Understanding Multiple Sclerosis Pathophysiology and Current Disease-Modifying Therapies: A Review of Unaddressed Aspects.

Multiple sclerosis (MS) is a complex autoimmune disorder of the central nervous system (CNS) with an unknown etiology and pathophysiology that is not completely understood. Although great strides have been made in developing disease-modifying therapies (DMTs) that have significantly improved the quality of life for MS patients, these treatments do not entirely prevent disease progression or relapse. Identifying the unaddressed pathophysiological aspects of MS and developing targeted therapies to fill in these gaps are essential in providing long-term relief for patients.

The Landscape of Cutaneous T-Cell Lymphoma (CTCL) in the Middle East and North Africa (MENA) and the Establishment of the MENA CTCL Working Group.

The high cancer burden in the Middle East and North Africa (MENA region) is coupled with an increasing cancer incidence. While the MENA region constitutes 6% of the world's population, it remains underrepresented in clinical trials. Cutaneous T-cell lymphomas (CTCLs) represent a heterogeneous group of rare extranodal non-Hodgkin lymphomas with variable clinical presentation.

The timed 100 mL water swallow test for patients with head and neck cancer: What constitutes a clinically significant difference?

Objectives: Swallowing function in patients with head and neck cancer (HNC) is often assessed pre-treatment, during and at intervals post-treatment to identify those with dysphagia as early as possible. This study aims to investigate the minimal clinical important difference (MCID) for the 100 mL water swallow test (100 mL WST) to increase its utility in clinical practice and in clinical trials.

Methods: Data from 211 HNC patients, treated by either single or combined modality were included.

The Safety of Novel Therapies in Chronic Lymphocytic Leukemia in the Era of Intermittent Fasting: A Pharmacology-Based Review.

Intermittent fasting (IF) has recently gained popularity due to its emerging benefits in reducing weight and improving metabolic health. Concurrently, novel agents (NAs) like venetoclax and Bruton tyrosine kinase inhibitors (BTKIs) have revolutionized the treatment of chronic lymphocytic leukemia (CLL). Unfortunately, it is unclear whether the associated risks of tumor lysis syndrome (TLS) and gastrointestinal bleeding (GIB) are increased in IF practitioners receiving NAs.

BRCA testing and management of BRCA-mutated early-stage breast cancer: a comprehensive statement by expert group from GCC region.

BReast CAncer ()1 and gene pathogenic variants account for most hereditary breast cancers (BC). Identification of mutations can significantly influence both prognosis and treatment outcomes. Furthermore, it enables the identification of individuals who are at heightened risk of developing BC due to inherited genetic mutations.

Unusual Presentation of Solitary Penile Metastasis of Prostate Cancer on 68 Ga-PSMA PET/CT.

A 75-year-old patient was referred with biochemical recurrence for prostate cancer. The patient underwent 68 Ga-PSMA (prostate-specific membrane antigen) PET/CT scan, which revealed a focal PSMA activity in the proximal left lateral penile margin. Although a subsequent ultrasound did not identify the abnormality, MRI pelvis revealed a 10-mm lesion in the left proximal corpus cavernosum.

Deep learning enhances acute lymphoblastic leukemia diagnosis and classification using bone marrow images.

Acute lymphoblastic leukemia (ALL) poses a significant health challenge, particularly in pediatric cases, requiring precise and rapid diagnostic approaches. This comprehensive review explores the transformative capacity of deep learning (DL) in enhancing ALL diagnosis and classification, focusing on bone marrow image analysis. Examining ten studies conducted between 2013 and 2023 across various countries, including India, China, KSA, and Mexico, the synthesis underscores the adaptability and proficiency of DL methodologies in detecting leukemia.

Circular RNA in Multiple Sclerosis: Pathogenicity and Potential Biomarker Development: A Systematic Review.

Multiple sclerosis (MS) is a complex autoimmune disorder of the CNS that affects millions of people worldwide. The causes of the disease remain unknown despite extensive efforts to understand it. CircRNAs are a unique class of endogenous non-coding RNA that are abundant, stable, conserved, and specifically expressed molecules, making them a promising biomarker of diseases.

Evidence-Based Management of Chronic Lymphocytic Leukemia: Consensus Statements from the Gulf Region.

Introduction: Despite recent advances in diagnosis, prognostication, and treatment options, chronic lymphocytic leukemia (CLL) is still a largely incurable disease. New concepts on diagnosis, staging, treatment, and follow-up on CLL have been incorporated throughout recent years. The lack of regional consensus guidelines has led to varying practices in the management of patients with CLL in the region.

Nationwide study of rates of reinfection with SARS-CoV-2 among adults in Kuwait.

Background: Data are scarce on differences in the rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection after the first infection.

Aims: We examined nationwide data on SARS-CoV-2 reinfection in Kuwait according to four-time windows to reinfection: 29-45 days, 46-60 days, 61-90 days, and ≥ 91 days.

Methods: This was a population-level retrospective cohort study conducted between 31 March 2020 and 31 March 2021.

Elderly Patient Involvement in the Decision-Making Process of Breast Cancer Management in Kuwait.

Introduction: Worldwide statistics highlight that around 40% of breast cancer cases occur in patients aged 65 years and above, with expectations that this will increase as the population gets older. Cancer management in elderly patients is still unclear and depends primarily on individual oncologist decisions. The literature suggests that elderly breast cancer patients receive less intensive chemotherapy than younger patients, which is mainly attributed to a lack of effective individualized assessment or age bias.

Lymphoma-associated acquired von Willebrand syndrome responsive to splenectomy: A case report.

