Cleft Lip and Palate Research Trends in Saudi Arabia: A Bibliometric Analysis.

As Saudi Arabia advances in medical education and patient care, assessing its contribution to cleft lip and palate (CLP) research is vital. This bibliometric analysis aims to map the trends, collaborations, and impact of Saudi research in CLP. Utilizing the Web of Science database, this study conducted a comprehensive bibliometric analysis of CLP research related to Saudi Arabian publications. The analysis included data extraction and assessment of publications, citations, H-index, and international collaborations using advanced bibliometric tools and software. A total of 89 CLP-related articles in Saudi Arabia were retrieved. The findings indicated a steady increase in publications and citations over the years, reflecting growing interest and recognition of CLP's challenges in the Saudi healthcare context. King Abdulaziz University and King Saud University emerged as leading contributors. International collaboration was evident, with significant partnerships with countries like the USA, Canada, the UK, and others. The Cleft Palate-Craniofacial Journal and the Saudi Dental Journal were identified as the most influential journals in disseminating Saudi CLP research. The study highlights a positive growth trajectory in Saudi CLP research, marked by increased publications, citations, and international collaborations. It underscores the importance of continuous research and the need for enhanced efforts to further the understanding and treatment of CLP. Future studies should consider including a broader range of databases to provide a more comprehensive global view of CLP research trends.

Decline in ESBL Production and Carbapenem Resistance in Urinary Tract Infections among Key Bacterial Species during the COVID-19 Pandemic.

The COVID-19 pandemic has led to significant changes in healthcare practices, including increased antibiotic usage. This study aimed to investigate the impact of the pandemic on the prevalence of extended-spectrum ß-lactamase (ESBL) production and carbapenem resistance among key bacterial species causing urinary tract infections (UTIs). Conducted at King Fahad Medical City in Riyadh from January 2018 to December 2022, the study analyzed urine samples from 9697 UTI patients. Patients were categorized into 'pre-COVID-19' and 'during COVID-19' groups. Bacterial isolates were identified, and antimicrobial susceptibility testing was performed following guidelines. ESBL production was detected using the Double-Disc Synergy Test. Escherichia coli and Klebsiella pneumoniae were the main pathogens. During the pandemic, ESBL production decreased in E. coli by 1.9% and in K. pneumoniae by 6.0%. Carbapenem resistance also declined, with E. coli displaying a 1.2% reduction and K. pneumoniae and Pseudomonas aeruginosa displaying 10.7% and 7.9% reductions, respectively. Notably, logistic regression analysis revealed that the odds of ESBL presence were 10% lower during the COVID-19 pandemic (OR 0.91; 95% CI 0.83-0.99; p = 0.040), and there was a significant reduction in the odds of carbapenem resistance (OR 0.43; 95% CI 0.37-0.51; p < 0.001). This study reveals a significant decrease in ESBL production and carbapenem resistance among UTI pathogens during the COVID-19 pandemic, hinting at the impact of modified antibiotic and healthcare approaches. It emphasizes the need for persistent antimicrobial resistance surveillance and policy adaptation to address resistance challenges, offering key directions for future public health actions.

Snakebite Advice and Counseling From Artificial Intelligence: An Acute Venomous Snakebite Consultation With ChatGPT.

BACKGROUND: Snakebites, particularly from venomous species, present a significant global public health challenge. Access to accurate and timely information regarding snakebite prevention, recognition, and management is crucial for minimizing morbidity and mortality. Artificial intelligence (AI) language models, such as ChatGPT (Chat Generative Pre-trained Transformer), have the potential to revolutionize the dissemination of medical information and improve patient education and satisfaction. METHODS: This study aimed to explore the utility of ChatGPT, an advanced language model, in simulating acute venomous snakebite consultations. Nine hypothetical questions based on comprehensive snakebite management guidelines were posed to ChatGPT, and the responses were evaluated by clinical toxicologists and emergency medicine physicians. RESULTS: ChatGPT provided accurate and informative responses related to the immediate management of snakebites, the urgency of seeking medical attention, symptoms, and health issues following venomous snakebites, the role of antivenom, misconceptions about snakebites, recovery, pain management, and prevention strategies. The model highlighted the importance of seeking professional medical care and adhering to healthcare practitioners' advice. However, some limitations were identified, including outdated knowledge, lack of personalization, and inability to consider regional variations and individual characteristics. CONCLUSION: ChatGPT demonstrated proficiency in generating intelligible and well-informed responses related to venomous snakebites. It offers accessible and real-time advice, making it a valuable resource for preliminary information, education, and triage support in remote or underserved areas. While acknowledging its limitations, such as the need for up-to-date information and personalized advice, ChatGPT can serve as a supplementary source of information to complement professional medical consultation and enhance patient education. Future research should focus on addressing the identified limitations and establishing region-specific guidelines for snakebite management.

