scholarly journals Future of Management of Multiple Sclerosis in the Middle East: A Consensus View from Specialists in Ten Countries

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Mohammed Aljumah ◽  
Raed Alroughani ◽  
I. Alsharoqi ◽  
Saeed A. Bohlega ◽  
Maurice Dahdaleh ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Middle East ◽  
Middle Eastern ◽  
Regulatory Body ◽  
Optimal Care ◽  
Single Vision ◽  
Disease Modifying Therapies ◽  
The Future ◽  
Risk Ratios

The prevalence of multiple sclerosis (MS) is now considered to be medium-to-high in the Middle East and is rising, particularly among women. While the characteristics of the disease and the response of patients to disease-modifying therapies are generally comparable between the Middle East and other areas, significant barriers to achieving optimal care for MS exist in these developing nations. A group of physicians involved in the management of MS in ten Middle Eastern countries met to consider the future of MS care in the region, using a structured process to reach a consensus. Six key priorities were identified: early diagnosis and management of MS, the provision of multidisciplinary MS centres, patient engagement and better communication with stakeholders, regulatory body education and reimbursement, a commitment to research, and more therapy options with better benefit-to-risk ratios. The experts distilled these priorities into a single vision statement: “Optimization of patient-centred multidisciplinary strategies to improve the quality of life of people with MS.” These core principles will contribute to the development of a broader consensus on the future of care for MS in the Middle East.

scholarly journals Monoclonal Antibodies in Multiple Sclerosis: Present and Future

Biomedicines ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 20 ◽  
Author(s):  
Natalia Voge ◽  
Enrique Alvarez
Keyword(s):  
Multiple Sclerosis ◽  
Monoclonal Antibodies ◽  
Morbidity Rate ◽  
High Morbidity ◽  
Disease Modifying Therapies ◽  
High Morbidity Rate ◽  
New Treatments ◽  
Near Future ◽  
Risk Ratios

The global incidence of multiple sclerosis (MS) appears to be increasing. Although it may not be associated with a high mortality rate, this disease has a high morbidity rate which affects the quality of life of patients and reduces their ability to do their activities of daily living. Thankfully, the development of novel disease modifying therapies continues to increase. Monoclonal antibodies (MABs) have become a mainstay of MS treatment and they are likely to continue to be developed for the treatment of this disease. Specifically, MABs have proven to be some of the most efficacious treatments at reducing relapses and the inflammation in MS patients, including the first treatment for primary progressive MS and are being explored as reparative/remyelinating agents as well. These relatively new treatments will be reviewed here to help evaluate their efficacy, adverse events, immunogenicity, and benefit-risk ratios in the treatment of the diverse spectrum of MS. The focus will be on MABs that are currently approved or may be approved in the near future.

Clinical Presentation, Quality of Care, Risk Factors and Outcomes in Women with Acute ST-Elevation Myocardial Infarction (STEMI): An Observational Report from Six Middle Eastern Countries

2019 ◽  
Vol 17 (4) ◽  
pp. 388-395 ◽  
Author(s):  
Abdulla Shehab ◽  
Khalid F. AlHabib ◽  
Akshaya S. Bhagavathula ◽  
Ahmad Hersi ◽  
Hussam Alfaleh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Quality Of Care ◽  
Middle East ◽  
Clinical Presentation ◽  
Middle Eastern ◽  
High Morbidity ◽  
Inhospital Mortality ◽  
Acute Stemi

