Objective: To determine the prevalence and the risk factors of diabetic peripheral neuropathy (DPN) in hospitalized adult Saudi diabetics. Methods: This is a retrospective, nested case-control study conducted at King Abdulaziz Medical City (KAMC) in Riyadh, Saudi Arabia. All diabetic patients admitted to the hospital between the January 1, and December 31, 2018 were considered for inclusion in the study. Patients with DPN were identified and three controls per case were randomly selected from the remaining diabetic patients without peripheral neuropathy (PN). Results: A total of 2,096 adult diabetic patients were identified during the study period. Of these, 73 patients (3.5%) were confirmed to be suffering from DPN and 219 were included as controls. When comparing diabetic with the control cases, DPN cases were significantly older (p=0.002), had a significantly higher proportion of type 2 diabetes (p=0.023), chronic kidney disease (p<0.0001), cerebral vascular stroke (p=0.027), hypertension (p=0.005), dyslipidemia (p=0.002), peripheral vascular disease (p<0.0001), osteoarthritis (p=0.034), diabetic ketoacidosis (p=0.003), foot ulcers (p=0.006), gangrene (p=0.001), lower limb ischemia (p=0.001), increased duration with diabetic disease (p=0.031), increased BMI (p=0.003), higher serum creatinine (p<0.001) and lower serum albumin levels (p=0.035). In the multivariate logistic regression, only older age {odds ratio (OR) 1.02, 95% CI 1.01-1.04, p=0.031}, chronic kidney disease (OR 2.39, 95% CI 1.23-4.64, p=0.010) and peripheral vascular disease (OR 3.14, 95% CI 1.39-7.13, p=0.006) were independently associated with DPN. Conclusion: This study identified several risk factors that contributed to the development of DPN in Saudis. These must be considered in strategies and campaigns aimed at risk reduction of cardiovascular and chronic diseases, and consequently progression of DPN.

Background: Abdominal compartment syndrome (ACS) refers to multi-organ dysfunction caused by intraabdominal hypertension. A devastating condition that can lead to a 100% mortality if not treated. ACS is often underrecognized in the emergency department (ED) because it mostly affects patients who are critically ill and admitted in intensive or surgical care units. Case Report: In this paper, we report a case of a young patient with a history of recent surgical intervention but no past medical history who presented with recurrent cardiac arrest that failed to respond to aggressive management. It was initially unrecognized, but later ACS was considered in the differential and the patient was treated accordingly and eventually revived and had good neurological outcome. Conclusion: ACS is a rare but critical diagnosis that might be under recognized in the ED. With high rates of ED turnover, it is essential for ED clinicians to be aware of this disease and have a high index of suspicion about it.