The burden of diabetes mellitus (DM) is a major challenge worldwide. This health problem has drawn attention, especially in Saudi Arabia, which is expected to be among the top five countries in 2030. The socioeconomic changes in KSA in recent decades resulted in changes in eating habits and lifestyle patterns. Diet is a modifiable factor that can prevent or delay the incidence of T2DM. Therefore, the relationship between diet and DM is crucial to deliver recommendations. Treatment of DM can only be effective if adequate attention is given to appropriate nutrition. Therefore, the Saudi Diabetes Clinical Practice Guidelines (SDCPG) (2021) recommended developing a nutrition therapy plan for each patient to achieve the treatment goals registered nutritionists provide for all individuals with DM. That is why a panel of 6 experts, a Saudi task force, gathered to develop an explicit, evidence-based consensus for nutrition therapy for T2DM people. An initial concept proposal was obtained. The proposal was divided into several topics discussed in September 2022. A literature review was carried out. The literature search was completed in March 2023. A drafted report was distributed to the entire panel. Approval of the recommendations required consensus, defined as a majority approval (i.e., above 80%). The recommendations were revised to accommodate any differences of opinion until a consensus was reached. Recommendations were finally formulated in June 2023. Subsequently, the panel reviewed and discussed the supporting rationale of the revised recommendations. This article presents these practical recommendations.

Functional dyspepsia (FD), a commonly prevalent multifactorial disorder of gut-brain interaction (DGBI), is encountered and managed in family practice and gastroenterology clinics. The diagnosis is solely clinical based on Rome-IV criteria, excluding the organic, systemic, or metabolic causes. Management is often challenging ranging from lifestyle modifications, H-pylori eradication, H2-receptor antagonists, proton pump inhibitors, and prokinetics (1st-line) to antidepressants, and antipsychotics (2nd line) of therapy, once the patient shows no response to 1st line. In severe cases, refractory to 1st & the 2nd line of treatment needs a team approach and gut-brain behavioral therapy. Herein, we present a young female patient diagnosed with FD, managed well with 2nd-line treatment (Sulpiride), an atypical antipsychotic medication, as the patient's symptoms showed no improvement with first-line treatment.

Liver illnesses that run in families might start childhood with cholestatic jaundice and proceed to severe hepatic dysfunction. Although congenital cytomegalovirus (cCMV) infection can initially affect the liver in otherwise healthy hosts, chronic hepatitis is rare. We present an infant with cholestatic jaudnice evolving since birth and dysmorphic facies revealing alagille syndrome, the biological tests is revealing a biological cholestasis and a CMV serology positive. The patient was treated for 3 months.

Intestinal obstruction is one of the common causes’ emergency department visits, the prompt management of which is complicated by wide array of causes. Supra-vesical hernia has been reported to be a rare surgical cause of obstruction. Early diagnosis is often difficult and therefore can it has high chances of acute & emergent presentation. Prompt recognition of symptoms and evaluation are important to prevent poor prognosis. We are presenting a case of 62-year-old, medical free, male patient presenting to emergency department with clinical picture of abdominal obstruction. Based on the clinical examination and abdominal radiography, a provisional diagnosis of small bowel obstruction was made. CT scan confirmed the diagnosis with further specifying the extent of the hernial sac reaching up to the urinary bladder. The patient was managed successfully through exploratory laparotomy with no injury to the urinary bladder.

Background: The advent of online fast-food delivery applications has transformed the food industry, providing consumers with unprecedented convenience and choice in ordering their favourite meals, which can be attributed to advancements in technology and changing consumer preferences. Methodology: A cross-sectional, community-based study was conducted with an estimated minimum sample size of 385, targeting the adult Saudi population. A Self-administered, structured questionnaire was used for data collection. The quantitative data was collected through an online survey. Results: We found usage of online food delivery application to be 65% among our study population. The most common frequency pattern of online food delivery was observed to be 1-2 times per month reported by 19.7% respondents, followed by 2-4 times per week reported by 15.9%, while about 5.7% reported that they use online food delivery for 2-4 times per week. No statistically significant association was observed between usage online fast-food delivery and age, gender, educational level, employment status and marital status (p>0.05). Conclusions: We found widespread usage of online food delivery across different socio-demographic sub-groups.

