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Hussein M Ismail,1,2 Abeer S Algrafi,2 Osama Amoudi,3 Sameh Ahmed,4 Sultan S Al-Thagfan,5 Hassan Shora,6 Mohammed Aljohani,7 Mohammed Almutairi,7 Fahad Alharbi,7 Abdullah Alhejaili,7 Majed Alamri,7 Abdullah Muhawish,7 Ayat Abdallah8,9 1Department of cardiology, College of Medicine, Suez Canal University, Ismailia, Egypt; 2Department of medicine, College of Medicine, Taibah University, Al-Madinah Al-Munawara, Saudi Arabia; 3Madinah Cardiac Center, Adult cardiology, Al-Madinah Al-Munawara, Saudi Arabia; 4Department of Pharmacognosy and Pharmaceutical Chemistry, College of Pharmacy, Taibah University, Al-Madinah Al-Munawara, Saudi Arabia; 5Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Al-Madinah Al-Munawara, Saudi Arabia; 6Department of molecular biology/biochemistry, Port Said University, Port Said, Egypt; 7Medical intern, Taibah University, Al-Madinah Al-Munawara, Saudi Arabia; 8Epidemiology and Preventive Medicine Department, National Liver Institute, Shebin El-Kom, Egypt; 9Department of Family and Community Medicine, Taibah University, Al-Madinah Al-Munawara, Saudi ArabiaCorrespondence: Hussein M IsmailDepartment of Cardiology, College of Medicine, Suez Canal University, Ismailia, EgyptEmail husseinismail@med.suez.edu.eg; drhussein72@gmail.comBackground: Vitamin D deficiency is considered an emerging health problem that affects at least one billion patients worldwide. Calcitriol 1,25(OH)2D3 has several systemic effects, including anti-inflammatory, anti-thrombotic and anti-atherosclerotic impacts that explain its cardioprotective effects. The precise association between vitamin D and its metabolites and the value of supplements in acute coronary syndrome (ACS) is still controversial. This study aims to search the association between vitamin D2, D3, and metabolites and ACS in patients undergoing coronary angiography.Materials and Methods: This was a case–control study on 73 consecutive adult patients with ACS undergoing coronary angiography compared to 50 controls without coronary artery disease and matched for age and sex from June 2019 till July 2019. Echocardiography and coronary angiography were done for all cases. Plasma vitamin D and its metabolites were measured at admission for all participants along with chemistry profiles.Results: Vitamin D and its metabolites were statistically significantly lower in ACS patients than the controls. Multivariate regression analysis revealed that low levels of 25-hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)2D) significantly predicted ACS occurrence; the other significant predictors were high systolic blood pressure (BP), high total cholesterol, and low high-density lipoprotein-cholesterol. Interestingly, vitamin D2 and D3 did not significantly predict ACS (p> 0.05). We did not find a statistically significant association between the number of affected coronary vessels and vitamin D metabolites. Moreover, there was no statistically significant correlation between vitamin D and its metabolites and left ventricular ejection fraction measured by echocardiography.Conclusion: There was a strong association between vitamin D and all its metabolites with ACS. Significantly, low 25(OH)D and 1,25(OH)2D predicted ACS, but vitamin D2 and D3 did not. Large randomized controlled trials are needed to verify the beneficial values of vitamin D supplementation in ACS patients.Keywords: vitamin D3, vitamin D2, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D3, acute coronary syndrome, coronary artery disease

Hatem A Emara,1,2,&ast; Eman Sobh,3,4,&ast; Raid Homoud Almohammadi,5 Emad Abdullah Alamri,5 Marwan MA Aljohani,1 Ayman Abdullah Alhammad1 1Physical Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, Medina, Saudi Arabia; 2Department of Physical Therapy for Growth and Developmental Disorders in Children and Its Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt; 3Respiratory Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, Medina, Saudi Arabia; 4Chest Diseases Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 5Department of Physical Therapy, Medical Rehabilitation Hospital, Ministry of Health, Medina, Saudi Arabia&ast;These authors contributed equally to this workCorrespondence: Hatem A Emara, Physical Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, Medina, Saudi Arabia, P.o 344, Medina, 41411, Saudi Arabia, Tel +966564156262, Fax +966148618888, Email drhatem_emara@yahoo.comPurpose: Children with cerebral palsy (CP) have limited postural control and functional ability. TheraTogs was reported to improve postural stability. However, studies involving the functional ability and quality of life are limited. We aimed to investigate the effects of TheraTogs use as an orthotic garment and strapping system on the balance and functional ability of children with spastic diplegic CP and if wearing TheraTogs improves their quality of life.Patients and Methods: A total of 34 children (aged 5– 8 years) with spastic diplegic cerebral palsy participated in this study. The control group received conventional physical therapy (CPT), whereas the study group received CPT in addition to wearing TheraTogs. Balance, lower limb strength, and functional abilities were examined using the Biodex balance system, 30-s chair rise test, and Pediatric Evaluation of Disability Inventory-PEDI).Results: The measured parameters of postural stability significantly improved in both groups post-treatment (p< 0.05). The study group showed significant improvement in balance and lower limb strength compared to the traditional physical therapy group (p < 0.05). Both groups showed significant improvement in functional skill mobility (0.001 and 0.01 for control and study groups respectively) and caregiver assistance mobility scores (p=0.001 and < 0.001 for control and study groups respectively); however, there was no significant improvement in self-care ability with TheraTogs. The 30s sit-to-stand showed increased number of sit to stands in both groups post treatment (p=< 0.001 for both groups) and the study group showed significant improvement compared to the control group (p=0.01).Conclusion: The findings in this study suggest that both conventional physical therapy and TheraTogs are beneficial in improving balance and functional ability. TheraTogs could be utilized as a useful posture orthosis to help improve the balance and functional strength of children with spastic diplegic cerebral, palsy indicating improved quality of life.Keywords: children with cerebral palsy, TheraTogs, functional ability, 30-s Sit-to-Stand Test, pediatric evaluation of disability inventory

