Survey of rectal cancer MRI technique and reporting tumour descriptors in the UK: a multi-centre British Society of Gastrointestinal and Abdominal Radiology (BSGAR) audit.

AIM: To evaluate variation in magnetic resonance imaging (MRI) technique and reporting of rectal cancer staging examinations across the UK. MATERIALS AND METHODS: A retrospective, multi-centre audit was undertaken of imaging protocols and information documented within consecutive MRI rectal cancer reports between March 2020 and August 2021, which were compared against American and European guidelines. Inclusion criteria included histologically proven rectal adenocarcinoma and baseline staging MRI rectum only. RESULTS: Fully anonymised data from 924 MRI reports by 78 radiologists at 24 centres were evaluated. Thirty-two per cent of radiologists used template reporting, but these reports offered superior documentation of 13 out of 18 key tumour features compared to free-text reports including T-stage, relation to peritoneal reflection and mesorectal fascia (MRF), nodal status, and presence of extramural venous invasion (EMVI; p<0.027 in each). There was no significant differences in the remaining five features. Across all tumour locations, the tumour relationship to the MRF, the presence of EMVI, and the presence of tumour deposits were reported in 79.5%, 85.6%, and 44% of cases, respectively, and tumour, nodal, and distant metastatic stage documented in 94.4%, 97.7%, and 78.3%. In low rectal tumours, the relationship to the anal sphincter complex was reported in only 54.6%. CONCLUSION: Considerable variation exists in rectal cancer MRI acquisition and reporting in this sample of UK centres. Inclusion of key radiological features in reports must be improved for risk stratification and treatment decisions. Template reporting is superior to free-text reporting. Routine adoption of standardised radiology practices should now be considered to improve standards to facilitate personalised precision treatment for patients to improve outcomes.

What is the educational value and clinical utility of artificial intelligence for intraoperative and postoperative video analysis? A survey of surgeons and trainees.

INTRODUCTION: Surgical complications often occur due to lapses in judgment and decision-making. Advances in artificial intelligence (AI) have made it possible to train algorithms that identify anatomy and interpret the surgical field. These algorithms can potentially be used for intraoperative decision-support and postoperative video analysis and feedback. Despite the very early success of proof-of-concept algorithms, it remains unknown whether this innovation meets the needs of end-users or how best to deploy it. This study explores users' opinion on the value, usability and design for adapting AI in operating rooms. METHODS: A device-agnostic web-accessible software was developed to provide AI inference either (1) intraoperatively on a live video stream (synchronous mode), or (2) on an uploaded video or image file (asynchronous mode) postoperatively for feedback. A validated AI model (GoNoGoNet), which identifies safe and dangerous zones of dissection during laparoscopic cholecystectomy, was used as the use case. Surgeons and trainees performing laparoscopic cholecystectomy interacted with the AI platform and completed a 5-point Likert scale survey to evaluate the educational value, usability and design of the platform. RESULTS: Twenty participants (11 surgeons and 9 trainees) evaluated the platform intraoperatively (n = 10) and postoperatively (n = 11). The majority agreed or strongly agreed that AI is an effective adjunct to surgical training (81%; neutral = 10%), effective for providing real-time feedback (70%; neutral = 20%), postoperative feedback (73%; neutral = 27%), and capable of improving surgeon confidence (67%; neutral = 29%). Only 40% (neutral = 50%) and 57% (neutral = 43%) believe that the tool is effective in improving intraoperative decisions and performance, or beneficial for patient care, respectively. Overall, 38% (neutral = 43%) reported they would use this platform consistently if available. The majority agreed or strongly agreed that the platform was easy to use (81%; neutral = 14%) and has acceptable resolution (62%; neutral = 24%), while 30% (neutral = 20%) reported that it disrupted the OR workflow, and 20% (neutral = 0%) reported significant time lag. All respondents reported that such a system should be available "on-demand" to turn on/off at their discretion. CONCLUSIONS: Most found AI to be a useful tool for providing support and feedback to surgeons, despite several implementation obstacles. The study findings will inform the future design and usability of this technology in order to optimize its clinical impact and adoption by end-users.

Imaging manifestations of IgG4-related disease.

