Prevalence and Variation of Medical Comorbidities in Oral Surgery Patients: A Retrospective Study at Jazan University.

BACKGROUND An aged population is susceptible to chronic diseases, which impacts oral surgery treatment procedures. This retrospective study aimed to evaluate the incidence of medical comorbidities in 640 oral surgery patients treated at the College of Dentistry, Jazan University. MATERIAL AND METHODS This single-center observational study investigated medical records of outpatients who visited Jazan University Dental College Hospital in a 1-year period (2018-2019). Patients’ clinical and radiographic archives were screened to obtain relevant data. Categorical and continuous variables were expressed in terms of frequency and mean values, respectively. Differences in variables were statistically analyzed using the chi-square goodness of fit and proportional test, with a probability value P≤0.05 considered significant. RESULTS Analysis of 640 patient records included records of 300 men and 340 women who underwent oral surgery, of whom 176 patients (27.5%), including 97 men and 79 women, had medical comorbidities. The most common comorbidities were endocrine disease (7.03%), cardiovascular disease (6.71%), respiratory disease (4.53%), and hematological disorders (3.43%). Individual diseases that showed higher prevalence were diabetes mellitus (4.68%), hypertension (3.43%), bronchial asthma (2.65%), and anemia (1.4%). Differences by sex were observed in many individual disorders. CONCLUSIONS Outpatients in oral surgery clinics presented a significant variance in the incidence of medical comorbidities, among which diabetes and hypertension were most common. A proper case history is the best preventive measure that helps a surgeon avert medical emergencies and post-surgical complications.

Can Fasting Blood Sugar be Used as an Indicator of Long-Term Diabetic Control Instead of Estimated Average Glucose?

BACKGROUND: Diabetes mellitus is a chronic illness that is a worldwide issue. HbA1c has been used to monitor glycemic control in patients with diabetes for many years. Although HbA1c measurement is needed for calculating estimated average blood glucose (eAG), it is now recommended that eAG is used instead of HbA1c for expression of blood glucose control and communication with patients and health care providers. This study, investigated fasting blood glucose (FBS) as an indicator of overall chronic blood sugar control by assessing the correlation between FBS with eAG derived from HbA1c. METHODS: The blood samples for HbA1c assay were collected in EDTA tubes and were analyzed by an HPLC analyzer (G8 Tosoh, Japan). Blood samples for FBS were collected in serum separator tubes, transported, and centrifuged for 15 minutes at 3,000 g. FBS levels were determined in serum samples with the enzymatic hexokinase method by a clinical chemistry analyzer (Architect 8000, Abbott, USA). RESULTS: Statistical analysis was performed on 1,740 patients with type 2 diabetes mellitus with HbA1c levels above 6.5 mmol/L. The difference between FBS (9.3 ± 3.7 mmol/L) and eAG (11.14 ± 2.7 mmol/L) was statistically signif-icant (p < 0.0001). The correlation coefficient between FBS and eAG was r = 0.65 (95% CI; 0.62 - 0.69), with a p-value < 0.0001. While the correlation coefficient between FBS and eAG at HbA1c < 6.5% was r = 0.251 (95% CI, 0.16 - 0.34), with a significant p-value of < 0.00001. The combined data, standard deviation (SD), median, and interquartile range of eAG and FBS for all of the diabetic groups (n = 2,315), were 10.1 ± 3.00 mmol/L, 9.5 mmol/L, and 7.75 - 12.03 mmol/L for eAG, respectively. Similarly, these values were 8.5 ± 3.6 mmol/L, 7.5 mmol/L, and 6.0 - 10.00 mmol/L for FBS, respectively. CONCLUSIONS: We concluded that there is a moderate and significant positive correlation between fasting blood sugar and the estimated average blood glucose derived from HbA1c. Although FBS might be helpful for daily monitoring of diabetes. Further studies must be conducted to provide solid results to support that FBS and its derived variable eAG can replace HbA1c as an indicator of long-term overall control of T2DM patients.

Replacement of the Distorted Dentition of the Cone-Beam Computed Tomography Scans for Orthognathic Surgery Planning.

