Pulp stones in unerupted teeth: a retrospective analysis using cone-beam computed tomography.

BACKGROUND: A pulp stone is a calcified mass that develops in the dental pulp of any tooth. Despite many studies examining the relationship between pulp stone formation and non-oral factors, the methods used in these studies have been unable to explain the exact role of these factors alone as distinct from probable effects within the oral cavity environment. Considering that totally unerupted (impacted or developing) teeth are unexposed to the oral cavity's environmental and functional conditions, they provide a more suitable material for studying the effects of these non-oral factors on pulp stone formation. This research study aimed to investigate pulp stones in unerupted teeth and the associated factors in a Saudi subpopulation. METHODS: The study included 644 cone-beam computed tomography images, with 496 (50.9%) maxillary and 479 (49.1%) mandibular teeth. Of the investigated patients, 293 (45.5%) were men, and 351 (54.5%) were women. The age range was 15-76 years. A chi-square test was used to investigate the associations between pulp stones and age, gender, and history of systemic disease and chronic medication use. RESULTS: Pulp stones in unerupted teeth were present in 24.2% of the examined dental jaws and 18.6% of the examined teeth. There was no statistically significant relationship between pulp stones and gender (p > 0.05). A significantly greater percentage of pulp stones were found with increasing age (p = 0.000). Additionally, a significantly increased number of pulp stones was observed in patients with systemic diseases and chronic medications (p < 0.05). CONCLUSIONS: The results support the idea that pulp stones can be present in any type of unerupted tooth. This study provides additional evidence of the increased incidence of pulp stones with age, systemic disease, and chronic medications.

Growth performance, nutrient digestion, rumen fermentation and blood biochemistry in response to partially replacing cottonseed cake with sesame meal in a lamb feedlot diet.

Recently, it is necessary to formulate high-quality, balanced and low-cost rations for ruminants from nontraditional sources. The present study conducted to investigate the impact of partially replacing corticated cottonseed (CS) cake with sesame meal (SM) in a lamb feedlot diet on growth performance, nutrient digestion, rumen fermentation and blood biochemistry. Fifteen growing lambs with an initial body weight of 27.4 ± 1.2 kg (6-7 months old) were randomly assigned into three equal groups (n = 5). Lambs in control group (CS) fed a basal diet, while 8% and 16% SM were used to replace an equal portion of corticated CS cake in the second (8SM) and third (16SM) groups respectively. Results showed that most parameters of growth performance and nutrient digestibility were significantly improved (p < 0.05) with the partial replacement of SM (8SM and/or 16SM). Regarding ruminal parameters, ruminal pH and total volatile fatty acids concentration increased (p < 0.05), while ammonia level and total protozoa count decreased with the partial replacement of SM. Moreover, blood parameters showed variant responses to SM partial replacement. Total protein increased, and glucose decreased significantly with 16SM, while cholesterol showed a significant decreasing with both SM replacement levels. SM may substitute CS cake in lamb diet without detrimental effects on performance, digestibility and ruminal fermentation.

Effects of Partial-Contact Tool Tilt Angle on Friction Stir Welded AA1050 Aluminum Joint Properties.

This study aims to investigate the impact of partial-contact tool tilt angle (TTA) on the mechanical and microstructure properties of the AA1050 alloy friction stir weld (FSW). Three levels of partial-contact TTA were tested, 0°, 1.5°, and 3°, compared to previous studies on total-contact TTA. The weldments were evaluated using surface roughness, tensile tests, microhardness, microstructure, and fracture analysis. The results show that in partial-contact conditions, increasing TTA decreases the generated heat in the joint line and increases the possibility of FSW tool wear. This trend was the opposite of joints that were friction stir welded via total-contact TTA. The microstructure of the FSW sample was finer at higher partial-contact TTA, while the possibility of defect formation at the root of the stir zone in higher TTA was more than in lower TTA. The robust sample prepared at 0° TTA had 45% of AA1050 alloy strength. The maximum recorded heat in 0° TTA was 336 °C and the ultimate tensile strength of this sample was 33 MPa. The elongation of the 0° TTA welded sample was 75% base metal, and the average hardness of the stir zone was 25 Hv. The fracture surface analysis of the 0° TTA welded sample consisted of a small dimple, indicating the brittle fracture mode.

