Physical activity assessment among patients with multiple sclerosis in Saudi Arabia.

OBJECTIVES: To measure and assess the physical activity (PA) of patients with multiple sclerosis (MS) and its association with the quality of life (QoL). METHODS: This cross-sectional study included patients with MS in Kingdom of Saudi Arabia from August, 2022 to November, 2022. Data were collected via social media platforms using a questionnaire that included 3 sections: sociodemographic data, International PA Questionnaire (IPAQ), and the Health Status Questionnaire Short Form-36 (SF-36). RESULTS: In total, 145 eligible patients with MS were included. The patients' ages ranged from 18 to 60 years, with a mean age of 33.2±13.9 years. Females were predominantly affected, and most of the patients were either not working or retired. Relapsing-remitting MS constituted the majority (66.2%) of patients. Additionally, most patients (75.9%) were free from co-morbidities. Approximately 41.7% of patients with high PA levels had good QoL scores. CONCLUSION: Higher PA levels was significantly associated with better QoL in patients with MS. High PA can improve the QoL by taking into consideration several factors that could influence readiness for exercise and its effect on MS symptoms.

Phenotype and Genotype of Saudi Pediatric Patients With Neurofibromatosis Type 1: A Seven-Year Multicenter Experience From Saudi Arabia.

Background Neurofibromatosis type 1 (NF1) is a complex disorder. Genetics and environment might be attributed as the leading cause of NF1, which is characterized by multisystemic involvement. We aim to elaborate on Saudi children's NF1 phenotypes and genotypes. Methods This study was conducted in the Ministry of National Guard Health Affairs (MNGHA), Saudi Arabia including three tertiary hospitals, using a retrospective cohort method. Electronic charts were reviewed to extract the variables. All Saudi pediatric patients aged less than 18 with NF1 were included. Consecutive sampling was used due to the limited number of patients. Results The study included 160 patients (81 males) with an average age of 8.08 years. Also, 33 (20.6%) patients had cutaneous neurofibroma while 31 (19.4%) patients had plexiform neurofibromas. Iris lisch nodules were seen in 33.75%. Optic pathway glioma was seen in 29 (18%) cases while non-optic pathway glioma was seen in 27 (17%) cases. Skeletal abnormalities were seen in 27 (17%) of cases. A first-degree relative with NF1 was seen in 83 (52%) of cases. Epilepsy was the presenting feature of 27 (17%) cases. Cognitive impairment was found in 15 (9.4%) patients. Genetic mutation was seen in 82/100 cases, the rest were negative. The types of mutations were as follows: nonsense 30 (36.6%); missense 20 (24.4%); splicing site mutation 12 (14.6%); frameshift 10 (12.2%); microdeletion 7 (8.5%); and whole gene deletion 3 (3.75%) patients. No phenotype-genotype correlation was seen. Conclusion In this cohort of Saudi pediatric patients with NF1, optic pathway glioma and other brain tumors were prevalent. The most common mutation is the nonsense mutation.

Secondary stroke prevention among stroke survivors in Riyadh city, Saudi Arabia. Risk Knowledge, adherence to stroke discharge medications and preventive strategies.

OBJECTIVE: To assess knowledge about secondary stroke and adherence to stroke discharge medication and prevention strategies among stroke survivors, and to identify possible causes of poor adherence. METHODS: A cross-sectional study that involved 82 stroke survivors who were treated at Prince Mohammed Bin Abdulaziz Hospital (PMAH) in Riyadh, Saudi Arabia, from July 2015 to August 2018. Patient adherence level (PAL) was assessed using a tool developed by Sidorkiewicz et al (2016). RESULTS: Of the 82 participants, 63.4% believed that the risk of secondary stroke is higher and 70.7% believed it would results in worse outcome, compared to primary stroke. Out of a list of 7 preventive strategies, treating risk factors (80.5%), keeping a healthy diet (65.9%) and regular exercise (63.4%) were the most frequently identified. Forgetful-ness (51.2%), polypharmacy (18.3%) and patient-perceived improvement (17.1%) were the most frequently reported causes for nonadherence. At the patients` level, PAL was adequate among 46.8%, and was higher among females (60.0% versus 35.7%, p=0.033) and married (52.2% versus 0.0%, p=0.006) ones, and lower among smokers (22.2% versus 54.2%, p=0.029), compared to their counterparts. No correlation of adherence level with knowledge was observed. Regression showed approximation to statistical significance for smoking (OR=4.28 [0.99, 18.41], p=0.051) as a predictor for inadequate adherence. CONCLUSION: Stroke survivors have suboptimal adherence to discharge prescriptions and preventive strategies, despite a relatively sound knowledge, which exposes them to high risk of secondary stroke. It is part of the healthcare providers` role to identify eventual barriers to adherence and to implement efficacious strategies to alleviate such barriers and improve patients` adherence.

Neuromyelitis optica spectrum disorders in Arabian Gulf (NMOAG); establishment and initial characterization of a patient registry.

OBJECTIVE: To describe the clinical and radiological characteristics of neuromyelitis optica spectrum disorders (NMOSD) patients from the Arabian Gulf relative to anti-aquaporin 4 antibody serostatus. METHODS: Retrospective multicentre study of hospital records of patients diagnosed with NMOSD based on 2015 International Panel on NMOSD Diagnosis (IPND) consensus criteria. RESULTS: One hundred forty four patients were evaluated, 64.3% were anti-AQP4 antibody positive. Mean age at onset and disease duration were 31±12 and 7 ±â€¯6 years respectively. Patients were predominantly female (4.7:1). Overall; relapsing course (80%) was more common than monophasic (20%). Optic neuritis was the most frequent presentation (48.6%), regardless of serostatus. The proportion of patients (54.3%) with visual acuity of ≤ 0.1 was higher in the seropositive group (p = 0.018). Primary presenting symptoms of transverse myelitis (TM) were observed in 29% of patients, and were the most significant correlate of hospitalization (p<0.001). Relative to anti-APQ4 serostatus, there were no significant differences in terms of age of onset, course, relapse rates or efficacy outcomes except for oligoclonal bands (OCB), which were more often present in seronegative patients (40% vs.22.5%; p = 0.054). Irrespective of serostatus, several disease modifying therapies were instituted including steroids or immunosuppressives, mostly, rituximab and azathioprine in the cohort irrespective of serostatus. The use of rituximab resulted in reduction in disease activity. CONCLUSION: This is the first descriptive NMOSD cohort in the Arabian Gulf region. Seropositive patients were more prevalent with female predominance. Relapsing course was more common than monophasic. However, anti-AQP4 serostatus did not impact disease duration, relapse rate or therapeutic effectiveness. These findings offer new insights into natural history of NMOSD in patients of the Arabian Gulf and allow comparison with patient populations in different World regions.