. Her liver profile was constantly raised. The genetic investigation has revealed a variant of the RBCK1 gene of unknown significance, which has later been confirmed as pathogenic via a variety of clinical, genetic, and histopathological approaches. More importantly, it is evident that the availability of sophisticated genetic testing, such as whole-exome sequencing, has significantly improved the knowledge of and diagnosis of many rare metabolic disorders.

Structure Engineering of Yolk-Shell Magnetic Mesoporous Silica Microspheres with Broccoli-Like Morphology for Efficient Catalysis and Enhanced Cellular Uptake.

Yolk-shell magnetic mesoporous microspheres exhibit potential applications in biomedicine, bioseparation, and catalysis. Most previous reports focus on establishing various interface assembly strategies to construct yolk-shell mesoporous structures, while little work has been done to control their surface topology and study their relevant applications. Herein, a unique kind of broccoli-like yolk-shell magnetic mesoporous silica (YS-BMM) microsphere is fabricated through a surfactant-free kinetic controlled interface assembly strategy. The obtained YS-BMM microspheres possess a well-defined structure consisting of a magnetic core, middle void, mesoporous silica shell with tunable surface roughness, large superparamagnetism (36.4 emu g-1 ), high specific surface area (174 m2 g-1 ), and large mesopores of 10.9 nm. Thanks to these merits and properties, the YS-BMM microspheres are demonstrated to be an ideal support for immobilization of ultrafine Pt nanoparticles (≈3.7 nm) and serve as superior nanocatalysts for hydrogenation of 4-nitrophenol with yield of over 90% and good magnetic recyclability. Furthermore, YS-BMM microspheres show excellent biocompatibility and can be easily phagocytosed by osteoclasts, revealing a potential candidate in sustained drug release in orthopedic disease therapy.

Sensing and sensitive visualization of latent fingerprints on various surfaces using a versatile fluorescent aggregation-induced emission-based coumarin derivative.

The marked rise in criminal activity in society has made a difficult task for forensic scientists who aim to track any crime scene effectively, therefore visualization of latent fingerprints (LFPs) plays an increasingly vital role in forensics. In the present report, a highly sensitive solvatochromism, aggregation-induced emission-based 2-(4-nitrophenyl)-3H-benzocoumarin fluorescent dye (CFD) was fabricated using an ultrasonication protocol. The fluorescence properties of the CFD were analyzed using fluorescence spectrophotometer. The CFD produced a greenish yellow emission in solid and fluid states. An in-depth visualization of LFPs showed detailed ridge patterns under normal and ultraviolet light sources (254 and 365 nm) due to the excellent chemisorption of CFD onto the ridge patterns on the finger. All three types of ridge details were visualized without any background interference when using a simple and quick powder dusting method. Results revealed that, the present fluorescent dye can be used successfully for detection of latent fingerprints (LFPs) on various nonporous substrates surfaces, in organic light-emitting diodes applications (OLEDs), and for electrochemical sensing.

Au Nanoparticles Decorated Mesoporous SiO2 -WO3 Hybrid Materials with Improved Pore Connectivity for Ultratrace Ethanol Detection at Low Operating Temperature.

Semiconducting metal oxides-based gas sensors with the capability to detect trace gases at low operating temperatures are highly desired in applications such as wearable devices, trace pollutant detection, and exhaled breath analysis, but it still remains a great challenge to realize this goal. Herein, a multi-component co-assembly method in combination with pore engineering strategy is proposed. By using bi-functional (3-mercaptopropyl) trimethoxysilane (MPTMS) that can co-hydrolyze with transition metal salt and meanwhile coordinate with gold precursor during their co-assembly with PEO-b-PS copolymers, ordered mesoporous SiO2 -WO3 composites with highly dispersed Au nanoparticles of 5 nm (mesoporous SiO2 -WO3 /Au) are straightforward synthesized. This multi-component co-assembly process avoids the aggregation of Au nanoparticles and pore blocking in conventional post-loading method. Furthermore, through controlled etching treatment, a small portion of silica can be removed from the pore wall, resulting in mesoporous SiO2 -WO3 /Au with increased specific surface area (129 m2  g-1 ), significantly improved pore connectivity, and enlarged pore window (>4.3 nm). Thanks to the presence of well-confined Au nanoparticles and ε-WO3 , the mesoporous SiO2 -WO3 /Au based gas sensors exhibit excellent sensing performance toward ethanol with high sensitivity (Ra /Rg = 2-14 to 50-250 ppb) at low operating temperature (150 °C).

