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Background: Isotretinoin is an effective treatment for acne but can cause side effects such as changes in blood lipids and liver enzymes. Laboratory monitoring is essential during treatment, but there is variation in monitoring practices. Aim: This study aims to investigate the relationship between isotretinoin therapy and its effects on complete blood count in Saudi Arabia to improve patient outcomes. Methods: The study was a retrospective cohort study conducted at King Khalid University Hospital in Riyadh, Saudi Arabia, between January 2016 and December 2020. Following the inclusion and exclusion criteria, 515 patients were randomly selected for the study. The data was analyzed using SPSS, and descriptive statistics and paired samples t-tests were employed to analyze the data. Results: In this study, 515 patients were enrolled. Of these participants, 76.7% (n=395) were females and 23.3% (n=120) were males. The mean age of the study participants was 23.98± 7.4 years and ranged between 16 and 65 years. The mean dose of Isotretinoin administered was 27.65± 9.6 mg/day, with a range of 10– 60 mg/day. The mean BMI of the study participants was 24.3± 4.1 kg/m2, ranging from 14.3 to 44.8 kg/m2. Regarding the effect of Isotretinoin on laboratory measures, significant statistical differences were found in hemoglobin measurements (t=− 3.379, p=0.001), platelets (t=− 3.169, p=0.002), neutrophils (%) (t=3.107, p=0.002), total cholesterol (t=− 13.017, p=0.000), AST (t=− 6.353, p=0.000), ALT (t=− 4.352, p=0.000), HDL (t=2.446, p=0.015), and LDL (t=− 12.943, p=0.000). However, there were no significant statistical differences in the measurements of WBC, neutrophils (count), or triglycerides. In the Chi-square analysis and Fisher's Exact test to identify the interaction between BMI, dose, and gender on abnormal lab results, significant interaction was found between participants' BMI and abnormal HDL measurements (p=0.006). Furthermore, there were significant interactions between Isotretinoin dose (either less than 30 mg/day or 30 mg/day or more) and abnormal neutrophil count (p=0.04), abnormal HDL measurements (p=0.010), and abnormal triglycerides measurements (p=0.020). Moreover, a statistically significant interaction was found between participants' gender and abnormal hemoglobin measurements (p=0.006), abnormal total cholesterol (p=0.016), abnormal AST measurements (p=0.001), abnormal ALT measurements (p=0.000), abnormal HDL measurements (p=0.000), and abnormal triglycerides measurements (p=0.007). Conclusion: In conclusion, the study found that isotretinoin therapy has significant effects on several laboratory measures, including hemoglobin, platelets, neutrophils, total cholesterol, AST, ALT, HDL, and LDL. The study also revealed significant interactions between BMI, dose, gender, and abnormal lab results. [ABSTRACT FROM AUTHOR]

Background: Epilepsy is a chronic neurological disorder. Stigma significantly contributes to the disease burden and delays in medical management. Enacted stigma involves discrimination against people with epilepsy, while felt stigma, or internalized stigma, is the shame associated with epilepsy. In Saudi Arabia, enacted stigma has been extensively studied, revealing misconceptions about epilepsy. This study aims to determine the severity of felt stigma, its association with sociodemographic characteristics, and its relation to epilepsy features., Methods: This cross-sectional study was conducted among people with epilepsy at a tertiary university hospital. The Internalized Stigma of Mental Illness (ISMI) scale, adapted for epilepsy, was used. The validated and translated questionnaire was self-administered electronically in Arabic. It consists of three sections: sociodemographic data, 29 items assessing internalized stigma using a 4-point Likert scale, and 6 items assessing epilepsy features. An average score of > 2 indicates stigma: ≥2, mild; ≥2.5, moderate; and ≥ 3, severe., Results: Of 112 participants, 19.6 % had mild internalized stigma, and 5.4 % had moderate internalized stigma, totalling 25 % with internalized stigma. No participant was found to have severe internalized stigma. Higher levels of internalized stigma were found among those who are single, have only school-level education, and low income. Epilepsy features associated with high internalized stigma include a history of status epilepticus and the use of ≥ 2 antiseizure medications., Conclusions: Felt stigma is prevalent in Saudi Arabia in mild to moderate severity. Controlling seizures and educating patients and their families about stigma can help reduce its prevalence., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 Elsevier Ltd. All rights reserved.)

Background: Vocal fold paralysis (VFP), involving one or both vocal folds, often indicates underlying pathologies. Identifying VFP causes is vital for excluding malignancies and focusing on treating the cause. While various imaging methods are used to investigate VFP causes, their detection abilities remain unclear. This study aims to assess the detection prevalence of different imaging techniques in determining the causes of VFP., Methods: In September 2023 a comprehensive search was conducted per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines across multiple databases, including Web of Science, PubMed, Scopus, Cochrane CENTRAL, and EMBASE. Following the search, the retrieved studies were screened based on the predefined eligibility criteria. Data extraction from the included studies was carried out independently by two authors. Outcomes were analyzed using pooled proportions and 95% confidence intervals., Results: Our meta-analysis encompassed 14 studies with 1492 VFP patients included. Malignant causes for VFP identification were most prevalent in F-fluorodeoxyglucose Positron Emission Tomography (PET)/Computed Tomography (CT) (41.5%) followed by Magnetic resonance imaging (MRI) (40%), with CT being the lowest (17.1%). Conversely, benign causes had the highest prevalence in F-fluorodeoxyglucose PET/CT (10.8%), followed by MRI (6.7%) and CT (4%). In the VFP cause identification, MRI had the highest detection prevalence (58.1%), followed by CT (30.1%), and Ultra Sound (US) had the lowest (26.8%). In chest lesion detection, CT had the highest prevalence (17.6%), followed by Chest X-ray (CXR) (6.5%). Head lesions were detected with CT at a prevalence of 15%, while neck lesion detection showed CT prevalence at 38.9% and US at 20.6%., Conclusion: Our study revealed varying prevalence rates for the identification of malignant and benign causes across different imaging modalities. MRI demonstrated the highest overall detection prevalence for VFP causes, while CT was most commonly used and had the highest prevalence for specific lesions detection in various regions. These findings provide valuable insights into the diagnostic utility of different imaging techniques in the evaluation of VFP., Competing Interests: Declaration of Competing Interest The authors have no conflict of interests, and the work was not supported or funded by any drug company., (Copyright © 2024 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)