Activation and upregulation of keratinocyte and epidermal transglutaminases are associated with depletion of their substrates in psoriatic lesions.

OBJECTIVE: Psoriasis is a chronic skin disorder caused by abnormal interactions between epidermal and immune cells. Thus, the interplay between the proliferation and differentiation of epidermal components should be tightly regulated to protect against psoriasis. The differentiation process is primarily controlled by transglutaminases (TGs). However, studies on TG enzymes and their molecular alterations in psoriatic skin lesions are limited. Therefore, this study aimed to investigate TG activity and gene and protein expression in human psoriatic and normal skin tissues. MATERIALS AND METHODS: Keratinocyte TG (TG1), and epidermal TG (TG3) activity, localization, protein levels, and gene expression in human psoriatic skin were determined by immunohistochemistry and RT-qPCR. The expression of TG substrates (loricin and involucrin - IVL) was also investigated using RT-qPCR. RESULTS: TG1 and TG3 enzymatic activities and gene expression were significantly higher in psoriatic skin tissue than in normal skin tissue. However, both TGs were present in the same location and were equally highly expressed. Moreover, the expression of two TG substrates (loricin and involucrin) was significantly decreased compared to that in psoriatic and healthy skin samples. CONCLUSIONS: The activation and upregulation of TG1 and TG3 result from the depletion of their substrates (loricin and involucrin), both of which play a major role in the pathogenicity of psoriatic skin tissue and are necessary for proper skin development.

Adult Attention Deficit Hyperactivity Disorder (ADHD) among residents of Saudi Arabia: a cross-sectional study.

 OBJECTIVE: In this study, we aim to estimate the prevalence of adult ADHD among Saudi adults, determine its demographic correlates, the impact of the disorder on school/work, social life, and productivity, and describe its association with other psychiatric disorders such as depression and anxiety. SUBJECTS AND METHODS: A cross-sectional study involving 993 adult participants was carried out utilizing a validated online questionnaire that was given to the Saudi population between January 2022 and March 2022. Socio-demographic information, the adult ADHD Self-Report Scale, the Sheehan Disability Scale (SDS), and the Hospital Anxiety and Depression Scale (HADS) are among the data gathered from the questionnaire. RESULTS: Participants' median age group was 21-30 years (48.4%), with 77.8% being females. The prevalence of participants who were positive for ADHD symptoms was 46.6%. In univariate analysis, age group, marital status, depression, anxiety, Sheehan scale domains, day lost, and unproductive days were all significant risk factors for ADHD. In a multivariate regression analysis, anxiety, depression, symptoms that disrupted work/school work, family life/home responsibilities, and days unproductive remained statistically significant and determined as the significant independent predictors of positive ADHD. CONCLUSIONS: Morbidity of adult ADHD symptoms appreciably existed among younger adults of Saudi Arabia, mostly students with no favorable genders. Adult ADHD symptoms were found to affect the quality of social life and work/schoolwork performance as they decreased the productivity rate and increased the absenteeism rate. Moreover, symptoms of depression and anxiety were in a profound correlation with Adult ADHD symptoms.

Clinical and genetic features of Calpainopathies in Saudi Arabia - a descriptive cross-sectional study.

OBJECTIVE: Limb-girdle muscular dystrophies (LGMD) is a heterogeneous group of genetic disorders characterized by progressive weakness of pelvic and shoulder girdle muscles. The objective is to characterize the phenotypic, pathological, radiological, and genetic findings in LGMD2A phenotype (Calpainopathies). PATIENTS AND METHODS: The National Saudi Arabian LGMD cohort database was screened for LGMD from January 2000 to January 2021. A descriptive cross-sectional study was done on a total of 112 families with LGMD. Screening for mutation in Calpain (CAPN3) gene was done. Clinical and genetic features of LGMD2A phenotype were the main outcome variables. Epi-info was used for statistical analysis. RESULTS: 34 subjects from 22 families (19.64%) had the specific LMGD2A phenotype. The mean age of onset was 9.9 ± 4.5 years (Range 4 to 19 years). The major initial symptoms were lower limb weakness, inability to climb stairs, and gait disturbance. Gower's sign occurred on an average of 3.75 to 7.25 years after onset. Loss of ambulation was observed in 55.8%. Two novel mutations in the CAPN3 gene were identified. CONCLUSIONS: The prevalence of LGMD2A was 19.64% among the national Saudi Arabian LGMD cohort. The clinical presentation was varied and was consistent with other reports from different ethnic groups.

Mode of bond failure between 3D-printed denture teeth and printed resin base material: effect of fabrication technique and dynamic loading. An in-vitro study.