A previously healthy 33-year-old female presented with a large hematoma over her right knee after kneeling. She was found to have pancytopenia and massive splenomegaly. Von Willebrand Factor (VWF) antigen level was 0.

Prospective study of Na[F]F PET/CT for cancer staging in morbidly obese patients compared with [Tc]Tc-MDP whole-body planar, SPECT and SPECT/CT.

Purpose: This prospective study aims to assess the diagnostic test characteristics of Na[F]F PET/CT for the skeletal staging of cancer in morbidly obese patients compared with Tc-methylene diphosphonate (MDP), whole-body planar (WBS), SPECT, and SPECT/CT acquisitions.

Material And Methods: One hundred seventeen obese patients (BMI 46.5 ± 6.

Real-world Treatment Patterns and Outcomes in Stage III Non-small Cell Lung Cancer: Middle East and Africa - KINDLE Study.

Introduction: The Middle East and Africa (MEA)-KINDLE, as part of a real-world global study, evaluated treatment patterns and survival outcomes in stage III non-small cell lung cancer (NSCLC) in the MEA.

Materials And Methods: Retrospective data were analyzed from 33 centers for patients diagnosed between January 01, 2013, and December 31, 2017. Descriptive analyses included clinical-demographics and treatment patterns; inferential statistics evaluated an association of first-line treatment with progression-free survival (PFS) and overall survival (OS).

Therapy-induced bone changes in oncology imaging with F-sodium fluoride (NaF) PET-CT.

F-Sodium fluoride (F-NaF) is a PET tracer that is mostly used in the evaluation of bone metastasis in oncology cases. Recently, F-NaF PET/CT is gaining wide popularity owing to its higher sensitivity over the other conventional bone tracer with higher and rapid single-pass extraction, negligible plasma protein binding, rapid blood, and renal clearance. In the era of constant evolution of cancer therapy regimens, considerable bone health impact is seen in the form of avascular necrosis, insufficiency fractures, among others.

Nasopharyngeal cancer in non-endemic areas: Impact of treatment intensity within a large retrospective multicentre cohort.

Aim: Recommendations for managing patients with nasopharyngeal carcinoma (NPC) in non-endemic areas are largely derived from studies conducted in endemic areas. We analysed the impact of treatment approaches on survival in non-endemic areas.

Methods: In an international, multicentre, retrospective study, we analyse consecutive patients with NPC diagnosed between 2004 and 2017 in 36 hospitals from 11 countries.

National Diagnostic Reference Levels for Nuclear Medicine in Kuwait.

The diagnostic reference level (DRL) is a patient-exposure optimization tool used to evaluate and provide guidance for radiation doses in medical imaging. In the past few decades, there has been a global increase in the number of diagnostic imaging procedures, including nuclear medicine procedures, and consequently in patient radiation exposure. This increase has encouraged international and national health-care organizations to take action and keep up with such changes to meet the expectation of increasing use of ionizing radiation in medicine.

Update on imaging in chronic kidney disease-mineral and bone disorder: promising role of functional imaging.

Disorders of mineral metabolism and bone disease are common complications in chronic kidney disease (CKD) patients and are associated with increased morbidity and mortality. Bone biopsies, bone scintigraphy, biochemical markers, and plain films have been used to assess bone disorders and bone turnover. Of these, functional imaging is less invasive than bone/marrow sampling, more specific than serum markers and is therefore ideally placed to assess total skeletal metabolism.

Symptomatic Os Navicular on 99mTc-MDP SPECT/CT.

Os navicular bone is an accessory bone of the foot, which is mainly found on the medial side of the proximal navicular bone. Os navicular bone may be symptomatic and cause medial foot pain. We report a case of a 42-year-old athlete male having right foot pain diagnosed with os navicular syndrome on 99mTc-MDP bone scintigraphy SPECT/CT.

Assessment of eye doses to staff involved in interventional cardiology procedures in Kuwait.

In this study, which is the first of its kind in the gulf region, eye doses of interventional cardiologists and nurses were measured using active dosimeters for left and right eyes, in 60 percutaneous coronary interventions in three main hospitals in Kuwait. The dose given in terms of H(0.07) per procedure when ceiling suspended screens were used by main operators ranged from 18.

Thyroid Cancer Detected on 68Ga-PMSA PET/CT.

Ga-68 PSMA is a promising radiotracer for both staging and detection of biochemical recurrence in prostate cancer. PSMA is also expressed in the endothelium of tumour-associated neo vasculature of various solid malignancies possibly due to tumour-associated angiogenic factors and endothelial cell sprouting. We report a case of 72-yearold male with known prostate cancer on follow-up with mild increase in serum PSA level.

Ga-Prostate-Specific Membrane Antigen Uptake as a Surrogate Biomarker of Neovascularity in Hepatocellular Carcinoma.

Ga-prostate-specific membrane antigen (Ga-PSMA) is expressed in the endothelium of tumor-associated neovasculature of various solid malignancies possibly due to tumor-associated angiogenic factors and endothelial cell sprouting. We report a case of a 45-year-old man with known colorectal cancer, cirrhosis, and hepatitis C. Contrast-enhanced computed tomography (CT) showed a hypervascular lesion in the liver, and F- positron emission tomography (PET) did not show any suspicious hepatic uptake.

18F-FDG PET Uptake in the Scalp After Platelet-Rich Plasma Therapy.

18F-FDG PET/CT has been found useful for the detection of the source of infection/inflammation in the body. Platelet-rich plasma is a new treatment modality in which plasma is injected subdermally or intradermally for potential hair regrowth into the scalp. We report a case of 43-year-old woman with right breast cancer who underwent surgery, chemotherapy, and radiotherapy 2 years ago and is currently on hormonal therapy.