IgG4-related disease is a multisystem immune-mediated disorder associated with lesions manifesting an IgG4-rich plasma cell infiltrate and often raised serum IgG4 concentrations. The disease can mimic neoplastic, infective, and inflammatory processes due to features such as development of masses or organ enlargement. Prompt consideration of this diagnosis is essential to avoid unnecessary investigations and offer appropriate treatments, which can include steroids and other immunosuppressive agents. Although histology is typically diagnostic, imaging is critical to assess disease burden, determine biopsy targets, and evaluate response to treatment. Characteristic imaging features can also point towards the diagnosis in the absence of biopsy. This review highlights these features, as well as more atypical findings, grouped by organ or system. Differential diagnoses are emphasised. The full spectrum of imaging methods is discussed. Whole-body imaging with integrated 2-[18F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography (PET)/computed tomography (CT) has an evolving role in the detection of multi-organ involvement and subsequent follow-up.

Appraisal of surface-groundwater anthropogenic indicators and associated human health risk in El Sharqia Governorate, Egypt.

The aim of this study was to integrate hydrogeochemistry with a multivariate statistical approach to understand the various processes that control the evolution/contamination of water resources in El Sharqia Governorate, Egypt with a particular emphasis on direct/indirect risks to human health. To achieve this, a representative collection of 21 groundwater and 35 drainage samples was taken and examined for physical, chemical, and trace element measurements. Results indicated that in shallow groundwater and drainage water samples, the relative abundance of major cations is Na+ > Mg2+ > Ca2+ > K+, and for anions it is HCO3- > Cl- > SO42- (on a molar basis). Natural processes involving the dissolution/precipitation of some minerals and other processes including leaching of solid waste, overuse of agricultural fertilizers application, and high loads of discharged sewage water are responsible for the evolution of water resources in El Sharqia Governorate. Ammonia, nitrate, biological oxygen demand (BOD), phosphate, turbidity, iron, manganese, lead, and aluminum concentrations were found to be higher than the limits set by internatio2nal drinking water regulations. The health risk index (HRI) values for children were found to be higher than those for adults when the water resources are used for drinking purposes, which poses a risk to human health.

Factors influencing international collaboration on the prevention of COVID-19.

OBJECTIVES: COVID-19 has spread rapidly throughout the world, which has highlighted the importance of collaboration between countries to prevent further transmission of the virus. This review aims to identify the factors that influence international collaboration between policymakers for COVID-19 prevention and consider strategies to manage pandemics in the future. STUDY DESIGN: A scoping review was conducted using the Arksey and O'Malley framework for scoping reviews. METHODS: A literature search was performed across PubMed, Google Scholar, Scopus and Embase databases using relevant keywords. The initial search identified 1010 articles; after selection criteria were applied, 28 studies were included in the review. RESULTS: Most of the selected articles were literature reviews, and China had the greatest contribution of articles to this study. The following seven key categories influencing international collaboration were identified: political, structure, infrastructure, leadership and governance, knowledge and information sharing, community engagement, and process/action. CONCLUSION: Leadership and governance was the most important factor identified in international collaboration between countries. In addition, knowledge and information sharing were seen to help avoid repetition of negative situations experienced in other countries. Moreover, controlling COVID-19 on a global scale is more likely to be achieved when there are sufficient structures and resources and when appropriate communication between countries, health systems and communities is used. This collaboration can also greatly benefit low- and middle-income countries where resources and expertise are often limited.

A cross sectional survey on the effect of COVID-19 related restrictions on undergraduate and postgraduate medical education in Qatar.

