Diabetes mellitus is a systemic disease affecting microvascular and macrovascular systems and is considered as the strongest risk factor for peripheral arterial disease. Although the prevalence of the peripheral arterial disease is high among people living with diabetes, its severity is not accurately detected with the prevalent diagnostic methodologies. The ankle-brachial index measurement is a simple, objective, and reliable tool for diagnosis of peripheral arterial disease. However, it is of limited value in the diagnosis of peripheral arterial disease among diabetic patients due to its low sensitivity among diabetic individuals. Diabetes mellitus results in atherosclerosis and calcification of peripheral arterial walls leading to false normal ankle-brachial index values. Therefore, healthcare practitioners should be careful not to misinterpret ankle-brachial index results among diabetic patients. A literature search was conducted using the keywords “ankle-brachial index,” “interpretation,” “limitations,” “diabetic foot,” and “peripheral arterial disease” on different medical search engines. The results were manually scanned and then further reviewed to select the articles related to our topic of discussion. This article will review the use of ankle-brachial index measurement among diabetic patients, its limitations and its prognostic value. In Conclusion, Ankle-brachial index can be used for diagnosis of peripheral arterial disease with some precautions (e.g. raising the threshold of diagnosis or using the lowest systolic pressure value measured at the ankle) and can also be a prognostic indicator for cardiovascular morbidity and mortality.

Background: obesity is associated with increased mortality and morbidity. The use of bariatric surgery has recently increased dramatically in order to lose weight fast; however, the heavy consequences and the long-term weight loss induced by bariatric surgery has favorable effects on life span remains unclear. Aim of Study: this study was aimed to explore knowledge and beliefs about safety, effectiveness and consequences of bariatric surgeries among community population in Jeddah city and to evaluate the role of demographic factors in shaping those beliefs, and assess possible associations between demographic characteristics with lose weight preventive behavior. Patients and methods: this study was done in 2016 and carried out among a sample of 474 citizens, of them 70.1% women and 29.9% men. The mean age of citizens was 35.77. To assess citizens' demographic factors, risk factors of obesity and beliefs about bariatric surgeries, consenting citizens responded to an anonymous online questionnaire. The data was entered and analyzed using SPSS version 20. Data were entered into the Statistical Package for Social Sciences (SPSS, version 20) and descriptive analysis conducted. Results: the results of the current study show that among the respondents, (24.5%) were obese, (13.7%) severely obese and (9.3%) were morbid obese. The majority of them believed that the lack of exercise is the cause of their obesity (45.7%), (71%) of the respondents think that genetics play a role in obesity, (69.3%) of respondents have someone in their family who suffers from obesity and (61.6%) were not keen to exercise. The majority of respondents (77.4%) think that weight loss procedures contribute to weight loss, however (69.8%) are not of favor towards weight loss procedures to get rid of obesity, (63.4%) of them have not undergone any surgery, and (86.6%) of the respondents do not think of surgeries as their first choice to lose weight without exercise or diet, also (71.0%) think that weight loss procedures and its complications may lead to death.The majority of the respondents (74%) have inadequate beliefs about bariatric surgery and (50.8%) of the respondents have good knowledge on prevention behavior of obesity.

Schistosomiasis (bilharziasis) is a common parasitic disease in subtropical and tropical parts of Africa, some parts of the Middle East, South America, Asia, and some parts of the Caribbean. It is a major public health problem and associated with significant morbidity and mortality in endemic areas. We describe a 28-yearold male patient presenting with bleeding per rectum associated with mucus secretion, abdominal pain, anorexia, and weight loss. Blood investigation showed pancytopenia with macrocytic hypochromic anemia. Meanwhile, his colonoscopy showed two large polyps 10 cm and 50 cm away from the anal verge, each measuring 3 cm in size. Microscopic examination of multiple colonic biopsies confirmed Schistosoma mansoni. The patient was treated with praziquantel, which improved his condition. Colonic schistosomiasis is an important differential diagnosis in patients with a history of travel to endemic areas. Early diagnosis and medical management can avoid unnecessary invasive intervention in such cases.

Acute appendicitis is one of the most common abdominal emergencies that present in the hospital. With acute appendicitis, there is always a possibility of complications of perforation and peritonitis. Even though medicine has advanced substantially in different investigational modalities, appendicitis is confirmed clinically with the aid of a clinical approach (i.e., Alvarado Score), laboratory, and investigational modalities. However, biomarkers such as pentraxin-3 and interleukin-6 have been recently researched to assess the possibility of confirming the diagnosis of acute appendicitis in both adults and the pediatric age group. This article breaks down the previous research on pentraxin-3 and interleukin-6 biomarkers in relation to appendicitis and proposes a new hypothetical way of confirming the diagnosis.