Background: Most of the available literature on ST-Elevated myocardial infarction (STEMI) in women was conducted in the developed world and data from Middle-East countries was limited. Aims: To examine the clinical presentation, patient management, quality of care, risk factors and inhospital outcomes of women with acute STEMI compared with men using data from a large STEMI registry from the Middle East. Methods: Data were derived from the third Gulf Registry of Acute Coronary Events (Gulf RACE-3Ps), a prospective, multinational study of adults with acute STEMI from 36 hospitals in 6 Middle-Eastern countries. The study included 2928 patients; 296 women (10.1%) and 2632 men (89.9%). Clinical presentations, management and in-hospital outcomes were compared between the 2 groups. Results: Women were 10 years older and more likely to have diabetes mellitus, hypertension, and hyperlipidemia compared with men who were more likely to be smokers (all p<0.001). Women had longer median symptom-onset to emergency department (ED) arrival times (230 vs. 170 min, p<0.001) and ED to diagnostic ECG (8 vs. 6 min., p<0.001). When primary percutaneous coronary intervention (PPCI) was performed, women had longer door-to-balloon time (DBT) (86 vs. 73 min., p=0.009). When thrombolytic therapy was not administered, women were less likely to receive PPCI (69.7 vs. 76.7%, p=0.036). The mean duration of hospital stay was longer in women (6.03 ± 22.51 vs. 3.41 ± 19.45 days, p=0.032) and the crude in-hospital mortality rate was higher in women (10.4 vs. 5.2%, p<0.001). However, after adjustments, multivariate analysis revealed a statistically non-significant trend of higher inhospital mortality among women than men (6.4 vs. 4.6%), (p=0.145). Conclusion: Our study demonstrates that women in our region have almost double the mortality from STEMI compared with men. Although this can partially be explained by older age and higher risk profiles in women, however, correction of identified gaps in quality of care should be attempted to reduce the high morbidity and mortality of STEMI in our women.

Middle East luxury retail sector – opportunities or uncertainties in the future?

2016 ◽  
Vol 6 (3) ◽  
pp. 1-39
Author(s):  
Roger Moser ◽  
Gopalakrishnan Narayanamurthy
Keyword(s):  
Middle East ◽  
Multinational Corporations ◽  
International Business ◽  
Market Entry ◽  
Middle Eastern ◽  
Subject Area ◽  
Retail Sector ◽  
Senior Executive ◽  
Content Type ◽  
The Future

Subject area The subject area is international business and global operations. Study level/applicability The study includes BSc, MSc and MBA students and management trainees who are interested in learning how an industry can be assessed to make a decision on market entry/expansion. Even senior management teams could be targeted in executive education programs, as this case provides a detailed procedure and methodology that is also used by companies (multinational corporations and small- and medium-sized enterprises) to develop strategies on corporate and functional levels. Case overview A group of five senior executive teams of different Swiss luxury and lifestyle companies wanted to enter the Middle East market. To figure out the optimal market entry and operating strategies, the senior executive team approached the Head of the Swiss Business Hub Middle East of Switzerland Global Enterprise, Thomas Meier, in December 2012. Although being marked with great potential and an over-proportional growth, the Middle Eastern luxury market contained impediments that international firms had to take into consideration. Therefore, Thomas had to analyze the future outlook for this segment of the Middle East retail sector to develop potential strategies for the five different Swiss luxury and lifestyle companies to potentially operate successfully in the Middle East luxury and lifestyle market. Expected learning outcomes The study identifies barriers and operations challenges especially for Swiss and other foreign luxury and lifestyle retailers in the Middle East, understands the future (2017) institutional environment of the luxury and lifestyle retail sector in the Middle East and applies the institutions-resources matrix in the context of a Swiss company to evaluate the uncertainties prevailing in the Middle East luxury and lifestyle retail sector. It helps in turning insights about future developments in an industry (segment) into consequences for the corporate and functional strategies of a company. Supplementary materials Teaching notes are available for educators only. Please contact your library to gain login details or e-mail [email protected] to request teaching notes. Subject code CSS 5: International Business.

scholarly journals Access to and Use of Clinical Services and Disease-Modifying Therapies by People with Progressive Multiple Sclerosis in the United Kingdom

2017 ◽  
Vol 19 (6) ◽  
pp. 275-282 ◽  
Author(s):  
Evan Campbell ◽  
Elaine H. Coulter ◽  
Paul Mattison ◽  
Angus McFadyen ◽  
Linda Miller ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Progressive Multiple Sclerosis ◽  
Clinical Services ◽  
The United Kingdom ◽  
Disease Modifying Therapies ◽  
Disease Modifying ◽  
The Uk ◽  
Regular Review

