✓ The natural history of brown tumor of the skull base, a rare and benign condition, has not been adequately documented, particularly after nonsurgical treatment and over a long follow-up period. The authors report a case of brown tumor of the ethmoidal sinus, documenting its clinical, neuroimaging, and pathological features with long-term follow-up results, and review previous reports on this disorder.

Background: Although the relationship between acromegaly and depression has been ascribed to the effects of chronic disease, the role of growth hormone (GH), and insulin like growth factor-1 (IGF-1) is not clear.Objective: To determine whether related hormones levels in acromegalics are correlated with depressive symptoms and whether these symptoms are ameliorated following surgery.Materials and Methods: A prospective cohort study was conducted on patients diagnosed with acromegaly (n = 15) or non-functioning pituitary adenomas (NFPA; n = 20, as controls) and undergoing first-time surgery, who completed the Center for Epidemiological Studies Depression (CES-D) questionnaire both pre-surgery and post-surgery. The primary outcome was the patient’s severity of depression symptomatology using the CES-D score; GH, IGF-1 levels, and tumor characteristics were also measured.Results: Hormone levels (GH and IGF-1) and depression scores in acromegaly patients showed significant reductions following surgery (p < 0.05). The average change in CES-D score was 5.73 ± 2.58 (mean ± SE). A moderate correlation was found between GH levels and CES-D scores (r = 0.52, p < 0.01). The depressed affect subscale accounted for the most improvement in CES-D scores postoperatively and correlated most highly with GH levels. We did not find similar declines in the matched cohort of NFPA patients.Conclusion and Relevance: Surgical resection of the pituitary tumor in acromegaly patients leads to reduction in GH levels that is correlated with reduction in CES-D scores. The results suggest a role for GH in depression and provide a stronger foundation on which to build the hypothesis that GH impacts affect. The study also suggests that hormones should be factored into the matrix that entails the neuro-biological underpinnings of depressive disorders. Future work could explore the mechanisms involved, further brain and neuropeptide interactions, and, novel potential therapeutic targets in depressive and other mental health disorders.

Pregabalin is a first-line therapy for neuropathic pain and for chronic pain. It has abuse potential. This study was conducted to assess community pharmacists’ perceptions towards pregabalin abuse and misuse in the Aseer region, Saudi Arabia, and identify predictors and associated factors. A cross-sectional survey using a structured questionnaire following a self-administrative study was conducted across community pharmacies in the Aseer region (Abha, Khamis Mushait, Mahayel, Sarat Abeeda, Ahad-Rufaida, and Bishah). A total of 206 respondents from community pharmacists participated in the study. Over the last six months, 136 respondents (66.0%) suspected pregabalin abuse in community pharmacies; male dominance in pregabalin abusers was also recorded (n = 165, 80.1%). Additionally, 40 (19.4%) respondents stated that a prescription was not issued for pregabalin demands. Over half (61.7%) of community pharmacists recorded an increased change in pregabalin abuse compared to the previous year. This is the first study to explore pharmacists’ perceptions in the community of the Aseer region towards customers’ misuse and abuse of pregabalin. Further monitoring and regulations on the prescribing and procurement of pregabalin are needed to avoid abuse.

Road traffic accidents (RTAs) are a leading cause of traumatic head injury (THI) and are regarded as a public health problem in Saudi Arabia. This hospital-based retrospective study aims to provide data on the frequency, type, and distribution of RTA-related THIs over the past decade; demonstrate their time trend and seasonality; and decipher age and sex differences in RTA-related THIs and their outcome. The results showed a decline in the number of RTA-related THIs between 2010 and 2019. The patients had a mean age of 26.16 ± 16.27 years, and the male-to-female ratio was 10.8:1. Head injury with multiple lesions was the most common diagnosis, followed by cerebral contusion and skull fracture (32.1%, 12.9%, and 11.2%, respectively). Subdural hematoma (SDH) and skull fracture were significantly more common in patients aged ≥60 years (standard residual > 1.96), and significantly less common in those aged ≤17 years (standard residual < 1.96), compared to other age groups. Males experienced significantly more SDHs than females (standard residual = −2.8, p = 0.029). The length of hospital stay was positively correlated with age (Spearman’s rho = 0.057, p = 0.046). No seasonal variation was found.