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.

Safety and Effectiveness of Evolocumab During Acute and Sub-acute Phases of Acute Coronary Syndrome (ACS): A Systematic Review and Meta-analysis.

BACKGROUND: Coronary artery disease (CAD), manifested mainly as acute coronary syndrome (ACS), continues to be a major cause of mortality globally and a significant contributing factor to the global disease burden. Elevation of low-density lipoprotein cholesterol levels attributed to proprotein convertase subtilisin/Kexin type-9 (PCSK9) during and following ACS puts patients at high risk of subsequent adverse events. Evolocumab is a PCSK9 inhibitor that is associated with a significant reduction in low-density lipoprotein cholesterol (LDL-C) levels through PCSK9 inhibition in comparison to traditional statin therapy. METHODS: We conducted a systematic review and meta-analysis of literature addressing the efficacy and safety of evolocumab compared to other lipid-lowering therapies or placebo. An extensive internet-based literature search using pre-determined key phrases supported by medical sub-headings and Boolean operators was performed in October 2022 to identify literature pertinent to the research topic. The search was primarily based on the National Library of Medicine (PubMed and Clinical Trials), MEDLINE, Cochrane, and the Science direct literature databases. Subsequently, the researchers devised PICOs-based screening criteria which had to be met by each identified study for inclusion in the review and meta-analysis. Two independent reviewers conducted data stratification and quality assessment of identified studies. Statistical analysis of the primary and secondary outcomes was conducted on the Cochrane REVMAN 5.4 statistical software for randomized trials. RESULTS: Two thousand five hundred and seventy-six potential studies were identified for inclusion in the systematic review. Data stratification, screening, and quality assessment of these studies based on the eligibility criteria led to the exclusion of two thousand five hundred and sixty-seven studies as they did not meet the standards set. Nine randomized controlled trials progressed to numerical analysis for validity and reliability. Eight studies were included in the meta-analysis. Meta-analytical results showed a significant decrease in LDL-C changes from initiation of evolocumab therapy to 8 weeks following ACS compared to placebo. Similar results were derived in the sub-acute phase of ACS [SMD -1.95 (95% CI -2.29, -1.62)]. The meta-analysis revealed no statistically significant relationship between the risk of adverse effects, serious adverse effects, and major adverse cardiovascular events (MACE) from treatment using evolocumab in comparison to placebo [(relative risk, RR 1.04 (95% CI 0.99, 1.08) (Z = 1.53; p=0.12)]. CONCLUSION: Early evolocumab therapy initiation was associated with a significant decrease in LDL-C levels and was not associated with an increased risk of adverse effects in comparison to placebo.

Prevalence of Anxiety, Depression, and Sleep Disturbances Associated With the COVID-19 Outbreak in Riyadh, Saudi Arabia.

Background COVID-19 became a global respiratory pandemic as it disrupted millions of lives and commerce. The implementation of strict lockdown measures to confine the outbreak can negatively affect people's overall sleep quality and mental health. We aimed to assess the prevalence of sleep disturbance and the psychological impact associated with the spread of COVID-19 in Riyadh, Saudi Arabia.  Materials and methods A cross-sectional study was conducted in Riyadh, Saudi Arabia. A nationally online questionnaire was sent to participants aged >18 years to assess their socio-demographic information, assessment of psychological status by Hospital Anxiety and Depression Scale (HADS), and assessment of sleep disturbance by Athens Insomnia Scale (AIS) and Insomnia Severity Index (ISI) scales.  Results The total sample consisted of 399 participants. The mean age was 34.70 ± 12.57 years; predominant responses were from females (69.4%). The study sample was mostly made up of students (32.1%), and more than half of the participants (52.6%) were married. The prevalence of anxiety, depression, and insomnia was 38.6%, 33.1%, and 54.9%, respectively. Participants with comorbidities were significantly at higher risk of having symptoms of depression in comparison to subjects free from chronic diseases (OR=2.19 95% Cl: 1.24-3.86, p=001).  Conclusion These findings suggest that the prevalence of poor sleep quality and worsening mental health in Riyadh, Saudi Arabia was high during the COVID-19 lockdown, which articulates the requirement for raising the awareness, screening, and management of worsening sleep quality and mental health due to the unwholesome effect they may have on the individual's health.