Preparation and Characterization of Poly(ethylene-co-vinyl alcohol)/poly(ε-caprolactone) Blend for Bioscaffolding Applications.

In order to improve the cell adhesion on poly(ε-caprolactone) (PCL) scaffolds, poly(ethylene-co-vinyl alcohol) (E-VAL) which has hydroxyl groups capable of developing hydrogen bonds with celling was blended with this polymer. To reach this goal, a series of E-VAL/PCL blends with different compositions were prepared by the solvent casting method. The miscibility of the polymer blend was proved by differential scanning calorimetry and Fourier-transform infrared spectroscopy spectrometry. Furthermore, the mechanical properties of the polymer blends were assessed in their wet state by dynamic mechanical analysis. The surfaces wettability of blends and their components were examined through static contact angle measurements. The pore interconnections in the resulted scaffolds were achieved by the incorporation of naphthalene microparticles which were used as porogen and then removed in its gas state by sublimation under reduced pressure. The presence of pores interconnected inside the polymeric materials and their surface morphologies was examined by scanning electron microscopy. The in-vitro cytotoxicity and cell adhesion on the prepared materials were examined by an MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay.

Adsorption of Azo Dye Methyl Orange from Aqueous Solutions Using Alkali-Activated Polypyrrole-Based Graphene Oxide.

The adsorption of methyl orange (MO) from aqueous solutions onto a KOH-activated polypyrrole-based adsorbent (PACK) was investigated using batch and fixed-bed column techniques. The structural, thermal, and morphological properties of the PACK, analyzed by various methods, support its applicability as an adsorbent. An adsorption kinetic study revealed a preferably pseudo-second-order (R2 = 0.9996) and rate-limiting step controlled by both film and intra-particle diffusions. The thermodynamic adsorption tests resulted in negative ΔG°, ΔH°, and ΔS° values, which decreased as the temperature and concentration increased, indicating the spontaneous and exothermic adsorption over 25-45 °C. The adsorption isotherms fit the experimental data in the order of Langmuir ≈ Freundlich > Temkin, with evidence of adsorption operating well via the monolayer physical adsorption process, and maximum monolayer adsorption ranging from 520.8 to 497.5 mg/g. The breakthrough curve of the fixed-bed column experiment was modeled using the Thomas, Yoon-Nelson, and Hill models, resulting in an equilibrium capacity of 57.21 mg/g. A 73% MO recovery was achieved, indicating the possibility of column regeneration. Compared to other adsorbents reported, PACK had comparable or even superior capacity toward MO. For cost-effectiveness, similar nitrogen-containing polymeric wastes could be exploited to obtain such excellent materials for various applications.

Nanoengineering of Core-Shell Magnetic Mesoporous Microspheres with Tunable Surface Roughness.

Functional core-shell mesoporous microspheres with integrated functions, controlled structure, and surface properties and morphologies have received increasing attention due to their excellent physicochemical properties. Herein, core-shell magnetic mesoporous materials with cauliflower-like morphology and tunable surface roughness have been synthesized through a kinetics-controlled interface co-assembly and deposition of mesostructured nanocomposites on Fe3O4@RF microspheres (RF refers to resorcinol formaldehyde resin). The obtained microspheres, synthesized via this interface nanoengineering method, possess well-defined sandwich structure with a tunable rough morphology, uniform size (560-1000 nm), perpendicularly aligned mesopores (∼5.7 nm) in the outer shell, RF-protected magnetic responsive core, high surface area up to 382 m2/g, and large pore volume of 0.66 cm3/g. As a result of the unique surface features and magnetic properties, these microspheres exhibit excellent performance in stabilizing and oxygen-free manipulating aqueous solutions in petroleum ether by a magnetic field. They also exhibit superior cell uptake properties compared with traditional smooth core-shell magnetic mesoporous silica microspheres, opening up the possible applications in fast drug delivery in cancer therapy.

Plasmolysis-Inspired Nanoengineering of Functional Yolk-Shell Microspheres with Magnetic Core and Mesoporous Silica Shell.

