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Almutairi AB, Alrashdi NZ, Vogtle L, Alotaibi MM. Effect of psychostimulant medications on physical function in children with cerebral palsy: scoping review. Pediatr Res 2024; 95:1217-1223. [PMID: 38071277 DOI: 10.1038/s41390-023-02933-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/18/2023] [Accepted: 11/14/2023] [Indexed: 04/24/2024]
Abstract
The aim of this scoping review is to examine the extent and depth of the literature on effects of central nervous system (CNS) stimulant medications on physical function in children with cerebral palsy (CP). A systematic search for relevant peer-reviewed studies was conducted of PubMed, CINAHL, Cochrane, SPORTDiscus, Embase, & Scopus (January 2002 & August 2022). We included studies that examined the effects of CNS stimulants on physical function in children with CP. Four studies met our selection criteria. All studies explored the effect of Modafinil on physical function outcomes. Three studies of the four included studies reported positive effects of Modafinil on spasticity, motor performance, and gait, whereas one study reported no significant effects of Modafinil. Our findings suggest that there is very low-quality evidence that suggests that Modafinil may enhance physical improvements in body structure and function, including reduction in spasticity and improvements in gait parameters. IMPACT: Central nervous system stimulants were examined for efficacy on physical function and spasticity in children with cerebral palsy. The evidence on the effects of central nervous system stimulants on physical function in children with CP is limited and inconsistent.
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Affiliation(s)
- Anwar B Almutairi
- Department of Physical Therapy, Faculty of Allied Health, Kuwait University, Jabriya, Kuwait.
| | - Naif Z Alrashdi
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Laura Vogtle
- Department of Occupational Therapy, School of Health Professions, Birmingham, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mansour M Alotaibi
- Department of Rehabilitation, Faculty of Applied Medical Sciences, Northern Border University, Arar, Saudi Arabia
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Alotaibi M, Almutairi AB, Alhirsan S, Alkazemi A, Alharbi M, Alrashdi N, Taqi A, Alamiri B, Vogtle L, Alqahtani MM. Psychostimulant Medications for Physical Function and Spasticity in Children With Cerebral Palsy: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e53728. [PMID: 38441919 PMCID: PMC10951828 DOI: 10.2196/53728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Cerebral palsy (CP) is a prevalent nonprogressive disorder that leads to impaired movement (ie, spasticity), posture, and balance, which affects functions such as walking and upper extremity tasks. Current medical treatments show efficacy in improving motor performance but have considerable side effects. Emerging off-label use of central nervous system (CNS) medications for improving motor performance has shown promising results in children with CP and other populations. OBJECTIVE The aim of this study is to describe a protocol for a pilot randomized controlled trial (RCT) to examine the safety, tolerability, and efficacy of methylphenidate (MPH) and modafinil on spasticity and motor performance in children with CP. METHODS This will be a protocol study for a pilot, triple-masked, placebo-controlled RCT (a class I trial following the American Academy of Neurology criteria) with blinded patients, outcome assessors, and intervention delivery team. Eligible children should be diagnosed with CP levels I or II based on the Gross Motor Function Classification System and be aged between 7 and 12 years. Thirty-six children with CP will be randomized into 3 groups to receive (1) MPH (2.5 mg of MPH + 100 mg placebo), (2) modafinil (100 mg modafinil + 2.5 mg placebo), or (3) a placebo (2.5 mg placebo + 100 mg placebo), in addition to physical therapy for 12 weeks. Primary outcomes include the Gross Motor Function Measure-66 and the Modified Ashworth Scale. Secondary outcomes include the Timed Up and Go test, 5 Time Sit to Stand test, Modified Clinical Test for Sensory Interaction of Balance, and 10-Meter Walk Test. RESULTS The protocol has been accepted by Kuwait University (VDR/EC-225) and the Ministry of Health of Kuwait (2022/2157). The inclusion of participants will start in June 2024. CONCLUSIONS The combination of CNS stimulant medications and controlling for rehabilitation has not been studied yet. The findings of this study may determine if using CNS stimulant medications is beneficial for the reduction of spasticity and improvement of physical function in children with spastic CP. TRIAL REGISTRATION ClinicalTrials.gov NCT05675098; https://clinicaltrials.gov/study/NCT05675098. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/53728.