Background: According to current UK guidelines, everyone with progressive multiple sclerosis (MS) should have access to an MS specialist, but levels of access and use of clinical services is unknown. We sought to investigate access to MS specialists and use of clinical services and disease-modifying therapies (DMTs) by people with progressive MS in the United Kingdom. Methods: A UK-wide online survey was conducted via the UK MS Register. The inclusion criteria were age 18 years or older, primary or secondary progressive MS, and a member of the UK MS Register. Participants were asked about access to MS specialists, recent clinical service use, receipt of regular review, and current and previous DMT use. Participant demographic data, quality of life, and disease impact measures were from the UK MS Register. Results: In total, 1298 individuals responded: 7% were currently taking a DMT, 23% had previously taken a DMT, and 95% reported access to an MS specialist. The most used practitioners were MS doctors/nurses (50%), general practitioners (45%), and physiotherapists (40%). Seventy-four percent of participants received a regular review, although 37% received theirs less often than annually. Current DMT use was associated with better quality of life, but past DMT use was associated with poorer quality of life and higher impact of disease. Conclusions: Access to and use of MS specialists was high. However, a gap in service provision was highlighted in both receipt and frequency of regular reviews.

Causes of delayed management of multiple sclerosis patients in Nasr city health insurance hospital

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M M Wahib ◽  
M O Abdulghani ◽  
H M A Aref ◽  
A M A Nasef
Keyword(s):  
Multiple Sclerosis ◽  
Daily Activities ◽  
Disease Modifying Therapies ◽  
Relapsing Remitting ◽  
The Face ◽  
Muscle Spasms ◽  
Save Energy ◽  
Multiple Sclerosis Patients ◽  
Fair Degree

Abstract In multiple sclerosis (MS), the immune system attacks and destroys the fatty myelin coating that surrounds and insulates nerve cells in a process known as demyelination. MS is a lifelong condition, and common symptoms include fatigue, muscle spasms, walking difficulties, or numbness and tingling of the face, body, arms and legs. These symptoms can worsen with time, affecting daily activities and reducing a person’s quality of life. The disease is highly variable, and some people are affected more than others upon and after diagnosis. Treatments are available to help manage a number of symptoms. Life expectancy for people with MS has increased considerably in the last 20 to 25 years. On average, however, a person with MS can expect to live seven fewer years than someone without this disease. According to the National MS Society, on average, an MS patient lives about seven fewer years than someone in the general public, largely because of disease complications or other medical conditions, like cardiovascular disease. Only rarely does the disease progress so quickly that it is deadly. Due to advances in treatments, care, and lifestyle adjustments, MS often progresses slowly. Many studies show that, nowadays, about two-thirds of all patients retain a fair degree of mobility—the ability to walk, although likely with an assisted device—some 20 years after being diagnosed. Assisted devices can range from supports to aid in walking, to scooters used on occasion to save energy and avoid fatigue. The course of the disease depends on each patient’s risk factors, like having a family member with MS, cigarette smoking, and vitamin D sunlight exposure. And, among African-Americans, the disease tends to be a more progressive form and progression can be quicker. MS prognosis is thought to be better for people with relapsing-remitting MS than for those with progressive forms of MS, likely because of a better response to disease-modifying therapies.

scholarly journals Inclusive security architecture in the Middle East: peculiarities of functioning and Prospects for expansion

2021 ◽  
pp. 1-14
Author(s):  
Danila Sergeevich Krylov
Keyword(s):  
Saudi Arabia ◽  
Middle East ◽  
Swot Analysis ◽  
Middle Eastern ◽  
Security Architecture ◽  
Peace And Security ◽  
The Future ◽  
The Creation

This article explores the prerequisites for the creation and peculiarities of functioning of the inclusive security architecture in the Middle East. This system of ensuring and maintaining peace was established by Russia, and currently includes two cross-regional Middle Eastern powers &ndash; Turkey and Iran. The author analyzes the potential of involving new actors &mdash; Saudi Arabia and Israel &ndash; into the functioning of the security architecture. The article employs the method of SWOT-analysis for determining the advantages and disadvantaged of the inclusive security architecture in the Middle East, as well as outlining the major threats and capabilities of the system. The novelty of this research lies in giving definition to the concept of &ldquo;inclusive security architecture&rdquo;; assessing the strengths and weaknesses of the inclusive security architecture created by Russia in the Middle East; outlining the major threats and vulnerabilities of the system, as well as the potential attraction of new actors therein. The author also highlights the peculiarities of the key five pairs of conflict relations in the Middle East (Saudi Arabia &mdash; Iran, Saudi Arabia &ndash; Turkey, Saudi Arabia &ndash; Israel, Israel &ndash; Iran, and Israel &ndash; Turkey), the nature of which Russia should take into account within the framework of long-term planning. The conclusion is made that in the future, the inclusive security architecture may become one of the key pillars of peace and security in the Middle East, and gradually mitigate the conflicts in this region.