Bioceramics utilization for the repair of internal resorption of the root: A case report.

BACKGROUND: The objective of this work is displaying a successful treatment for an internal resorption case under operating microscope using bioceramic material. CASE SUMMARY: Periapical radiograph showed radiolucent lesion representing large internal resorption of the root. The respective defect was obturated using endoscquence bioceramic material follow up at the month 18 after treatment revealed no abnormal finings clinically and radiographically. CONCLUSION: New generations bioceramics have many advantages that internal root resorption cases can benefit from. The use of operating microscope helps to apply obturating materials with precision. However, long term study on a large sample is required in future studies.

The Effects of Pin Profile on HDPE Thermomechanical Phenomena during FSW.

Friction stir welding (FSW) of polymeric materials has recently attracted significant attention. Herein, we present the effect of the tool pin profile on the FSW of high-density polyethylene (HDPE) joints through joint experimental analysis and thermomechanical simulations. For analysis of pin profile effects on the thermomechanical properties of HDPE joints, frustum (FPT), cubic (CPT), and triangular (TPT) pin shapes were selected in this study. This research investigated the heat generation of the parts of the different tools as well as heat flux (internal and surface). The results revealed that the heat generation in pins with more edges (cubic (96 °C) and triangular (94 °C)) was greater than in pins with a smooth shape (frustum (91 °C)). The higher heat generation caused the heat flux on the surface of the HDPE from the cubic pin profile to be greater than for other joints. Due to the properties of HDPE, higher heat generation caused higher material velocity in the stirring zone, where the velocity of the materials in TPT, CPT, and FPT pins were 0.41 m/s, 0.42 m/s, and 0.4 m/s, respectively. The simulation results show sharp-edged pins, such as triangular and cubic, lead to over-stirring action and internal voids formed along the joint line. Furthermore, the simulation results indicated that the size of the stirred zones (SZs) of the FPT, TPT, and CPT samples were 17 mm2, 19 mm2, and 21 mm2, respectively, which is around three times the corresponding values in the HAZ.

The potential use of urinary transferrin, urinary adiponectin, urinary Retinol Binding Protein, and serum zinc alpha 2 glycoprotein levels as novel biomarkers for early diagnosis of diabetic nephropathy: A case-control study.

BACKGROUND AND AIMS: The level of albuminuria is used to evaluate diabetic nephropathy (DN). However, to detect or predict the early stages of DN, better biomarkers are needed. METHODS: This study is a case-control observational study. 80 Egyptians participated in the study: 60 patients with type 2 diabetes mellitus (T2DM) were divided into three groups (20 patients each), and 20 healthy subjects with matched age and gender were used as controls. Demographic and laboratory data were analyzed. An enzyme-linked immunosorbent assay was used to determine the levels of four biomarkers of DN; urinary adiponectin (ADP), urinary transferrin, serum Zinc Alpha 2 Glycoprotein (ZAG), and urinary Retinol Binding Protein (RBP). RESULTS: The levels of DN biomarkers urinary ADP, transferrin, RBP, and serum, ZAG were significantly higher in patients with T2DM than in controls. The ROC curve of the validity of the simultaneous use of all four biomarkers in predicting albuminuria indicates a sensitivity of 90% and a specificity of 90%. The Area Under the Curve (AUC) was 0.948, the 95% confidence interval was 0.998-0.897, and the p-value was 0.001. CONCLUSIONS: In patients with T2DM, urine adiponectin, transferrin, RBP, and serum ZAG concentration may be useful biomarkers in the early diagnosis of DN. A further longitudinal prospective study is required to explore the potential utility of these biomarkers.

Effects of Underwater Friction Stir Welding Heat Generation on Residual Stress of AA6068-T6 Aluminum Alloy.

