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Background: Tobacco misuse has not been universally acknowledged as a modifiable risk factor in diabetes preventive or screening methods, despite mounting data revealing substantial epidemiological and mechanistic connections between smoking, hyperglycemia, and the development of type 2 diabetes. Purpose:A growing number of research on the effect of smoking cessation on the development of type 2 diabetes mellitus. The goal of this systematic review was to search the available evidence on the impact of smoking cessation and risk for type 2 diabetes mellitus. Methods: We searched PubMed, Embase, and Scopus (January 1995--October 2022) for prospective observational studies that evaluated the effects smoking and smoking cessation as risk factors for type 2 diabetes mellitus. Results: Type 2 diabetes risk was increased by a factor of 1.37 (95% CI: 1.33 to 1.42) for current smokers, 1.14 (1.10 to 1.18) for ex-smokers, and 1.22 (1.10 to 1.35) for passive smokers, compared to those who had never smoked (7 studies). The associations persisted across all subgroups, and a dose-response relation was discovered between current smoking and diabetes risk, with the RRs (95% CIs) for light, moderate, and heavy smokers, compared with never smokers, being 1.21 (1.10-1.33), 1.34 (1.27-1.41), and 1.57 (1.47-1.66), respectively. If there is a causal relationship between smoking and diabetes, we calculated that 10% in men and 2% in women of all instances of type 2 diabetes globally (about 25 million) may be attributed to smoking. The pooled RR (95% CI) from 10 studies showed that recent ex-smokers (within 5 years) had a lower risk of relapse than never smokers, while long-term ex-smokers (within 10 years) had a lower risk of relapse than current smokers. Conclusion: Both active and passive smoking are strongly connected with higher risks of type 2 diabetes. The risk of diabetes is higher among recent ex-smokers, although it lowers significantly with time.

Background: In March 2020, WHO declared COVID-19 as pandemic with very high incidence of case-fatality, after that COVID-19 Pandemic was found in China, Europe and USA where these regions were the most affected areas. The new virus attack patients with low-immunity than healthier population causing many psychological conditions. In this study, we aimed to assess prevalence of patient have low immunity symptoms, determine general psychological state in corona season, and demographic factors affecting both variable. Methodology: This is an analytical cross-sectional study conducted in kingdom of Saudi Arabia (General population) from 19/7/2020 till 25/10/2020. The study depended on online self-report questionnaire which assessing demographic factors including age and nationality besides disease-related information. Results: We had received 228 responses to our questionnaire where three quarter of them were female (75.9%). 21.1% of the participants were between 19-25 years old while 19.7% were between 36-40 while most of the sample had bachelor (73.7%). It was found that the most common symptoms were having trouble sleeping, low energy, felling tired, having to change the diet and having asthma where 8.8% had at least one symptom, 8.3% had two symptoms and 14.2% had 3 or more symptoms. Considering psychological status, we had found that the most common symptoms reported by participants were concerning about future, the always need for naps and caffeine, afraid of getting sick, afraid of worsen health, and extreme mood change. It was found that gender had a significant effect on developing both low immunity and poor psychological status (P=0.029, 0.02) where female seems to have more low immunity and poorer psychological status than male. Age is another significant factor in determining low immunity and poor psychological status (P=0.026, 0.001) where younger participants reported more symptoms of low immunity and poor psychological than older participants where the most affected age interval was 19-25 years old. Conclusion: we had found high prevalence of low immune status and poor psychological status which were more associated with females and younger populations. Moreover, there is a significant correlation between poor psychological status and low immune status.

Background: Upper gastrointestinal bleeding is the most common gastrointestinal cause of admission in emergency departments worldwide with about 10% inpatient mortality rate that has not decreased during the last three decades. Aim: In this review, we aim to study the pathophysiology behind the development of upper gastrointestinal bleeding, and explore the approach to its management in emergency situation. Materials and Methods: We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 2001, through February 2017. The following search terms were used: upper gastro intestinal bleeding, variceal bleeding, emergency management of gastrointestinal hemorrhage, varices, esophageal bleeding. Results: Managing patients with bleeding varices must have two goals that should be considered: to stop the bleeding, and to prevent rebleeding since 60% of patients will rebleed after the acute bleeding was stopped leading to a mortality rate of 33%, unless adequately treated. Conclusion: Bleeding varices are always considered urgent emergencies due to associated morbidity and mortality. Moreover, bleeding varices can cause hemodynamic instability and end-organ failure. The most important intervention is therapeutic endoscopy. Other approaches include vasoactive drugs, and prophylactic antibiotics. After acute management of the bleeding, patients should undergo further evaluation and treatment to prevent the recurrence of another bleeding.