BACKGROUND: COVID-19 pandemic has affected all dimensions of day to day life across the world and medical education was no exception. With this study, we aimed to understand the effect of nationwide restrictions on medical education in Qatar, the models of education adopted during this period and perceptions of participants to the same. METHODS: We conducted a cross-sectional study utilizing an online questionnaire distributed via convenience sampling between April-October 2020. Study participants were faculty and trainees in governmental undergraduate and postgraduate medical education institutes. Two sets of questionnaires were designed for each group. They were asked a series of questions to assess pre- and post-COVID pandemic educational practices, their preferred teaching methods, and their familiarity with electronic teaching platforms. Faculty respondents were asked about their perceived barriers to delivery of medical education during the pandemic and their agreement on a 5-point Likert scale on specific elements. Trainees were asked a series of multiple-choice questions to characterize their pre- and post-COVID pandemic educational experiences. Both groups were asked open-ended questions to provide qualitative insights into their answers. Data were analysed using STATA software version 12.0. RESULTS: Majority of trainees (58.5%) responded that the pandemic has adversely affected medical education at both the undergraduate and postgraduate levels. Trainees (58.5%) and faculty (35.7%) reported an increased reliance on e-learning. Trainees preferred face-to-face education, while faculty preferred a combination of models of education delivery (33.5% versus 37.1%, p = 0.38). Although 52.5% of the faculty had no previous experience of delivering education through e-learning modalities, 58.9% however felt confident in using e-learning software. CONCLUSIONS: Faculty and trainees agree that the COVID-19 pandemic has had a significant impact on the provision of medical education and training in Qatar, with an increased dependence on e-learning. As trainee's prefer face-to-face models of education, we may have to consider restructuring of medical curricula in order to ensure that optimum learning is achieved via e-learning, while at the same time enhancing our use, knowledge and understanding of the e -learning methods. Further research is warranted to assess if these changes have influenced objective educational outcomes like graduation rates or board scores.

Lamb-Wave-Based Multistage Damage Detection Method Using an Active PZT Sensor Network for Large Structures.

A multistage damage detection method is introduced in this work that uses piezoelectric lead zirconate titanate (PZT) transducers to excite/sense the Lamb wave signals. A continuous wavelet transformation (CWT), based on the Gabor wavelet, is applied to accurately process the complicated wave signals caused by the damage. For a network of transducers, the damage can be detected in one detection cell based on the signals scattered by the damage, and then it can be quantitatively estimated by three detection stages using the outer tangent circle and least-squares methods. First, a single-stage damage detection method is carried out by exciting a transducer at the center of the detection cell to locate the damaged subcell. Then, the corner transducers are excited in the second and third stages of detection to improve the damage detection, especially the size estimation. The method does not require any baseline signal, and it only utilizes the same arrangement of transducers and the same data processing technique in all stages. The results from previous detection stages contribute to the improvement of damage detection in the subsequent stages. Both numerical simulation and experimental evaluation were used to verify that the method can accurately quantify the damage location and size. It was also found that the size of the detection cell plays a vital role in the accuracy of the results in this Lamb-wave-based multistage damage detection method.

Changes in essential salivary parameters in patients undergoing fixed orthodontic treatment: A longitudinal study.

OBJECTIVE: Orthodontic treatment using fixed appliances is known to alter the oral environment and encourage plaque retention around orthodontic brackets and bands, resulting in enamel demineralization and gingival inflammation. This study aimed to evaluate the changes in essential salivary parameters in patients undergoing fixed orthodontic treatment. MATERIALS AND METHODS: Saliva samples were collected from 60 patients before and 2 months after commencing fixed orthodontic treatment. The salivary flow rate, pH, buffering capacity, and levels of amylase, total protein, and glucose were determined. Parametric and nonparametric tests for paired samples were used for comparing the mean differences before and after commencing treatment. RESULTS: Significant reductions in the salivary flow rate, pH, and buffering capacity were noted 2 months after commencing treatment (P < 0.05). Total protein concentrations and calcium levels decreased significantly and amylase and glucose levels increased after commencing treatment (P < 0.05). Significant correlations were observed between salivary total protein concentrations and buffering capacity as well as calcium levels (P < 0.05). CONCLUSION: These findings indicate that the biochemical properties of saliva are altered after introducing fixed orthodontic appliances into the oral cavity, thereby promoting plaque retention and increasing the susceptibility to tooth demineralization and gingival inflammation.

Efficient use of artificial micro-RNA to downregulate the expression of genes at the post-transcriptional level in Arabidopsis thaliana.