This article aims to study water-cooling effects on residual stress friction stir welding (FSW) of AA6068-T6 aluminum alloy. For this reason, the FSW and submerged FSW processes are simulated by computational fluid dynamic (CFD) method to study heat generation. The increment hole drilling technique was used to measure the residual stress of welded samples. The simulation results show that materials softening during the FSW process are more than submerged. This phenomenon caused the residual stress of the joint line in the submerged case to be lower than in the regular FSW joint. On the other hand, the results revealed that the maximum residual stresses in both cases are below the yielding strength of the AA6068-T6 aluminum alloy. The results indicated that the residual stress along the longitudinal direction of the joint line is much larger than the transverse direction in both samples.

Amblyopia screening for first and second-grade children in Jordan.

AIM: To share the results of a national screening program for amblyopia in school children in the north of Jordan. METHODS: This is a prospective national screening study for amblyopia. The program rolls first and second-grade children (6 to 7 years old) in the north of Jordan. The eye examination included: best-corrected visual acuity, cover-uncover test, and cycloplegic retinoscopy. Monocular visual acuity was tested using an ETDRS visual acuity chart without correction. Moreover, children were tested with full cycloplegic refraction when the test criteria were met. Unilateral amblyopia was defined as a best-corrected visual acuity difference of 2 or more lines. In comparison, bilateral amblyopia was defined as a best-corrected visual acuity of 20/40 or worse in the best eye. RESULTS: The prevalence of amblyopia for the total sample tested (n=17 203) was 2.78% (n=479). The most common cause of amblyopia was hypermetropia (64.45%), followed by previous ocular surgeries (15.1%), myopia (10.43%), strabismus (9.39%), and congenital cataract (0.63%). CONCLUSION: This is the first and only study, identifing modifiable risk factors in Jordanian children with amblyopia. In their first couple of years of elementary education, many Jordanian children are affected by amblyopia and pass unnoticed. A more governmental effort is needed into screening programs to improve vision in the Jordanian population.

Graphene enhanced detoxification of wastewater rich 4-nitrophenol in multistage anaerobic reactor followed by baffled high-rate algal pond.

The presence of 4-nitrophenol (4-NP) in the wastewater industry causes toxicity and inhibition of the anaerobic degrading bacteria. The anaerobes in the multistage anaerobic reactor were loaded by 30.0 mg/gVS Graphene nanoparticles (MAR-Gn) as an electron acceptor to detoxify wastewater industry. The half maximal inhibitory concentration (IC50) was reduced from 455 ± 22.5 to 135 ± 12.7 µg Gallic acid equivalent/mL at 4-NP loading rate of 47.9 g/m3d. Furthermore, 4-NP was decreased by a value of 83.7 ± 4.9% in MAR-Gn compared to 65.6 ± 4.8% in control MAR. The 4-aminophenol (4-AP) recovery was accounted for 44.8% in the MAR-Gn at an average oxidation-reduction potential (ORP) of - 167.3 ± 21.2 mV. The remaining portions of 4-NP and 4-AP in the MAR-Gn effluent were efficiently removed by baffled high rate algal pond (BHRAP), resulting in overall removal efficiency of 91.6 ± 6.3 and 92.3 ± 4.6%, respectively. The Methanosaeta (52.9%) and Methanosphaerula (10.9%) were dominant species in MAR-Gn for reduction of 4-NP into 4-AP. Moreover, Chlorophyta cells (Chlorella vulgaris, Scenedesmus obliquus, Scenedesmus quadricauda and Ulothrix subtilissima were abundant in the BHRAP for complete degradation of 4-NP and 4-AP.

Pin Angle Thermal Effects on Friction Stir Welding of AA5058 Aluminum Alloy: CFD Simulation and Experimental Validation.

The friction stir welding (FSW) of tool pin geometry plays a critical role in the final properties of the produced joint. The tool pin geometry directly affects the generation of heat and the flow of internal materials during the FSW process. The effects of the FSW tool pin angle on heat generation and internal flow have not been quantitatively investigated in detail. In this manuscript, a validated Computational Fluid Dynamic (CFD) model was implemented to analyze the effects of pin angle on the thermo-mechanical action during the FSW process of AA5058 Al-Mg alloy. Experimental test results validate the thermal outcomes of the used model. The obtained results revealed that, when the pin angle is increased, the heat generation decreases while the mechanical action of the tool increases. The internal heat distribution at a higher pin angle is symmetrical. The higher mechanical action of the tool decreases the viscosity of the internal materials and increases stirring action (materials flow) around the pin. Furthermore, plastic flow near the tool increased stirring action and formed a larger stir zone in the joint area.

