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This study aims to measure the level of awareness about stroke symptoms, risk factors, and preventive health practices that could be taken to reduce the risk of stroke among diabetic patients in Al-Ahsa, Saudi Arabia. MethodsA cross-sectional study was conducted in Al-Ahsa, Saudi Arabia in 2020. The sample included a total of 202 male and female Saudi adults aged 18-65 years, with either type 1 or type 2 diabetes mellitus, and living in Al Ahsa, Saudi Arabia. The information was collected randomly through an online questionnaire distributed among patients after getting their contact information from relevant governmental and private diabetes clinics and after signing the informed consent.For awareness and knowledge items, each correct answer was scored one point and the total summation of the discrete scores of the different items was calculated. A diabetic patient with a score less than 60% of the total score was considered to have poor awareness while a score of 60% or more of the total score was considered a good level of awareness. ResultsA total of 87 (43.1%) participants had an overall good awareness level, while 115 (56.9%) had poor awareness levels. Around 40.6% of the study patients had heard about stroke, 61.9% knew that stroke affects the brain, and 24.3% reported that stroke is higher among males. As for factors associated with stroke, the most reported was high blood pressure (71.8%), followed by diabetes mellitus (69.3%). Exactly 65.8% of participants knew about the mechanism of ischemic stroke and 42.6% reported hemorrhagic stroke. A high percentage of patients (73.1%) realize that they could reduce their risk of stroke. ConclusionThe findings of the current study showed that less than half (43.1%) of the Saudi patients with DM had a good awareness level regarding stroke and its related risk factors and warning signs. Older patients (aged 50-65 years) with high social levels (high education and income) and those with a family history of stroke had significantly higher awareness levels. Hypertension, DM, and smoking are the highest reported known risk factors of stroke, and speech disorders are the highest known stroke presentation to the respondents.

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Opioids are drugs that are used to manage wide range of chronic painful diseases. They are classified as broadspectrum analgesics. They are frequently prescribed to manage cancer and chronic pain, post-operative pain among certain other conditions. However, there is a well-known phenomenon of psychological addiction that can develop with the use of opioids leading to prolonged use, abuse and misuse which undermines their clinical efficacy associated with their use. Although in some conditions long-term opioid therapy is needed. According to clinical recommendations, long-term opioid therapy involves taking opioids every day for more than three months. The criteria for defining long-term opioid therapy in clinical settings and research, however, vary. Certain conditions are associated with its long-term use including impaired cognitive effects, sedation, constipation, nausea, vomiting, physical dependence, tolerance, and respiratory depression which are quite common with the opioid treatment. Clinical concerns regarding addiction may hinder appropriate prescribing, resulting in insufficient pain management. Delay in stomach emptying, hyperalgesia, immunologic and hormonal abnormalities, muscular rigidity, and myoclonus are examples of less prevalent effects reported with long-term opioid use. Opioid induced constipation is commonly reported in long-term use and may get severe enough to necessitate stopping the opioids and cause underdosing and insufficient analgesia. Respiratory and sleep disorders also frequently observed in longterm users of opioids. Also, incidence of new episode of depression is quite commonly linked to the chronic use of opioid. The purpose of this research is to review the available information about common conditions associated with long term opioid usage.

Background: Inadequate Thyroid Hormone at birth in newborns is known as Congenital Hypothyroidism (CH) and it has a critical role in their growth and brain development. As a result, untreated CH and abnormal GH/IGF1 levels can lead to failure to thrive, osteoporosis, and Diabetic Retinopathies, among other problems. This retrospective study examines the chances of developing growthhormone disruption and Diabetes Mellitus in patients diagnosed with Congenital Hypothyroidism at the Security Forces Hospital in Riyadh, Saudi Arabia. Methodology: A retrospective chart review of growth hormone deficient (GHD) patients was done at the security force hospital in Riyadh, Saudi Arabia. The data was collected from the medical records of the patients. The study included all patients with growth hormone deficiency (GHD) who had complete clinical, diagnostic and treatment data. Result: At the beginning of the research, 287 growth hormone-deficient (GHD) children ranging in age from 1 to 15 years old were evaluated for diabetes. A total of 151 (52.6%) of the 287 patients got levothyroxine therapy, while the remaining 136 (47.4%) did not (control group). Because the p-value <0.05 (t(149) = 1.165, p = 0.246), the mean difference in blood sugar level changes is not statistically significant (t(149) = 1.165, p = 0.246). Conclusion: We found that levothyroxine therapy has no discernible effect on blood sugar level fluctuations in males and females. Key words: Growth hormone deficiency, Kingdom of Saudi Arabia, Diabetes.