Saudi Journal for Health Sciences最新文献

{"title":"Utility of next-generation sequencing in the diagnosis of neurological disorders","authors":"Adnan Raina, Sana Ahuja, Sushil Razdan, A. Khan, Murtaza Habib","doi":"10.4103/sjhs.sjhs_84_23","DOIUrl":"https://doi.org/10.4103/sjhs.sjhs_84_23","url":null,"abstract":"Background: The spectrum of neurological diseases encompasses a large number of disorders, including neuromuscular disorder (NMDs), ataxias, and muscular dystrophies. A detailed clinical examination, followed by electromyography and muscle biopsy, is a traditional diagnostic approach. However, it is never helpful in the identification of the subgroups of either neuropathies or muscular dystrophies apart from being a painful procedure. Aim: The present study was to assess the diagnostic yield of next-generation sequencing (NGS) in the diagnosis of neurological disorders. Materials and Methods: It was a cross-sectional study where consecutive neurological patients for whom NGS was done were included. These variants were classified as pathogenic/likely pathogenic, variants of uncertain significance (VUS), likely benign and benign. Results: Among the 45 cases included, 31 variants were identified in 30 genes, and in 15 patients, no variants were detected. Among 31 variants, 14 were previously reported for the causal of neurological disorder, including NMD, whereas 16 were novel variants (14 missense, 1 frameshift, and 1 splice donor). A definite molecular diagnosis was achieved in 21 cases that were either pathogenic/likely pathogenic, whereas 9 came to be VUS; however, the clinical manifestations correlated well. The phenotype-based sequencing showed a high diagnostic yield of 66% in the present study. Conclusion: NGS improves diagnostic efficiency with quicker and earlier diagnosis. In addition, it is a reliable and noninvasive technique that is effective in the detection of single nucleotide polymorphisms and small deletions.","PeriodicalId":32639,"journal":{"name":"Saudi Journal for Health Sciences","volume":"79 1","pages":"188 - 194"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139345179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incident management system comparison: Hospital Incident Command System versus Major Incident Medical Management and Support","authors":"Bandr Mzahim, Abdulrahman Alzahrani, Abdullah Alzahrani, Sarah Aldharman, Wala Alkhamis, Bandar Almutairi, Abdulrahman Sabbagh, Anas Khan","doi":"10.4103/sjhs.sjhs_118_23","DOIUrl":"https://doi.org/10.4103/sjhs.sjhs_118_23","url":null,"abstract":"The Hospital Incident Command System (HICS) and Medical Major Incident Management System (MMIMS) are incident management systems that any hospital may utilize to deal with threats, scheduled events, or emergencies. Both are valuable systems since they provide an organizational framework for incident management and include planning, developing, and adjusting that structure. HICS is used in the United States and MMIMS in the United Kingdom. The aim of this study is to find and show the difference, elements, and concepts of MIMMS and HICS. A scoping review of relevant papers and documents for the HICS was conducted. Medical Incident Command System, HICS, Healthcare Incident Command System, MMIMS, and Major Incident Management System are all referred to the same definition of HICS that was mentioned in the introduction. This research took place from March through June of 2022. From January 1, 1995, to June 15, 2022, all publications, books, guidelines, and manuals were extracted. We searched PubMed, Ovid, Springer, Scopus, Web of Science, and Google Scholar for articles. In conclusion, the main principles, strengths and weak points, and characteristics of the HICS and MMIMS appear to be the same. The differences were specified in the elements and chain of commands, which were designed to the geographic and governmental factors. Both systems are efficient and competent to achieve the goal of HICS but should be applied within the country's borders as it is an integrated system.","PeriodicalId":32639,"journal":{"name":"Saudi Journal for Health Sciences","volume":"239 1","pages":"178 - 187"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139344253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac autopsy findings in patients with COVID-19: A review of the literature","authors":"S. Zaheer, D. Aden, Shamaila Sameen","doi":"10.4103/sjhs.sjhs_149_22","DOIUrl":"https://doi.org/10.4103/sjhs.sjhs_149_22","url":null,"abstract":"Coronavirus disease 2019 (COVID-19) infection was first discovered in December 2019 and was soon declared a worldwide pandemic. With