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Research ArticleOriginal Article
Open Access

Is non-traditional therapy for multiple sclerosis overwhelming in Saudi Arabia

Erum M. Shariff, Foziah J. Al-Shammrani, Saima Nazish, Azra S. Zafar, Rizwana M. Shahid, Inam E. Khuda, Mohammad A. Zeeshan, Majed A. Alabdali, Aishah I. Al-Bakr, Danah T. Aljaafari, Ibtesam O. Balharith, Ali A. Alahmed, Sadiq A. Alsalman, Alaa M. Almajed and Fahd A. Alkhamis
Neurosciences Journal July 2019, 24 (3) 192-198; DOI: https://doi.org/10.17712/nsj.2019.3.20180010
Erum M. Shariff
From the Department of Neurology (Shariff, Al-Shammrani, Nazish, Zafar, Shahid, Khuda, Alabdali, Al-Bakr, Aljaafari, Balharith, Alahmed, Alsalman, Almajed, Alkhamis), and from the Department of Medical Education (Zeeshan), King Fahd Hospital, Imam AbdulRahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
MBBS, FCPS
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  • For correspondence: [email protected]
Foziah J. Al-Shammrani
From the Department of Neurology (Shariff, Al-Shammrani, Nazish, Zafar, Shahid, Khuda, Alabdali, Al-Bakr, Aljaafari, Balharith, Alahmed, Alsalman, Almajed, Alkhamis), and from the Department of Medical Education (Zeeshan), King Fahd Hospital, Imam AbdulRahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
MD, FRCPC
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Saima Nazish
From the Department of Neurology (Shariff, Al-Shammrani, Nazish, Zafar, Shahid, Khuda, Alabdali, Al-Bakr, Aljaafari, Balharith, Alahmed, Alsalman, Almajed, Alkhamis), and from the Department of Medical Education (Zeeshan), King Fahd Hospital, Imam AbdulRahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
MBBS, FCPS
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Azra S. Zafar
From the Department of Neurology (Shariff, Al-Shammrani, Nazish, Zafar, Shahid, Khuda, Alabdali, Al-Bakr, Aljaafari, Balharith, Alahmed, Alsalman, Almajed, Alkhamis), and from the Department of Medical Education (Zeeshan), King Fahd Hospital, Imam AbdulRahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
MBBS, FCPS
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Rizwana M. Shahid
From the Department of Neurology (Shariff, Al-Shammrani, Nazish, Zafar, Shahid, Khuda, Alabdali, Al-Bakr, Aljaafari, Balharith, Alahmed, Alsalman, Almajed, Alkhamis), and from the Department of Medical Education (Zeeshan), King Fahd Hospital, Imam AbdulRahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
MBBS, FCPS
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Inam E. Khuda
From the Department of Neurology (Shariff, Al-Shammrani, Nazish, Zafar, Shahid, Khuda, Alabdali, Al-Bakr, Aljaafari, Balharith, Alahmed, Alsalman, Almajed, Alkhamis), and from the Department of Medical Education (Zeeshan), King Fahd Hospital, Imam AbdulRahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
MBBS, FCPS
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Mohammad A. Zeeshan
From the Department of Neurology (Shariff, Al-Shammrani, Nazish, Zafar, Shahid, Khuda, Alabdali, Al-Bakr, Aljaafari, Balharith, Alahmed, Alsalman, Almajed, Alkhamis), and from the Department of Medical Education (Zeeshan), King Fahd Hospital, Imam AbdulRahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
MSc, BSc
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Majed A. Alabdali
From the Department of Neurology (Shariff, Al-Shammrani, Nazish, Zafar, Shahid, Khuda, Alabdali, Al-Bakr, Aljaafari, Balharith, Alahmed, Alsalman, Almajed, Alkhamis), and from the Department of Medical Education (Zeeshan), King Fahd Hospital, Imam AbdulRahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
MD, FRCPS
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Aishah I. Al-Bakr
From the Department of Neurology (Shariff, Al-Shammrani, Nazish, Zafar, Shahid, Khuda, Alabdali, Al-Bakr, Aljaafari, Balharith, Alahmed, Alsalman, Almajed, Alkhamis), and from the Department of Medical Education (Zeeshan), King Fahd Hospital, Imam AbdulRahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
MD, FRCPC
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Danah T. Aljaafari
From the Department of Neurology (Shariff, Al-Shammrani, Nazish, Zafar, Shahid, Khuda, Alabdali, Al-Bakr, Aljaafari, Balharith, Alahmed, Alsalman, Almajed, Alkhamis), and from the Department of Medical Education (Zeeshan), King Fahd Hospital, Imam AbdulRahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
MD, FRCPC
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Ibtesam O. Balharith
From the Department of Neurology (Shariff, Al-Shammrani, Nazish, Zafar, Shahid, Khuda, Alabdali, Al-Bakr, Aljaafari, Balharith, Alahmed, Alsalman, Almajed, Alkhamis), and from the Department of Medical Education (Zeeshan), King Fahd Hospital, Imam AbdulRahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
Bs, HSc
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Ali A. Alahmed
From the Department of Neurology (Shariff, Al-Shammrani, Nazish, Zafar, Shahid, Khuda, Alabdali, Al-Bakr, Aljaafari, Balharith, Alahmed, Alsalman, Almajed, Alkhamis), and from the Department of Medical Education (Zeeshan), King Fahd Hospital, Imam AbdulRahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
MBBS, HSc
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Sadiq A. Alsalman
From the Department of Neurology (Shariff, Al-Shammrani, Nazish, Zafar, Shahid, Khuda, Alabdali, Al-Bakr, Aljaafari, Balharith, Alahmed, Alsalman, Almajed, Alkhamis), and from the Department of Medical Education (Zeeshan), King Fahd Hospital, Imam AbdulRahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
MD, FRCPC
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Alaa M. Almajed
From the Department of Neurology (Shariff, Al-Shammrani, Nazish, Zafar, Shahid, Khuda, Alabdali, Al-Bakr, Aljaafari, Balharith, Alahmed, Alsalman, Almajed, Alkhamis), and from the Department of Medical Education (Zeeshan), King Fahd Hospital, Imam AbdulRahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
MD, MBBS
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Fahd A. Alkhamis
From the Department of Neurology (Shariff, Al-Shammrani, Nazish, Zafar, Shahid, Khuda, Alabdali, Al-Bakr, Aljaafari, Balharith, Alahmed, Alsalman, Almajed, Alkhamis), and from the Department of Medical Education (Zeeshan), King Fahd Hospital, Imam AbdulRahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
MD, FRCPC
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    Figure 1