PURPOSE: To evaluate the failure load of 3D-printed denture resin material and teeth before and after dynamic loading. MATERIALS AND METHODS: A total of 40 specimens were fabricated following ISO/TS 19736 and were divided into two equal groups. In the test group, the cylindrical base and denture teeth were 3D printed separately and then luted together. In the control group, the specimens were fabricated from conventional heat-cured polymethyl methacrylate (PMMA) and commercially available denture teeth using the compression-molding technique. Ten specimens from each group were subjected to dynamic load of 50 N for 250,000 cycles in a chewing simulator. All specimens were subjected to static load of 50 N using Instron machine with a crosshead speed of 1 mm/minute until fracture. The fractured surfaces were analyzed using field emission scanning electron microscopy. The failure loads were calculated and compared using analysis of variance (P < .05). RESULTS: All specimens survived the loading, undergoing 250,000 cycles without fracture. The mean failure load was influenced by fabrication technique and was significantly higher for the 3D-printed test group (P = .028). 3D-printed teeth showed a mixed mode of fracture, whereas in the control group, the specimens showed cohesive fracture within the teeth. CONCLUSION: The fabrication technique has an influence on the mode of failure between acrylic teeth and resin base material. Cohesive failure in teeth was predominant in the conventional group, suggesting possibly higher bond strength between the teeth and resin base in this group. The observed failure modes reveal that both fabrication techniques exhibited satisfactory bond strength. Chewing simulation did not significantly influence the bond strength of any of the tested groups.

Does build angle have an influence on surface roughness of anterior 3D-printed restorations? An in-vitro study.

PURPOSE: To evaluate the effect of build direction on the surface roughness (Ra) of stereolithography (SLA) printed full-coverage anterior dental restorations before and after surface polishing. MATERIALS AND METHODS: A total of 45 full-coverage dental restorations were 3D printed using the SLA additive manufacturing technique. Five groups were defined based on the build angles: 90, 120, 135, 150, and 180 degrees. The Ra was measured with the contact profilometer to evaluate the arithmetic average of the absolute Ra value on the labial surface before and after polishing procedures. Data were analyzed using two-way ANOVA, and statistical significance was set at α = .05. RESULTS: The highest Ra was recorded in specimens printed with the 90-degree build angle, whereas the lowest values were recorded in specimens printed with the 180-degree build angle (P = .000). In all groups, the Ra values measured after polishing were significantly lower than prepolished values (P = .000), with no difference among the different build angles. CONCLUSION: Build angle significantly influenced the Ra of the SLA-printed full-coverage restorations. Polishing minimized the effect of build angle on the Ra. The 180-degree build angle is recommended when SLA printing an anterior restoration, as it provides the lowest Ra values and also requires a minimal support area and minimal number of support structures.

Cervical epidural neurosarcoidosis: A case report and literature review.

BACKGROUND: Neurosarcoidosis is a rare disease. In the spine, it commonly presents as an intramedullary lesion. Epidural spinal lesions are extremely rare. CASE DESCRIPTION: A 29-year-old patient presented with a 22-month history of progressive neck, upper limb pain, and myelopathy. The cervical MRI showed a large epidural mass infiltrating the paraspinal soft tissue. After an open biopsy, the diagnosis of neurosarcoidosis was established and was followed-up by appropriate medical management. CONCLUSION: To manage cervical epidural neurosarcoidosis, first, you must obtain a tissue diagnosis and then follow with appropriate medical management.

The Saudi Thoracic Society pneumococcal vaccination guidelines-2016.

Streptococcus pneumoniae (pneumococcus) is the leading cause of morbidity and mortality worldwide. Saudi Arabia is a host to millions of pilgrims who travel annually from all over the world for Umrah and the Hajj pilgrimages and are at risk of developing pneumococcal pneumonia or invasive pneumococcal disease (IPD). There is also the risk of transmission of S. pneumoniae including antibiotic resistant strains between pilgrims and their potential global spread upon their return. The country also has unique challenges posed by susceptible population to IPD due to people with hemoglobinopathies, younger age groups with chronic conditions, and growing problem of antibiotic resistance. Since the epidemiology of pneumococcal disease is constantly changing, with an increase in nonvaccine pneumococcal serotypes, vaccination policies on the effectiveness and usefulness of vaccines require regular revision. As part of the Saudi Thoracic Society (STS) commitment to promote the best practices in the field of respiratory diseases, we conducted a review of S. pneumoniae infections and the best evidence base available in the literature. The aim of the present study is to develop the STS pneumococcal vaccination guidelines for healthcare workers in Saudi Arabia. We recommend vaccination against pneumococcal infections for all children <5 years old, adults ≥50 years old, and people ≥6 years old with certain risk factors. These recommendations are based on the presence of a large number of comorbidities in Saudi Arabia population <50 years of age, many of whom have risk factors for contracting pneumococcal infections. A section for pneumococcal vaccination before the Umrah and Hajj pilgrimages is included as well.