scholarly journals Comparing the Quality of Life among Patients with Relapsing Remitting Multiple Sclerosis in Iraq Using Different Disease Modifying Therapies

2018 ◽  
pp. 102-114
Author(s):  
Ruaa Natiq Yahya ◽  
Ali A.Kasim ◽  
Gheyath A. Al Gawwam
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Sensory Loss ◽  
Unknown Etiology ◽  
Disease Modifying Therapies ◽  
Relapsing Remitting ◽  
Disease Modifying ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis

Multiple sclerosis (MS) is a chronic, neurodegenerative disease of the central nervous system with unknown etiology mostly affecting young adults with mean age of 30 years, twice as high in women compared to men. The symptoms of MS, such as weakness, sensory loss, and ataxia, which are directly related to demyelination and axonal loss, along with other symptoms such as reactive depression or social isolation, can result in functional limitations, disability and reduced quality of life (QoL).  QoL assessments in patients with a chronic disease may contribute to improving treatment and could even be of prognostic value. The goals  of this study were  to  assess the QoL among  Iraqi patients with relapsing remitting multiple sclerosis(RRMS), using one of three different disease modifying therapies(DMTs) administered orally, subcutaneously, and by slow infusion; namely, fingolimod, IFN?-1b, and natalizumab, respectively. And to assess the role of certain predictors on  QoL. Functional Assessment of Multiple Sclerosis (FAMS) questionnaire version 4 was used to assess QoL. Sociodemographic and clinical characteristics were tested by univariate and multivariate regression analysis to assess the contribution of these predictors to QoL.  No significant differences were found in Symptoms, Thinking/fatigue subscales and FAMS total scores. In conclusions: Iraqi MS patients using IFN?-1b, fingolimod or natalizumab have a comparable low level of QoL. The expanded disability status scale (EDSS) is negatively associated with QoL of MS patients in all of the three therapies, while other predictors such as occupational status, educational status, smoking habit and MS duration have different impact in different treatments.

scholarly journals The use and quality of reporting of propensity score methods in multiple sclerosis literature: A review

2020 ◽  
pp. 135245852097255
Author(s):  
Mohammad Ehsanul Karim ◽  
Fabio Pellegrini ◽  
Robert W Platt ◽  
Gabrielle Simoneau ◽  
Julie Rouette ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Propensity Score ◽  
Statistical Tests ◽  
Quality Of Reporting ◽  
Propensity Score Methods ◽  
The Past ◽  
Disease Modifying Therapies ◽  
Pubmed Database ◽  
Effectiveness Studies

Background: Propensity score (PS) analyses are increasingly used in multiple sclerosis (MS) research, largely owing to the greater availability of large observational cohorts and registry databases. Objective: To evaluate the use and quality of reporting of PS methods in the recent MS literature. Methods: We searched the PubMed database for articles published between January 2013 and July 2019. We restricted the search to comparative effectiveness studies of two disease-modifying therapies. Results: Thirty-nine studies were included in the review, with most studies (62%) published within the past 3 years. All studies reported the list of covariates used for the PS model, but only 21% of studies mentioned how those covariates were selected. Most studies used PS matching (72%), followed by PS adjustment (18%), weighting (15%), and stratification (3%), with some overlap. Most studies using matching or weighting reported checking post-PS covariate imbalance (91%), although about 45% of these studies relied on p values from various statistical tests. Only 25% of studies using matching reported calculating robust standard errors for the PS analyses. Conclusions: The quality of reporting of PS methods in the MS literature is sub-optimal in general, and in some cases, inappropriate methods are used.

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