    Specific symptoms to be addressed by complementary and alternative medicine (CAM).

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    Table 1

    Clinical and demographic characteristics of cases with MS (N=133).

    Characteristicsn (%)
    Gender
     Male49 (36.8)
     Female84 (63.2)
    Age (years) Mean±SD32.3±7.6 (18-56)
     <3051 (38.3)
     ≥3082 (61.7)
    Marital status
     Married62 (46.6)
     Unmarried71 (53.4)
    Educational level
     No education5 (3.8)
     Elementary2 (1.5)
     Middle5 (3.8)
     High28 (21)
     Graduate93 (69.9)
    Occupation
     Job71 (53.4)
     Business1 (0.8)
     Household18 (13.5)
     Student17 (12.8)
     Jobless25 (18.8)
    Diagnosis
     RRMS110 (82.7)
     PPMS16 (12)
     SPMS3 (2.3)
     CIS1 (0.8)
    Disease duration
     >10 years62 (45.9)
     5-10 years45 (33.8)
     <5 years25 (18.8)
    EDSS
     <2.551 (38.3)
     2.5-4.568 (51.1)
     >4.51014 (10.5)
    • MS - multiple sclerosis, SD - standard deviation, RRMS - Relapsing remitting multiple Sclerosis, PPMS - Primary progressive multiple sclerosis, SPMS - Secondary progressive multiple sclerosis, CIS - clinically isolated syndrome, EDSS - extended disability status scale

    • View popup
    Table 2

    The CAM use with and without conventional treatment.