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Affiliation(s)
- Mansour Alotaibi
- Department of Rehabilitation, Faculty of Applied Medical Sciences, Northern Border University, Arar, Saudi Arabia
- Center for Health Research, Northern Border University, Arar, Saudi Arabia
| | - Anwar B Almutairi
- Department of Physical Therapy, Faculty of Allied Health, Kuwait University, Kuwait City, Kuwait
| | - Saleh Alhirsan
- Department of Physical Therapy, College of Applied Medical Sciences, Jouf University, Aljouf, Saudi Arabia
| | - Afrah Alkazemi
- Department of Pharmacy Practice, College of Pharmacy, Kuwait University, Kuwait City, Kuwait
| | - Maha Alharbi
- Department of Pharmacy Practice, College of Pharmacy, Kuwait University, Kuwait City, Kuwait
| | - Naif Alrashdi
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al-Majmaah, Saudi Arabia
- The Health and Scientific Research Center, Majmaah University, Majmaah, Saudi Arabia
| | - Ahmad Taqi
- Department of Pharmacy Practice, College of Pharmacy, Kuwait University, Kuwait City, Kuwait
| | - Bibi Alamiri
- Kuwait Center for Mental Health, Public Authority for Disability Affairs, Almanara, Kuwait
| | - Laura Vogtle
- Department of Occupational Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Mohammed M Alqahtani
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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Alqahtani MM, Alanazi AMM, Aljohani H, Ismaeil TT, Algarni SS, Alotaibi TF, Alotaibi MM, Kalan ME, Lein DH, Alqahtani MK, Alwadeai KS, Almutairi AB, Hendricks PS. The relationship between chronic lung disease diagnosis and the susceptibility to e-cigarette use in adults: The mediation effects of psychosocial, cognitive influences, and the moderation effect of physiological factors. Tob Induc Dis 2023; 21:116. [PMID: 37745030 PMCID: PMC10515703 DOI: 10.18332/tid/169741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/16/2023] [Accepted: 07/19/2023] [Indexed: 09/26/2023] Open
Abstract
INTRODUCTION There is a paucity of studies on e-cigarette use among adults with chronic lung disease. In the present study, we aimed to assess whether psychosocial or cognitive factors elucidate the relationship between chronic lung disease (CLD) and susceptibility to e-cigarette use and whether the relationship between CLD and e-cigarette use is conditional on the presence of respiratory symptoms. METHODS We recruited adults aged ≥18 years in Alabama with CLD from university medical clinics (n=140) and individuals without CLD (n=123 as a reference group). Information on sociodemographics, susceptibility to e-cigarette use, psychosocial factors, and cognitive factors were collected. Mediation analysis was used to assess whether the psychosocial factors or cognitive factors explained the association between CLD and susceptibility to using e-cigarettes, and moderation analysis was conducted to determine if respiratory factors would change the association between CLD and susceptibility to e-cigarette use. RESULTS Psychosocial factors (stress, depression, anxiety) and e-cigarette positive expectancy were notably high among individuals with CLD. Having CLD was associated with a lower likelihood of susceptibility to e-cigarette use. Higher levels of stress, being a smoker, boredom, taste/sensorimotor manipulation, and social facilitation were associated with higher odds of susceptibility to using e-cigarettes among individuals with CLD. Mediation analysis indicated a statistically significant indirect effect of CLD on the susceptibility to using e-cigarettes through stress and boredom reduction. We did not find a statistically significant interaction between CLD and respiratory symptoms affecting susceptibility to using e-cigarettes. CONCLUSIONS Individuals with CLD often exhibit stress, depression, and a positive view of e-cigarettes but are generally less inclined to use them. Stress, smoking habits, boredom, taste, and social influence can increase their susceptibility to e-cigarette use. Our findings call for further exploration to evaluate the temporal relationship between CLD status, psychosocial factors, cognitive factors, and susceptibility to using e-cigarettes. TRIAL REGISTRATION The study was registered on ClinicalTrials.gov, on 5 November 2019. Identifier: NCT04151784.
