This is the first issue this year which is rich with papers that are relevant to primary healthcare. Almalki.et al., followed a cross-sectional study among school teachers in Al-Kharj City, Saudi Arabia, to assess the knowledge and attitude toward epilepsy and seizure first aid among school teachers in Al-Kharj City, Saudi Arabia. In total, 500 school teachers were included in this study. The authors concluded that despite adequate knowledge and attitude demonstrated by the school teachers, nearly half of them showed a lack of understanding about epilepsy and seizure first aid. More education and training are required among school teachers to narrow the gaps in their knowledge about epilepsy and seizure management.

Moussa, et al., did a cross sectional study using A structured questionnaire-based study (DSMQ,) and the hospital electronic medical records system to collect sociodemographic and clinical information. among diabetic patients registered in 3 primary health care clinics in Qatar. With a convenience sample of 400 patients with diabetes. The aim of this study was to explore the status of diabetes self-management (DSM) among patient with diabetes in Qatar and its relationship with glycemic control and other demographic variables. Mean age of participants was 54.36±11.58 years and mean duration of diabetes was 10.53±7.47years. Nearly one third of the patients used insulin and the majority used oral hypoglycemic. The results of this study revealed that good adherence to diabetes self-management was reported among 52.8% of adult diabetic patients while the inadequate cases where around 47.3 % which demonstrated lack of diabetes self-management and subsequently at increased risk of complications. The authors concluded that results indicated that around 47 % of diabetic patients in Qatar do not perform Diabetes self-management (DSM) consistently.

Alotaibi, et al., did an online cross-sectional study of patients with cutaneous hyperpigmentation was conducted in Saudi Arabia. Data were collected by questionnaire-based survey, which was designed by the researcher after a thorough literature review. The aim was to assess the sun protection practices in Saudi Arabia among patients with cutaneous hyperpigmentation. A total of 418 people took part in this study. Approximately 47.0% of sunscreen users reported using sunscreen with a UV protection factor of 21-50. Almost one-third (35.0%) of the patients reported not reapplying sunscreen during the day. The authors concluded that Saudi hyperpigmentation patients use sunscreen inadequately. Males used sunscreen less than females. Healthcare authorities should conduct an educational campaign to inform this group of patients about their condition and the necessity of sunscreen.

Mohialdeen Rahman, et al., looked at the role of MRI CSF flowmetry in the evaluation of patients with suspected hydrocephalus was undertaken by conducting a systematic literature review. The current review was reported as required reporting features for systematic reviews and meta-analysis statements (PRISMA). The authors concluded that the condition of hydrocephalus makes the ventricular size increase and eventually puts pressure on the brain due to excess accumulation of fluid while blocking the CSF flow after it exits ventricles. Currently, many imaging techniques are available for the detection of hydrocephalus that studies the CSF flow dynamics and its related parameters. Among them, the MRI technique is the most reliable, rapid, and most importantly, a non-invasive method for the quantitative measurement of CSF flow rate and intracranial pulsations.

Alsharif , did a retrospective study was done in a hospital on 81 patients randomly selected in a population of over 688,693 were included. Data was collected from patients' ?les, laboratory results data, and echocardiographic results. The aim was to determine trends in rheumatic heart disease in the western region of Saudi Arabia in one decade. The authors concluded that mitral regurgitation (33.3%) and mitral stenosis (33.3%) were echocardiographic fi ndings accounting for more than half of cases. The most common reported signs of rheumatic heart disease were murmur and atrial fibrillation which goes with international study findings. We recommend to raising the level of public awareness about rheumatic heart disease is required in order to lower the incidence of the disease.

Helvaci MR et al advised that recurrent upper abdominal discomfort may be the cause of nearly half of the applications to the Internal Medicine Clinics, and irritable bowel syndrome (IBS) and chronic gastritis (CG) may be the most commonly diagnosed disorders in such cases. The study included 936 patients with the IBS (592 females) and 346 control cases, totally. They found that FPG and triglycerides are well-known acute phase reactants in the body, IBS and CG may be low-grade inflammatory processes initiated with anxiety, depression, infection, inflammation, trauma, and cancer fear-like stresses of the body, and eventually terminate with smoking, antidepressants use, hemorrhoids, and urolithiasis. Because of the highly significant association of the IBS and CG, they may actually be the two sides of the same paper, and should be called as the irritable gastrointestinal syndrome.

Bin Abdulrahman, et al., did a cross-sectional, and participants completed an online self-administered questionnaire on sleeve gastrectomy in Riyadh to measure the awareness of the indications and complications of sleeve gastrectomy. The total number of respondents assigned is 1700. Among these individuals, women outnumbered males with a percentage of (67.4%) versus (23.6%). The authors concluded that according to their findings, the study population is moderately aware of the indications and complications. However, to ensure that our community has a significant level of knowledge about complications, we must raise social awareness about the indications and complications of sleeve gastrectomy.

Al-Shahrani, et al., conducted a cross-sectional study in primary health centers using a self-report questionnaire from PHC physicians. Challenges in providing health services for type 2 diabetes were assessed. Two hundred and twenty-two primary care physicians participated in the study. Half of them, 114 (51%), had adequate confidentiality in treating patients with COVID-19. The majority of participating physicians (216; 97.3%) faced challenges in managing diabetic patients during the COVID-19 pandemic (p-value ? 0.05). The authors concluded that most PHC physicians face challenges in managing patients with diabetes mellitus who have COVID-19. Decision makers should increase preparedness for future emergencies to address the significant challenges identified.

Bin Abdulrahman, et al., conducted a cross-sectional study over six months on medical students. Data was collected by using an online self-reported questionnaire. The aim was to assess the prevalence of medical students' syndrome and measure the impact of the syndrome on the GPA among medical students in Riyadh, Saudi Arabia. Four hundred thirteen (413) medical students completed the study questionnaire. According to the Medical students' disease distress scale (MSD-5), 88.9 % of the students had at least one mental disorder. Anxiety was the major mental disorder found in 83.9 % of the medical students, followed by depression (73.6 %). The authors concluded that medical students are more vulnerable to mental conditions like medical students' syndrome, which has negatively impacted their academic achievement. Since students face stress and pressure in their college life, medical students' mental and psychological health should be the top priority to overcome and prevent the occurrence of MSS among students.

Bin Abdulrahman, et al., did a cross-sectional, online survey, looking at the impact of online learning on the psychological state of medical students at Imam Mohammad Ibn Saud Islamic University (IMSIU). Out of 400 participated in the study, 317 (79%) completed the survey; the majority were male (64.7%). The mental state was worsened in 143 (46.5%) students. At the same time, 77 (25%) were psychologically improved. However, 97 (32%) students did not notice any change in their mental health. The results show an effect on the mental state of the medical students during the quarantine of COVID-19.

Alhazmi, et al., did a cross-sectional study of either parent of ASD child aged 1 to 14 years following up at the OPD setting. The aim was to assess the factors influencing the quality of life differences between families caring for a child with Autistic Spectrum disorder diagnosis.
Marital status, housing settings, total household income, current employment, being part of support groups and associated illness in the ASD child were significantly impacting at least one domain of WHOQOL-BREF. The authors concluded that Modifiable factors that have the ability to elevate the quality of life for parents of ASD children; marital status, housing settings, total household income, current employment, being part of support groups overall care of ASD children.