Environmental exposures and the risk of multiple sclerosis in Saudi Arabia

Abstract Background Multiple sclerosis (MS) is the most common non-traumatic condition that leads to disability among young individuals. It is associated with demyelination, inflammation, and neurodegeneration within the central nervous system. Information on risk factors of multiple sclerosis is crucial for the prevention and control of the disease. The aim of this study was to determine risk factors of MS among adults in Saudi Arabia. Methods A matched multicenter case-control study, including 307 MS patients and 307 healthy controls, was conducted in MS clinics and wards in 3 main cities of Saudi Arabia. Age, gender, and hospital were matched. Information on demographics, family history of MS, past medical and family history, sun exposure at different age periods, tobacco use, diet, consanguinity, and coffee consumption was obtained from self-administered questionnaires. ORs and 95% confidence intervals (CIs) were calculated. A conditional logistic regression model was used to control for potential confounding factors. Results The conditional logistic regression adjusted for age and gender showed that being the first child in the family (Adjusted Odds Ratio (AOR) 1.68, 95% CI: 1.03–2.74), having a family history of MS (AOR 5.83, 95% CI: 2.83–12), eating fast food ≥5 times weekly (AOR 2.05, 95% CI: 1.03–4.08), and having had measles (AOR 3.77, 95% CI: 2.05–6.96), were independently associated with an increased risk of MS. In contrast, eating ≥5 servings of fruit per week (AOR 0.25, 95% CI: 0.16–0.38), drinking coffee daily (AOR 0.46, 95% CI: 0.31–0.68), and having a high level of sun exposure at the primary school level and university level (AOR 0.57, 95% CI: 0.38–0.85 and AOR 0.48, 95% CI: 0.30–0.76, respectively) were independently associated with a decreased risk of MS. Conclusions Our study suggested that high levels of sun exposure during primary school and university, consumption of fruits and drinking coffee protect against MS. In contrast, eating fast food was associated with an increased risk of the disease. Encouraging outdoor activity and healthy diets in school, especially for females, is highly recommended

Additional file 1: of Environmental exposures and the risk of multiple sclerosis in Saudi Arabia

Table S1. Bivariate analysis of variables associated with risk of Multiple Sclerosis. (PDF 338 kb

Spectrum of viral skin infections in patients attending the dermatology clinic at King Fahd Hospital of the University in Alkhobar, Kingdom of Saudi Arabia during the period 2010-2014

Introduction: Viral skin infections are an important disease group in the dermatology field. Many factors play a role in the incidence of skin diseases. There are only a few reports of surveys conducted on the prevalence of viral infections in Saudi Arabia. Our study is the first in the gulf region which can serve as a good reference for planning therapeutic healthcare measures. Objectives: To determine the prevalence of viral skin infections in patients who attended the dermatology clinic at King Fahad Hospital of the University (KFHU) in Alkhobar, Kingdom of Saudi Arabia during a period of five years. Materials and Methods: A retrospective study conducted at the outpatient clinic of the Dermatology Department of KFHU for the period between January 2010 and December 2014. Patients age, gender, diagnosis were documented in a data sheet and analyzed using SPSS V.16. Results: The total number of patients seen during that period was 4798, 25.8% were in the age group of 21-30 years, 19.5% were in the age group of 11-20 years, and 14.1% were in the age group of 2-10 years. The most commonly encountered skin diseases were acne (16.5%) followed by eczema (15%), pigmentary disorders (9.6%) and viral infections (7.9%). A variety of viral skin infections were diagnosed including warts, herpes labialis, herpes genitalis, chicken pox and molluscum contagiosum. Warts comprised 72.5% of the total reported viral infections while Chicken pox and herpes genitalis were the least common reported diseases. Discussion: The most commonly encountered disease group among the 4798 patients seen at KFHU was acne (16.5%). The second was dermatitis and eczema (15%). Pigmentary disorders came in third place (9.6%), and viral infections followed in fourth place (7.9%). Compared to previous studies in Saudi Arabia, ours showed the lowest prevalence. Warts comprised 72%. Molluscum contagiosum (11.4%) and Herpes zoster 7.7%. The least commonly encountered viral diseases were chicken pox and herpes genitalis. Conclusion: Viral skin diseases are one of the major health problems in the dermatology specialty. Further studies should be performed to control these conditions

Saudi Consensus Recommendations on the Management of Multiple Sclerosis: Disease-Modifying Therapies and Management of Relapses

For the past 10 years, disease-modifying therapy (DMT) options for multiple sclerosis (MS) have grown remarkably where DMTs have been shown to reduce the risk of MS relapses. MS patients are advised to begin treatment with a DMT shortly after diagnosis to limit the possibility of disease progression over time. While patients with radiologically isolated syndrome do not require pharmacologic treatment, high-risk patients with clinically isolated syndrome are advised to start DMTs. This article provides evidence-based recommendations for DMT use in MS management, helping healthcare practitioners advise patients on treatment decisions. We aim to provide recommendations for the management of acute MS relapses. The recommendations herein were developed following the gathering of a panel of experts after evaluating international guidelines, and the latest evidence was collected through a comprehensive literature review

Saudi Consensus Recommendations on the Management of Multiple Sclerosis: Disease-Modifying Therapies and Management of Relapses

For the past 10 years, disease-modifying therapy (DMT) options for multiple sclerosis (MS) have grown remarkably where DMTs have been shown to reduce the risk of MS relapses. MS patients are advised to begin treatment with a DMT shortly after diagnosis to limit the possibility of disease progression over time. While patients with radiologically isolated syndrome do not require pharmacologic treatment, high-risk patients with clinically isolated syndrome are advised to start DMTs. This article provides evidence-based recommendations for DMT use in MS management, helping healthcare practitioners advise patients on treatment decisions. We aim to provide recommendations for the management of acute MS relapses. The recommendations herein were developed following the gathering of a panel of experts after evaluating international guidelines, and the latest evidence was collected through a comprehensive literature review

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population