Introduction: The 2021 IDF-DAR risk calculator had been previously evaluated in multiple studies and subsequently widely accepted and applied in clinical practice as a practical standardized tool for patient risk stratification. Recently updated, the 2026 IDF-DAR Risk calculator enables a more individualized, evidence-related evaluation of patientrelated and disease-related risk factors, incorporating modern diabetes technologies, including continuous glucose monitoring (CGM), automated insulin delivery (AID) systems, and advanced insulin formulations to enhance risk stratification. This tool allows medical professionals to tailor Ramadan practices based on overall factors toward promoting safe fasting. Methodology: This prospective multicentre observational study recruited adults with Type 1 and Type 2 diabetes attending public hospitals nationwide. People with diabetes (PwD) intending to perform Ramadan fasting were invited to participate and assessed using the 2026 IDF-DAR Risk Calculator in the 6-week pre-Ramadan period between 30th January and 19th March 2026. Results: A total of 458 PwD were evaluated and stratified into low (15.7%), moderate (41%), and high risk (43.3%) categories. Most participants had Type 2 diabetes (83.6%), with 60.3% having a disease duration exceeding 10 years and 43% exhibiting poor glycemic control (hemoglobin A1c >9%). Insulin therapy was used by 76.4% of participants, including two individuals with Type 1 diabetes using AID systems. Most participants reported no recent hypoglycemia (76.4%), 81.0% performed glucose monitoring, and 3.3% used CGM. Severe comorbidities were uncommon, with 1.1% having unstable macrovascular disease and 4.4% advanced chronic kidney disease (estimated glomerular filtration rate <30). Notably, 72.2% received structured Ramadan education. Conclusion Majority of PwD attending tertiary diabetes clinics were in the moderate- to high-risk category and intended to fast despite medical advice against fasting in some cases. Although most participants were on insulin therapy, hypoglycemia was low in the pre-Ramadan period. Integration of modern technologies, advanced insulin therapies, and structured education may support safer fasting practices.
Risk Assessment ; Diabetes Mellitus ; Hospitals ; Fasting

Purpose: This study aimed to explore pharmacy students’ perceptions of remote flipped classrooms in Malaysia, focusing on their learning experiences and identifying areas for potential improvement to inform future educational strategies. Methods: A qualitative approach was employed, utilizing inductive thematic analysis. Twenty Bachelor of Pharmacy students (18 women, 2 men; age range, 19–24 years) from Monash University participated in 8 focus group discussions over 2 rounds during the coronavirus disease 2019 pandemic. Participants were recruited via convenience sampling. The focus group discussions, led by experienced academics, were conducted in English via Zoom, recorded, and transcribed for analysis using NVivo. Themes were identified through emergent coding and iterative discussions to ensure thematic saturation. Results: Five major themes emerged: flexibility, communication, technological challenges, skill-based learning challenges, and time-based effects. Students appreciated the flexibility of accessing and reviewing pre-class materials at their convenience. Increased engagement through anonymous question submission was noted, yet communication difficulties and lack of non-verbal cues in remote workshops were significant drawbacks. Technological issues, such as internet connectivity problems, hindered learning, especially during assessments. Skill-based learning faced challenges in remote settings, including lab activities and clinical examinations. Additionally, prolonged remote learning led to feelings of isolation, fatigue, and a desire to return to in-person interactions. Conclusion Remote flipped classrooms offer flexibility and engagement benefits but present notable challenges related to communication, technology, and skill-based learning. To improve remote education, institutions should integrate robust technological support, enhance communication strategies, and incorporate virtual simulations for practical skills. Balancing asynchronous and synchronous methods while addressing academic success and socioemotional wellness is essential for effective remote learning environments.

Purpose: This study aimed to explore pharmacy students’ perceptions of remote flipped classrooms in Malaysia, focusing on their learning experiences and identifying areas for potential improvement to inform future educational strategies. Methods: A qualitative approach was employed, utilizing inductive thematic analysis. Twenty Bachelor of Pharmacy students (18 women, 2 men; age range, 19–24 years) from Monash University participated in 8 focus group discussions over 2 rounds during the coronavirus disease 2019 pandemic. Participants were recruited via convenience sampling. The focus group discussions, led by experienced academics, were conducted in English via Zoom, recorded, and transcribed for analysis using NVivo. Themes were identified through emergent coding and iterative discussions to ensure thematic saturation. Results: Five major themes emerged: flexibility, communication, technological challenges, skill-based learning challenges, and time-based effects. Students appreciated the flexibility of accessing and reviewing pre-class materials at their convenience. Increased engagement through anonymous question submission was noted, yet communication difficulties and lack of non-verbal cues in remote workshops were significant drawbacks. Technological issues, such as internet connectivity problems, hindered learning, especially during assessments. Skill-based learning faced challenges in remote settings, including lab activities and clinical examinations. Additionally, prolonged remote learning led to feelings of isolation, fatigue, and a desire to return to in-person interactions. Conclusion Remote flipped classrooms offer flexibility and engagement benefits but present notable challenges related to communication, technology, and skill-based learning. To improve remote education, institutions should integrate robust technological support, enhance communication strategies, and incorporate virtual simulations for practical skills. Balancing asynchronous and synchronous methods while addressing academic success and socioemotional wellness is essential for effective remote learning environments.