Effect of Pin Shape on Thermal History of Aluminum-Steel Friction Stir Welded Joint: Computational Fluid Dynamic Modeling and Validation.

This article studied the effects of pin angle on heat generation and temperature distribution during friction stir welding (FSW) of AA1100 aluminum alloy and St-14 low carbon steel. A validated computational fluid dynamics (CFD) model was implemented to simulate the FSW process. Scanning electron microscopy (SEM) was employed in order to investigate internal materials' flow. Simulation results revealed that the mechanical work on the joint line increased with the pin angle and larger stir zone forms. The simulation results show that in the angled pin tool, more than 26% of the total heat is produced by the pin. Meanwhile, in other cases, the total heat produced by the pin was near 15% of the total generated heat. The thermo-mechanical cycle in the steel zone increased, and consequently, mechanical interlock between base metals increased. The simulation output demonstrated that the frictional heat generation with a tool without a pin angle is higher than an angled pin. The calculation result also shows that the maximum heat was generated on the steel side.

Autoantibody Profile of Egyptian Juvenile Systemic Lupus Erythematosus Patients and Its Association with Clinical Characteristics and Disease Activity.

OBJECTIVE: This study was conducted to estimate the frequency of anti-nuclear antibodies (ANAs), anti-dsDNA, and anti-extractable nuclear antigen (ENA) antibodies in juvenile systemic lupus erythematosus (JSLE) patients and their association with different clinical manifestations and disease activity. PATIENTS AND METHODS: A cross-sectional study that includes 100 JSLE patients from Ain Shams University Hospital was conducted. All subjects underwent history taking, clinical examination, assessment of disease activity based on the SLE disease activity index (SLEDAI), laboratory investigations, and tests for autoantibodies, namely ANA, anti-dsDNA, and anti-ENA antibodies, including anti-Ro (SSA), anti-La (SSB), anti-Smith (Sm), and anti-U1-ribonucleoprotein (U1-RNP). RESULTS: The most common clinical features were polyarthralgia (71%), haematological manifestations (65%), malar rash (54%), and nephritis (51%), respectively. All patients had positive ANA (100%), while anti-dsDNA frequency was 83%. The most common anti-ENA antibodies were anti-RNP (41%), anti-Sm (31%), anti-SSA (27%), and anti-SSB (20%), respectively. Anti-RNP had a clinical association with oral ulcer, Raynaud' phenomena, haematological, neuropsychiatric and thromboembolic manifestations. Meanwhile, anti-Sm had a significant association with serositis, mucocutaneous, constitutional, and neuropsychiatric manifestations. Anti-SSA was associated with mucocutaneous, musculoskeletal, Raynaud' phenomena, renal, haematological and cardiac manifestations, while anti-SSB was significantly associated with malar rash, serositis, thromboembolic, musculoskeletal, and neuropsychiatric manifestations. Concerning SLEADI score, anti-dsDNA antibody was significantly associated with moderate disease activity score (p=0.032) while anti-SSA significantly associated with high disease activity (p=0.045). Both anti-SSB and anti-Sm were significantly associated with both moderate and high disease activities, meanwhile anti-U1-RNP was associated with moderate disease activity (p=0.014). CONCLUSION: Anti-dsDNA and anti-ENAs antibodies were frequently found in JSLE patients (83%, 63%), respectively. They were significantly associated with variable clinical manifestations and could be used as predictors for assessment of disease activity.

Syndecan-1 Promotes Angiogenesis in Triple-Negative Breast Cancer through the Prognostically Relevant Tissue Factor Pathway and Additional Angiogenic Routes.

