{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T03:40:54Z","timestamp":1778643654565,"version":"3.51.4"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T00:00:00Z","timestamp":1622505600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Multiple Sclerosis International"],"published-print":{"date-parts":[[2021,6,1]]},"abstract":"<jats:p>Objectives. To assess the probable risk factors associated with Multiple sclerosis among Syrian patients in the city of Damascus. Method. In a case-control study conducted from May to September 2020, 140 MS patients and 140 healthy controls were selected from two main hospitals in Damascus. Data regarding risk factors associated with MS was collected via a structured questionnaire and complementary laboratory tests. The statistical analysis was carried out by the SPSS Statistical Software Version 26. Results. Factors such as smoking, family history of MS, migraine, and vitamin D deficiency were associated with a higher risk of developing MS: Smoking (<jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mtext>OR<\/a:mtext>\n                        <a:mo>=<\/a:mo>\n                        <a:mn>2.275<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula> 95% CI (1.348-3.841) <jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mi>P<\/c:mi>\n                        <c:mo>=<\/c:mo>\n                        <c:mn>0.002<\/c:mn>\n                     <\/c:math>\n                  <\/jats:inline-formula>). Family history of MS (<jats:inline-formula>\n                     <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mtext>OR<\/e:mtext>\n                        <e:mo>=<\/e:mo>\n                        <e:mn>3.970<\/e:mn>\n                     <\/e:math>\n                  <\/jats:inline-formula> 95% CI (1.807-8.719) <jats:inline-formula>\n                     <g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                        <g:mi>P<\/g:mi>\n                        <g:mo>\u2264<\/g:mo>\n                        <g:mn>0.001<\/g:mn>\n                     <\/g:math>\n                  <\/jats:inline-formula>). Migraine (<jats:inline-formula>\n                     <i:math xmlns:i=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\">\n                        <i:mtext>OR<\/i:mtext>\n                        <i:mo>=<\/i:mo>\n                        <i:mn>3.011<\/i:mn>\n                     <\/i:math>\n                  <\/jats:inline-formula> 95% CI (1.345-6.741) <jats:inline-formula>\n                     <k:math xmlns:k=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\">\n                        <k:mi>P<\/k:mi>\n                        <k:mo>=<\/k:mo>\n                        <k:mn>0.005<\/k:mn>\n                     <\/k:math>\n                  <\/jats:inline-formula>). Vitamin D deficiency (<jats:inline-formula>\n                     <m:math xmlns:m=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\">\n                        <m:mtext>OR<\/m:mtext>\n                        <m:mo>=<\/m:mo>\n                        <m:mn>4.778<\/m:mn>\n                     <\/m:math>\n                  <\/jats:inline-formula> 95% CI (2.863-7.972) <jats:inline-formula>\n                     <o:math xmlns:o=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M8\">\n                        <o:mi>P<\/o:mi>\n                        <o:mo>\u2264<\/o:mo>\n                        <o:mn>0.001<\/o:mn>\n                     <\/o:math>\n                  <\/jats:inline-formula>). However, factors such as diabetes, hypertension, a surgical history of appendectomy, tonsillectomy, and being the first-born in a family were statistically irrelevant: Diabetes (<jats:inline-formula>\n                     <q:math xmlns:q=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M9\">\n                        <q:mtext>OR<\/q:mtext>\n                        <q:mo>=<\/q:mo>\n                        <q:mn>0.652<\/q:mn>\n                     <\/q:math>\n                  <\/jats:inline-formula> 95% CI (0.226-1.882) <jats:inline-formula>\n                     <s:math xmlns:s=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M10\">\n                        <s:mi>P<\/s:mi>\n                        <s:mo>=<\/s:mo>\n                        <s:mn>0.426<\/s:mn>\n                     <\/s:math>\n                  <\/jats:inline-formula>). Hypertension (<jats:inline-formula>\n                     <u:math xmlns:u=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M11\">\n                        <u:mtext>OR<\/u:mtext>\n                        <u:mo>=<\/u:mo>\n                        <u:mn>1.445<\/u:mn>\n                     <\/u:math>\n                  <\/jats:inline-formula> 95% CI (0.724-2.885) <jats:inline-formula>\n                     <w:math xmlns:w=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M12\">\n                        <w:mi>P<\/w:mi>\n                        <w:mo>=<\/w:mo>\n                        <w:mn>0.295<\/w:mn>\n                     <\/w:math>\n                  <\/jats:inline-formula>) Appendectomy (<jats:inline-formula>\n                     <y:math xmlns:y=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M13\">\n                        <y:mtext>OR<\/y:mtext>\n                        <y:mo>=<\/y:mo>\n                        <y:mn>1.269<\/y:mn>\n                     <\/y:math>\n                  <\/jats:inline-formula> 