PURPOSE: Cone-beam computed tomography (CBCT) does not record dental morphology accurately because of the scattering produced by metallic restorations and the reported magnification of the dentition. The aim of this study was the development and evaluation of a new method for the replacement of the distorted dentition of CBCT scans with a 3-dimensional (3D) dental image captured by a digital intraoral camera. MATERIALS AND METHODS: Six dried skulls with orthodontic brackets fixed on the teeth were used in this study. Three intraoral markers made of dental stone were constructed and attached to orthodontic brackets. The skulls were scanned by CBCT and the occlusal surfaces were captured using the TRIOS 3D intraoral scanner. The digital intraoral scan (IOS) was fused into the CBCT models. This produced a new composite digital model of the skull and the dentition. The skulls were scanned again using the commercially accurate Faro laser arm to produce the 3D model the skull and teeth gold standard for the assessment of the accuracy of the developed method. This was assessed by measuring the distance between the occlusal surfaces of the new composite model and the gold standard 3D laser produced model. RESULTS: The results showed the errors related to the superimposition of the intraoral image on the CBCT to replace the distorted dentition were 0.11 to 0.20 mm. CONCLUSION: The results of this novel method suggest that the dentition on the CBCT scan can be accurately replaced with the digital IOS image captured by an intraoral scanner to create a composite model that will improve the accuracy of digital orthognathic surgical planning and the fabrication of the guiding occlusal wafer.

Prevalence of Adverse Respiratory Symptoms Among E-Cigarette Users in Saudi Arabia - A Cross-Sectional Study.

Electronic cigarettes, frequently referred to as e-cigarettes, have emerged as a controversial and rapidly growing phenomenon in the realm of tobacco and nicotine consumption worldwide. This study reports the prevalence of respiratory symptoms among e-cigarette users. This study also helps to understand the potential harmful effects and importance of quitting e-cigarette smoking. An observational cross-sectional study was carried out in Saudi Arabia. The study period was from September 2022 to August 2023. The sample size was 447 participants. Among recent e-cigarette users in this Saudi study, usage varied, with 44.1% using 1-5 days, 33.6% using 6-30 days, and 22.4% using e-cigarettes previously but not in the previous month. Vape devices were predominant (42.7%). There were significant associations emerged between e-cigarette use frequency and symptoms such as fatigue, breathlessness, and shortness of breath. E-cigarette use was notably linked to asthma-related symptoms, underscoring its concerning impact on respiratory health (P < 0.05). E-cigarette consumption has a significant impact on respiratory effects and specifically asthma-related symptoms among this Saudi population.

Headache Characteristics and Their Influencing Factors Among Pregnant Women in Saudi Arabia: A Survey Study.

Background Headache disorders, particularly migraines, significantly impact public health globally. The Global Burden of Disease (GBD) report highlights migraines as the second leading cause of disability worldwide, especially among women under 50. Hormonal changes, particularly estrogen, play a role in primary headaches like migraines, and this connection becomes important during pregnancy due to physiological changes.  Materials and methods A cross-sectional survey was conducted among pregnant women in Saudi Arabia to assess the characteristics of the headaches and explore their influencing factors. The study initiated the data collection process across various regions of Saudi Arabia from February 2023 to July 2023. Participants included pregnant women aged 18 or above residing in Saudi Arabia. Data were collected through an online self-administered survey with multiple-choice questions. Descriptive analysis and Pearson Chi-Square tests were performed using IBM SPSS Statistics version 25 (IBM Corp., Armonk, USA). Results A study surveyed 411 pregnant women to investigate the characteristics of headaches during pregnancy. The majority of participants were Saudi nationals 381 (92.7%) and 242 (58.9%) aged 18-30 and 357 (86.9%) resided in urban areas. Around 72 (17.5%) reported having chronic diseases. Results showed that 246 (59.9%) of pregnant women were diagnosed with headaches before pregnancy, with migraines being the most common type by 145 (35.3%). Headache frequency increased during pregnancy for 171 (41.6%) of participants, and the majority 275 (66.9%) experienced headaches lasting 0-3 hours. Nausea 219 (53.3%) and holo-cranial pain 112 (27.3%) were common accompanying symptoms. Conclusion This study provides valuable insights into the burden of headaches among pregnant women in Saudi Arabia, emphasizing the importance of improved healthcare practices and educational initiatives to effectively address this issue.