Purpose: This study aimed to explore pharmacy students’ perceptions of remote flipped classrooms in Malaysia, focusing on their learning experiences and identifying areas for potential improvement to inform future educational strategies. Methods: A qualitative approach was employed, utilizing inductive thematic analysis. Twenty Bachelor of Pharmacy students (18 women, 2 men; age range, 19–24 years) from Monash University participated in 8 focus group discussions over 2 rounds during the coronavirus disease 2019 pandemic. Participants were recruited via convenience sampling. The focus group discussions, led by experienced academics, were conducted in English via Zoom, recorded, and transcribed for analysis using NVivo. Themes were identified through emergent coding and iterative discussions to ensure thematic saturation. Results: Five major themes emerged: flexibility, communication, technological challenges, skill-based learning challenges, and time-based effects. Students appreciated the flexibility of accessing and reviewing pre-class materials at their convenience. Increased engagement through anonymous question submission was noted, yet communication difficulties and lack of non-verbal cues in remote workshops were significant drawbacks. Technological issues, such as internet connectivity problems, hindered learning, especially during assessments. Skill-based learning faced challenges in remote settings, including lab activities and clinical examinations. Additionally, prolonged remote learning led to feelings of isolation, fatigue, and a desire to return to in-person interactions. Conclusion Remote flipped classrooms offer flexibility and engagement benefits but present notable challenges related to communication, technology, and skill-based learning. To improve remote education, institutions should integrate robust technological support, enhance communication strategies, and incorporate virtual simulations for practical skills. Balancing asynchronous and synchronous methods while addressing academic success and socioemotional wellness is essential for effective remote learning environments.

Less invasive transcatheter tricuspid therapies are optimal alternative for surgery in high-risk individuals with severe symptomatic tricuspid regurgitation on medical therapy. Various techniques are available with Transcatheter Edge-to-Edge Repair (TEER) having the greatest experience worldwide. When the coaptation gap becomes too large for TEER, caval valve implantation (CAVI) emerge as a better option. We described a series of 4 patients who underwent CAVI with the TricValve system and periprocedural computed tomography angiography imaging for the purpose of TricValve sizing. There were few procedural complications, with significant improvements in New York Heart Association functional class and right ventricular function post-procedure.

China has classified the Corona Virus Disease 2019(COVID-19) as a statutory category B infectious disease and managed it according to Category B since January 8, 2023.In view that Omicron variant is currently the main epidemic strain in China, in order to guide the treatment of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in children with the times, refer to the Diagnosis and Treatment Protocol for Novel Coronavirus Infection (Trial 10 th Edition), Expert Consensus on Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fourth Edition) and the Diagnosis and Treatment Strategy for Pediatric Related Viral Infections.The Expert Consensus on the Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fifth Edition) has been formulated and updated accordingly on related etiology, epidemiology, pathogenic mechanism, clinical manifestations, auxiliary examination, diagnosis and treatment, and added key points for the treatment of COVID-19 related encephalopathy, fulminating myocarditis and other serious complications for clinical reference.

Obturator hernia is an uncommon intra-abdominal hernia with the incidence of 0.05-1.4% of all hernias. Diagnosis is often delayed as the clinical picture is usually non-specific and poses a diagnostic challenge to clinicians. This report describes a case of an 80-year-old woman, who presented to the Emergency Department with left lower quadrant abdominal pain that radiates to the left hip region for one day. Plain abdominal radiography showed dilated loops of small bowel in the pelvic region. Contrasted Enhanced Computed Tomography (CECT) of abdomen and pelvis demonstrated left obturator hernia with small bowel obstruction. Emergency laparoscopic obturator hernia repair was performed. Intraoperative findings confirmed a left incarcerated obturator hernia. The small bowel was reduced and viable. Subsequently, a primary closure of the hernia orifice was performed. This case report emphasizes the successful use of a laparoscopic approach in obstructed obturator hernia and its feasibility in an emergency setting.
Laparoscopy

Since December 2019, severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infections have raged globally for more than 2 years.China has always adopted scientific and effective prevention and control measures to achieved some success.However, with the continuous variation of SARS-CoV-2 cases and imported cases from abroad, the prevention and control work has become more difficult and complex.With the variation of the mutant strain, the number of cases in children changed, and some new special symptoms and complications were found, which proposed a new topic for the prevention and treatment of SARS-CoV-2 infection in children in China.Based on the third edition, the present consensus according to the characteristics of the new strain, expounded the etiology, pathology, pathogenesis, and according to the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of effective prevention and treatment of SARS-CoV-2 infection in children in China.