95% CI (0.486-3.317) <jats:inline-formula>\n                     <ab:math xmlns:ab=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M14\">\n                        <ab:mi>P<\/ab:mi>\n                        <ab:mo>=<\/ab:mo>\n                        <ab:mn>0.626<\/ab:mn>\n                     <\/ab:math>\n                  <\/jats:inline-formula>) Tonsillectomy (<jats:inline-formula>\n                     <cb:math xmlns:cb=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M15\">\n                        <cb:mtext>OR<\/cb:mtext>\n                        <cb:mo>=<\/cb:mo>\n                        <cb:mn>1.280<\/cb:mn>\n                     <\/cb:math>\n                  <\/jats:inline-formula> 95% CI (0.576-2.843) <jats:inline-formula>\n                     <eb:math xmlns:eb=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M16\">\n                        <eb:mi>P<\/eb:mi>\n                        <eb:mo>=<\/eb:mo>\n                        <eb:mn>0.544<\/eb:mn>\n                     <\/eb:math>\n                  <\/jats:inline-formula>). First-born Child (<jats:inline-formula>\n                     <gb:math xmlns:gb=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M17\">\n                        <gb:mtext>OR<\/gb:mtext>\n                        <gb:mo>=<\/gb:mo>\n                        <gb:mn>0.933<\/gb:mn>\n                     <\/gb:math>\n                  <\/jats:inline-formula> 95% CI (0.558-1.562) <jats:inline-formula>\n                     <ib:math xmlns:ib=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M18\">\n                        <ib:mi>P<\/ib:mi>\n                        <ib:mo>=<\/ib:mo>\n                        <ib:mn>0.793<\/ib:mn>\n                     <\/ib:math>\n                  <\/jats:inline-formula>). Conclusion. Our study suggests that smoking, vitamin D deficiency, family history of MS, and migraine are probable risk factors for multiple sclerosis. Therefore, engaging in outdoor activities and maintaining a healthy diet\u2014for females in particular\u2014is highly recommended.<\/jats:p>","DOI":"10.1155\/2021\/8147451","type":"journal-article","created":{"date-parts":[[2021,6,2]],"date-time":"2021-06-02T22:07:09Z","timestamp":1622671629000},"page":"1-5","source":"Crossref","is-referenced-by-count":9,"title":["Risk Factors Associated with Multiple Sclerosis: A Case-Control Study in Damascus, Syria"],"prefix":"10.1155","volume":"2021","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0794-1658","authenticated-orcid":true,"given":"Maher","family":"Taan","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Damascus University, Damascus, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4373-283X","authenticated-orcid":true,"given":"Farah","family":"Al Ahmad","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Damascus University, Damascus, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4741-680X","authenticated-orcid":true,"given":"Mohammad Karim","family":"Ercksousi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Damascus University, Damascus, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3699-453X","authenticated-orcid":true,"given":"Ghassan","family":"Hamza","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Damascus University, Damascus, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1159\/000431042"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1159\/000325368"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-016-2685-8"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.15537\/smj.2018.8.22864"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-017-3080-9"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-018-1090-8"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.159.11.1862"},{"key":"8","volume-title":"The impact of the Syrian war on Multiple Sclerosis (MS) patients (P3. 338)","author":"E. 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Goldsmith","year":"2015"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0115488"},{"key":"18","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318216715e"},{"key":"19","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.63.7.1001"},{"key":"20","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2018.07.011"},{"key":"21","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-13-41"},{"key":"22","doi-asserted-by":"publisher","DOI":"10.1177\/135245850000600211"},{"key":"23","doi-asserted-by":"publisher","DOI":"10.3233\/HAB-150281"}],"container-title":["Multiple Sclerosis International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/msi\/2021\/8147451.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/msi\/2021\/8147451.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/msi\/2021\/8147451.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,2]],"date-time":"2021-06-02T22:07:12Z","timestamp":1622671632000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/msi\/2021\/8147451\/"}},"subtitle":[],"editor":[{"given":"H. P.","family":"Hartung","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,6,1]]},"references-count":23,"alternative-id":["8147451","8147451"],"URL":"https:\/\/doi.org\/10.1155\/2021\/8147451","relation":{},"ISSN":["2090-2662","2090-2654"],"issn-type":[{"value":"2090-2662","type":"electronic"},{"value":"2090-2654","type":"print"}],"subject":[],"published":{"date-parts":[[2021,6,1]]}}}