Artificial Intelligence (AI) Chatbots in Medicine: A Supplement, Not a Substitute.

This editorial discusses the role of artificial intelligence (AI) chatbots in the healthcare sector, emphasizing their potential as supplements rather than substitutes for medical professionals. While AI chatbots have demonstrated significant potential in managing routine tasks, processing vast amounts of data, and aiding in patient education, they still lack the empathy, intuition, and experience intrinsic to human healthcare providers. Furthermore, the deployment of AI in medicine brings forth ethical and legal considerations that require robust regulatory measures. As we move towards the future, the editorial underscores the importance of a collaborative model, wherein AI chatbots and medical professionals work together to optimize patient outcomes. Despite the potential for AI advancements, the likelihood of chatbots completely replacing medical professionals remains low, as the complexity of healthcare necessitates human involvement. The ultimate aim should be to use technology like AI chatbots to enhance patient care and outcomes, not to replace the irreplaceable human elements of healthcare.

Bacterial Pathogens and Antimicrobial Susceptibility Patterns of Urinary Tract Infections in Children during COVID-19 2019-2020: A Large Tertiary Care Center in Saudi Arabia.

BACKGROUND: One of the most prevalent bacterial infections in children is urinary tract infection (UTI), which has become a major concern with increasing resistance of the pathogens to the routinely used antimicrobial agents. The aim of the study is to determine the antimicrobial susceptibility patterns of pediatric UTI-causing pathogens, including ESBL-producing bacteria, in Saudi Arabia. METHODS: This cross-sectional retrospective study was conducted to ascertain the frequency of isolation and the antimicrobial resistance pattern of uropathogens among children aged 0-15 years. The data from the urine cultures was collected during 2019-2020 at the King Fahad Medical City, a major tertiary hospital in Riyadh, Saudi Arabia. A total of 1022 urine samples from patients diagnosed with urinary tract infections (UTIs) were collected for this study. Microbial species present in the samples were cultured and identified using standard biochemical techniques. To assess the resistance of these strains to antimicrobial drugs, an in vitro method was employed, and the criteria set by the Clinical Laboratory Standard Institute (CLSI) were followed. In addition, a double-disc synergy test was conducted to identify strains of E. coli that produce extended-spectrum beta-lactamase (ESBL). RESULTS: The predominant pathogens were E. coli (58.6%), followed by Klebsiella sp. (23.9%). E. coli isolates were more sensitive to meropenem and ertapenem in 99.2% of cases, followed by amikacin (99%). Klebsiella sp. were sensitive to amikacin in 97.1% of cases, followed by meropenem and ertapenem (92.2% in both). The highest sensitivities of antimicrobials toward ESBL were for meropenem and ertapenem (100% in both), followed by amikacin (99%). CONCLUSIONS: Our study recommends using local antibiotic sensitivity data for empirical UTI treatment. Amikacin, ertapenem, and meropenem are effective intravenous options. Cephalosporin, cefuroxime, amoxicillin/clavulanic acid, and nitrofurantoin are suitable oral choices. No significant changes in antimicrobial susceptibility were observed during the COVID-19 pandemic. Further research is needed to assess potential pandemic-related alterations.

Evaluation of pre-alginate impression preparation methods in the surface accuracy of dental cast.

