Background: Late diagnosis of type 2 diabetes mellitus causes preventable complications and higher morbidity. Obesity, inactivity, poor diet, and smoking increase the risk of diabetes; however, their relationship with undiagnosed diseases in middle-aged adults requires further clarification. Methods: Between January and June 2024, we enrolled 200 adults aged 35–45 years from outpatient clinics. The staff measured the height, weight, and body mass index of each participant. Participants completed the International Physical Activity Questionnaire and Mediterranean Diet Adherence Screener and reported their smoking histories. After overnight fasting, we measured the fasting blood glucose and HbA1c levels. Undiagnosed diabetes was defined according to the 2024 American Diabetes Association criteria (FBG ≥ 126 mg/dL or HbA1c ≥ 6.5%) in patients without a prior diagnosis. Statistical analyses included independent t -tests, chi-square tests, and multivariable logistic regression. Results: Undiagnosed diabetes was found in 29 participants (14.5, 95% CI 9.8–19.2). Those with undiagnosed diabetes had a higher body mass index (30.6 ± 2.6 vs. 27.6 ± 3.4 kg/m ² , p < 0.001), lower physical activity prevalence (10.3% vs. 21.6%, p < 0.018), and higher smoking rates (48.3% vs. 26.3%, p < 0.024). After adjusting for physical activity, smoking, and diet quality, body mass index remained independently associated with undiagnosed diabetes (OR 1.36 per kg/m ² , 95% CI 1.16–1.70, p < 0.001). Physical activity level (OR 1.54 per category decrease, 95% CI 1.30–1.92, p < 0.024) and smoking (OR 1.33, 95% CI 1.13–1.66, p < 0.005) were also independently associated with undiagnosed status. Model discrimination was good (area under the curve 0.74, 95% CI 0.67–0.81), with a 93.3% negative predictive value. Conclusion: Approximately one in seven middle-aged adults in outpatient settings has undiagnosed type 2 diabetes. A higher body mass index, lower physical activity, and smoking were independently associated with an undiagnosed status. These readily assessable socio-behavioral factors should inform screening strategies and risk assessments in primary care.

Background/Objectives: Sodium–glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) have shown blood pressure (BP) reduction in type 2 diabetes (T2D). However, head-to-head comparisons in hypertensive patients remain limited. This study assessed the effects of SGLT2i and GLP-1RA on systolic BP (SBP), diastolic BP (DBP), antihypertensive regimen modifications, and adverse events in Saudi patients with both conditions. Methods: A retrospective cohort study was conducted between January 2022 and April 2024 using records from two hospitals. Adults with T2D and hypertension who initiated SGLT2i or GLP-1RA and had ≥2 BP readings were included. BP changes were analyzed with ANOVA; adverse events and treatment discontinuation were assessed with Chi-square and Kaplan–Meier analysis. Results: Of 505 patients, 291 (57.6%) received SGLT2i and 214 received GLP-1RA. Both classes significantly reduced SBP (p < 0.001), and DBP decreased significantly only in the SGLT2i group (p < 0.001). Antihypertensive regimen reduction occurred in 6.9% of patients, most commonly among SGLT2i users (74.3%), while 76.8% remained on the same regimen; the remaining patients had other modifications such as dosage adjustments or changes in individual agents. Adverse events occurred in 6.3% of patients with no group differences. Therapy discontinuation was higher with GLP-1RA (12.6%) versus SGLT2i (2.4%, p < 0.001). Conclusions: Both SGLT2i and GLP-1RA might be considered in patients with T2D and hypertension, with SGLT2i potentially offering additional benefits for DBP reduction and simplifying antihypertensive regimens, which could support clinical decision-making in real-world practice.

