This is the last issue of this year that is rich with papers from the region. At the end of the year , I would like to thank the editorial board , the reviewers and the publishing manager in their great effort for a successful year. At the time, I would like thank you the authors for their trust in our journal and for the valuable readers that we hoped enjoyed reading our papers this year. At the end I wish all a happy holiday season and Happy New Year.

Al Qaatri et al., looked at the increased Psychological Disorders among Pediatric Population. The authors stressed that generally, the pediatric population is at a higher risk of developing psychological disorders during COVID-19 than other age groups. Educational status, developmental age, poor economic background, and existing mental health issues are among the vulnerability factors that cause the difference in psychological disorders prevalence between age groups . According to the authors, social distancing and lockdown practices have resulted in anxiety and fear, leading to long and short-term mental health and psychosocial impacts on school-age children. This literature review will focus on examining increased psychological disorders among adolescents and children during COVID-19 and the most effective practices to implement to promote early detection.

Alkubaisi et al., did a retrospective chart review (baseline audit) looking at the clinical effectiveness Department, Directorate of Clinical Affairs, Primary Health Care Corporation, Doha, Qatar. They reviewed 245 health records of children attended well-baby clinic for three months. The aim was to ensure that well-baby services provide clinical care according to children's age as per well-baby service protocol within primary health care centers, to find gaps if any and, generate action plan for further improvement. The authors concluded that impactful audits with actionable recommendation make real difference in practice and compliance. In conclusion, action plan implemented further to the baseline audit are effective in increasing the compliance in most of the areas.

Altaf et al., looked did a comparative cross-sectional study was conducted by comparing patients' demographic information, and compliance to virtual calls and physician recommendations during 2020 with the regular physical attendance clinics in 2019. Patient data was collected from the electronic medical records after randomly selecting the sample for each year from 6 main outpatient clinics. During the 4-month period of 2020 (March-June), which virtual clinics were implemented in, there was a significant decrease in the attendance compliance when compared to the same period in 2019 conventional clinics. The authors concluded that COVID-19 pandemic had significant negative impact on patient care. Although that impact was seen greatest among those with chronic conditions and oncology patients, it was an essential step towards infection control during this difficult period. However, the pandemic is an opportunity to establish a comprehensive virtual care that will ensure easy access and continuity of patient care.

El-Gamal et al., attempted to identify the major socio-demographic, and health risk factors of stunting in 2-6 years old Saudi children. They did a cross sectional study. It was a convenient sampling method, and was conducted at the outpatient clinics of two general hospitals in Jeddah city. Wasting was encountered among 3.11% of the children, while stunting was found among 22.91%, and underweight among 20.32% of the children. Stunting was more common in early years of life (b=0.015). Short stature of the mothers (b = 0.021), and decrease in her BMI (b= 0.043) were significantly associated with stunting in their children (P < .05). The authors concluded that male gender and very young age are significant risk factors of stunting. Double malnutrition was common among children with stunting. Hereditary may be an important determinant factor of stunting in children.

Al-Jadidi, et al., did a pilot study, weighted and measurable outcome of community service program in decreasing relapse, length of hospital stay and the financial sequel of relapse of the service provided. In this study , there is a statistically significant deference between number of relapse before and after enrolments to community services , the mean number of relapse decreased after enrolment to community and the decreases mean cost per admission for the patients after enrolment to the community program . Decrease in number of admissions among patient enrolled on CMHS from (M 2.68 SD 2.76) to (M 1.51 SD 2.5) with P value 0.001 .The authors concluded that CMHS in Oman is effective in decreasing relapse rate and cost.

Rashed et al., looked at the role of SGLT2 inhibitors and GLP-1analogs in cardiovascular risk reduction in type 2 diabetes. The leading cause of morbidity and mortality in patients with type-2 diabetes mellitus is cardiovascular (CV) disease, that makes it an important target in management. Sodium-glucose cotransporter 2 (SGLT-2) inhibitors and glucagon-like peptide-1 receptor agonist (GLP-1 RA) are both two new antidiabetic drug classes that showed significant reduction in major cardiovascular events (MACE). With the introduction of these drugs, comprehensive CV risk reduction has been achieved in addition to glucose control. Both drugs work in different ways, the SGLT-2 Inhibitors leads to urinary excretion of 60-90 grams of glucose and as well sodium leading to osmotic diuresis. Both the SGLT2 inhibitors and GLP-1 agonists have undergone large trials that have led to massive evidence on their cardiovascular safety and renal benefits. The decision on using which drug from both classes depends on different factors like atherosclerotic disease and chronic Kidney disease.

Almonawar, et al., looked to measure non-compliance and to identify barriers to compliance among hypertensive patients. A total of 200 hypertensive patients attending Al-Qabel Primary Health Care (PHC) Center since at least one year were included in this study. A structured data collection interview questionnaire was used. To assess non-compliance of hypertensive patients, the Hill-Bone Non-Compliance to High Blood Pressure Therapy Scale was used. Only 11% of hypertensive patients were highly compliant. The main barriers for full compliance were forgetfulness (39%) and being asymptomatic (30%). The authors concluded that non-compliance of hypertensive patients attending PHC settings in Abha is high. Main barriers against full compliance of hypertensive patients are forgetfulness, absence of symptoms, dissatisfaction with provided health care and being tired of treatment side effects. Non-compliance is significantly higher among younger, newly diagnosed, Saudi, married, smoker patients. Non-compliance is significantly higher among hypertensive patients on multiple antihypertensive medications.

Alburaidi et al., attempt to assess the level of knowledge among patients with LBP related to their disease. They did a cross-sectional study was conducted at region of Asser, Saudi Arabia and comprised patients presenting with lower back pain. In this study, they used the Arabic version of validated questionnaire called (LBP knowledge questionnaire "LKQ"). we received 183 responses from patients with LBP. Among this sample, male represented 60.7 % of the sample. The authors concluded that the level of knowledge among patients toward LBP was inadequate where most of patients had partial level of knowledge about their condition. Age, gender, martial status and monthly income had no effect on this level of knowledge. More investigations should be conducted using another design as prospective design in order to indicate the acutely reasons for this low level of knowledge among patients toward LBP.

Alasmari, et al., tried to assess proton pump inhibitors awareness level among physicians and pharmacists and its detriments in PHCCs, Aseer region, Saudi Arabia. They did an analytical cross-sectional study was applied to answer the main research question. The study targeted all physicians and pharmacists in primary healthcare centres in Abha who will be accessible during the study period from 23 May to 27 July. A total of 178 participants completed the study questionnaire. 97 (54.5%) participants were pharmacists, 45 (25.3%) were clinical pharmacists, and 36 (20.2%) were physicians. The authors concluded that the current study showed that medical staff in the primary healthcare centres