the decrease in the severity of the deadly disease, there is a false sense of relief globally. However, there has been an increasing trend in the cases of cardiovascular and other complications of COVID-19 which has raised concern about the sequelae of this infection. The number of cases of sudden cardiac death and myocardial infection, post-COVID-19 has seen a major leap, especially in healthy people of both genders. Systemic comorbidities and immunocompromised states have a direct effect on the prognosis of patients. The SARS-CoV-2 infection not just affects the respiratory system but multi-organ involvement is seen due to this deadly virus. The heart is a vital organ that has acute- acute and long-term consequences, what is known as long-COVID, which lead to increased morbidity and mortality. There are increased cases of multiple cardiovascular problems such as blood clots, cardiovascular accidents, myocarditis, myocardial infarction, and heart failure in people after recovering from SARS-CoV-2 infection. The histopathological findings in the heart due to COVID-19 infection can be interstitial edema with the presence or absence of myocarditis, lymphocytic endotheliitis, microvascular microthrombi, thrombosis, interstitial fibrosis with no endothelins, or rarely myocarditis. While the tissue diagnosis during acute illness is less likely feasible, autopsy findings can be helpful to understand better pathophysiology of the disease and thus help in the better management of the patient. This review was performed to analyze the postmortem findings of the heart in patients infected with the SARS-COV-2 virus, to understand the effect of COVID-19 and its complications on the heart. The pathological changes in the cardiovascular system need to be explained and correlated with the clinical findings and prognosis of the patients. We also want to hypothesize that these findings, especially myocarditis lead to sudden death in the young, which gets undetected on routine investigations.","PeriodicalId":32639,"journal":{"name":"Saudi Journal for Health Sciences","volume":"67 1","pages":"67 - 90"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80320722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relation between alexithymia, eating attitude, and sleep pattern among university students during the lockdown period of COVID-19 pandemic","authors":"M. Rizvi, Mahak Sharma, D. Sanghi., Ankita Sharma, Shubra Saraswat, Preeti Saini, Sunita Kumari","doi":"10.4103/sjhs.sjhs_22_23","DOIUrl":"https://doi.org/10.4103/sjhs.sjhs_22_23","url":null,"abstract":"Background: COVID-19 lockdown's impact on physical and mental health includes increased prevalence of alexithymia (difficulty recognizing emotions) among university students. Alexithymia is strongly correlated with eating disorders and disrupted eating behaviors. Understanding these associations is crucial for assessing the well-being of students during lockdown. Aims: The aim was to evaluate the prevalence of alexithymia and eating disorders in relation to sleep disturbance during this lockdown phase amongst university students. Settings and Design: This study employed an online cross-sectional design to collect data from participants. The study included adolescents of either gender, aged between 20 and 27 years, who were enrolled in the faculty of Allied Health Sciences at Manav Rachna International Institute of Research & Studies. Methods and Material: The study comprised 419 university students during the COVID-19 lockdown. Alexithymia was assessed using the Toronto Alexithymia Scale-20, eating disorders with the Eating Aptitude Test-26, and sleep patterns with a modified Pittsburgh Sleep Scale. Statistical Analysis Used: Descriptive statistics, including Mean±SD for continuous variables and frequency/percentages for categorical data, were calculated. Statistical analysis involved Student t-test and chi-square. Reliability of the questionnaire was assessed using Cronbach's Alpha. Results: This study involved 77.8% (n=326) female students as compared to 22.2%(n=93) male students. The prevalence of alexithymia was found to be considerably higher(30.5%) in the present study, with female students more affected than males. An eating disorder was found to be only 16.7%, and the majority of students (65.4%) had BMI in the range of normal weight. Further, the students reported the absence of sleep apnea with 41% of students having a sleep duration of 6-7 hours and 32% more than 7 hours. Only 19% of students reported poor sleep quality. Trouble sleeping during the initial 30 minutes prior to lying down, waking up in the middle of the