    Variablesn (%)
    CAM used only18 (20)
    CAM use with conventional treatments81.98 (91)
    Total100 (111)
    • CAM - complementary and alternative medicine

    • View popup
    Table 3

    Modes of CAM used by patients.

    Variablesn (%)
    Relaxation therapy/meditation14 (12.6)
    Support groups1 (0.9)
    Sound therapy2 (1.8)
    Cognitive-behavioral therapy/psychological1 (0.9)
    Yoga1 (0.9)
    Reflexology2 (1.8)
    Vitamins and minerals25 (22.5)
    Special dietary pattern (goat milk, salt-free, fat-free, gluten free, camel milk)8 (7.2)
    Energy medicine1 (0.9)
    Others
    Cupping (Hejama)23 (20.7)
    Acupuncture2 (1.8)
    Bee venom7 (6.3)
    prayers18 (16.2)
    Going to Sheikh6 (5.4)
    • CAM - complementary and alternative medicine.

    • View popup
    Table 4

    Association of CAM use.

    CharacteristicsCAM useP-value
    YesNo
    n (%)
    Gender
     Male40 (36)9 (40.9)0.67
     Female71 (64)13 (59.1)
    Age (years)
     <3042 (37.8)8 (36.4)0.87
     ≥3068 (62.2)14 (63.6)
    Educational level
     No education4 (3.6)1 (4.5)0.75
     Elementary2 (1.8)0
     Middle5 (4.5)0
     High school22 (19.8)6 (27.3)
     Graduate/PG78 (70.3)15 (68.2)
    Disease duration
     >10 years47 (42.3)14 (63.6)0.32
     5-10 years39 (35.1)6 (27.3)
     <5 year23 (20.7)2 (9.1)
    EDSS
     <2.545 (40.5)6 (27.3)0.31
     2.5-4.556 (50.5)12 (54.5)
     >4.510 (9)4 (18.2)
    • CAM - complementary and alternative medicine, EDSS - extended disability status scale.

    • View popup
    Table 5

    Associations of CAM disclosure.

    CharacteristicsDisclosure of CAMP-value
    Willing to tell only family members/friendsWilling to tell physiciansNot willing at all
    n (%)
    Gender
     Male7 (26.9)24 (46.2)9 (28.1)0.19
     Female19 (73.1)28 (53.8)23 (71.9)
    Age (years)
     <3012 (46.2)16 (31.4)14 (43.8)0.43
     >3014 (53.8)35 (68.6)18 (56.2)
    Marital status
     Married10 (38.5)26 (50)17 (53.1)0.52
     Unmarried16 (61.5)26 (50)15 (46.9)
    EDSS
     <2.511 (42.3)19 (36.5)15 (46.9)0.056
     2.5-4.512 (46.2%)28 (53.8)16 (50)
     >4.53 (11.5)5 (9.6)1 (3.1)
    • CAM - complementary and alternative medicine, EDSS - extended disability status scale

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Is non-traditional therapy for multiple sclerosis overwhelming in Saudi Arabia
Erum M. Shariff, Foziah J. Al-Shammrani, Saima Nazish, Azra S. Zafar, Rizwana M. Shahid, Inam E. Khuda, Mohammad A. Zeeshan, Majed A. Alabdali, Aishah I. Al-Bakr, Danah T. Aljaafari, Ibtesam O. Balharith, Ali A. Alahmed, Sadiq A. Alsalman, Alaa M. Almajed, Fahd A. Alkhamis
Neurosciences Journal Jul 2019, 24 (3) 192-198; DOI: 10.17712/nsj.2019.3.20180010

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Is non-traditional therapy for multiple sclerosis overwhelming in Saudi Arabia
Erum M. Shariff, Foziah J. Al-Shammrani, Saima Nazish, Azra S. Zafar, Rizwana M. Shahid, Inam E. Khuda, Mohammad A. Zeeshan, Majed A. Alabdali, Aishah I. Al-Bakr, Danah T. Aljaafari, Ibtesam O. Balharith, Ali A. Alahmed, Sadiq A. Alsalman, Alaa M. Almajed, Fahd A. Alkhamis
Neurosciences Journal Jul 2019, 24 (3) 192-198; DOI: 10.17712/nsj.2019.3.20180010
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