Utility of the Anatomage Virtual Dissection Table in Creating Clinical Anatomy and Radiology Learning Modules.

Purpose: During the COVID-19 pandemic, teaching has required online-learning modalities to facilitate easily accessible yet high-quality education. However, since the nature of anatomy requires hands-on experience in laboratories with cadavers, teaching anatomy in an online setting has proven especially difficult. This matter may be resolved with the Anatomage Table, an advanced anatomy visualization tool, which several studies have suggested can augment learning experiences for students in anatomy courses. Our objective was to provide accessible online modules, through utilization of the Anatomage Table, for medical students to facilitate their learning and enhance online learning experience. Materials and Methods: Ten modules were designed, consisting of a presentation, a pre- and post-self-assessment, as well as anatomical images and radiographs taken from Anatomage Table. The modules were based on a single organ system, and a clinical case pertaining to that organ system was presented. Weill Cornell Medicine-Qatar (WCM-Q) second-year medical students contributed 102 responses in total throughout the 10 modules. Using a paired t-test, the study compared the students' pre- and post-assessment scores to determine how beneficial the modules were. Results: A significant difference in scores on the pre- and post-assessments was found for all 10 modules using a paired t-test. At the end of the modules, the students completed a feedback survey to assess the quality and convenience. Most of the students agreed or strongly agreed that the modules were beneficial to their online anatomy learning and wanted to see similar anatomical modules in the future. Conclusion: The Anatomage Table is an innovative virtual resource that can significantly contribute to a more engaging and productive experience for medical students.

The Frequency of Genetic Mutations in Pediatric Patients Diagnosed with Nephrotic Syndrome: A Single-Center Retrospective Study in Saudi Arabia.

Limited data are available on the common genetic mutations causing nephrotic syndrome (NS) in the Saudi pediatric population. We therefore conducted this study to estimate the frequency of genetic mutations in pediatric patients diagnosed with NS. We conducted this retrospective cross-sectional study at a single center in Riyadh, Saudi Arabia. The data of pediatric patients diagnosed with NS from 2015 to 2019 were reviewed. Percentages were calculated for categorical variables such as gender and mutant gene. We identified a total of 206 patients diagnosed with NS during the study. Molecular genetic profiling was performed only for 35 patients who met the inclusion criteria. Female patients represented 42.8% of all cases (n = 15). The median age of the patients at diagnosis was 36 months (interquartile range 12-72). Associated anomalies were recognized in 37.14% of the patients (n = 13). Out of the 35 patients, 19 had positive molecular genetic results. Consanguinity was present in 18 (51.42%) of these patients. The most common homozygous mutation detected was PLCE1 (42.1%; n = 8), followed by NPHS1 (26.32%; n = 5). Heterozygous mutations were detected in three children (15.8%). Complement factor B and WT1 mutations accounted for one patient each and both COL4A5 and INF2 mutations were reported in a single child. Two mutant genes of unknown zygosity - CD151 and COL4A3 were also identified. PLCE1 is a major underlying cause of NS. PLCE1 may cause diffuse mesangial sclerosis in the kidney with early-onset NS and a poor prognosis.

Epigenetic Effects of Gut Metabolites: Exploring the Path of Dietary Prevention of Type 1 Diabetes.

Type 1 diabetes (T1D) has increased over the past half century and has now become the second most frequent autoimmune disease in childhood and one of major public health concern worldwide. Evidence suggests that modern lifestyles and rapid environmental changes are driving factors that underlie this increase. The integration of these two factors brings about changes in food intake. This, in turn, alters epigenetic regulations of the genome and intestinal microbiota composition, which may ultimately play a role in pathogenesis of T1D. Recent evidence shows that dysbiosis of the gut microbiota is closely associated with T1D and that a dietary intervention can influence epigenetic changes associated with this disease and may modify gene expression patterns through epigenetic mechanisms. In this review focus on how a diet can shape the gut microbiome, its effect on the epigenome in T1D, and the future of T1D management by microbiome therapy.