Triple-negative breast cancer (TNBC) is characterized by increased angiogenesis, metastasis, and poor survival. Dysregulation of the cell surface heparan sulfate proteoglycan and signaling co-receptor Syndecan-1 is linked to poor prognosis. To study its role in angiogenesis, we silenced Syndecan-1 in TNBC cell lines using a 3D human umbilical vein endothelial cell (HUVEC) co-culture system. Syndecan-1 siRNA depletion in SUM-149, MDA-MB-468, and MDA-MB-231 cells decreased HUVEC tubule network formation. Angiogenesis array revealed reduced VEGF-A and tissue factor (TF) in the Syndecan-1-silenced secretome. qPCR independently confirmed altered expression of F3, F7, F2R/PAR1, F2RL1/PAR2, VEGF-A, EDN1, IGFBP1, and IGFBP2 in SUM-149, MDA-MB-231, and MDA-MB-468 cells. ELISA revealed reduced secreted endothelin-1 (SUM-149, MDA-MB-468) and TF (all cell lines) upon Syndecan-1 depletion, while TF pathway inhibitor treatment impaired angiogenesis. Survival analysis of 3951 patients demonstrated that high expression of F3 and F7 are associated with better relapse-free survival, whereas poor survival was observed in TNBC and p53 mutant basal breast cancer (F3) and in ER-negative and HER2-positive breast cancer (F2R, F2RL1). STRING protein network analysis revealed associations of Syndecan-1 with VEGF-A and IGFBP1, further associated with the TF and ET-1 pathways. Our study suggests that TNBC Syndecan-1 regulates angiogenesis via the TF and additional angiogenic pathways and marks its constituents as novel prognostic markers and therapeutic targets.

Salvage liver transplantation after resection of colorectal cancer liver metastasis with favorable outcomes: a case report and review of the literature.

BACKGROUND: Approximately 50% of patients with colorectal cancer (CRC) develop metastases most commonly in the liver. Liver transplantation (LT) can be used in certain cases of primary liver malignancy or in metastatic diseases, such as Neuroendocrine tumors. However, there are controversies regarding LT as a treatment option for liver metastasis from CRC due to poor outcomes in previously reported cases. CASE PRESENTATION: We report a 37-year-old male who underwent resection of the left-sided colon due to cancer and was found to have synchronous liver metastasis for which he received chemotherapy. Later, he underwent a right hepatectomy, which was complicated by insufficient liver remnant function despite the preserved liver perfusion. Therefore, salvage liver transplantation was performed successfully with a good long-term outcome. CONCLUSIONS: Many studies examined the survival and quality of life in patients undergoing liver transplantation for unresectable colorectal liver metastasis; these studies include the SECA Study (secondary cancer) and others with favorable outcomes. We reviewed the literature and compared the outcomes of some of these studies in this article. Our case emphasizes that liver transplantation could be an option for some colon cancer liver metastasis (CLM) patients, specifically, as a salvage procedure. Thus, more research is needed to develop selection criteria for patients who may benefit from liver transplantation.

Inflammatory Breast Carcinoma: Elevated microRNA miR-181b-5p and Reduced miR-200b-3p, miR-200c-3p, and miR-203a-3p Expression as Potential Biomarkers with Diagnostic Value.

Inflammatory breast cancer (IBC) is a rare yet aggressive breast cancer variant, associated with a poor prognosis. The major challenge for IBC is misdiagnosis due to the lack of molecular biomarkers. We profiled dysregulated expression of microRNAs (miRNAs) in primary samples of IBC and non-IBC tumors using human breast cancer miRNA PCR array. We discovered that 28 miRNAs were dysregulated (10 were upregulated, while 18 were underexpressed) in IBC vs. non-IBC tumors. We identified 128 hub genes, which are putative targets of the differentially expressed miRNAs and modulate important cancer biological processes. Furthermore, our qPCR analysis independently verified a significantly upregulated expression of miR-181b-5p, whereas a significant downregulation of miR-200b-3p, miR-200c-3p, and miR-203a-3p was detected in IBC tumors. Receiver operating characteristic (ROC) curves implied that the four miRNAs individually had a diagnostic accuracy in discriminating patients with IBC from non-IBC and that miR-203a-3p had the highest diagnostic value with an AUC of 0.821. Interestingly, a combination of miR-181b-5p, miR-200b-3p, and miR-200c-3p robustly improved the diagnostic accuracy, with an area under the curve (AUC) of 0.897. Intriguingly, qPCR revealed that the expression of zinc finger E box-binding homeobox 2 (ZEB2) mRNA, the putative target of miR-200b-3p, miR-200c-3p, and miR-203a-3p, was upregulated in IBC tumors. Overall, this study identified a set of miRNAs serving as potential biomarkers with diagnostic relevance for IBC.