OBJECTIVE: The aim of this study was to investigate the influence of pre-preparation technique (finger smearing and saliva ejection) of alginate impressions on the quality and accuracy of dental casts. MATERIALS AND METHODS: Twenty mandibular impressions from 20 patients (10 males, 10 females) with an age range of 20-40 years were recorded using stock trays. A standard impression and pre-preparation technique for alginate were employed. This included removal of saliva with saliva ejector, smearing of alginate on occlusal surfaces of posterior teeth and smoothing of the material in the tray (Group-1: Test) and no drying and smearing or smoothing of the material prior to impression (Group-2: Control). Standardized disinfection, storage, pouring and removal from die stone techniques were used for all samples. Surface defects (nodules/blebs) on the occlusal surface of casts as examined with digital microscope, were classified according to their sizes and surface area into; Type-A (<500); Type-B (>500 <100); Type-C (>1000) in micrometers (µm). Data was tabulated and analyzed by SPSS using Anova and Tukey's test. RESULTS: Defects were significantly higher (p < 0.01) in samples in Group-2 (1225.51 ±â€¯823.44 µm) as compared to Group-1 (783.68 ±â€¯501.41 µm). All types of defects (Types A, B and C) were significantly higher in samples from Group-2 as compared to Group-1. CONCLUSIONS: Use of pre-preparation technique of finger smearing and saliva ejector prior to alginate impressions resulted in significant reduction of surface nodules/blebs and enhanced the quality and accuracy of fabricated casts. Therefore, the use of saliva ejector, finger smearing on the occlusal surface of teeth and smoothening of alginate impression, immediately prior to intra-oral placement is clinically recommended.

Fast food consumption and its associations with heart rate, blood pressure, cognitive function and quality of life. Pilot study.

BACKGROUND: To investigate the relationship of fast food consumption with cognitive and metabolic function of adults (18-25 years old) in Riyadh, Kingdom of Saudi Arabia. MATERIALS AND METHOD: This cross-sectional study was conducted at the College of Medicine at King Khalid University Hospital, Riyadh, Saudi Arabia. The conventionally recruited subjects underwent an evaluation that included demographic data, quality of life (wellness, stress, sleepiness, and physical activity), mini-mental status examination, and the frequency of fast food consumption. To investigate metabolic function, blood was drawn to evaluate serum HDL, LDL, cholesterol, and triglyceride levels. Cognitive function was assessed by the Cambridge neuropsychological test automated battery. The participants were divided into 2 groups based on fast food consumption: those who consumed fast food 3 times per week or less (Group 1) and those who consumed fast food more than 3 times per week (Group 2). RESULTS: The mean diastolic blood pressure in Group 1 and Group 2 was 72 mmHg and 77 mmHg, respectively, a significant difference (p = 0.04). There was no significant difference for cognitive function and quality of life between the two groups. There was significant correlation of HDL with AST correct mean latency and the AST correct mean latency congruent (p = 0.02, p = 0.01, respectively) and TC with diastolic blood pressure (p = 0.003). CONCLUSIONS: We concluded that fast food consumption has an effect on blood pressure but has no direct effect on cognition or quality of life.

Comparison of fracture resistance and fracture characterization of bilayered zirconia/fluorapatite and monolithic lithium disilicate all ceramic crowns.

PURPOSE: To compare the fracture resistance between bilayered zirconia/ fluorapatite and monolithic lithium disilicate heat-pressed crowns and characterize the mode of fracture failure. MATERIALS AND METHODS: Thirty crown samples were sequentially fitted on a mandibular right first molar metal replica of an ivory prepared molar tooth. The crown specimens were divided in three groups (A, B, and C; n = 10 for each group). Group A consisted of bilayered zirconia/fluorhapatite pressed-over crowns with standard design crown copings (0.7 mm uniform thickness), Group B of bilayered zirconia/fluorhapatite with anatomical design crown copings, and Group C of lithium disilicate monolithic crowns. The samples were then dynamically loaded under water for 100,000 cycles with a profile of 250 N maximum load at 1,000 N/s rate and 2.0 Hz frequency. Loading was performed with a steel ball (5 mm in diameter) coming into contact with the test crown, loading to maximum, holding for 0.2 s, unloading and lifting off 0.5 mm. The samples were then fractured under static loading, in order to determine the ultimate crown strength. Analysis of the recorded fracture load values was carried out with one-way analysis of variance (ANOVA) followed by Tukey tests. Fractured specimens were examined by stereomicroscopy and scanning electron microscopy. RESULTS: The fracture loads measured were (N, means and standard deviations): Group A: 561.87 (72.63), Group B: 1,014.16 (70.18) and Group C: 1,360.63 (77.95). All mean differences were statistically significant (P < 0.001). Catastrophic fractures occurred in Group C, whereas mainly veneer fractures were observed in Groups A and B. CONCLUSION: In the present study, the heat-pressed monolithic lithium-disilicate crowns showed more fracture resistance than zirconia/fluorapatite pressed-over crowns. Within the bilayered groups, the anatomical zirconia coping design presented increased ceramic fracture resistance.