Background: Trastuzumab deruxtecan (T-DXd), a HER2-directed antibody-drug conjugate, has significantly advanced the management of HER2-expressing malignancies. However, interstitial lung disease (ILD) remains a clinically significant adverse effect. Despite increasing clinical use of T-DXd, real-world data on ILD incidence, characteristics, and outcomes—particularly in Middle Eastern populations remain limited. Methods: This retrospective study analyzed medical records of patients who received trastuzumab deruxtecan (T-DXd) at a tertiary care hospital. Data collected included demographics, tumor characteristics, prior treatments, and interstitial lung disease (ILD)-related outcomes. ILD events were identified and graded according to the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Descriptive statistics were used to summarize baseline characteristics and ILD features. Univariate logistic regression was performed to assess potential risk factors associated with ILD development. Kaplan–Meier survival analysis was used to evaluate time-to-event outcomes, including time to ILD onset and resolution. Results: Among 65 patients with advanced stage IV cancer (90.8% with breast cancer), 16 (24.6%) developed ILD following T-DXd therapy. The median time to ILD onset was 125.5 days. The most common presenting symptoms were dyspnea and cough (50%). A history of ground-glass opacities was associated with increased odds of ILD (OR 2.7; p = 0.236), though not statistically significant. Patients with Grade ≥ 3 ILD had significantly lower oxygen saturation levels compared to those with milder grades (88.3% vs. 97.7%, p = 0.049). Median time to clinical resolution was 297 days (95% CI: 77.5–516). No significant associations were observed with smoking history, pulmonary metastases, or prior thoracic radiation. Conclusions: In this real-world cohort, ILD occurred in nearly one-quarter of patients receiving T-DXd, predominantly within the first six months of treatment. The findings highlight the importance of early respiratory symptom monitoring and pulse oximetry—particularly in patients with pre-existing pulmonary abnormalities. These results underscore the need for vigilant ILD surveillance strategies and further prospective studies to validate predictive risk factors and optimize management protocols.

Background: Lipid metabolism disturbances are common in end-stage renal disease (ESRD) patients on hemodialysis (HD), leading to dyslipidemia, which is characterized by abnormal plasma lipids and lipoproteins. Although large randomized controlled trials have generally not demonstrated a survival benefit associated with statin therapy among patients receiving hemodialysis, limited observational studies have reported potential associations with improved clinical outcomes in this population. Methods: This retrospective cohort study investigated the clinical and safety outcomes of statin use in ESRD patients on HD with documented dyslipidemia over a two-year period from 1 January 2018 to 30 December 2019. The primary endpoints evaluated the clinical outcomes of statins by assessing changes in specific lipid parameters, including low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), total cholesterol (TC), and high-density lipoprotein cholesterol (HDL-C). The secondary endpoints assessed safety by monitoring liver enzymes and creatine kinase (CK) levels. Results: Among 179 participants, diabetes mellitus was present in 134 patients (74.9%), while 168 patients (93.9%) had hypertension. Cardiovascular events occurred in 95 patients (53.1%). Statin therapy was administered to 146 patients (82.0%), with atorvastatin being the most frequently prescribed statin (69.3%). Modest reductions in LDL-C levels were observed in the rosuvastatin and atorvastatin groups, whereas slight increases were noted in the simvastatin and non-statin groups. None of these within-group changes were statistically significant. In the atorvastatin group, LDL-C decreased slightly from 2.058 to 2.003 mmol/L. The rosuvastatin group experienced a more pronounced LDL-C reduction from 2.607 to 2.113 mmol/L. Conversely, the simvastatin group showed an LDL-C increase from 1.550 to 1.901 mmol/L. Among the non-statin group, LDL-C increased from 2.678 to 2.820 mmol/L. Liver enzyme and CK levels fluctuated slightly but remained within normal ranges. Conclusions: This study evaluated statin therapy in hemodialysis patients with dyslipidemia. Although modest reductions in LDL-C levels were observed in the atorvastatin and rosuvastatin groups, statin therapy did not reduce the incidence of atherosclerotic events in hemodialysis patients with dyslipidemia. Additionally, statin use was not associated with any clinically or statistically significant effects.