Knockdown of Musashi RNA Binding Proteins Decreases Radioresistance but Enhances Cell Motility and Invasion in Triple-Negative Breast Cancer.

The therapeutic potential of Musashi (MSI) RNA-binding proteins, important stemness-associated gene expression regulators, remains insufficiently understood in breast cancer. This study identifies the interplay between MSI protein expression, stem cell characteristics, radioresistance, cell invasiveness and migration. MSI-1, MSI-2 and Notch pathway elements were investigated via quantitative polymerase chain reaction (qPCR) in 19 triple-negative breast cancer samples. Measurements were repeated in MDA-MB-231 cells after MSI-1 and -2 siRNA-mediated double knockdown, with further experiments performed after MSI silencing. Flow cytometry helped quantify expression of CD44 and leukemia inhibitory factor receptor (LIFR), changes in apoptosis and cell cycle progression. Proliferation and irradiation-induced effects were assessed using colony formation assays. Radiation-related proteins were investigated via Western blots. Finally, cell invasion assays and digital holographic microscopy for cell migration were performed. MSI proteins showed strong correlations with Notch pathway elements. MSI knockdown resulted in reduction of stem cell marker expression, cell cycle progression and proliferation, while increasing apoptosis. Cells were radiosensitized as radioresistance-conferring proteins were downregulated. However, MSI-silencing-mediated LIFR downregulation resulted in enhanced cell invasion and migration. We conclude that, while MSI knockdown results in several therapeutically desirable consequences, enhanced invasion and migration need to be counteracted before knockdown advantages can be fully exploited.

Cyclic Fatigue Comparison of TruNatomy, Twisted File, and ProTaper Next Rotary Systems.

TruNatomy (TN; Dentsply Sirona, Maillefer, Ballaigues, Switzerland) is a newly released system that was not tested in any previous studies. The objective of this work is to evaluate cyclic fatigue resistance of the new file and compare it with the Twisted Files (TF) and ProTaper Next (PTN). Forty-five files were distributed into 3 groups: PTN X2 (size 25 and taper 0.06), TF (size 25 and taper 0.06), and TN prime file (size 26 and taper 0.04). Each group included 15 files. Lengths of all files were 25 mm. Cyclic fatigue testing was done using artificial stainless-steel canals with 60-degree curvature and 5 mm radius. Continuous rotation movement at 300 rpm was used until the file fractures. Time for file separation was recorded in seconds. The number of cycles to failure (NCF) mean and standard deviation for each group was calculated. For statistical analysis of data, ANOVA and Tukey's multiple comparison test were used. Mean and standard deviation (SD) of NCF were 259 ± 37.2, 521.67 ± 63.07 and 846.67 ± 37.16 for PTN, TF, and TN respectively. TN on average had significantly the highest NCF compared with PTN (p < 0.05) and TF (p < 0.05). TruNatomy file showed superior cyclic fatigue resistance. With its potential to preserve tooth structure, this file offers a good cyclic fatigue advantage. However, future studies are required to evaluate other properties of this file and to examine its clinical performance.

Lipomatous tumors of adrenal gland: A case series of 5 patients and review of the literature.

