The present collection of manuscripts reflects the breadth and depth of current clinical and public health research emerging from the Middle East, with a particular focus on Saudi Arabia. Each contribution offers unique insights into priority health issues, combining rigorous methodological approaches with an emphasis on practical implications for patient care and policy.

Attention Deficit Hyperactivity Disorder (ADHD) remains a significant concern in pediatric populations worldwide, and the study by AlGhassab et al. sheds light on the knowledge, attitudes, and practices of primary healthcare physicians in Tabuk City. Despite generally good awareness of ADHD, the findings underscore persistent misconceptions and limited direct management experience, highlighting the urgent need for enhanced training and clearer guidelines to empower primary care providers in early identification and referral.

In the realm of dementia, Abyad's comprehensive clinical review offers an invaluable synthesis of current knowledge on dementia subtypes, diagnostics, and treatment options. As the Middle East witnesses rapid population aging, such updated overviews are crucial for guiding clinicians and policymakers in building responsive care systems and advancing research in neurodegenerative diseases.

Preventive health remains a recurring theme across the collection. The cross-sectional study on herpes zoster vaccination uptake among older adults in Tabuk emphasizes both promising levels of general awareness and persistent barriers such as fear of side effects and perceived low personal risk. This research underscores the importance of physician recommendations and targeted public health messaging to improve immunization rates in vulnerable populations.

The intersection of autoimmunity and chronic disease is exemplified in the retrospective study of celiac disease prevalence among patients with type 1 diabetes mellitus. Despite a modest prevalence (2.4%), the study identifies underweight status as a potential clinical marker warranting proactive screening, reinforcing recommendations for integrated care models in endocrinology and gastroenterology.

Public health nutrition also features prominently, with Dr. Ebtisam Elghblawi's paper on the global obesity epidemicpresenting a compelling call to action. The review eloquently outlines the systemic and environmental drivers of "globesity," reminding readers that obesity is not simply a matter of individual choice but a reflection of pervasive societal and commercial pressures.

The collection further includes a thought-provoking hypothesis paper by Helvaci et al. suggesting that chronic idiopathic thrombocytopenic purpura-a condition traditionally regarded as deleterious-might paradoxically confer survival benefits by modulating platelet-driven atherosclerosis. While preliminary, this perspective contributes to the broader discourse on the complex interplay between hemostasis and vascular disease.

Finally, the cross-sectional study on sleep disorders among primary healthcare physicians provides timely insights into occupational health. Alarmingly high rates of poor sleep hygiene and daytime sleepiness were observed, strongly associated with modifiable factors such as long working hours, night shifts, and inadequate rest. These findings carry clear implications for healthcare system reform and physician well-being initiatives.

Collectively, these manuscripts illustrate a shared commitment to advancing evidence-based practice across disciplines and addressing both emerging and longstanding health challenges in the region. Whether exploring neurodevelopmental disorders, chronic disease comorbidities, vaccine hesitancy, or clinician burnout, the studies underscore the importance of context-specific data to inform local policy and improve patient outcomes.

I commend the authors for their rigorous scholarship and their contributions to enhancing our understanding of health and disease in the Middle East. This body of work offers valuable guidance for clinicians, researchers, and public health professionals committed to improving care delivery in complex and evolving healthcare landscapes.

Warm regards,

Dr. Abdulrazak Abyad
Editor-in-Chief
Middle East Journal of Family Medicine
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