Micro-RNAs are cellular components regulating gene expression at the post-transcription level. In the present study, artificial micro-RNAs were used to decrease the transcript level of two genes, AtExpA8 (encoding an expansin) and AHL25 (encoding an AT-hook motif nuclear localized protein) in Arabidopsis thaliana. The backbone of the Arabidopsis endogenous MIR319a micro-RNA was used in a site-directed mutagenesis approach for the generation of artificial micro-RNAs targeting two genes. The recombinant cassettes were expressed under the control of the CaMV 35S promoter in individual A. thaliana plants. Transgenic lines of the third generation were tested by isolating total RNA and by subsequent cDNA synthesis using oligo-dT18 primers and mRNAs as templates. The expression of the two target genes was checked through quantitative real-time polymerase chain reaction to confirm reduced transcript levels for AtExpA8 and AHL25. Downregulation of AtExpA8 resulted in the formation of short hypocotyls compared with those of the wild-type control in response to low pH and high salt concentration. This technology could be used to prevent the expression of exogenous and invading genes posing a threat to the normal cellular physiology of the host plant.

Turbulent heat transfer and pressure drop characteristics of dilute water based Al2O3-Cu hybrid nanofluids.

A study on fully developed turbulent convective heat transfer and pressure drop characteristics of Al2O3-Cu/water hybrid nanofluid flowing through a uniformly heated circular tube is presented in this paper. For this, Al2O3-Cu nanocomposite powder was synthesized in a thermo chemical route using hydrogen reduction technique and dispersed the hybrid nano powder in deionised water to form a stable hybrid nanofluid of 0.1% volume concentration. The prepared powder was characterized by X-ray Diffraction (XRD) and Scanning Electron Microscope (SEM) to confirm the chemical composition, determine the particle size and study the surface morphology. Stability of the nanofluid was ensured by pH and zeta potential measurements. The average heat transfer enhancement for Al2O3-Cu/water hybrid nanofluid is 8.02% when compared to pure water. The experimental results also showed that 0.1% Al2O3-Cu/water hybrid nanofluids have slightly higher friction factor compared to 0.1% Al2O3/water nanofluid. The empirical correlations proposed for Nusselt number and friction factor were well agreed with the experimental data.

The Pro12Ala polymorphism of the gene for peroxisome proliferator activated receptor-gamma is associated with a lower Global Acne Grading System score in patients with acne vulgaris.

BACKGROUND: Acne vulgaris is a multifactorial disease of the skin. Several studies have shown that sebocyte proliferation and/or lipogenesis, as well as inflammatory reactions, may be regulated by peroxisome proliferator-activated receptor (PPAR)γ-mediated pathways. AIM: To investigate whether the Pro12Ala polymorphism of the PPARγ gene might be associated with the risk of acne, and to assess the effect of this polymorphism on acne severity. METHODS: This case-control study enrolled 100 patients with acne and 100 apparently healthy subjects. The clinical grade of acne was assessed using the Global Acne Grading System. We used PCR to identify the presence of the Pro12Ala polymorphism in exon 2 of PPARγ. RESULTS: Our results revealed a statistically significant difference (P = 0.001) in the genotype distribution between patients and controls, with higher incidence of the Pro/Ala genotype in controls (51%) than in patients (28%). A statistically significant association (P < 0.001) between disease severity and genotype distribution was found, indicating that the Pro/Ala genotype is less prevalent in patients with severe acne. CONCLUSIONS: Our results suggest that that the Ala allele might be a protective factor against acne development or may attenuate acne severity.

Hydrological and environmental assessment of urban growth in a sub-tropical town in India.

Roorkee, a sub-tropical urban town in India, has shown a rapid unplanned growth in the past. This paper presents the findings of a study of characteristics of urban soil, rainwater, and runoff emanating from different sources areas and the stormwater flows in the drains. Urban soil showed significant increase in the concentration of all constituents in comparison to the nearby rural soil. Soil metal pollution index suggested multi-element contamination. The traffic and transportation system emerged as the major source of metals and organics. Concentration of rainwater ions was observed to follow the pattern Ca²âº > HCO(3)(-) > Cl⁻ > NO(3)(-) > Na⁺ > Mg²âº > SO(4)(²â») > K⁺. Runoff results indicated a significant enhancement in the concentration of most measured constituents over their rainfall levels. The values of runoff coefficient varied between 0.05 and 0.58, with the high values displayed by the paved areas. Multiple regression equations were developed relating event mean concentration to various storm characteristics. The total load of all measured constituents was observed to vary considerably among the study sites, the direct runoff loads being much higher than the dry weather loads.