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Affiliation(s)
- Mohammed M Alqahtani
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Department of Respiratory Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Abdullah M M Alanazi
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Department of Respiratory Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Hassan Aljohani
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Department of Respiratory Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Taha T Ismaeil
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Department of Respiratory Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Saleh S Algarni
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Department of Respiratory Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Tareq F Alotaibi
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Department of Respiratory Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Mansour M Alotaibi
- Department of Physical Therapy, College of Applied Medical Sciences, Northern Border University, Arar, Saudi Arabia
| | | | - Donald H Lein
- Department of Physical Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham, United States
| | - Mobarak K Alqahtani
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Department of Respiratory Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Khalid S Alwadeai
- Department of Rehabilitation Science, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Anwar B Almutairi
- Physical Therapy Department, School of Allied Health, Kuwait University, Kuwait City, Kuwait
| | - Peter S Hendricks
- Department of Psychiatry, School of Medicine, University of Alabama at Birmingham, Birmingham, United States
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Aloyari WO, Alghuyaythat WKZ, Almazrou MA, Saqyan AHB, Almutairi AB, Aljameeli AG, Almutairi MA, Alhaidari MM, Alshuwaish LA, Albar HM. Meta-analysis of prevalence and prognosis of AHF in patients admitted with myocardial infarction: role of invasive management in determining patients' outcomes. Eur Rev Med Pharmacol Sci 2023; 27:4028-4037. [PMID: 37203826 DOI: 10.26355/eurrev_202305_32308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
OBJECTIVE This meta-analysis aimed to reveal the prevalence and prognosis of heart failure in myocardial patients. This study further sought to explore the role of treatment in determining outcomes. MATERIALS AND METHODS This systematic analysis was performed on the principles of the pre-designed protocol of meta-analysis and systematic reviews statement. Online search articles were accessed for analysis. Studies from January 2012 to August 2020 were considered to identify the prognosis and prevalence of acute heart failure and myocardial infarction. Cochran's Q-test and I2-test were used to measure heterogeneity across the studies. Meta-regression was also performed to identify the potential source of heterogeneity. RESULTS For the final analysis, 30 studies were included. No significant publication bias was reported on the funnel plot. However, a 0.462 value was reported for short-term mortality, whereas 0.274 was reported for the long term while performing Egger's tests. Meanwhile, the Begg test showed a value of 0.274 for publication bias. However, an asymmetrical funnel plot suggested potential publication bias. CONCLUSIONS After adjustment of clinical and cardiovascular baseline, significant results related to the impact of sex differences on mortality could be obtained. Disease prognosis may be affected by co-morbidities, especially diabetes Mellitus, kidney disease, hypertension, and COPD worsening the situation of patients.
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Affiliation(s)
- W O Aloyari
- College of Medicine, Majmaah University, Majmaah, Saudi Arabia.
