Background Pheochromocytoma and paraganglioma (PPGLs) are rare, catecholamine-secreting tumors derived from chromaffin cells, which are diagnosed with paroxysmal or sustained hypertension. The disease can occur as sporadic or as part of a familial syndrome, which needs genetic testing, and is sometimes discovered as an adrenal incidentaloma. The definitive treatment is surgical removal of the tumor. Objective To assess the data of patients with PPGLs in the Faiha Specialized Diabetes Endocrine and Metabolism Center in Basrah, Iraq. Patients and methods A cross-sectional retrospective study involved Electronic Medical Records from 57 patients with PPGLs referred to Faiha Specialized Diabetes Endocrine and Metabolism Center between August 2017 and January 2025. Data analysis was conducted from January to May 2025. We assessed the patients’ general characteristics, biochemical, radiological, and histopathological features. Results This study found that the mean age of patients was 41.8 ± 17 years, with equal sex distribution (1: 1). About 40.4% were incidentally discovered, 57.9% by symptomatic screening, and 1.8% via family screening. Pheochromocytomas constitute 89.5% of PPGLs, and 10.5% are paragangliomas. A 10.5 and 70.2% of patients had ischemic heart disease and hypertension, respectively. Tumor size more than 4 cm in 79%. Biochemically, 25.5% of patients were positive for mild autonomous cortisol secretion. Syndromic features were reported in 15.8%. Metastases were found in 10.5% of tumor. Adrenalectomy with open surgery was performed in 90%, compared to about 10% with the laparoscopic approach. Among the histopathological data analyzed, only 10.5% had a Pheochromocytoma of the Adrenal Gland Scaled score more than or equal to 4. Conclusions A substantial proportion of patients with PPGLs in Basrah were incidentally diagnosed on imaging. Most tumors were large (>4 cm), and approximately one-quarter of patients had mild autonomous cortisol secretion. Open surgery was the predominant resection approach. This represents the first descriptive study of PPGLs in Iraq.
Background Prostate cancer is a leading malignancy in men, and multiparametric MRI (mpMRI), particularly dynamic contrast-enhanced (DCE)-MRI, plays a key role in identifying and characterizing lesions. While prostate imaging reporting and data system (PI-RADS) v2.1 standardizes mpMRI reporting, it relies mainly on T2W and diffusion-weighted imaging, assigning DCE-MRI a secondary, qualitative role. This study explores whether quantitative perfusion parameters from DCE-MRI can enhance lesion assessment and improve PI-RADS scoring. Results This study included 53 patients with 58 total lesions. PI-RADS alone demonstrated strong diagnostic performance with an area under the curve (AUC) of 0.978, achieving 100% sensitivity and 84.21% specificity. Ktrans exhibited the highest individual performance among DCE-MRI parameters (AUC = 0.964), while Kep and Ve had moderate accuracy (AUC = 0.850 and 0.795, respectively). The combination of Ktrans with PI-RADS achieved perfect classification (AUC = 1.000), with 100% sensitivity, specificity, and accuracy. Conclusion While PI-RADS alone demonstrated excellent diagnostic performance, combining Ktrans with PI-RADS significantly enhanced accuracy, particularly in resolving diagnostic uncertainty for PI-RADS category 3 lesions, suggesting their potential as reliable complementary diagnostic tools.
