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Introduction Multiple sclerosis (MS) is a disease that constitutes a high burden on both patients and caregivers. Although many studies have assessed the burden of MS caregivers worldwide, no such studies have been conducted in Saudi Arabia. In this study, we aim to assess the burden of MS patients' caregivers in Saudi Arabia. Methods This cross-sectional study included caregivers of MS patients (for >1 year) who visited the neurology clinic at King Abdulaziz Medical City, Jeddah, Saudi Arabia, between July 2017 and December 2018. The study utilized the Zarit Burden Interview (ZBI) to assess the burden on MS patients' caregivers. In addition, the caregivers' demographic profile and certain information regarding the patient were also collected through an oral interview. Results There were a total of 219 respondents, of which 117 (53.4%) male caregivers. For ZBI, the majority of caregivers reported little or no burden (57.1%), followed by a mild to moderate burden (30.1%), then a moderate to severe burden (10.5%), and only five (2.3%) reported a severe burden. Conclusion Our results showed a limited burden of MS on the life caregivers of MS patients. We stress the importance of assessing the burden in MS patients and caregivers as routine practice with the other important measures such as quality of life and medication compliance. The finding of this study will help in encouraging medical centers to establish more specialized MS clinics that put into consideration the psychological factors, burden of the disease, multidisciplinary approach, and support groups, which are currently few in number.

BACKGROUND: Surgical residency program is considered one of the toughest residency programs, which affects quality of life of the residents during training years. To date, no study has evaluated quality of life among residents, especially surgical residents here in Saudi Arabia. AIM: The objective of this study is to evaluate quality of life among surgical residents. METHODS: The study is a cross-sectional study conducted during September 2018 in King Khalid Hospital at King Abdulaziz Medical City (KAMC) Jeddah, Saudi Arabia. The study utilized the Work-Related Quality of Life, WRQoL, scale which measures perceived quality of life covering six domains: General Well-Being (GWB), Home-Work Interface (HWI), Job and Career Satisfaction (JCS), Control at Work (CAW), Working Conditions (WCS) and Stress at Work (SAW), in addition to demographic questions, asking about (age, gender, marital status, resident level, specialty, BMI, smoking, number of days of exercise per week, hours of sleep per day, on-calls per month, clinics per week, operations per week). RESULTS: Of the 99 surgical residents training at KAMC, 73 residents returned the survey with a response rate of 72.8%. The mean age of the residents was 28 ± 2.1 years with the mean BMI of 25 kg/m2. 54.8% were married, and 42.5% were smokers. Half of the residents (50.7%) working in King Abdulaziz Medical City have low work-related quality of life. In comparison between male and female residents’ overall Quality of life, there was no significant difference between them (p = 0.363). CONCLUSIONS: Our main study finding is that half of the residents (50.7%) working at KAMC has low work-related quality of life, and there is no significant difference between male and female residents. Further studies are needed to determine the causes and improve the work-related quality of life among surgical residents.

Context: The study was undertaken to compare developing breast cancer-related lymphedema between those who underwent mastectomy with reconstruction and mastectomy alone. Aims: One of the most feared consequences after a mastectomy is breast cancer-related lymphedema (BCRL). However, few papers have questioned whether breast reconstruction impacts the development of lymphedema. This study aims to determine if breast reconstruction has an effect on the incidence of BCRL. Furthermore, the effect of the time (immediate vs. delayed) and type (implant based vs. autologous) of breast reconstruction on the development of BCRL will be evaluated. Settings and Design: We conducted a retrospective cohort study on 320 patients who underwent mastectomy with reconstruction and mastectomy alone between January 1, 2007, and December 31, 2017, at King Abdulaziz Medical City – Jeddah. Subjects and Methods: We conducted a retrospective cohort study on 320 patients who underwent mastectomy with or without breast reconstruction between January 2007 and December 2017. We reviewed patient medical records progressively to extract patients' characteristics, operative details, and lymphedema information. We divided our sample into two main groups: patients who underwent mastectomy with reconstruction and mastectomy alone. Mastectomy with reconstruction group was subdivided into immediate or delayed reconstruction and autologous or implant-based reconstruction. Statistical Analysis Used: Statistical analysis was performed using the Statistical Package for the Social Sciences version 20. Results: Of the total sample size 320, only 78 (24.4% (underwent mastectomy with breast reconstruction (Group 1), while the rest 242 (75.6%) underwent mastectomy alone (Group 2). From both the groups, 24 (7.5%) patients developed lymphedema; there was no significant difference between the breast reconstruction and development of lymphedema (P = 0.67). We subdivided Group 1 (patients who underwent mastectomy with breast reconstruction) into immediate breast reconstruction (40 patients, [51%]) and delayed breast reconstruction (38 patients, [49%]). In comparison between immediate versus delayed breast reconstruction, there was no significant difference between immediate and delayed breast reconstruction (P = 0.67). In terms of the type of reconstruction, we further subdivided Group 1 (patients who underwent mastectomy with breast reconstruction) into implant-based breast reconstruction (42 patients, [54%]), and autologous breast reconstruction (36 patients, [46%]). In comparison between implant-based versus autologous breast reconstruction, there was no significant difference between implant-based and autologous breast reconstruction (P = 0.66). Conclusions: Although our result is insignificant, it suggests that patients who underwent mastectomy with reconstruction have a lower incidence of BCRL in comparison with those who underwent mastectomy alone. Moreover, our result suggests that immediate breast reconstruction and implant-based breast reconstruction have a lower incidence than delayed and autologous breast reconstruction. Further studies are needed to determine if the breast reconstruction has an effect on the development of lymphedema.