Differential Expression of Human Peripheral Mononuclear Cells Phenotype Markers in Type 2 Diabetic Patients and Type 2 Diabetic Patients on Metformin

Background: Although peripheral blood mononuclear cells (PBMC) have been demonstrated to be in a pro-inflammatory state in obesity and type 2 Diabetes Mellitus (T2DM), characterization of circulating PBMC phenotypes in the obese and T2DM and the effect of Metformin on these phenotypes in humans is still ill-defined and remains to be determined.Methods: Thirty normal healthy adult volunteers of normal weight, 30 obese subjects, 20 obese newly diagnosed diabetics and 30 obese diabetics on Metformin were recruited for the study. Fasting blood samples were collected and PBMC were isolated from whole blood. Polarization markers (CD86, IL-6, TNFα, iNOS, CD36, CD11c, CD169, CD206, CD163, CD68, CD11b, CD16, and CD14) were measured by RT-qPCR. Gene expression fold changes were calculated using the 2−ΔΔCT method for RT-qPCR.Results: Obesity and T2DM are associated an increased CD68 marker in PBMC. mRNA expression of CD11b, CD11c, CD169, and CD163 were significantly reduced in PBMC from T2DM subjects whereas CD11c was significantly inhibited in PBMC from obese subjects. On the other hand, macrophage M1-like phenotype was observed in T2DM circulation as demonstrated by increased mRNA expression of CD16, IL-6, iNOS, TNFα, and CD36. There were no significant changes in CD14 and CD86 in the obese and T2DM when compared to the lean subjects. Metformin treatment in T2DM reverted CD11c, CD169, IL-6, iNOS, TNFα, and CD36 to levels comparable to lean subjects. CD206 mRNA expression was significantly upregulated in PBMC of T2DM while Metformin treatment inhibited CD206 expression levels.Conclusions: These data support the notion that PBMC in circulation in T2DM express different pattern of phenotypic markers than the patterns typically present in M1 and M2 like cells. These phenotypic markers could be representative of metabolically activated macrophages (MMe)-like cells. Metformin, on the other hand, reduces MMe-like cells in circulation

The Effect of Participation in Festivals on Subjective Well-being and Satisfaction: A Case Study of the Boulevard World Festival in Saudi Arabia

The aim of this study was to explore the potential effects of attending the Boulevard World Festival in Riyadh, Saudi Arabia, on local visitors' subjective well-being and satisfaction with the festival, as well as their perceptions of the impact of attending the festival on their culture. Prior literature examining the effect of festival attendance on subjective well-being was reviewed to illuminate the scope of this study and the knowledge gap. The analysis of the literature revealed the paucity of available and reliable tourism data regarding international festivals in developing countries. Thus, the adoption of the case study strategy will produce a rich source of information for Saudi Arabia regarding the effect of hosting festivals like the Boulevard World on local residents. Specifically, the study looks at the relationships between variables linking festival attendance to subjective well-being and satisfaction with the festival, namely, length of stay, type of companions, visitor demographics, visit frequency, future behavioural intention, loyalty to the destination and local visitor culture. Thus, this study contributes to a deeper understanding of the potential effects of festival participation on visitors' subjective well-being and satisfaction with the festival within a given cultural context. Although studies of festival tourism have emerged, knowledge is limited about the effect of festival attendance on the subjective well-being and visitors’ satisfaction with the festival. A mixed methods approach involving a survey and semi-structured interviews was utilised. The participants who visited Boulevard World Festival 2021 were Saudis of both genders aged 18 years and over. A closed questionnaire was distributed to visitors to the festival and 296 completed questionnaires were received. The aim of the questionnaires was to obtain a broad, general picture of the effect of festival attendance on visitors' subjective well-being and festival satisfaction. The data obtained were analysed using SPSS software program, whereby cross tabulation was performed to produce the descriptive analysis to determine the visitors' backgrounds, tendencies and opinions on a set of dimensions. Subsequently, in-depth information and a comprehensive understanding were obtained by conducting interviews with a purposive sample of 28 survey participants. Thematic analysis was used to interpret and explore the interview data. The survey results showed that festival attendance can significantly improve visitors' subjective well-being. Participants who visited the festival multiple times, along with those who stayed for a longer period reported a higher level of subjective well-being. In addition, it was confirmed that festival satisfaction had a more significant effect on single, younger and less-educated participants, whereas gender was not found to be significant. The results established that festival satisfaction is significantly and positively associated with behavioural intention and future loyalty. Finally, the results indicated that there was a significant relationship between the cultural values of the participants and the level of their subjective well-being and their satisfaction with the festival. The more that visitors respect their traditional values while not being open to other cultures, the lower their level of subjective well-being and satisfaction with the festival and vice versa. The interviews revealed that there were concerns about international festivals which ranged from annoyance to more concerns about the type of events and the behaviour of performers and visitors. However, it was also notable that most of the participants had no concerns because they believed that festivals such as the Boulevard World would bring prosperity, improve Saudi Arabia's image abroad, provide fun for the whole family and offered an opportunity to experience a range of other cultures. The study concludes by proposing a number of recommendations for stakeholders in the recreational tourism sector, especially international festival tourism, in line with the stated aims of Saudi Arabia’s Vision 2030, as well as for future research