Background Adolescents face increasing social, emotional, and academic pressures, so it is important to know how common emotional and behavioral problems (EBPs) are and what factors put them at risk so we can support their mental health during this formative period. The study aimed to determine the prevalence of EBPs and to identify associated risk factors among intermediate and high school students in the southern region of Saudi Arabia. Patients and methods A cross-sectional study was conducted from September to December 2024 among 234 randomly selected intermediate and high school students aged 11–17 in Khamis Mushait, Saudi Arabia, in both public and private schools. Data were collected using a self-administered questionnaire that included demographic variables and the Arabic version of the Strengths and Difficulties Questionnaire. Results Among the 234 students (mean age 14.23 years), 60.3% were females, and 56.4% lived in urban areas. Most were Saudi nationals (95.7%) with no chronic conditions (97%) or prior psychological support (97.4%). EBPs were present in 40.6% of students, with peer problems being the most common (56.4%), followed by emotional/prosocial issues (18.4%), hyperactivity (15.8%), and conduct problems (15.4%). No significant associations were found between these problems and students’ age or sex, though higher rates were noted among older and female students. Conclusions In southern Saudi Arabia, over a third of students dealt with emotional and behavioral challenges, the majority of which were caused by their peers. No significant links were found between demographic characteristics and the concerns; however, there were higher frequencies among female learners and older students. The majority of pupils show signs of lacking prior psychological care, making it necessary to implement early intervention and comprehensive school-based mental health initiatives. It is recommended that further study be conducted to examine additional risk variables besides age and sex.
Introduction Texture analysis (TA) has developed as a significant tool for the study of medical images, especially those of lung cancer. In this study, we aimed to assess the diagnostic value of TA data extracted from intratumoral and peritumoral parenchyma in predicting mutational alteration, mediastinal lymph node involvement, and distant metastasis in lung adenocarcinomas. Patients and methods The study included pretreatment computed tomography images of 45 patients aged 18–99 years for whom mutational and clinical information were accessible. Images obtained using a 16-detector computed tomography device were segmented with the Olea Sphere software. Three types of segmentation were performed: intratumoral, rim, and peritumoral parenchyma. TA data were extracted from each segmentation and evaluated based on genetic alterations [e.g. anaplastic lymphoma kinase gene rearrangement, epidermal growth factor receptor (EGFR) mutation, and wild-type], distant metastasis, and mediastinal lymph node metastasis. Results Statistically significant relationships were found between TA data and genetic variations, distant metastasis, mediastinal lymph node metastasis, except for intratumoral texture parameters in EGFR mutated lesion. Logistic regression analysis was performed with three segmentation datasets, the statistical model’s estimated accuracy rates were measured to be 57.1% for anaplastic lymphoma kinase gene rearrangement, 76.9% for EGFR mutation, 100% for wild-type tumors, 97.1% for distant metastasis, and 96.9% for mediastinal lymph node metastasis. Conclusions Our results indicated the potential of predicting genetic alterations, distant metastasis, and mediastinal lymph node metastasis by evaluating intratumoral TA data together with TA data obtained from the peritumoral area.
Background Benign bone lesions are a heterogeneous group of conditions with variable biological behaviour. Although open curettage has been traditionally used for simple and aneurysmal bone cysts, it is associated with notable morbidity, while percutaneous techniques may limit adequate visualization. Endoscopic-assisted curettage has emerged as a minimally invasive alternative that combines reduced surgical morbidity with direct visualization for accurate lesion clearance. Objective The aim of the study was to assess the functional and radiological outcomes of endoscopically-assisted curettage of benign cystic bone lesions. Patients and methods This prospective study included 30 patients admitted to El-Hadra University Hospital with symptomatic contained intraosseous benign cystic bone lesions. All patients were treated surgically by endoscopically-assisted intralesional curettage. Patients were followed up for at least 1 year. Functional results were assessed using musculoskeletal tumor society (MSTS) scoring system and radiological healing was assessed using the Modified Neer Classification system after 1 year. Results A total of 29 (96.7%) patients had satisfactory MSTS scores and Modified Neer Classification outcomes, but one (3.3%) patient had an unsatisfactory score and radiological outcome with recurrent aneurysmal cyst. The mean MSTS score was 29.43 ± 1.61. Conclusion Endoscopic assisted curettage is a safe and effective minimally invasive option for treating benign cystic bone lesions in pediatric and adolescent patients, providing reliable radiological healing, excellent functional outcomes, and a low complication rate.