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Khalaf A, Almutairi AB, Saeed R, Alotaibi N, Alhamad H, Ghadanfar L. The Supervisees' Perspectives Concerning the Clinical Supervision of Radiologic Sciences Students at Clinical Sites: Implications and Future Directions. Adv Med Educ Pract 2023; 14:305-312. [PMID: 37016623 PMCID: PMC10066897 DOI: 10.2147/amep.s397035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 03/13/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Clinical supervision (CS) is essential to practice-based learning in radiology. The assessment of the effectiveness of CS is essential to ensure the success of the process and to provide high-quality patient care. PURPOSE This study aimed to evaluate the CS of both Diagnostic Radiography (DR) and Nuclear Medicine (NM) technology students studying at Kuwait University. METHODS The Manchester Clinical Supervision Scale-26 (MCSS-26©) was distributed electronically to 90 third and fourth year students from Radiologic Sciences department. Ethical approval was obtained from the Health Sciences Centre (HSC) Ethical Committee and all the participants provided electronic informed consent. Data are presented as mean ± SD. RESULTS Seventy responses were collected from DR and NM (response rate 78%, DR: n= 51, NM: n=19). Overall, the mean CS score from the MCSS was 67.7±11.3, n=70. CS in NM scored more effective than that in DR with a p=0.037 (72.3±10.1, 66.0±11.3, respectively). CONCLUSION The effectiveness of CS has been evaluated in third and fourth year students across the two divisions of RS the department at Kuwait University. This study showed that students value the impact of CS in their professional role and 70% reported being satisfied with the overall CS experience. Limited studies are available that focuses on students' perceptions about clinical supervision; therefore, more studies are needed to evaluate the effectiveness of CS among RS students. Implications for interprofessional education are presented.
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Affiliation(s)
- Asseel Khalaf
- Radiologic Sciences Department, Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
| | - Anwar B Almutairi
- Physical Therapy Department, Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
| | - Raed Saeed
- Radiologic Sciences Department, Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
| | - Naser Alotaibi
- Occupational Therapy Department, Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
| | - Hamad Alhamad
- Occupational Therapy Department, Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
| | - Layla Ghadanfar
- Radiologic Sciences Department, Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
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Shaik RA, Holyachi S, Ahmad MS, Ahmad RK, Yusuf M, Khan M, Almutairi AB, Alghuyaythat WKZ. Neurological manifestation with special reference to HIV-associated neurocognitive disorder (HAND) among people on anti-retroviral treatment in India. Eur Rev Med Pharmacol Sci 2021; 25:6999-7004. [PMID: 34859862 DOI: 10.26355/eurrev_202111_27248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The neurological manifestations and their severity in patients on antiretroviral treatment (ART) are currently unexplained. We aimed at studying the prevalence of HIV Associated Neurological Disorders (HAND) among people on antiretroviral treatment, using the International HIV Dementia Scale (IHDS). PATIENTS AND METHODS A predesigned and pretested proforma including the International HIV Dementia Scale (IHDS) was administered to 100 HIV patients attending to ART center of KIMS teaching Hospital (Koppal, Karnataka) from January 2020 to March 2020. The data was analyzed SPSS version 15 software. Descriptive statistics were used for demographic characteristics. The Student's t-test and chi-square test methods were applied to determine the relationship between qualitative characteristics. RESULTS The prevalence was found to be 59%. Out of 100, 57 HIV patients scored less than 10 whereas 43 HIV patients scored ≥10 on the IHDS scale. The mean age of the study population was 39.14 ±13.01 years; the total IHDS score was 9.96±1.53 and the CD4 count was 427.91±226.0. This study demonstrated that the patients with CD4 count more than 350 (i.e., 63.60%) had a better IHDS score. CONCLUSIONS Neurocognitive disorder was found to be more common than anticipated. All ICTC Centers need to consider assessing HIV-associated neurocognitive disability (HAND), and the International HIV Dementia Scale (IHDS) as one instrument for such assessment.
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Affiliation(s)
- R A Shaik
- Department of Community Medicine/Public Health, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia.