Hatem A Emara,1,2,&ast; Ahmed H Al-Johany,3 Osama A Khaled,1,4 Abdullah M Al-Shenqiti,1 Abdul Rahman H Ali,5 Marwan M Aljohani,1 Eman Sobh6,7,&ast; 1Physical Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, Medina, Saudi Arabia; 2Department of Physical Therapy for Growth and Developmental Disorders in Children and its Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt; 3Medical Rehabilitation Hospital, Ministry of Health, Medina, Saudi Arabia; 4Basic Science Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt; 5College of Medical Rehabilitation Sciences, Taibah University, Medina, Saudi Arabia; 6Respiratory Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, Medina, Saudi Arabia; 7Chest Diseases Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt&ast;These authors contributed equally to this workCorrespondence: Hatem A Emara, Physical Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, P.O 344, Medina, 41411, Saudi Arabia, Tel +966564156262, Fax +966148618888, Email drhatem_emara@yahoo.comPurpose: To investigate the effect of dynamic orthotic garments (Thera togs) on foot pressure distribution, postural control, and endurance in children with spastic diplegic CP.Patients and Methods: This is a single-blind randomized controlled clinical trial involving 34 (8– 10 years) with spastic diplegic CP. The control group received conventional physical therapy (CPT), whereas the study group received CPT in addition to wearing TheraTogs. We recorded foot pressure distribution, trunk control measurement scale, trunk position sense, Pediatric Berg Balance Scale (PBS), and six-minute walking distance (6MWD).Results: Both groups showed improvement. The study group had significant improvement in foot pressure distribution (p-value 0.003, 0.001, < 0.001 for forefoot, midfoot, and rearfoot mean pressures respectively, and 0.005, < 0.001, and 0.005 for forefoot, midfoot, and rearfoot peak pressures respectively), Pediatric balance scale, The trunk control measurement scale, and Trunk position sense (p-value < 0.001) and six-minute walking distance (p-value 0.029). Our data suggest that adding TheraTogs to conventional physiotherapy improves foot pressure, postural control, and endurance in children with spastic diplegic cerebral palsy.Conclusion: Both TheraTogs and conventional physical therapy corrected foot pressure distribution, trunk control, improved balance, and increased 6MWD in children with spastic diplegic CP but the improvement was more significant in TheraTogs group.Clinical Trial Registration: NCT05271149.Keywords: children with disability, theratogs, foot pressure, balance score, orthotic devices

Abdulmajeed A Alkhamees,1 Moath S Aljohani,2 Mohammed A Alghesen,3 Ali T Alhabib4 1Department of Medicine, College of Medicine and Medical Sciences, Qassim University, Mlida, Al Qassim, Saudi Arabia; 2Department of Family and Community Medicine, College of Medicine and Medical Sciences, Qassim University, Mlida, Al Qassim, Saudi Arabia; 3Psychiatry Mental Hospital, Ministry of Health, Buraydah, Al Qassim, Saudi Arabia; 4King Fahd Medical City Academy for Postgraduate Studies in Family Medicine, Ministry of Health, Riyadh, Saudi ArabiaCorrespondence: Abdulmajeed A AlkhameesDepartment of Medicine, College of Medicine and Medical Sciences, Qassim University, Buraydah, Al Qassim, Saudi ArabiaEmail a.alkhamees@qu.edu.saBackground: Quarantine is a useful measure for preventing and controlling pandemics; however, it might be stressful for quarantined individuals. Fear and anxiety about a disease can be overwhelming. These emotions were reported for individuals in involuntary quarantine facilities dedicated to quarantine purposes.Methods: This cross-sectional study surveyed the individuals in involuntary quarantine institutions (for a planned period of 14 days of quarantine) in two regions of Saudi Arabia. The mental health status of individuals was assessed using the Revised Impact of Event Scale (IES-R) and Depression, Anxiety, and Stress Scale (DASS-21).Results: The study surveyed 214 quarantined/isolated individuals. The stress, anxiety, and depression rates were 25.7%, 21.5%, and 32.7%, respectively. On the IES-R, 28.0% of the participants met the criteria for psychological distress. Female gender, self-reported history of psychiatric disorder, and average health status were significantly associated with negative psychological impact and depression, anxiety, and stress symptoms (p< 0.05). Watching television was found to be a factor in reducing rates on the IES-R and DASS-21 scale while working out lowered rates on the IES-R alone (p< 0.05).Conclusion: During an institutional involuntary quarantine, additional attention should be paid to vulnerable groups like females and individuals with a history of psychiatric illness. More than one-fourth of our sample experienced a negative psychological impact; therefore, coping practices like working out should be encouraged. This study contributes to the ongoing discussion about the psychological aspects of being quarantined. Much work remains to be done to identify strategies that prevent and mitigate psychological distress throughout the quarantine experience and to determine whether these impacts will last for an extended period of time.Keywords: COVID-19, anxiety, IES, depression, knowledge, quarantine, psychological impact, stress, pandemic, Saudi Arabia