The role of diffusion-weighted MRI in the accurate diagnosis of vertebral compression fractures: A comparative study.

INTRODUCTION: Accurately distinguishing between benign and malignant vertebral compression fractures is crucial for clinical management. This study evaluated the predictive accuracy of diffusion-weighted imaging (DWI) in differentiating the cause of vertebral fractures using MRI. METHODS: A longitudinal cross-over study was conducted at Jinnah Postgraduate Medical Centre (JPMC) Karachi from July 2018 to January 2021. Patients with vertebral compression fractures underwent T1-weighted, T2-weighted, and DWI imaging with ADC mapping on a 1.5 T MRI scanner. Imaging findings were compared with histopathologic results and clinical follow-up. Sensitivity, specificity, and ROC curve analyses were performed. RESULTS: The study enrolled 303 patients with a mean age of 43.6 ± 10.9 years, of whom 118 were male. DWI demonstrated high accuracy in predicting the cause of vertebral compression fractures, with a sensitivity of 96.2 %, a specificity of 76.2 %, and an area under the ROC curve of 0.857. The optimal ADC cut-off value was 0.82 × 10˄-3 mm˄2/s, which yielded a positive predictive value of 79.7 % and a negative predictive value of 95.4 %. CONCLUSIONS: DWI is a safe and non-invasive imaging modality with excellent predictive accuracy in differentiating between benign and malignant vertebral compression fractures. Iso- or hypointensity of collapsed vertebral bodies on DWI suggests a benign lesion, while T2-weighted hyperintensity is highly indicative of malignancy. Low signal on ADC is also highly indicative of malignant vertebral fractures. Incorporating DWI improves accuracy in assessing vertebral lesions, especially when standard sequences are inconclusive. IMPLICATIONS FOR PRACTICE: DWI revolutionizes vertebral compression fracture diagnosis, distinguishing between benign and malignant cases. This precision guides treatment decisions, minimizing the necessity for invasive procedures like biopsy. As a safe and reliable imaging method, DWI elevates patient care, ensuring accurate diagnostics and improved outcomes.

Prevalence of Long COVID Syndrome and its Association With Blood Group: A Cross-Sectional Study.

BACKGROUND:  The coronavirus disease 2019 (COVID-19) virus pandemic rapidly spread across the globe since 2020. It was characterized by a number of acute signs and symptoms. There were, however, some new-onset signs and symptoms labelled as "Long COVID". This study was conducted to study its prevalence and associations with blood group. METHODS: A retrospective analysis was conducted in Islamabad for patients diagnosed with COVID-19 in 2020-2021. Information was collected through an online and physical questionnaire regarding personal demographics, symptoms during and after COVID-19, and blood group. The data was analyzed using IBM SPSS Statistics for Windows, Version 25.0 (Released 2017; IBM Corp., Armonk, New York, United States). RESULTS: The study identified 196 participants out of which 48.5% were male and 51% were female, with a median age of 30. Most participants (62.2%) belonged to the Punjabi ethnicity. The mean BMI was 25.56 kg/m2. The majority of the study participants reported having blood group B (n=76) followed by A (n=52). Acute symptoms were experienced by 95.4% of participants, with fatigue being the most persistent symptom at four weeks (45.9%). After four weeks, 63.3% of participants reported new symptoms like hair loss. Females were found more likely to experience long COVID symptoms. The perceived severity of acute infection was significantly associated with long COVID symptoms (p=<0.01). There was no association found between long COVID and blood group (p=0.158). CONCLUSION:  There was no association found between long COVID and ABO blood groups. Females were more likely than males to experience long COVID. Long COVID was found to be more likely to develop in those with perceived severe acute infection, highlighting the need for further research regarding aggressive care from the onset of COVID-19 infection.

Comparing the Long-term Success Rates of Immediate Implant Placement vs. Delayed Implant Placement in Patients with Periodontally Compromised Teeth.