Musculoskeletal pain post-COVID-19 in patients undergoing physical therapy in Saudi Arabia: a cross-sectional study

Abstract Background The COVID-19 (coronavirus disease 2019) pandemic has posed a challenge to the physical therapy service. In addition to pandemic-associated treatment interference, many recovered COVID-19 patients developed new or worsening musculoskeletal pain as a sequela of COVID-19, which has been shown to affect the musculoskeletal system. The objective of the study was to examine musculoskeletal pain post-COVID-19 in patients undergoing physical therapy in Saudi Arabia. Methods The design of the study was a cross-sectional study. We approached patients attending physical therapy clinics who had COVID-19. Data were collected through an electronic survey consisting of multiple-choice questions related to sociodemographic data and pain. Pain severity was rated on a 10-point numerical rating scale. Results A total of 85 recovered COVID-19 patients participated in this study, 30 had musculoskeletal pain prior to getting COVID-19, while 55 acquired it after. The most affected sites for musculoskeletal pain were the lower back and shoulder. Mean pain levels reported increased from 4.48 ± 2.54 pre-COVID-19 to 6.92 ± 8.06 post-COVID-19 (mean difference, 1.61 ± 2.61; t = 5.68; p < 0.0001). Mean pain scores did not associate significantly with demographic or clinical factors. Patient responses skewed toward increased pain as well as decreased activity levels after being infected with COVID-19 versus pre-COVID-19 (all p < 0.0001). Conclusions Recovered COVID-19 patients reported increased pain intensity and frequency, together with reduced activity levels, relative to pre-COVID-19 levels, without effects of sociodemographic or clinical characteristics

Frequency and characteristics of chronic fatigue syndrome in multiple sclerosis patients at a university hospital in Eastern Saudi Arabia

BACKGROUND: Multiple sclerosis (MS) is a chronic, inflammatory demyelinating disease that affects various parts of the central nervous system. Fatigue, a common symptom, transient, prolonged, or chronic experienced by individuals with MS, can significantly impact daily functioning. It can be associated with underlying pathological processes or can have an idiopathic cause, such as chronic fatigue syndrome (CFS). The study aimed to assess the presence and etiology of fatigue in MS patients and its relationship with CFS. MATERIALS AND METHODS: This cross-sectional study was conducted in the Eastern Province of Saudi Arabia. Data were collected using a questionnaire from a sample of 225 MS patients receiving care at our university hospital. The questionnaire included the Centers for Disease Control and Prevention (CDC) criteria for diagnosing CFS and the Expanded Disability Status Scale to evaluate fatigue in MS patients. RESULTS: Of the total of 225 MS patients who participated in this study, 87.1% were diagnosed with relapsing-remitting MS, 6.7% with primary progressive MS, 3.6% with clinically isolated syndrome, and 2.7% with secondary progressive MS. About 53% had experienced fatigue that persisted for over 6 months. Analysis of CFS diagnosis revealed that 7.3% of patients met both CDC criteria and self-reported answers while 17.5% reported having CFS despite not meeting the CDC criteria. These findings highlight a significant lack of agreement between patient-reported diagnoses and established criteria, indicating poor agreement (P = 0.028). CONCLUSION: The study found an association between CFS and MS, and a significant impact on daily functioning. The study revealed lack of agreement between patient-reported diagnoses and established criteria for CFS. This emphasizes the need for a standardized approach to diagnosis and evaluation of fatigue in MS patients