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Bin Mahfoz TM, Alzahrani M, Shaik RA, Ahmad MS, Ahmad RK, Yusuf M, Khan M, Almutairi AB, Alghuyaythat WKZ, Almutairi SB. Association of indoor air pollution on cognitive dysfunction among elderly. Eur Rev Med Pharmacol Sci 2021; 25:5664-5673. [PMID: 34604958 DOI: 10.26355/eurrev_202109_26785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Cognitive dysfunction among the elderly is a devastating condition preceded by accumulation of neuropathology leading to accelerated cognitive decline. Many epidemiologic studies have reported the relation between indoor air pollution exposure and cognitive impairment. To clarify the nature of the association, a comprehensive systematic review and meta-analysis were performed. MATERIALS AND METHODS The analysis included all observational studies, including cross-sectional studies, prospective and retrospective cohort studies. Experimental studies, randomized controlled trials (RCTs), and controlled clinical trials were excluded. Studies on the relationships of indoor air pollution and cognition published before 30 April 2021 which are peer-reviewed scientific publications available in English were included after performing a structured literature search through electronic databases, including PubMed, Embase, Cochrane Library, and clinical trial.gov. A total of 146 articles were collected, and after screening thoroughly only, 9 studies were selected. Meta-analysis for the final set of selected studies was performed using the R software. RESULTS The quality of all the studies was adequate as almost all reported an association between at least one pollutant and cognitive dysfunction. However, relatively few studies considered outcomes that provide the most substantial evidence for a causal effect. In total, 5 studies have reported on cognitive function. The pooled mean of cognitive function was 12.16 (95% CI: 10.73 to 13.58). However, the heterogeneity was very high (I2=100%; chi-square test for heterogeneity = p<0.001). We used a modified JBI structured risk of the bias assessment tool, and it was minimal among the included studies as most of the studies have followed a random sampling method and explicitly mention it in their methods. CONCLUSIONS Exposure to indoor air pollution through fuels used for cooking and heating was significantly associated with cognitive dysfunction among elderly women. Given the limitations, a more extensive meta-analysis and longitudinal studies are recommended to investigate the biological mechanism behind the impact of indoor air pollution on cognitive health.
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Affiliation(s)
- T M Bin Mahfoz
- Otolaryngology Department, College of Medicine, Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia.
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Ahmad MS, Shaik RA, Ahmad RK, Yusuf M, Khan M, Almutairi AB, Alghuyaythat WKZ, Almutairi SB. "LONG COVID": an insight. Eur Rev Med Pharmacol Sci 2021; 25:5561-5577. [PMID: 34533807 DOI: 10.26355/eurrev_202109_26669] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We aimed this systematic review to analyze and review the currently available published literature related to long COVID, understanding its pattern, and predicting the long-term effects on survivors. We thoroughly searched the databases for relevant articles till May 2021. The research articles that met our inclusion and exclusion criteria were assessed and reviewed by two independent researchers. After preliminary screening of the identified articles through title and abstract, 249 were selected. Consequently, 167 full-text articles were assessed and reviewed based on our inclusion criteria and thus 20 articles were regarded as eligible and analyzed in the present analysis. All the studies included adult population aged between 18 and above 60 years. The median length of hospital stay of the COVID-19 patients during the acute infection phase ranged from 8 days to 17 days. The most common prevalent long-term symptoms in COVID-19 patients included persistent fatigue and dyspnea in almost all of the studies. Other reported common symptoms included: shortness of breath, cough, joint pain, chest pain or tightness, headache, loss of smell/taste, sore throat, diarrhea, loss of memory, depression, anxiety. Associated cardiovascular events included arrhythmias, palpitations and hypotension, increased HR, venous thromboembolic diseases, myocarditis, and acute/decompensated heart failure as well. Among neurological manifestations headache, peripheral neuropathy symptoms, memory issues, concentration, and sleep disorders were most commonly observed with varying frequencies. Mental health issues affecting mental abilities, mood fluctuations namely anxiety and depression, and sleep disorders were commonly seen. Further, diarrhea, vomiting, digestive disorders, and Loss of appetite or weight loss are common gastrointestinal manifestations. Therefore, appropriate clinical evaluation is required in long COVID cases which in turn may help us to identify the risk factors, etiology, and to my help, we treat them early with appropriate management strategies.
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Affiliation(s)
- M S Ahmad
- Department of Community Medicine/Public Health, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia.
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