In this issueSystematic ReviewOriginal Articles
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# Systematic Review {#article-title-2}

**Hypothyroidism is a risk factor for transient ischemic attack. *A meta-analysis***

J. Li et al investigate a total of 7 studies the relationship between hypothyroidism and transient ischemic attack (TIA) and determine whether hypothyroidism is a risk factor for TIA. Hypothyroidism showed a significant association with TIA. The association was significant in clinical hypothyroidism but not evident in subclinical hypothyroidism. Hypothyroidism, particularly clinical hypothyroidism, may be an independent risk factor for TIA.

***see page 117***

![Figure1](http://smj.org.sa/https://smj.org.sa/content/smj/46/2/115/F1.medium.gif)

[Figure1](http://smj.org.sa/content/46/2/115/F1)

Publication bias funnel plot.

# Original Articles {#article-title-3}

**Neutrophil-to-lymphocyte ratio, platelets-to-lymphocyte ratio, and red cell distribution width as prognostic indicators for length of hospital stay in pediatric asthma**

Eltayeb et al examine the relationship between neutrophil-to-lymphocyte ratio (NLR), platelets-to-lymphocyte ratio (PLR), and red cell distribution width (RDW) and the length of hospital stay (LOS) in children with bronchial asthma. This study involved 489 children, with a mean age of 5.8±3.5 years, of which 59.7% were male. Notably, 77.7% of the patients resided in rural areas of Jazan. Among the blood biomarkers assessed, PLR demonstrated the highest predictive value for LOS in children with asthma, yielding an area under the curve of 0.664. The findings showed no significant association between NLR and RDW with LOS.

***see page 143***

![Figure2](http://smj.org.sa/https://smj.org.sa/content/smj/46/2/115/F2.medium.gif)

[Figure2](http://smj.org.sa/content/46/2/115/F2)

A receiver operating characteristic curve (ROC curve) to analyze the predictive value of each blood biomarker for length of hospital stay in asthma children.

**GLP-1RA and SGLT2i utilization in people with type 2 diabetes with atherosclerotic cardiovascular disease (ASCVD) or at high risk of ASCVD in the Gulf Region. *Results from the PACT-MEA study***

Al-Dahi et al provide insights to 1062 diagnosed with type 2 diabetes (T2D) on the real-world usage of glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT2i) among individuals with 2D from Bahrain, Kuwait, and Qatar. Among T2D participants with established atherosclerotic cardiovascular disease, a significantly higher proportion (41.3%) received SGLT2i compared to GLP-1RA (10.5%, *p*<0.001). There were notable variations in GLP-1RA/SGLT2i utilization across countries (*p*<0.001): being lowest in Bahrain (2.3%/18%), 26.9%/58.2% in Kuwait and 10.5%/67.1% in Qatar. The use of both medications was significantly higher in individuals with body mass index (BMI) ≥30 kg/m2 (*p*<0.05). The study findings suggest a suboptimal use of GLP-1RA and SGLT2i in a real-world setting.

***see page 163***

**Giant left gastric artery aneurysm with intrathoracic extension**

Ackali et al present a 40-year-old female patient involving an unruptured left gastric artery aneurysm (LGAA) that extended into the right hemithorax. This case report outlines the categorization, clinical manifestations, and diagnostic challenges associated with such aneurysms. Our findings could offer valuable insights for clinicians and radiologists when adopting a systematic approach for the early detection and management of LGAA. In the context of diagnostic evaluations for solitary lung lesions, it should be mandatory to contain aneurysmatic expansion of branches stems from the celiac truncus.

***see page 199***

![Figure3](http://smj.org.sa/https://smj.org.sa/content/smj/46/2/115/F3.medium.gif)

[Figure3](http://smj.org.sa/content/46/2/115/F3)

Macroscopic specimen of a giant aneurysmal sac completely removed from the right hemithorax using the video-assisted thoracoscopic surgery.

*   Copyright: © Saudi Medical Journal

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