night, and waking up to use the bathroom were the main factors causing sleep disturbances. Conclusions: This study reported a high alexithymia prevalence since there were under house arrest and going through psychological stress during lockdown phase of COVID-19 pandemic. Eating disorders was not prevalent because the students ate healthy balanced diets at home rather than junk food. Sleep patterns were also significantly improved and did not show any relation to the increased prevalence of alexithymia.","PeriodicalId":32639,"journal":{"name":"Saudi Journal for Health Sciences","volume":"34 1","pages":"126 - 134"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73496312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective audit of transfusion utilization trends and transfusion practices at a rural tertiary care hospital in Central India","authors":"Vihanka Vaidya, A. Deshmukh, V. Shivkumar, Manish Meshram","doi":"10.4103/sjhs.sjhs_56_23","DOIUrl":"https://doi.org/10.4103/sjhs.sjhs_56_23","url":null,"abstract":"Background: In modern health-care system, practicing safe and appropriate transfusion services is essential. Care should be taken at all three phases of transfusion practices, i.e. pretransfusion, transfusion, and posttransfusion. The blood unit should be appropriately used by the clinicians. Aims: The aim of this study was to evaluate blood transfusion practices at pretransfusion level at blood center as well as bedside and posttransfusion practices. Settings and Design: This was a prospective observational study. Materials and Methods: A total of 15022 requisition forms were received in our blood center for a total of 19904 units of blood and blood products during the study period of 21 months. Statistical Analysis Used: The data were recorded using Microsoft Excel and analyzed using the IBM Corp. Released 2011. The categorical variables were expressed in terms of number and percentage. Results: During the study period, blood bank received transfusion request for a total of 12840 units of blood bag for cross matching. Out of which only 9907 blood units were transfused to the recipients while rest of 2573 blood units were not transfused to the recipient and thus it was ordered excessively for cross match. When looked for overall utilization trends, we found that crossmatch-to-transfusion ratio was 1.26, transfusion probability was 79.38, and transfusion index was 0.79. There were 65 transfusion reactions, out of which only 27.69% (n = 18) reactions were reported and 72.31% (n = 47) were not reported to our blood center. Conclusions: It is important to sensitize the clinicians about the importance of ordering blood unit only when it is absolutely indicated along with correctly and completely filled blood transfusion request forms to lessen the transfusion reactions. It will ultimately improve the clinical practices in the hospital.","PeriodicalId":32639,"journal":{"name":"Saudi Journal for Health Sciences","volume":"98 1","pages":"151 - 156"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76114851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficiency of transrectal fine-needle aspiration cytology and histopathologic correlation in prostatic lesions and survival outcomes in prostate carcinoma","authors":"Pravinkumar Ghongade, Bharat Patil, Manisha A. Atram, Anupama Gupta","doi":"10.4103/sjhs.sjhs_59_23","DOIUrl":"https://doi.org/10.4103/sjhs.sjhs_59_23","url":null,"abstract":"Background: Transrectal fine-needle aspiration cytology (TRFNAC) is a beneficial practical method for the early diagnosis of prostate lesions. Aim: The aim of this study was to analyze the efficacy of TRFNAC in diagnosing prostatic lesions and its correlation with histologic diagnosis and evaluate the survival outcome and prognostic factors in prostatic cancer (PCa). Setting and Design: This was a retrospective study conducted from January 2014 to December 2018. Materials and Methods: Data regarding clinical findings, prostate-specific antigen (PSA), TRFNAC diagnosis, histopathological findings, treatment, and patient status were retrieved. Statistical Analysis: The Kaplan–Meier curve and log-rank (Mantel-Cox) were used for analysis. Results: Two hundred and fifty-seven cases of the prostatic lesion were selected. The overall diagnostic accuracy of TRFNAC for prostatic lesions was 95.41%. The sensitivity and specificity of TRFNAC were reported as 84.84% and 97.1%, respectively. The positive predictive value (PPV) and negative predictive value were reported as 82.35% and 97.57% on TRFNAC, respectively. The diagnostic accuracy of TRFNAC for prostate intraepithelial neoplasia was 