INTRODUCTION: Lipomatous tumors of the adrenal glands are a diverse group of tumors characterized by the composition of adipose tissue. This group of tumors include myelolipomas, angiomyolipomas (AML), lipomas, and teratomas. They are usually benign, non-functioning tumors, and they account for 5% of all primary adrenal tumors. This study aimed to elucidate the management of the initial size of the adrenal mass and symptoms of presentation. We provide a succinct literature review regarding angiomyolipomas tumors of the adrenal glands. PRESENTATION OF CASES: Here, we report 5 cases of lipomatous tumors of the adrenal glands. All 5 tumors were non-functioning. Four of them were myelolipoma, and one was AML. Two cases of myelolipoma presented with flank pain, while the rest of the 3 cases presented with hypochondrium pain. Three cases of myelolipoma were managed with laparoscopic adrenalectomy, one case of myelolipoma was converted from laparoscopic to open adrenalectomy because of abdominal adhesions, and the last case was AML and was managed with open adrenalectomy. All patients had an uneventful recovery with regular follow-up. DISCUSSION: Myelolipoma, the most common lipomatous tumor of the adrenal gland, consists of a mixture of bone morrow element and adipose tissue. AML consists of a mixture of a thick-walled blood vessel, smooth muscle, and adipose tissue. They mimic many different benign and malignant tumors on radiography, and the histopathological examination is still needed to confirm the diagnosis. There is still controversy in the management of these tumors. Usually, the management is individualized on each case. Reporting of these tumors are increasing due the wide-spread use of modern imaging modalities. CONCLUSION: Adrenal lipomatous tumors are uncommon but with the increase use of imaging modalities their detection has increased. Further studies are needed to establish guidelines in the management of these tumors, especially that they can mimic malignant conditions.

Prevalence of three-rooted mandibular permanent first and second molars in the Saudi population.

INTRODUCTION: This study aims to explore the frequency and factors affecting the prevalence of an extra root in the lower first and second permanent molars in the Saudi population. METHODS: Images of 379 Saudi patients who underwent CBCT for routine dental treatment were assessed. The CBCT images were evaluated on a 34-inch LED screen in a dark room and assessed by two examiners to count the prevalence of an additional root in the lower molars. Laterality and the gender factors were used to analyze that prevalence. Percentages represent categorical variables; Fisher's exact test and Chi square test were also used for the categorical variables. RESULTS: In the lower first molars, the prevalence of extra root in female patients was 5.7%, 3% in male patients and the overall prevalence was 3.05%; in lower second molars, the prevalence was 1.81% in female patients and 3.04% in male patients with an overall prevalence of 1.48%. A statistically significant difference was fond in the existence of an additional root with regard to laterality, to be more common on the right compared to the left side for both mandibular molars. The extra root prevalence was statistically significant in female patients at the first molar compared to male patients (p < 0.05). CONCLUSION: The overall of extra roots prevalence in the lower first and second molars in the Saudi population are 3.05% and 1.48%, respectively. Consideration and identification of this variation is essential to ensure successful endodontic treatment.

Systematic review and meta-analysis of randomized controlled trials of atosiban versus nifedipine for inhibition of preterm labor.

BACKGROUND: Two tocolytic drugs-atosiban and nifedipine-are currently used for first-line treatment of preterm labor (PTL). OBJECTIVE: To compare the efficacy and safety of atosiban with nifedipine for PTL treatment. SEARCH STRATEGY: In May 2017, we searched PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Clinical Trials with search terms including "nifedipine", "atosiban", and "preterm labor". SELECTION CRITERIA: Randomized controlled trials of women with PTL. DATA COLLECTION AND ANALYSIS: Data were extracted for study design, patient characteristics, risk of bias domains, and study outcomes. A random-effects model was used to generate pooled risk ratios (RRs) and 95% confidence intervals (CIs). RESULTS: We included seven studies that enrolled 992 patients. There was no significant difference between atosiban and nifedipine for pregnancy prolongation of 48 hours or more regarding efficacy (RR 1.06, 95% CI 0.92-1.22; P=0.440) or effectiveness (0.93, 0.84-1.03; P=0.177). Pregnancy prolongation for 7 days or more also did not differ between groups for efficacy (RR 1.04, 95% CI 0.89-1.21; P=0.656) or effectiveness (0.91, 0.79-1.05; P=0.177). Atosiban-however-was associated with fewer maternal side-effects than nifedipine. CONCLUSION: Atosiban resulted in fewer maternal side-effects than nifedipine, with no difference in pregnancy prolongation. PROSPERO registration: CRD42018090223.