Yolk-shell nanomaterials with a rattle-like structure have been considered ideal carriers and nanoreactors. Traditional methods to constructing yolk-shell nanostructures mainly rely on multistep sacrificial template strategy. In this study, a facile and effective plasmolysis-inspired nanoengineering strategy is developed to controllably fabricate yolk-shell magnetic mesoporous silica microspheres via the swelling-shrinkage of resorcinol-formaldehyde (RF) upon soaking in or removal of n-hexane. Using Fe3O4@RF microspheres as seeds, surfactant-silica mesostructured composite is deposited on the swelled seeds through the multicomponent interface coassembly, followed by solvent extraction to remove surfactant and simultaneously induce shrinkage of RF shell. The obtained yolk-shell microspheres (Fe3O4@RF@void@mSiO2) possess a high magnetization of 40.3 emu/g, high surface area (439 m2/g), radially aligned mesopores (5.4 nm) in the outer shell, tunable middle hollow space (472-638 nm in diameter), and a superparamagnetic core. This simple method allows a simultaneous encapsulation of Au nanoparticles into the hollow space during synthesis, and it leads to spherical Fe3O4@RF@void-Au@mSiO2 magnetic nanocatalysts, which show excellent catalysis efficiency for hydrogenation of 4-nitrophenol by NaBH4 with a high conversion rate (98%) and magnetic recycling stability.

Mesoporous Tungsten Oxides with Crystalline Framework for Highly Sensitive and Selective Detection of Foodborne Pathogens.

Foodborne pathogens like Listeria monocytogenes can cause various illnesses and pose a serious threat to public health. They produce species-specific microbial volatile organic compounds, i.e., the biomarkers, making it possible to indirectly measure microbial contamination in foodstuff. Herein, highly ordered mesoporous tungsten oxides with high surface areas and tunable pores have been synthesized and used as sensing materials to achieve an exceptionally sensitive and selective detection of trace Listeria monocytogenes. The mesoporous WO3-based chemiresistive sensors exhibit a rapid response, superior sensitivity, and highly selective detection of 3-hydroxy-2-butanone. The chemical mechanism study reveals that acetic acid is the main product generated by the surface catalytic reaction of the biomarker molecule over mesoporous WO3. Furthermore, by using the mesoporous WO3-based sensors, a rapid bacteria detection was achieved, with a high sensitivity, a linear relationship in a broad range, and a high specificity for Listeria monocytogenes. Such a good gas sensing performance foresees the great potential application of mesoporous WO3-based sensors for fast and effective detection of microbial contamination for the safety of food, water safety and public health.

A Micelle Fusion-Aggregation Assembly Approach to Mesoporous Carbon Materials with Rich Active Sites for Ultrasensitive Ammonia Sensing.

Nanostructured carbon materials have received considerable attention due to their special physicochemical properties. Herein, ordered mesoporous carbons (OMCs) with two-dimension (2D) hexagonal mesostructure and unique buckled large mesopores have successfully been synthesized via a micelle fusion-aggregation assembly method by using poly(ethylene oxide)-block-polystyrene (PEO-b-PS) diblock copolymers as a template and resorcinol-based phenolic resin as a carbon precursor. The obtained ordered mesoporous carbons possess unique fiber-like morphology, specific surface area of 571-880 m(2)/g, pore volume of 0.54 cm(3)/g and large mesopores (up to 36.3 nm) and high density of active sites (i.e., carboxylic groups) of 0.188/nm(2). Gas sensor based on the ordered mesoporous carbons exhibits an excellent performance in sensing NH3 at a low temperature with fast response (<2 min), ultralow limit of detection (<1 ppm), and good selectivity, due to the large pore sizes, high surface area and rich active sites in the carbon pore walls.

An Interface Coassembly in Biliquid Phase: Toward Core-Shell Magnetic Mesoporous Silica Microspheres with Tunable Pore Size.

Core-shell magnetic mesoporous silica microspheres (Magn-MSMs) with tunable large mesopores in the shell are highly desired in biocatalysis, magnetic bioseparation, and enrichment. In this study, a shearing assisted interface coassembly in n-hexane/water biliquid systems is developed to synthesize uniform Magn-MSMs with magnetic core and mesoporous silica shell for an efficient size-selective biocatalysis. The synthesis features the rational control over the electrostatic interaction among cationic surfactant molecules, silicate oligomers, and Fe3O4@RF microspheres (RF: resorcinol formaldehyde) in the presence of shearing-regulated solubilization of n-hexane in surfactant micelles. Through this multicomponent interface coassembly, surfactant-silica mesostructured composite has been uniformly deposited on the Fe3O4@RF microspheres, and core-shell Magn-MSMs are obtained after removing the surfactant and n-hexane. The obtained Magn-MSMs possess excellent water dispersibility, uniform diameter (600 nm), large and tunable perpendicular mesopores (5.0-9.0 nm), high surface area (498-623 m(2)/g), large pore volume (0.91-0.98 cm(3)/g), and high magnetization (34.5-37.1 emu/g). By utilization of their large and open mesopores, Magn-MSMs with a pore size of about 9.0 nm have been demonstrated to be able to immobilize a large bioenzyme (trypsin with size of 4.0 nm) with a high loading capacity of ∼97 µg/mg via chemically binding. Magn-MSMs with immobilized trypsin exhibit an excellent convenient and size selective enzymolysis of low molecular proteins in the mixture of proteins of different sizes and a good recycling performance by using the magnetic separability of the microspheres.