22.2%. The overall survival outcome in PCa patients was 100% at 1 year, 71.2% at 3 years, and 59.3% at 5 years. Survival outcome significantly altered depending on the Gleason score, PSA level, metastases status, and treatment given, which showed Chi-square values of 78.49 (P = 0.000), 39.26 (P = 0.000), 16.52 (P = 0.000), and 31.92 (P = 0.000), respectively. The median survival time of PCa cases was 1522.01 days with a standard error of 152.92. Conclusions: TRFNAC is a beneficial and reliable tool for screening and diagnosing prostatic lesions. Prognostic factors such as surgery alone or combination, Gleason score ≤ 6, no metastases status, and PSA < 50 are associated with good survival.","PeriodicalId":32639,"journal":{"name":"Saudi Journal for Health Sciences","volume":"11 1","pages":"143 - 150"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88692444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fungal empyema thoracis: A rare occurrence at the rural tertiary care","authors":"Darshan Rakhecha, BharatUmakant Patil, R. Gore, Samir Yelwatkar","doi":"10.4103/sjhs.sjhs_78_23","DOIUrl":"https://doi.org/10.4103/sjhs.sjhs_78_23","url":null,"abstract":"Fungal empyema (FE), which has a death rate of 70%, is still a rare condition. FE is a rare cause of empyema. Its association with chronic pancreatitis in immunocompetent patients is rarely reported. This rare case is reported from the tertiary care hospital in central rural India. We present the case of a 40-year-old male known alcoholic with chronic pancreatitis who presented with dyspnea, fever, and left-sided localized chest pain for 2 months. Pleural fluid cytology revealed periodic acid–Schiff and Giemsa stain-positive fungal hyphae morphologically appear to be Candida albicans. Candida empyema thoracic in an immunocompetent patient with chronic pancreatitis responded well to early treatment with pleurocentesis and intravenous fluconazole.","PeriodicalId":32639,"journal":{"name":"Saudi Journal for Health Sciences","volume":"38 1","pages":"167 - 170"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90381422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the formation of neutrophil extracellular traps (NETosis) in the pathophysiology and the complications of COVID-19: A review of the literature","authors":"Vagisha Sharma, D. Aden, S. Zaheer, S. Ranga","doi":"10.4103/sjhs.sjhs_65_23","DOIUrl":"https://doi.org/10.4103/sjhs.sjhs_65_23","url":null,"abstract":"Coronavirus disease 2019 (COVID-19) pandemic which caused a significant disaster globally, has long term health implication known as long COVID. Long COVID refers to a wide range of symptoms that persist or develop after the acute phase of COVID-19 infection, which can last for weeks or months. Some of the symptoms associated with long COVID include fatigue, shortness of breath, chest pain, joint pain, cognitive impairment, and depression. Recent studies have also shown that long COVID can lead to various cardiovascular complications, including myocarditis, pericarditis, heart failure, and arrhythmias. These can significantly increase morbidity and mortality rates in COVID-19 patients, particularly those with preexisting cardiovascular conditions. The exact mechanisms underlying the cardiovascular complications associated with long COVID are not yet fully understood. However, it is believed that the persistent inflammation and immune dysregulation associated with COVID-19 may contribute to endothelial dysfunction, oxidative stress, and fibrosis in the cardiovascular system, leading to long-term cardiovascular complications. Neutrophils play a crucial role in immune system's response to infection. Upon encountering pathogens, neutrophils release neutrophil extracellular traps (NETs) to trap and kill microbes. The severity of COVID-19 has been linked to various factors, including the role of neutrophils and NETs. These extracellular webs, composed of chromatin, microbicidal proteins, and oxidant enzymes, are released by neutrophils to fight infections. However, excessive or dysregulated NET formation can lead to damage to surrounding tissues and organs, contributing to the development of inflammatory and thrombotic complications in various diseases, including COVID-19. COVID-19 patients with severe disease have increased levels of NETs in their blood, suggesting that NETs contribute to the disease's pathogenesis. NETs have been implicated in COVID-19-associated coagulopathy, acute respiratory distress syndrome, and multi-organ failure. Moreover, the presence of autoantibodies that target NET components has been reported in COVID-19 patients with severe