Background: This study aims to compare the long-term success rates of immediate implant placement and delayed implant placement in patients with periodontally compromised teeth. Materials and Methods: A total of 30 patients presenting with periodontally compromised teeth requiring extraction and subsequent implant placement were enrolled in this retrospective study. Patients were divided into two groups based on the timing of implant placement: Group A (immediate implant placement) and Group B (delayed implant placement). Implants were placed according to standard protocols. Patient records were reviewed for implant survival, peri-implant bone loss, and prosthetic complications. Data were statistically analyzed using appropriate tests. Results: The mean follow-up period was 5 years. In Group A, the implant survival rate was 90%, while in Group B, it was 83%. The mean peri-implant bone loss was 1.5 mm in Group A and 2.2 mm in Group B. Prosthetic complications were observed in three cases in Group A and five cases in Group B. The differences in implant survival and bone loss between the two groups were not statistically significant (P > 0.05). Conclusion: Both immediate implant placement and delayed implant placement demonstrated comparable long-term success rates in patients with periodontally compromised teeth.

The Effect of a Low-Carbohydrate Diet on Periodontal Health and Inflammation in Patients with Type 2 Diabetes.

Background: The interaction between type 2 diabetes and periodontal disease underscores the importance of exploring dietary interventions that could mitigate inflammation and improve periodontal health in diabetic patients. Materials and Methods: This randomized controlled trial included 100 patients with type 2 diabetes who were equally divided into two groups: Group A (low-carbohydrate diet) and Group B (control group). Patients in Group A followed a low-carbohydrate diet for 12 weeks, while Group B maintained their regular dietary habits. Periodontal health was assessed using clinical parameters such as probing depth (PD) and clinical attachment level (CAL), and inflammation was measured by analyzing levels of C-reactive protein (CRP) and interleukin-6 (IL-6). Statistical analyses were performed using appropriate tests. Results: After 12 weeks, Group A exhibited significant improvements in periodontal health compared to Group B. The mean PD reduction was 0.5 mm in Group A and 0.1 mm in Group B, with a corresponding mean CAL gain of 0.3 mm in Group A and no significant change in Group B. Inflammatory markers also showed favorable outcomes in Group A, with a decrease of 1.2 mg/L in CRP levels and 20% reduction in IL-6 levels. In contrast, Group B demonstrated minimal changes in inflammatory markers. The differences in PD, CAL, CRP, and IL-6 levels between the two groups were statistically significant (P < 0.05). Conclusion: The adoption of a low-carbohydrate diet for 12 weeks demonstrated significant improvements in periodontal health and reduction of inflammation in patients with type 2 diabetes.

Green synthesis of nanomaterials by using plant extracts as reducing and capping agents.

An alternative method to conventional synthesis is examined in this review by the use of plant extracts as reducing and capping agents. The use of plant extracts represents an economically viable and environmentally friendly alternative to conventional synthesis. In contrast to previous reviews, this review focuses on the synthesis of nano-compounds utilizing plant extracts, which lack comprehensive reports. In order to synthesize diverse nanostructures, researchers have discovered a sustainable and cost-effective method of harnessing functional groups in plant extracts. Each plant extract is discussed in detail, along with its potential applications, demonstrating the remarkable morphological diversity achieved by using these green synthesis approaches. A reduction and capping agent made from plant extracts is aligned with the principles of green chemistry and offers economic advantages as well as paving the way for industrial applications. In this review, it is discussed the significance of using plant extracts to synthesize nano-compounds, emphasizing their potential to shape the future of nanomaterials in a sustainable and ecologically friendly manner.

Assessing the gas sensing capability of undoped and doped aluminum nitride nanotubes.

CONTEXT: CO2 and CO gas sensors are very important to recognize the insulation situation of electrical tools. ToCO explore the application of noble metal doped of aluminum nitride nanotubes for gas sensors, DFT computations according to the first principal theory were applied to study sensitivity, adsorption attributes, and electronic manner. In this investigation, platinum-doped aluminum nitride nanotubes were offered for the first time to analyze the adsorption towards CO2 and CO gases. Firm construction of platinum-doped aluminum nitride nanotubes (Pt-AlNNT) was investigated in four feasible places, and the binding energy of firm construction is 1.314 eV. Respectively, the adsorption energy between the CO2 and Pt-AlNNT systems was - 2.107 eV, while for instance of CO, the adsorption energy was - 3.258 eV. The mentioned analysis and computations are considerable for studying Pt-AlNNT as a new CO2 and CO gas sensor for electrical tools insulation. The current study revealed that the Pt-AlNNT possesses high selectivity and sensitivity towards CO2 and CO. METHODS: In this research, Pt-doped AlNNT (Pt-AlNNT) has been studied as sensing materials of CO and CO2 for the first time. The adsorption process of Pt-AlNNT has been computed and analyzed through the DFT approach. DFT computations by using B3LYP functional and 6-31 + G* basis sets have been applied in the GAMESS code for sensing attributes, which contribute to potential applications.

