Myofascial Pain Syndrome: A Report of 11 Cases Treated by Myofascial Massage Therapy, Riyadh, Saudi Arabia | Chapter 2 | Trends in Pharmaceutical Research and Development Vol. 1

Background: Myofascial pain syndrome (MPS) is a common pain condition characterized by a key symptoms and signs, determined by multiple etiologies, comorbid with a variety of systemic diseases and regional pain syndromes (RPS) and managed by diverse integrative therapies including complementary and alternative modalities (CAM) with variable outcomes. Objective: This study aimed to concisely report 11 cases of myofascial pain syndrome managed by myofascial trigger point therapy.  Methods: The relevant information about 11 cases was collected prospectively using a semistructured proforma. All patients were diagnosed mainly by detailed history and gold standard palpation method that helps identify taut muscles, tender myofascial trigger points, local twitch response and autonomic manifestations.  Results: Most of the patients with variable age and profession presented in emergency room with acute pain, limited motion, weakness, referred pain of specific pattern and associated autonomic signs and symptoms. Myofascial trigger point therapy alone with a timeline of about 30-60 minutes of 1-3 sessions brought about good results in all 11 patients (100%) who remained stable at two to three months follow-up.   Conclusion: Myofascial pain syndrome linked with latent or active myofascial trigger points developed due to repeated strains and injuries needs to be diagnosed by history and palpation method, systemic evaluation and laboratory investigations. Though several interventions are used in myofascial pain syndrome, myofascial trigger point massage therapy alone is found to be reasonably effective with excellent results. This clinical case series is calling for double-blind randomized controlled trials among patients with myofascial pain syndrome not only in Saudi Arabia but also in other Middle East countries in future.

Author(s) Details

Naseem Akhtar Qureshi 
National Center for Mental Health Promotion, Ministry of Health, Riyadh, Saudi Arabia.

Hamoud Abdullah Alsubaie
National Center for Complementary and Alternative Medicine (NCCAM), Ministry of Health, Riyadh, Saudi Arabia.

Dr. Mohammed Khulaif Alharbi
Department of Anesthesia, Faculty of Anesthesiology, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia.

Gazzaffi Ibrahim Mahjoub Ali
National Center for Complementary and Alternative Medicine (NCCAM), Ministry of Health, Riyadh, Saudi Arabia.

Dr. Saud Mohammed Alsanad
College of Medicine, Imam Muhammad Ibn Saud Islamic University (IMSIU), Riyadh, Kingdom of Saudi  
Arabia.

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A Comparison of Rheumatoid Arthritis Patients in Kuwait with Other Populations: Results from the KRRD Registry | Chapter 07 | Innovations in Medicine and Medical Research Vol. 1

Objective: Data on rheumatoid arthritis (RA) in Kuwait and The Middle East is scarce. Available data from Western countries may not be representative of the region. We describe RA patients in Kuwait and compare them with other RA populations and with Kuwaiti general population.

Methods: Adult RA patients from Kuwait Registry for Rheumatic Diseases (KRRD), the first RA registry in The Middle East, were studied from February 2013 through February 2015. Demographic, clinical and serologic data were compared with other RA populations and with Kuwaiti general population.

Results: 835 patients were enrolled, 62.3% female. Mean age 50.6±12 years and disease duration 6.1±6 years. RA was diagnosed at a mean age of 44.9±12 years. 17.1% had family history of autoimmune rheumatic diseases. 3.1% had rheumatoid nodules. Rheumatoid factor (RF) and anti-citrullinated peptide (ACPA) were detected in 75.6% and 57.8%, respectively. Both were positive in 49% (r=0.287, p=0.001). ANA was positive in 19.1%. Both ACPA and a combination of positive RF and ACPA were more in males (p=0.017, 0.004 respectively), whereas ANA was more in females (p=0.01). One third of male patients were smokers versus 1.9% of females. Smoking was correlated to RF (p=0.009) and ACPA (p=0,002). Difference in ACPA between genders was statistically explained by the predominance of smoking in males. Comorbidities included diabetes mellitus (DM) (20.8%), hypertension (20.2%), hyperlipidemia (10.5%) and coronary artery disease (CAD) (3.1%). 4 cases of cancer were reported.

Conclusion: RA population in Kuwait includes less women than other RA populations but more than Kuwaiti general population. Family history is more common. A higher positive ACPA in males was explained by smoking difference. Hypertension and hyperlipidemia were less reported than in both Kuwaiti general population and other RA populations. CAD was similar to other RA populations. DM was more reported, reflecting its high background prevalence in Kuwait.

Author(s) Details

Dr. Adeeba Al-Herz
Amiri Hospital, Kuwait City, Kuwait.

Adel Al-Awadhi
Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait.

Khulood Saleh
Farwania Hospital, Farwaniya Governorate, Kuwait

Waleed Al-Kandari
Farwania Hospital, Farwaniya Governorate, Kuwait.

Eman Hasan
Amiri Hospital, Kuwait City, Kuwait.

Aqeel Ghanem
Mubarak Al-Kabeer Hospital, Hawally Governorate, Kuwait.

Fatemah Abutiban
Jahra Hospital, Jahra Governorate, Kuwait.

Ahmad Alenizi
Jahra Hospital, Jahra Governorate, Kuwait.

Mohammed Hussain
Amiri Hospital, Kuwait City, Kuwait.

Yaser Ali
Mubarak Al-Kabeer Hospital, Hawally Governorate, Kuwait.

Ahmad Khadrawy
Farwania Hospital, Farwaniya Governorate, Kuwait.

Ammad Fazal
Farwania Hospital, Farwaniya Governorate, Kuwait.

Khaled Mokaddem
Amiri Hospital, Kuwait City, Kuwait.

Beena Aftab
Jahra Hospital, Jahra Governorate, Kuwait.

Najaf Haider
Jahra Hospital, Jahra Governorate, Kuwait.

Ajaz Zaman
Mubarak Al-Kabeer Hospital, Hawally Governorate, Kuwait.

Ghada Mazloum
Mubarak Al-Kabeer Hospital, Hawally Governorate, Kuwait.

Youssef Bartella
Amiri Hospital, Kuwait City, Kuwait.

Sally Hamed
Amiri Hospital, Kuwait City, Kuwait.

Ahmed Al-Saber
Department of Mathematics and Statistics, University of Strathclyde, Glasgow, Scotland.

View Volume: http://bp.bookpi.org/index.php/bpi/catalog/book/139