Background and Objectives: Diabetes mellitus is a prevalent chronic disease caused by inadequate insulin secretion or ineffective insulin response, leading to complications such as retinopathy, nephropathy, heart attacks, and strokes. Recently, “diabetes distress (DD)” has emerged as a concept, highlighting the significant emotional burden of managing diabetes, which can impact disease outcomes. Thus, this study evaluates the impact of virtual clinics on diabetes distress and glycemic measures in individuals with diabetes mellitus. Materials and Methods: A cross-sectional study was conducted between May and August 2024 at the Endocrine and Diabetes Center in Alahsa, Saudi Arabia, targeting persons aged 18 and older with diabetes who had engaged in-person clinics, virtual clinics, or both between 2019 and 2024. Data were collected through structured phone interviews, supplemented by laboratory results from clinical records. The survey included demographic details, diabetes information, and the Diabetes Distress Scale. Statistical analyses, including descriptive statistics, were performed to explore the relationships between diabetes distress, clinic visit type, and glycemic control, with Mann–Whitney and Chi-Squared tests used to compare variables between two groups. Results: Of the 108 participants, 55.6% were male, with a mean age of 38.5 years. Type 2 diabetes was reported in 51.9% of individuals, while 48.1% had type 1. High emotional burden (44.4%) and regimen-related distress (28.7%) were prevalent, particularly among individuals with suboptimal glycemic control. While virtual visits were not significantly correlated with lower distress levels, individuals with suboptimal glycemic control exhibited significantly higher diabetes distress across various domains, including emotional and regimen-related distress (p < 0.05). Laboratory analysis showed a median HbA1c of 8.2%, with poor control associated with greater distress. Conclusions: Diabetic individuals with suboptimal glycemic control report higher diabetes distress levels, underscoring the need for integrated psychological support in DM care. Although virtual clinic visits did not significantly reduce distress, they provide a feasible option for individual follow-up.

Introduction: Interstitial ectopic pregnancy is a rare and potentially life‐threatening condition that occurs when a fertilized ovum implants in the interstitial (intramural) portion of the fallopian tube within the myometrium. It accounts for 2%–4% of all ectopic pregnancies and poses significant risks due to the potential for rupture and severe hemorrhage. Case Presentation: We report the case of a 34‐year‐old woman, gravida 5 para 3 + 1, living 4, who presented with right iliac fossa pain at 5 weeks of gestation. Ultrasonography and elevated β ‐hCG levels revealed a suspicious interstitial ectopic pregnancy. Initial treatment with systemic methotrexate was administered; however, due to plateauing β ‐hCG levels, a second dose of methotrexate was given via direct injection into the ectopic site. Follow‐up monitoring demonstrated a significant reduction in β ‐hCG levels, resulting in the successful resolution of the ectopic pregnancy. Conclusion: This case highlights the successful treatment of interstitial ectopic pregnancy with local methotrexate injection, emphasizing the importance of early diagnosis and timely intervention. Future studies with larger sample sizes and standardized treatment criteria are recommended.

Background and Clinical Significance: Scaphoid fractures and nonunion are uncommon in skeletally immature patients. Pediatric nonunion most often follows a missed or delayed diagnosis or failure of conservative treatment. Inferior-pole nonunion is particularly uncommon, and evidence guiding graft selection in children is limited. We report a case in which preoperative and intraoperative assessment of fragment viability supported the use of a non-vascularized graft. Case presentation: A 12-year-old boy sustained a right inferior-pole scaphoid fracture after falling onto an outstretched hand. The fracture was missed at the initial emergency-department visit. Thumb-spica immobilization was subsequently prescribed, but the patient repeatedly removed the cast, missed appointments, and was lost to follow-up. At referral six months after injury, radiographs and multiplanar CT demonstrated established inferior-pole nonunion. MRI showed preserved marrow fat signal in both fragments without osteonecrosis. Open reduction and internal fixation were performed through a dorsal approach using a 2.4 mm headless compression screw and approximately 1 cc of cancellous iliac-crest autograft. Intraoperatively, both fragments appeared viable, without cystic or sclerotic change. At two months, the patient was pain-free and radiographs showed progressing union. The Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score improved from 25 preoperatively to 10 at two months. CT at six months confirmed complete osseous union, with a QuickDASH score of 0. At 1.5 years, he remained pain-free, had full flexion with a 5° terminal extension lag, and had returned to table tennis without functional limitation. Conclusions: In this inferior-pole scaphoid nonunion, open reduction and internal fixation with iliac-crest cancellous autograft achieved CT-confirmed union and sustained functional recovery. MRI and intraoperative confirmation of viable bone supported selection of a non-vascularized graft. At 1.5 years, the patient was pain-free, had returned to sport without functional limitation, and had a QuickDASH score of 0.