Introduction: Pediatric delirium, a neuropsychiatric disorder, affects up to 66% of critically ill children, disrupting cerebral functioning. Often misdiagnosed or confused with other conditions, delirium remains a challenge in pediatric care. This study aims to evaluate the awareness, practices, and management strategies for pediatric delirium in Saudi Arabia among healthcare professionals working in pediatric intensive care units (PICUs). Method: A cross-sectional study was undertaken to assess pediatric delirium awareness and management among physicians practicing in PICUs across various healthcare facilities in Saudi Arabia. The study spanned from December 2023 to February 2024 and included physicians with expertise in pediatric delirium. Utilizing a validated tool, data analysis was performed using SPSS version 24®. Statistical analyses included chi-square and Fisher exact tests for categorical variables with two groups, and One-Way ANOVA for those with more than two groups. A p-value of less than 0.05 was deemed statistically significant. Results: Ninety-eight participants responded to the emailed questionnaire (response rate: 61.25%). Most were PICU consultants (53.1%) working in government hospitals (85.7%). Uncertainty prevailed regarding delirium prevalence in their units were (53.1%), with hyperactive delirium being the most reported type (31.6%). Preventive measures included maintaining a normal sleep-wake cycle (85.7%), modifying contributing factors (75.5%), and optimizing sedation goals (75.5%). The Cornell Assessment of Pediatric Delirium (CAP-D) was the primary assessment tool. Supportive treatment (60.2%), non-pharmacological interventions (58.2%), and benzodiazepines (41.8%) were common preventive measures. A statistically significant associations were found between professional qualification and recognizing delirium-mistaken conditions (p-value=0.001). PICUs with at least one consultant (p-value=0.023) and a nurse-to-patient ratio of 1:1 (p-value= <0.001) had significantly higher awareness, while single-patient rooms showed greater awareness compared to multiple-patient occupancy settings (p-value= 0.009) among healthcare professionals. Conclusion: The study identified inadequate knowledge for delirium and assessment in PICUs, it underscores the importance of enhancing the knowledge of consultants working in these units. Keeping in mind the side effects of pharmacological interventions, the modifiable factors and non-pharmacological management should be encouraged for achieving an optimal outcome of pediatric delirium.

Background: Post-COVID syndrome, defined by the WHO as persistent multisystem symptoms extending beyond 4 weeks post-infection, has emerged as a critical public health concern in South Asia, a region home to approximately 1. 9 billion individuals across Pakistan, India and Bangladesh. Despite the disproportionate burden affecting an estimated 54.3 million individuals in this region, no prior systematic synthesis has integrated evidence across all three major South Asian countries, creating a significant gap in the evidence-based policy development. Methods: This systematic narrative review, conducted following the PRISMA-ScR guidelines, synthesized evidence from 388 peer-reviewed publications identified through PubMed, Scopus, and Google Scholar databases (January 2020–December 2023). Study quality was assessed using the JBI Critical Appraisal Checklist and the GRADE framework. Two independent reviewers performed the screening (inter-rater reliability: 87.3%) and data extraction (concordance: 94.1%). Results: The prevalence of post-COVID syndrome varied geographically: 15.8%−18.3% in Pakistan, 9.4%−22.5% to 11.2%−16.8% in India, Females consistently demonstrated higher prevalence across all countries, with ratios ranging from 1.41:1 to 1.81:1. The peak burden occurred in the 35–54 age group. Urban areas reported a higher prevalence than rural areas, with disparities correlating with healthcare infrastructure metrics. Fatigue (58.3%), brain fog (52.1%), and memory problems (48.7%) were the most prevalent symptoms. The prevalence declined across successive pandemic waves, with vaccination associated with substantial reductions in later waves. Conclusion: Post-COVID syndrome poses a substantial and ongoing public health challenge in South Asia, disproportionately affecting women and adults of working age. Urban-rural disparities in prevalence reflect underlying healthcare access inequities rather than true epidemiological differences. Urgent priorities include establishing dedicated post-COVID clinics, strengthening rehabilitation infrastructure, and conducting region-specific genetic and long-term outcome research to inform evidence-based interventions for this vulnerable population.

As a form of active learning, educational campaigns enhance student engagement, critical thinking, and professionalism. However, their impact on knowledge

Atrial fibrillation (AF) affects about 1 to 2% of the general population and increases the risk of ischaemic stroke by 5-fold. Non-valvular atrial fibrillation (NVAF), the most common form of AF, i...