ABSTRACT
BACKGROUND: The long-term use of opioids for chronic non-cancer pain (CNCP) has drawn more attention and debate. Although opioids are frequently used to treat chronic pain, their effectiveness and safety over extended periods are still unknown. OBJECTIVES: The purpose of this review is to provide an overview of what is currently known about the adverse events of long-term use of opioids in CNCP. It also delivers patient-centered strategies designed to mitigate these risks. METHODS: We conducted a literature search in PubMed, MEDLINE, EMBASE, and Web of Science databases. Search terms included CNCP, pain pathophysiology, opioid pharmacodynamics, opioid prescribing trends, guidelines for opioid use, and opioid side effects. Results: Our review highlights that while opioids may provide short-term relief from CNCP, their effectiveness diminishes over time due to the development of opioid tolerance. This tolerance often leads to increased dosages, which can subsequently result in opioid dependence. Additionally, long-term opioid therapy is associated with a spectrum of adverse effects, including constipation, drowsiness, respiratory depression, and potential for drug interactions. Furthermore, our review indicates that alternative pain management strategies play a crucial role in controlling CNCP. They offer significant benefits with fewer adverse events. These strategies include non-opioid medications, physical therapy, cognitive-behavioral therapy (CBT), various interventional procedures, injection therapy, and acupuncture. CONCLUSION: Using opioids to manage CNCP presents several challenges. Given these challenges, alternative treatments are being considered as viable options. Moreover, it is crucial to customize treatment plans to align with the patients' specific health requirements, existing conditions, and potential risks to ensure the best possible outcomes.
ABSTRACT
Background Hair plays a significant role in physical appearance and hair loss can profoundly affect self-esteem and mental health. Studies show that people with clinically obvious and undetectable hair loss may have dramatically decreased quality of life (QoL). This study investigated the impact of androgenic alopecia on the quality of life of male individuals in the Eastern Province of Saudi Arabia and their willingness to seek treatment. Methods In the eastern province of Saudi Arabia, a cross-sectional study was carried out among men identified with androgenic alopecia (AGA). A self-administered survey was disseminated among the patients through social media sites. The questionnaire includes fundamental demographic factors including age, place of residence, level of education, the severity of androgenic alopecia, treatment method, and Skindex-29 to assess the patient's quality of life. Results Four hundred-two male patients out of 717 participants were selected, and 158 (39.3%) were aged between 20 to 29 years old. Satisfaction with treatment medication was reported by 24 (19.5%) out of those who underwent treatment (n=123). Less effectiveness was the most common reason for treatment dissatisfaction (81, 81.8%). The overall mean Skindex-29 score was 23.2 (SD 19.6) out of 100 points. Younger age, suffering hair loss for a shorter duration, undergoing alopecia treatment, being diagnosed with alopecia by a medical doctor, and having a moderate level of AGA were the factors that greatly affected the patient's QoL. Conclusion Consistent with the literature, this study showed that AGA significantly impaired patients' QoL. Among QoL domains, the symptoms domain had a greater effect on patients than the emotions or functional domains. Younger males who were suffering recently from hair loss and were diagnosed with AGA by the medical doctor demonstrated greater QoL impairment than the rest of the patients. A multicenter study may result in a better representation of the impact of QoL in patients with AGA.
ABSTRACT
Background Cardiovascular diseases (CVDs), primarily coronary artery disease (CAD) and stroke, stand as a leading cause of morbidity and mortality globally. Our objective was to predict the 10-year risk of CVD in the Eastern Province of Saudi Arabia. Methods This cross-sectional study was conducted in eight randomly selected primary healthcare centers using cluster sampling based on geographical location in Saudi Arabia's Eastern Province, specifically the Al-Ahsa region. The study aimed to assess the risk of developing CVD in the next 10 years among patients with at least one cardiovascular risk factor. Patients visiting the healthcare centers for checkups filled out the Framingham Cardiovascular Disease (10-year risk) score questionnaire. Results Of the 665 patients enrolled, 54.4% were female. The average age of the patients was 54.2 (SD 8.48) years. The overall average Framingham Risk Score (FRS) percentage was 19.2% (SD 15.4%). In terms of 10-year CVD risk, 34.6% of the patients were at high risk, 31.6% were at moderate risk, and 33.8% were considered low-risk individuals. Factors associated with a higher risk of CVD included older age, male gender, lower educational attainment, smoking, normal BMI, stage 2 hypertension, and diagnoses of hypertension, diabetes, and obesity. Conclusion Utilizing the FRS, it was determined that older men with lower educational levels had a higher 10-year risk of developing CVD. Furthermore, CVD risk factors such as diabetes, hypertension, obesity, and smoking were associated with individuals' CVD risk. Considering the ease of use and applicability of the FRS in daily clinical practice, as well as its potential to identify high-risk individuals, a more systematic implementation in general practice appears to be warranted.
