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Background: Acute kidney injury (AKI) following cardiac surgery is a well-described phenomenon, usually associated with hemodynamic changes ultimately leading to ischemic injury to the kidneys. In this study, we assessed the occurrence of AKI in a cohort of patients undergoing elective cardiac surgery at a single center., Methods: Patients undergoing elective cardiac surgery (coronary artery bypass grafting (CABG) and/or valve repair) between the years 2016 and 2022 were retrospectively included in the study., Results: During the study, 167 patients underwent CABG, valve replacement, or both procedures. The majority were male (85.0%). Post-operative AKI was observed in 27.5% of patients, with 2.4% requiring continuous renal replacement therapy (CRRT)/dialysis. The majority of AKI cases were staged as Kidney Disease: Improving Global Outcomes (KDIGO) stage 1. Among patients needing CRRT/dialysis, 1.8% recovered renal function within 3 months, with 0.6% experiencing 30-day mortality. In univariate analysis, factors associated with AKI included older age (P = 0.003), severe anemia (P < 0.0001), pre-operative creatinine elevation (P < 0.0001), complex surgeries (P < 0.0001), blood product transfusion (P < 0.0001), longer cross-clamp (XC) and cardiopulmonary bypass (CPB) times (P < 0.0001), and inotropes usage (P < 0.0001). Classical risk factors like diabetes mellitus (DM) and hypertension did not show significant differences. The majority of these factors (severe anemia, age, pre-operative creatinine, post-operative inotrope usage, and cross-clamp times) were consistently significant (P < 0.05) in logistic regression analysis., Conclusion: Post-operative AKI following cardiac surgery is frequent, with significant associations seen especially with pre-operative anemia. Future investigations focusing on the specific causes of anemia linked to AKI development are essential, considering the high prevalence of hemoglobinopathy traits in our population., Competing Interests: None to declare., (Copyright 2024, Mohrag et al.)

Cannabinoid hyperemesis syndrome (CHS) pathophysiology remains largely unknown, and it is often misdiagnosed. This paper identifies the clinical causes of CHS, outlines diagnostic and therapeutic approaches, and emphasizes early detection, comprehensive treatment, and timely intervention for improved patient outcomes. This case describes a 38-year-old male with a known history of cannabis use who experienced repeated episodes of intense vomiting, nausea, and abdominal pain consistent with symptoms of CHS. He was initially misdiagnosed with other gastrointestinal conditions despite the knowledge of marijuana ingestion. The diagnosis of CHS was initially missed; however, after further examination and consideration of his marijuana use, CHS was correctly identified. The patient's symptoms improved after the cessation of marijuana use. This case illustrates the diagnostic difficulties of cannabinoid hyperemesis syndrome (CHS) in cannabis users with significant gastrointestinal symptoms. The early detection and cessation of marijuana use are crucial for symptom management and resolution, emphasizing clinical awareness and personalized treatment., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. 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, Oraibi et al.)

Background: In developing and developed countries, the prevalence of overweight and obesity has grown. The college phase is a critical period during which healthy behaviors are learned through lifestyle and social environment. College students are prone to increased stress, negatively affecting their daily activities and academic performance., Objective: The general study objective was to investigate the prevalence of obesity among Jazan University students., Methods: This observational cross-sectional study used a pre-tested self-administered anonymous electronic questionnaire to evaluate the prevalence of obesity among 474 Jazan University students and its association with academic performance, physical activity, and social support. Data were analyzed using the Statistical Package for the Social Sciences, and associations between variables were assessed using the chi-square test., Results: Approximately 21% and 9.2% of the male and female students were obese, respectively, and the prevalence of obesity significantly differed between them. The use of one or more tobacco products was significantly associated with the prevalence of obesity (P < 0.001); the prevalence of obesity was substantially higher among the tobacco product users than among the non-users (35.3% vs. 14.4%). The presence of a morbidity was also significantly associated with the prevalence of obesity (P = 0.007); the prevalence of obesity was significantly higher among the students with at least one comorbidity than among the medically free students (28.8% vs. 14.9%). Conversely, obesity was not associated with academic performance and depression. Specifically, the grade point average was not affected across the academic years (P = 0.085 and P = 0.308, respectively)., Conclusion: Obesity is significantly associated with male sex and the use of one or more tobacco products. This finding warrants the need for strategic and multidisciplinary plans at all levels to encourage healthy behaviors among college students, including an active, healthy lifestyle., Competing Interests: None to decalre., (© 2024 Omar Oraibi, Mohammed Somaili, Khaled Daghriri, Mohammed Alameer, Mohamed Arishi , Ali Sahli, Atiah Najmi, Faisal Otaif, Hanadi Abueishah, Bassem Oraibi, Abdulhameed Alhazmi, Luai Alhazmi.)