Depression and anxiety among patients with epilepsy: A cross-sectional study from Riyadh, Saudi Arabia.

Background: It is well established that epileptic disorders are associated with a wide range of psychosocial issues that overburden the affected individuals and limit their lifestyle. This study aimed to determine the commonalities between depression and anxiety symptoms among patients with epilepsy (PWE). In addition, we assessed whether depression and anxiety rates varied depending on factors related to the disease. Materials and Methods: A cross-sectional study was conducted between October 2021 and March 2022 among all PWE at Prince Mohammed bin Abdulaziz Hospital, and 147 patients who responded to the questionnaires were included for analysis (65.6% response rate). Depression was measured using the Patient Health Questionnaire depression scale (PHQ-9), while anxiety levels were measured using the Generalized Anxiety Disorder scale (GAD-7). Demographic variables such as sex, age, marital status, and factors related to epilepsy were also recorded. Results: The results showed that 39.5% and 27.9% of participants had major depressive disorder (MDD) and generalized anxiety disorder (GAD), respectively. The presence of factors that increased susceptibility to seizures was associated with a greater expression of depression (P = 0.035) and anxiety (P = 0.002) symptoms. The presence of symptoms/signs that precede seizures was associated with a higher risk of moderate and severe depression (P = 0.001) and moderate and severe anxiety (P < 0.001). Irregular use of medications was associated with a higher risk of moderate and severe depression (P = 0.037); however, lamotrigine was associated with lower rates of depression among the participants (P = 0.023). Conclusion: This study found that PWE had a higher prevalence of MDD and GAD than the general population. However, this accepted paradigm has yet to reflect a meaningful change in constructing condition-specific recommendations for PWE. Our study revealed that the presence of subjectively recognized signs of an impending ictal episode was significantly associated with a higher risk of moderate and severe depression and anxiety. Furthermore, factors that increase the susceptibility to seizures were associated with a higher risk of depression and anxiety. Irregular medication use was associated with a higher risk of moderate and severe depression. However, lamotrigine was associated with lower rates of depression among participants.

The effect of photodynamic therapy on the salivary flow rate, IgA concentration and C-reactive protein levels in active smokers: a case-control study.

OBJECTIVE: This study aimed to evaluate the effect of photodynamic therapy (PDT) on the salivary flow rate, secretory immunoglobulin A, and C-reactive protein levels in active smokers. PATIENTS AND METHODS: The present study is a prospective case-control study. Twenty active smokers were allocated to two groups randomly of ten participants each: the experimental group was irradiated while the control was exposed to sham irradiation by turning off the equipment. In the experimental group, methylene blue mediated PDT was applied both intra- and extra-orally over the major and minor salivary glands using a diode laser. 780 nm wavelength and 4 J/cm2 of energy were used to irradiate the 10 points of major salivary glands (6 for parotid and 2 for submandibular glands and 2 for sublingual glands). On the other hand, 660 nm was used to apply 10 J/cm2 of energy over the minor salivary glands at numerous points. The samples of the stimulated and unstimulated saliva were collected from both groups to assess the SFR. ELISA method was used to assess the level of salivary IgA levels, statistical analysis was done using a one-way ANOVA, and a p-value of <0.05 was considered significant. RESULTS: The results showed a significant increment in salivary and secretory immunoglobulin A levels of subjects undergone photodynamic therapy. C-reactive protein levels were significantly decreased in subjects exposed to irradiation. CONCLUSIONS: The present study concludes that photodynamic therapy significantly improves the salivary flow rate, secretory Immunoglobulin A, and oral health quality of life in smokers. The inflammatory salivary marker C-reactive protein, which is usually raised in smokers, is also reduced.