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Background Prediabetes refers to a clinical condition in which blood glucose levels are elevated but do not meet the threshold for diabetes. Prediabetes is now thought to be reversible; lifestyle changes and other interventions can be successfully implemented during the prediabetes phase to avoid the development of type 2 diabetes. This study aims to improve health outcomes among Saudi community members who are at risk of developing prediabetes by assessing their knowledge, attitudes, practices, and barriers using a validated prediabetes questionnaire. Methods This study employed a cross-sectional design across various regions of Saudi Arabia. It included patients who were all non-diabetic Saudi adults over 18 years old and visited outpatient clinics. Structured questionnaires, which included participants' demographic information, knowledge, attitudes, practices, and barriers related to prediabetes, were employed. The collected data were analyzed using Statistical Product and Service Solutions (SPSS; IBM SPSS Statistics for Windows, Armonk, NY) software program. Results Data from 641 patients were collected in this survey. The respondents were predominantly female (330, 51.5%), with the mean ± SD of age being 36.3 ± 12.3. The participant knowledge levels of prediabetes were found to be good (399, 62.2%), moderate (193, 30.1%), and poor (49, 7.6%). The knowledge scores were significantly associated with age (P = 0.027), educational level (P < 0.001), education in the medical field (P = 0.019), and monthly family income (P = 0.009). The overall attitude of the participants toward prediabetes was generally positive (468, 73%). The practices related to diet and lifestyle among the participants were generally poor (538, 84%). Some participants did not take blood sugar tests because they were not available (121, 18.9%), lacked time (179, 27.9%), and were afraid of learning the test results (130, 20.3%). Conclusion The study found that, despite possessing an adequate level of knowledge and positive attitudes, Saudi patients poorly practice prevention methods for prediabetes. It highlights the need for targeted interventions to improve prediabetes awareness, promote healthier lifestyles, and address screening barriers. Prioritizing evidence-based strategies that cater to diverse demographic needs can prevent the progression of type 2 diabetes and enhance public health. The findings emphasize the importance of health education in Saudi Arabia and suggest that future research should focus on overcoming barriers, such as management complexity, diagnosis apprehension, and time constraints for check-ups., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. King Fahad Hospital-Hofuf issued approval 64-EP-2023. To allow admission to all hospitals, further ethical approval was obtained from King Fahad Hospital-Hofuf (64-EP-2023). Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Alsalman et al.)

Background Patients with subclinical hypothyroidism (SCH) have a high serum concentration of thyroid-stimulating hormone (TSH), whereas their serum-free thyroxine concentrations are normal. Lipid metabolism is regulated in large part by thyroid hormones. It could be connected to a changed lipid profile. This study aimed to evaluate the relationship between SCH and alterations in the lipid profile. Methodology Data from 99 patients with SCH and 109 euthyroid cases were collected from King Abdulaziz Medical City, Jeddah, Saudi Arabia, from 2016 to 2022. Patients older than 18 years were included in the study. The groups were matched in terms of gender, age, and body mass index. SCH was defined as a TSH value of 4.5 to 10 mIU/L, and normal T4 as 5 to 18 μg/dL. Control cases had a normal TSH ranging from 0.45 to 4.5 mIU/L. The total serum cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride (TG) levels in both groups were examined and the results were recorded. Results In comparison to the control group, SCH patients had greater median glycated hemoglobin (HbA1C) (p = 0.001) and lower median vitamin D levels (p = 0.004) before therapy. Before therapy, SCH patients also showed considerably lower HDL levels and significantly higher LDL and TG levels (p < 0.001). Conclusions There is a substantial correlation between SCH and reduced HDL and vitamin D levels. It was linked to increased TG, LDL, and HbA1c levels. Only vitamin D and LDL were pathologically high. Treatment with levothyroxine raised total and LDL cholesterol levels. Future research should look into the affordability of treating SCH., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Review Board, King Abdullah International Medical Research Center issued approval NRJ23J/228/09. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Alzahrani et al.)

Background: Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy. It may be attributed to certain placental hormones during pregnancy which render insulin less effective. Our study aimed to focus on the levels of insulin in gestational diabetic women in the Kingdom of Bahrain as compared with non-diabetic pregnant women. Furthermore, we studied the correlation between insulin levels by ethnicity and age of the pregnant women.  Methods: A cross-sectional study was conducted on 75 pregnant participants: 41 with GDM (test group) and 34 without GDM (control group). Insulin levels were determined in patients with GDM and compared to non-diabetic pregnant women. A comparison between Bahraini and non-Bahraini women was carried out in two different age groups: below and above 30 years of age. P values < 0.05 were considered significant., Results: The results showed higher mean values of fasting blood glucose (FBG), random blood glucose (RBG), and insulin levels in the test group when compared to the control group. There was no significant difference in FBG, RBG, and insulin levels among Bahraini women with GDM and non-Bahraini women (Indian, Pakistani. Bengali, and Filipino) with GDM. Age, less than 30 vs more than 30 years, had no significant effect on women with GDM., Conclusion: Insulin levels were higher in pregnant women with GDM irrespective of their ethnicity or age. The lack of blood glucose control in GDM even in the presence of high insulin secretion may suggest loss of insulin effectiveness due to other factors such as stress and lactogenic placental hormones., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Research and Ethics Committee at the College of Medicine and Medical Sciences, Arabian Gulf University, Kingdom of Bahrain issued approval E1-P1-10-22. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, AlShaibani et al.)