Background: With evolving diabetes technology, continuous glucose monitoring (CGM) and time in range have been advanced as critical measurements to assess complications. They have shown improvement in A1C levels and decreased episodes of blood glucose extrusion., Aims: This study aimed to assess the awareness and utilization of blood glucose time in range and its effectiveness in reducing the risk of blood glucose extrusion and improving blood glucose metrics among patients with type 1 diabetes mellitus., Methods: A retrospective study included 342 patients who met the inclusion criteria and were using the CGM, aiming for a TIR of 70% daily. Glycemic control was followed using TIR data, blood glucose extrusion frequency (including hyperglycemia and hypoglycemia events), active sensor time, average blood glucose, and glucose management indicator (GMI) levels., Results: A total of 342 individuals participated in this study, the majority of whom were below 18 years of age (62.3%). The hypoglycemic frequency was significantly increased compared to the baseline, and most participants experienced hypoglycemia events (p = 0.0001). The incidences increased over time, with 90.9% and 93% having hypoglycemia at 60 and 90 days (p = 0.0001), respectively. The active scan and sensor time were not followed, which led to the blood glucose target not being achieved, with no improvement throughout the study. Consequently, no improvement occurred in glycemic control., Conclusion: CGM technology has been promising and proven effective in improving glycemic. However, our study did not show these benefits as expected, which could be explained by the underutilization and improper use of the CGM., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Impaired awareness of hypoglycemia (IAH) is related to a three- to sixfold increase in the risk of severe hypoglycemia in adults with type 1 diabetes mellitus (T1D). This study aimed to assess the prevalence of IAH and its risk factors and determine the frequency of hypoglycemic symptoms., Objective: This study aimed to assess the prevalence of IAH and its risk factors and determine the frequency of hypoglycemic symptoms., Methodology: A cross-sectional study was conducted among T1D patients attending Jazan Endocrine and Diabetes Center in Jazan province, Saudi Arabia. A total of 151 patients participated, using the interview-based Clarke questionnaire, a validated eight-item questionnaire to evaluate IAH. Scoring four or more answers as reduced awareness categorizes the participant as having IAH., Results: The prevalence of IAH was 25.2% among the T1D patients. IAH was significantly associated with body mass index (BMI; p = 0.034), occupation (p = 0.014), and blood glucose monitoring methods (p = 0.027). Shaking and sweating were the most commonly reported symptoms of hypoglycemia. A BMI of <25 kg/m 2 was higher linked to hunger and speech difficulty compared to a BMI of ≥25 kg/m2 (p < 0.05). Changing the insulin injection site was associated with confusion, odd behavior, and speech difficulty (p < 0.05). Monitoring blood glucose four times daily was associated with sweating, odd behavior, and incoordination (p = 0.024) compared to monitoring less than four times daily (p < 0.05). A hemoglobin A1c (HbA1c) reading of ≥7 was linked to odd behavior compared to an HbA1c reading of <7 (p = 0.032). Patients committed to insulin injections were more likely to experience palpitations than non-committed patients (p = 0.038). Each one-unit increase in age, monitoring blood glucose, and income was associated with a decrease in the odds of IAH (OR of Age = 0.89, 95% CI: 0.83-0.95) (OR of income = 0.10, 95% CI: 0.01-0.55). Moreover, individuals with a Body Mass Index (BMI) greater than or equal to 25 (OR = 2.99, 95% CI: 1.13-8.25), employed individuals (OR = 18.2, 95% CI: 3.75-105), and diabetes duration of more than ten years (OR = 3.96, 95% CI: 1.31- 13.2) exhibited an increase in the higher risk of IAH., Conclusion: IAH was prevalent among T1D patients attending Jazan Endocrine and Diabetes Center. The main associated factors included BMI, blood glucose monitoring method, and occupation. Future research should investigate the underlying causes of the observed associations and explore strategies to enhance the awareness of hypoglycemia., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)