Background: Myocardial infarction (MI) is a common emergency department (ED) and coronary care unit (CCU) presentation globally. The purpose of this investigation was to determine the prevalent pattern and clinical presentation of STEMI type among Sudanese patients in the state of Northern Kordofan (rural population). Methodology: This is a descriptive study conducted at Coronary Care Unit (CCU) at El-Obeid Teaching hospital in El-Obeid city, North Kordofan State, Sudan. The study included a full coverage of patients admitted with clinical diagnosis of STEMI, during the period from Nov 2018 to March 29, 2022. Besides initial presenting symptoms, the diagnosis and STEMI categorization based on the ECG findings. Results: Only 141 of the 174 patients admitted to our facility had comprehensive patient identification information. The majority of patients had an anterior presentation, followed by anteroseptal, inferior, anterolateral, septal, and inferolateral, with proportions of 46/141 (32.6%), 32/141 (22.7%), 29/141 (20.4%), 26/141 (18.4%), 7/141 (5.0%), and 1/141 (0.7%), respectively. Only 32/141 (22%) of the 141 individuals presented within 12 hours of their initial chest discomfort. Approximately 59 out of 141 (41.8%) patients presented themselves after 72 hours had passed. Streptokinase was administered to about 40 individuals, and 12 of them (30%) presented after 12 hours. Conclusion: STEM is prevalent in rural Sudan, with an increasing prevalence of anterior type. The majority of patients presented late in response to their initial chest discomfort, which can lead to unfavorable or poor outcomes. Health education regarding MI is considered essential in rural communities.

Background: Multidrug-resistant tuberculosis (MDR-TB) poses a significant global health threat, with treatment challenges linked to patient non-compliance. Education has been proposed as a potential strategy to improve adherence and reduce the risk of MDR-TB. This study aims to assess the impact of education on non-compliance and MDR-TB risk among patients receiving treatment at a specialized hospital. Objective: The primary objective of this retrospective cross-sectional study was to determine whether education provided to MDR-TB patients could reduce non-compliance rates and subsequently mitigate the risk of MDR-TB. Methods: The study included 50 MDR-TB patients who had received at least three months of treatment. Data were collected from the MDR-TB wards at the National Institute of Disease of the Chest and Hospital in Dhaka, spanning from October 2011 to March 2012. Patient education interventions focused on treatment adherence and MDR-TB prevention. Results: The study's findings demonstrate a substantial decrease in non-compliance rates Among MDR-TB patients, 64% had a history of non-compliance, with 72% being male and primarily having lower educational backgrounds. Conversely, 70% of drug-compliant patients had attained at least a secondary education level. Educational interventions led to a significant 20% reduction in non-compliance, from an initial 28% to a final 8%, emphasizing their potential to reduce MDR-TB risk. Conclusion: This study demonstrates the positive impact of education on reducing non-compliance among MDR-TB patients. A 20% reduction in non-compliance rates indicates that educational interventions can effectively contribute to decreasing the risk of MDR-TB. Future efforts should prioritize integrating education into MDR-TB treatment programs to enhance patient adherence and reduce the burden of MDR-TB.

Background: Numerous malignancies, both benign and malignant is hosted by the sinonasal cavity that poses a diagnostic and therapeutic challenge to otolaryngologist and pathologists. One of the extremely rare neoplasm of the sinonasal cavity is secretory carcinoma (SC), previously called, mammary analogue secretory carcinoma (MASC). Majority of MASCs are localized to the parotid and salivary glands however, it is rarely documented in the sinonasal tract. Herein, we review the reported cases and report a twenty-one-year-old female patient presented to our ear, nose & throat outpatient department of tertiary care center as a polyp in the nasal cavity initially, which was excised on first diagnoses with normal histopathology (H/P). However, a year later she has a recurrence with an invasive course, followed by surgical exploration and confirmed as “Secretory Carcinoma” (SC) on histopathology, immunohistochemistry & genetic confirmation. At two-years follow-up, the patient has no clinical and radiological signs of recurrence. Aim: this review aims to outline the demographic, clinicopathologic, and confirmatory (radiologic, histopathologic, and immunohistochemistry) findings of the published cases. Methods: PubMed, Google Scholar, and MEDLINE search done with search words such as, secretary carcinoma, sinonasal tract, mammary analogue secretary carcinoma. Results: Total eight case including our case included in this review. The male/female ratio of occurrence of the SC of the sinonasal cavity was 3:5 (34.5:62.5%). Majority of the cases (7/8) reported in middle and old age group except one as reported in a 12 years old child. Equal case distribution among smoker ad non-smoker patients. The common symptoms were nasal obstruction, nasopharyngeal secretions, presence of mass, epistaxis and hyposmia. All cases were characterized by the presence of the ETV6-NTRK3 fusion transcript and / or rearrangement of ETV6 gene. Surgical excision with chemo/radiotherapy was the management considered in majority of the cases with good outcome. Almost all eight cases (100%) has no signs of recurrence both clinical and radiologically at a mean follow-up period of one year. Conclusion: Secretary carcinoma of the sinonasal tract is a new entity. More cases / studies are required to know the demographic, clinicopathologic nature, & prognosis of this newly emerging carcinoma.