Solitary plasmacytoma of the calvarium: A successful management of a long-standing large lesion with a long-term follow-up.

Background: Solitary plasmacytoma of the calvarium (SPC), without evidence of multiple myeloma (MM), is extremely rare. We report a case of a long-standing large SPC that was treated successfully by surgical excision and adjuvant radiotherapy with a long follow-up period. Case Description: A 58-year-old male patient presented with a 5-year history of painless skull swelling. On the physical examination, the mass was 6 × 6 cm in size, oval, not tender, and firm in consistency with normal skin color. A brain computed tomography scan showed a destructive skull lesion. A brain magnetic reasoning imaging (MRI) showed a large expansile lytic mass lesion arising from the skull vault in the frontal-parietal region with multiple internal septa. The patient underwent a craniectomy and excision of the lesion, followed by cranioplasty using methyl methacrylate. The final diagnosis was consistent with plasmacytoma based on the histopathological features. One month follow-up brain MRI showed no evidence of residual tumor. The skeletal survey and bone marrow biopsy did not reveal any evidence of MM. The patient was referred to medical oncology for further treatment and received radiation therapy. During nine years of clinical and radiological follow-up, there was no evidence of any metastasis or recurrence. Conclusion: SPC is a rare disease with high rates of misdiagnosis. Careful evaluations are crucial to exclude systemic involvement. Surgical resection followed by radiotherapy may be adequate for the disease control. Close follow-up with regular lifelong examinations is important to avoid a generalized incurable disease.

Intracranial Cysts: A Single-Institution Experience With 27 Surgically Managed Cases.

Introduction Intracranial cysts (ICs) are rare pathologies that are often found incidentally during radiological examinations. They may appear in various brain regions and are categorized as normal, congenital, traumatic, or tumor-associated variants. ICs can be asymptomatic or cause symptoms, such as headaches, visual impairments, or seizures, depending on their size and location. Severe complications include obstructive hydrocephalus, loss of consciousness, and intracranial bleeding. Surgical excision is the most accepted type of management in most ICs. Objectives This study aimed to evaluate 27 surgically managed ICs in a tertiary hospital focusing on their clinical, radiological, histopathological, surgical outcomes, and prognosis to enhance understanding and management of these rare, benign cysts. Methodology This retrospective cohort study included 27 surgically managed ICs with pathological confirmation in King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, Saudi Arabia, from May 2016 to May 2023. All extracranial and nonsurgically managed cysts have been excluded from this study. Data on demographics, clinical presentations, radiological features, surgical outcomes, and follow-up were retrospectively extracted and analyzed. MRI and CT scans were reviewed to determine cyst characteristics. Surgical outcomes and postoperative complications were recorded. Data were collected via Google Forms and analyzed using the JMP Pro software. Ethical approval was obtained from King Abdullah International Medical Research Center, Jeddah, Saudi Arabia. Results The study included 27 ICs: 11 (40.74%) colloid cysts, six (22.22%) epidermoid cysts, five (18.51%) adamantinomatous craniopharyngiomas, two (7.40%) neuroepithelial cysts, and one each of Rathke's cleft cyst (3.70%), xanthogranuloma (3.70%), and dermoid cyst (3.70%). All 27 cases were surgically managed (100.00%), with gross total resection achieved in 14 (51.85%) cases. Only 12 cases (44.44%) did not develop any surgical complications. Twenty-two cases (81.48%) experienced an improvement in the preoperative presenting symptoms. During the follow-up, only three cases (11.11%) had evidence of recurrence. Conclusion This study analyzed 27 ICs of various histopathological types. Each type showed distinct clinical and radiological features. Surgical management generally improved preoperative symptoms with low mortality and recurrence rates, although complications were common. Identifying specific radiological features is crucial for an accurate preoperative diagnosis and optimal surgical outcomes.

Enhancement in Tomato Yield and Quality Using Biochar Amendments in Greenhouse under Salinity and Drought Stress.