Recent studies suggest a role for anthocyanins in the treatment of non-alcoholic fatty liver disease (NAFLD). The purpose of the present review was to assess the effect of anthocyanins as an adjuvant treatment in patients with NAFLD. The literature search was conducted on MEDLINE/PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), the Web of Science, and Scopus without language or time limits up to March 27, 2024. The primary outcomes included the severity of liver fibrosis and the level of liver transaminases. Secondary outcomes included obesity and lipid profile assessments. Standardized mean differences (SMDs) with 95% CIs were calculated for numerical outcomes. Five studies were included. The pooled effect sizes showed lower levels of liver fibrosis and liver transaminases in the anthocyanin group, but the difference was nonsignificant and small in size. The same result was obtained with anthropometric measurements of total cholesterol, low-density lipoprotein, and serum triglycerides, where effect sizes ranged from negligible to medium in magnitude but were all nonsignificant. The anthocyanin group showed a significantly lower body fat percentage (SMD = -0.41 (95%CI: -0.76; -0.06), P = 0.021). Currently, no evidence is available on the efficacy of anthocyanins in improving liver fibrosis or dyslipidemia in patients with NAFLD. There is limited evidence that anthocyanins can lower body fat percentages, but the effect was not reflected in the pooled results of other obesity indices. The few available clinical trials showed several limitations and variations regarding the doses of anthocyanins. Future clinical trials should avoid the limitations of the current studies and provide evidence supporting or refuting the use of anthocyanins in NAFLD patients., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Khan et al.)

Applying extracts from plants is considered a safe approach in biomedicine and bio-nanotechnology. The present report is considered the first study that evaluated the seeds of Lasiurus scindicus and Panicum turgidum as biogenic agents in the synthesis of silver nanoparticles (AgNPs) which had bioactivity against cancer cells and bacteria. Assessment of NPs activity against varied cell lines (colorectal cancer HCT116 and breast cancer MDA MBA 231 and MCF 10A used as control) was performed beside the antibacterial efficiency. Different techniques (DLS, TEM, EDX and FTIR) were applied to characterize the biosynthesized AgNPs. The phytochemicals from both L. scindicus and Panicum turgidum were identified by GC-MS analysis. Spherical monodisperse NPs at average diameters of 149.6 and 100.4 nm were obtained from seed extract of L. scindicus (L-AgNPs) and P. turgidum, (P-AgNPs) respectively. A strong absorption peak at 3 keV is observed by the EDX spectrum in the tested NPs. Our study provided effective NPs in mitigating the tested cell lines and the lowest IC 50 were 7.8 and 10.30 for MDA MB231 treated by L-AgNPs and P-AgNPs, respectively. Both fabricated NPs might differentially target the MDA MB231 cells compared to HCT116 and MCF10A. Ultrastructural changes and damage for the NPs-treated MDA MB231 cells were studied using TEM and LSM analysis. Antibacterial activity was also observed. About 200 compounds were identified in L. scindicus and P. turgidum by GC-MS analysis might be responsible for the NPs reduction and capping abilities. Efficient NPs against cancer cells and microbes were obtained, however large-scale screening is needed to validate our findings., (© 2024. The Author(s).)

Soybean is an important oilseed crop worldwide; however, it has a high sensitivity to temperature variation, particularly at the vegetative stage to the pod-filling stage. Temperature change affects physiochemical and genetic traits regulating the soybean agronomic yield. In this regard, the current study aimed to comparatively evaluate the effects of varying regimes of day and night temperatures (T1 = 20°C/12°C, T2 = 25°C/17°C, T3 = 30°C/22°C, T4 = 35°C/27°C, and T5 = 40°C/32°C) on physiological (chlorophyll, photosynthesis, stomatal conductance, transpiration, and membrane damage) biochemical (proline and antioxidant enzymes), genetic ( GmDNJ1 , GmDREB1G;1 , GmHSF-34 , GmPYL21 , GmPIF4b , GmPIP1;6 , GmGBP1 , GmHsp90A2 , GmTIP2;6 , and GmEF8 ), and agronomic traits (pods per plant, seeds per plant, pod weight per plant, and seed yield per plant) of soybean cultivars (Swat-84 and NARC-1). The experiment was performed in soil plant atmosphere research (SPAR) units using two factorial arrangements with cultivars as one factor and temperature treatments as another factor. A significant increase in physiological, biochemical, and agronomic traits with increased gene expression was observed in both soybean cultivars at T4 (35°C/27°C) as compared to below and above regimes of temperatures. Additionally, it was established by correlation, principal component analysis (PCA), and heatmap analysis that the nature of soybean cultivars and the type of temperature treatments have a significant impact on the paired association of agronomic and biochemical traits, which in turn affects agronomic productivity. Furthermore, at corresponding temperature regimes, the expression of the genes matched the expression of physiochemical traits. The current study has demonstrated through extensive physiochemical, genetic, and biochemical analyses that the ideal day and night temperature for soybeans is T4 (35°C/27°C), with a small variation having a significant impact on productivity from the vegetative stage to the grain-filling stage., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Ding, Alghabari, Rauf, Zhao, Javed, Alshamrani, Ghazy, Al-Doss, Khalid, Yang and Shah.)