disease, indicating that these autoantibodies may contribute to the development of hyperinflammation and thrombosis. Several potential therapeutic interventions targeting NETs have been proposed for COVID-19 patients, including the use of agents that inhibit NET formation or degradation. The role of NETs in the pathogenesis of COVID-19 and its associated complications is an active area of research. Further studies are needed to elucidate the mechanisms underlying NET dysregulation in COVID-19 and to evaluate the potential of NET-targeting therapies as a treatment strategy for COVID-19 patients. The purpose of this review is to analyze the potential contribution of NETosis in the pathophysiology of COVID-19 and its subsequent complications apart from its beneficial effect. This may provide insight int","PeriodicalId":32639,"journal":{"name":"Saudi Journal for Health Sciences","volume":"1 1","pages":"91 - 113"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83827256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seminal plasma level of bisphenol A among males investigated for infertility in Benin City, Nigeria","authors":"Mathias Abiodun Emokpae, Juliet Obialor, J. Osaikhuwuomwan","doi":"10.4103/sjhs.sjhs_20_23","DOIUrl":"https://doi.org/10.4103/sjhs.sjhs_20_23","url":null,"abstract":"Background: Evidence of an increasing rate of male infertility is replete in literature and has been attributed to several factors associated with environmental toxicants such as bisphenol A (BPA). It's presence in several products frequently used and the potential harmful effect on humans has raised serious concerns. Aims: The objective of this study was to determine the seminal plasma concentration of BPA among men investigated for infertility. Setting and Design: This was a cross-sectional study of men investigated for infertility in a tertiary hospital in Benin City, Nigeria. Materials and Methods: A total of 144 males (mean age: 40.55 ± 7.30) and 50 control subjects of proven fertility (mean age: 39.96 ± 5.68) were enrolled in the study. A structured questionnaire was used to obtain the sociodemographic data. Semen was collected after at least 3 days of sexual abstinence. Semen analysis was done according to the World Health Organization guidelines and seminal plasma BPA was determined using the enzyme-linked immunosorbent assay technique. Statistical Analysis Used: Chi-square, Student's t-test, and analysis of variance were used to compare measured variables. Pearson's correlation coefficient was used to determine the relationship between seminal plasma BPA and sperm indices. Results: Seminal plasma BPA was significantly higher (P < 0.001) among infertile men than control subjects. The mean seminal plasma BPA concentrations increased with declining sperm count (P < 0.001). Seminal plasma BPA levels strongly correlated inversely with sperm motility (r = −0.857, P < 0.001) and sperm count (r = −0.821, P < 0.001) and positively with abnormal morphology (r = 0.815, P < 0.001). The likelihood ratios of elevated BPA concentration to cause harm to sperm count (14.562), motility (10.425), and morphology (27.838) were several folds higher among subjects being investigated for infertility. Conclusions: Seminal plasma BPA levels were significantly higher among infertile men than controls. The detection of high levels of BPA in the seminal plasma is an indication of human exposure to high concentrations of BPA, this information may be used to formulate environmental policy that may minimize human exposure and improve male reproduction.","PeriodicalId":32639,"journal":{"name":"Saudi Journal for Health Sciences","volume":"216 1","pages":"120 - 125"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75596165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of alemtuzumab-induced thyroid disease with a fluctuating course","authors":"Sarah A Alghamdi, R. Ismail, S. Samargandy","doi":"10.4103/sjhs.sjhs_46_23","DOIUrl":"https://doi.org/10.4103/sjhs.sjhs_46_23","url":null,"abstract":"Alemtuzumab (ALZ) is a humanized monoclonal antibody licensed for the treatment of relapsing–remitting multiple sclerosis (RRMS). One of its common side effects is autoimmune thyroid disease, most commonly Graves' disease (GD). Here, we present a case of a 39-year-old female that was on ALZ for the treatment of RRMS. After two cycles, she developed GD, which later converted to severe hypothyroidism.","PeriodicalId":32639,"journal":{"name":"Saudi Journal for Health Sciences","volume":"130 1","pages":"165 - 166"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88789028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}