Enhancing saline water productivity in arid regions is essential for sustainable agriculture. Adding biochar can improve the quantity and quality of tomato yield under higher levels of salinity and lower levels of irrigation. The experiment aimed to evaluate the effects of biochar on enhancing tomato fruit quality and yield under salinity and drought stress. The experiment combines two treatments for irrigation water quality (0.9 and 2.3 dS m-1), four irrigation levels (40, 60, 80, and 100%) of crop evapotranspiration (ETc), and the addition of 5% of biochar to treated soil (BC5%) and untreated soil (BC0%). The results showed that the decrease in the water quality and irrigation levels negatively impacted the yield and properties of tomato fruit, while 5% of biochar application positively improved the yield. Adding biochar decreased the tomato yield by 29.33% and 42.51% under lower-saline-irrigation water than the control, negatively affecting the fruit's physical parameters and mineral content. In contrast, adding biochar and irrigating with saline water at 60% of ETc improved the firmness and quality characteristics of the fruit by 56.60%, 67.19, 99.75, and 73.57% for vitamin C (VC), total titratable acidity (TA), total soluble solids (TSS), and total sugars (TS), respectively, compared to the control, and also reduced the sodium content of the fruits under all irrigation levels compared to untreated plants by biochar. Generally, biochar with saline water under deficit irrigation with 80 and 60% of ETc could be an excellent strategy to enhance the qualitative characteristics of tomato fruits and save approximately 20-40% of the applied water.

Frequency and Determinants of Depression in Hypothyroidism Patients at a Tertiary Care Hospital in the Western Region of Saudi Arabia.

Background: Several studies have reported a strong association between depression and hypothyroidism, including from several regions of Saudi Arabia. However, studies on the frequency of depression among patients with hypothyroidism from the Western region of Saudi Arabia is limited. Objectives: To determine the frequency and risk factors of depression among patients with hypothyroidism in the Western Region of Saudi Arabia. Materials and Methods: This cross-sectional study was conducted at a tertiary care hospital in Jeddah, Saudi Arabia, and included adult patients diagnosed with hypothyroidism. After contacting the patients through phone calls and obtaining their consent, a questionnaire weblink was sent. The first part of the questionnaire elicited details regarding demographics and history of hypothyroidism, while the second part comprised the Arabic version of the Patient Health Questionnaire-9 to evaluate depression. Results: A total of 100 patients completed the survey, of which 80% were found to have depression (mild: 35%, moderate: 26%, moderate to severe: 12, severe: 7%). There was no significant association between depression and gender, age group, employment status, and marital status. In the bivariate analysis, a significant association was found between depression and reporting fatigue (P < 0.001), constipation (P < 0.001), hair loss (P = 0.002), cold intolerance (P = 0.014), dry skin (P = 0.028), memory problems (P = 0.029), and menorrhagia (P = 0.037). However, in the multivariate analysis, only reporting fatigue was found to be significantly associated with depression (P = 0.040; OR = 15.215). Conclusion: This study found that the prevalence of depression was very high among patients with hypothyroidism in the Western region of Saudi Arabia, and that fatigue is an independent risk factor of depression.

The Prevalence of Depression and Acceptance Rate of Referral to Psychiatrist Among Psoriatic Patients in Saudi Arabia.

Background Psoriasis is a chronic inflammatory disease that primarily affects the skin and can significantly impact the quality of life. Previous studies have shown that psoriasis increases the risk of depression; however, there is a lack of information about the prevalence of depression and psoriatic patients' acceptance of referral to a psychiatric clinic in Saudi Arabia. This study aims to estimate the prevalence of depression among psoriatic patients in Saudi Arabia, determine their referral acceptance rate to psychiatric clinics, and assess their knowledge regarding the impact of depressive symptoms on psoriasis. Methods This questionnaire-based cross-sectional study included patients with psoriasis who presented to dermatology clinics in Saudi Arabia. All patients were instructed to complete three sets of questionnaires encompassing sociodemographic information, the clinical characteristics of their illness, and the Beck Depression Inventory. Results Of 406 patients, 54.9% had symptoms of depression, and 46.3% were willing to go to a psychiatrist when symptoms of depression were present. Most of the patients (70%) thought that depression affects psoriasis. Conclusions More than half of the psoriatic patients in this study were depressed. The patients understood that depression can lead to a worsening of their symptoms, but the majority refused to see a psychiatrist. To remove barriers to seeing a psychiatrist, psoriasis patients should be provided with mental health assistance, taught to identify psychological stressors and effective strategies to cope with these stressors, and educated about available services, including telemedicine.