Background/Objectives: COVID-19 has significantly impacted lives, and data show that receiving a booster vaccination has been demonstrated to lower the spread of COVID-19 and reduce the severity of the risk of infection. The Saudi government has actively promoted booster dose vaccines among university students who can spread the virus to older populations, especially in high-density environments, where the risk of virus transmission and spread is elevated. This study focuses on the acceptance of COVID-19 booster shots among students at Imam Abdulrahman bin Faisal University. The study assessed students’ willingness to receive a COVID-19 booster dose and the factors influencing their decision. Methods: A descriptive, cross-sectional study design using an online self-administered survey was conducted among medical and non-medical students at Imam Abdulrahman bin Faisal University. A convenience sampling technique was used to recruit participants via email and social media platforms (WhatsApp version 2.3). Quantitative analysis was performed using IBM SPSS version 28.0. using descriptive statistics. Logistic regression analysis was used to predict factors affecting COVID-19 booster dose acceptance and hesitancy. Results: Among 315 respondents, 171 (54.3%) were males, and 144 (45.7%) were females. All the respondents fell in the 18–25 years age group. About 173 (54.9%) respondents were from health-related colleges. Overall, 24.44% (77/315) agreed to get a COVID-19 vaccine booster dose. However, 77.14% (243/315) were confident of getting the vaccine whenever they wanted. About 48.88% (154/315) of respondents considered COVID-19 a serious severe infection, while 14.06% (46/315) of respondents were concerned about the probability of receiving COVID-19 immunization (World Health Organization, 2021). Conclusions: The study revealed that students were not accepting COVID-19 booster doses, highlighting the need for awareness campaigns to dispel myths and improve vaccination rates.

Introduction: Calciphylaxis, also known as calcific uremic arteriolopathy (CUA), is a rare and potentially fatal condition primarily affecting patients with end-stage renal disease (ESRD) on hemodialysis (HD). It is characterized by calcification in small blood vessels, leading to painful skin ulcers and high mortality rates. Case Description: This is a case of a 42-year-old female with ESRD on HD who developed calciphylaxis, presenting with non-healing ulcers on her thighs. Discussion: Despite initial treatments, including wound care and pain management, her condition did not improve. A skin biopsy was inconclusive, highlighting the diagnostic challenges associated with calciphylaxis. Based on clinical judgment, warfarin and calcium-based therapies were discontinued, and the patient’s HD regimen was adjusted. Due to the persistence of symptoms, sodium thiosulfate (STS) therapy was initiated, leading to significant improvement in her ulcers after six months of treatment. Conclusions: This case highlights the importance of clinical judgment in the diagnosis and management of calciphylaxis, particularly when histopathological diagnostic methods yield inconclusive results. Clinical criteria, alongside a thorough assessment of the patient’s history and presentation, are vital for achieving a timely diagnosis in such challenging cases. The successful use of sodium thiosulfate in this patient adds to the growing body of evidence supporting its use as a potential treatment for calciphylaxis, especially in cases that do not respond to conventional therapy.

Background: Diabetic kidney disease (DKD) represents a significant microvascular complication associated with type 2 diabetes mellitus (T2DM), markedly elevating the risk of kidney failure, cardiovascular events, and premature mortality. Despite advancements in therapeutic management, such as renin–angiotensin–aldosterone system (RAAS) blockade and sodium–glucose cotransporter 2 (SGLT2) inhibitors, residual risk remains significant. Finerenone, a novel nonsteroidal and selective mineralocorticoid receptor antagonist (MRA), has demonstrated substantial cardiorenal benefits in clinical trials; however, real-world data, especially from Saudi Arabia, remain limited. Method: This single-center, retrospective cohort study. All adult patients (≥18 years) who received finerenone as part of routine clinical care were eligible if they met either of the following criteria: (1) documented diabetic kidney disease (DKD) based on KDIGO-aligned clinical criteria, including diabetes mellitus with chronic kidney disease manifested by albuminuria/proteinuria and/or reduced eGFR; (2) and/or a urine protein-to-creatinine ratio (uPCR) >0.3 mg/mg. Longitudinal changes in uPCR, eGFR, and serum potassium were analyzed using linear mixed-effects models adjusted for relevant clinical covariates. Results: A total of 75 patients prescribed finerenone were screened, of whom 67 met the inclusion criteria. The median age was 63 years, and 53.7% were female. Comorbidities were highly prevalent, including diabetes mellitus (89.6%), hypertension (97.0%), dyslipidemia (92.5%), heart failure (56.8%), and coronary artery disease (40.3%). A significant effect of time on uPCR was observed (F[3,193] = 3.457; P = 0.018), with a mean reduction of 0.464 mg/mg after six months (95% CI, −0.895 to −0.034; P = 0.027). The estimated eGFR slope after finerenone initiation was −1.08 mL/min/1.73 m² per month (95% CI −1.74 to −0.41; P = 0.002), corresponding to an annualized decline of approximately −12.9 mL/min/1.73 m² per year. Serum potassium increased modestly at early follow-up points (F[5,245] = 4.008; P = 0.002), rising by +0.209, + 0.256, and +0.286 mmol/L at the first three readings (P = 0.029, 0.005, and 0.006, respectively), then plateaued thereafter (P > 0.5). Conclusion: Finerenone use among DKD patients in Saudi Arabia was associated with significant reductions in proteinuria, an early decline in eGFR that requires cautious interpretation, and an overall favorable safety profile. These real-world findings align with results from pivotal clinical trials and support the incorporation of finerenone into standard DKD management. Future multicenter prospective studies are warranted to confirm these outcomes and evaluate long-term cardiorenal benefits.