Background: This study was conducted to assess the level of knowledge and awareness of hypothyroidism and its neuropsychiatric clinical manifestations among the Saudi population. Methods: This was a cross-sectional study employing a convenient sampling technique, conducted between February and May 2022. A questionnaire was distributed online to all participants in all five regions. Results: In this survey, a total of 2016 Saudi citizens participated. When asked about depression, more than half of the participants (59.6%) correctly identified depression as one of the neuropsychiatric clinical symptoms of hypothyroidism. Nearly half of the participants (47.5%) were unaware that anxiety was not a neuropsychiatric manifestation of hypothyroidism. With a percentage of 91.0%, the majority of participants exhibited poor knowledge. The regression analysis showed that males have significantly reduced knowledge about hypothyroidism than females (coefficient −3.686, p-value < 0.0001). Similarly, those who have “enough income and can save” were more knowledgeable than others (coefficient 0.731, p-value < 0.02). Regarding the source of information, journals provide three times more information (p-value 0.0001), and healthcare practitioners provides four times more information as compared to family and friends (p-value 0.0001). Conclusion: Due to a lack of knowledge about hypothyroidism and its complications, symptoms, risk factors, and treatment, the most viable solution to these misconceptions would be to implement a variety of educational programs to increase public awareness of this issue.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease worldwide and simultaneously the most common indication for liver transplants in Western countries This study aims to evaluate the effectiveness of laparoscopic sleeve gastrectomy (LSG) or Roux-en-Y gastric bypass (RYGB) on MDASLD histologically and biochemically. 14 studies met our criteria with a total population of 1942 who underwent LSG or RYGB 1–14. The Newcastle-Ottawa Scale (NOS) was used for quality evaluation of the included studies. Results: Both surgeries were effective in decreasing laboratory biomarkers like ALP, GGT, AST, and ALT with non-significant superiority of LSG over RYGB which did not significantly improve the AST level after one year. LSG showed more decrease in ALT levels (MD = −17.56, 95% CI = (−23.04, −12.089), p 0.001) and LSG was associated with increased change in NAS score with slight superiority. Both LSG and RYBG improve NAD and NASH outcomes after one and 10 years of surgery. However, randomized clinical trials with large samples are needed to confirm these results.

Neuroendocrine tumors (NETs) are usually found in the gastrointestinal tract and pancreas; however, they are rare in the middle ear. The presentation of vague symptoms, such as tinnitus and conductive hearing loss, complicates the diagnosis. We present a 46-year-old male with a history of right ear discharge and a previous canal wall-down mastoidectomy, suspected to have cholesteatoma recurrence. Imaging and surgery demonstrated a well-differentiated G1 NET in the middle ear. Postoperative metastatic workup revealed few pulmonary nodules needing ongoing observation. Middle-ear NETs are difficult to diagnose due to their rarity. This case underscores the importance of histological and immunohistochemical evaluation and the need for systemic assessment to rule out metastasis due to pulmonary nodules. We contribute to the limited literature highlighting the need to include NETs in the differential of middle ear masses and the usefulness of interdisciplinary teamwork.