"Knowledge, clinical experience, and perceived need for training regarding molar-incisor hypomineralization among a group of Egyptian dental students: a cross-sectional study".

BACKGROUND: Molar-Incisor Hypomineralization (MIH) is a common oral health condition that can lead to difficulties and complications for both dental professionals and patients. It also has a negative impact on the oral health-related quality of life. The present study aimed to assess the knowledge, clinical experience, and perceived need for training of a group of Egyptian dental students regarding MIH. METHODS: Paper-based survey administration method was used to collect the responses of dental students regarding their knowledge, clinical experience, and perceived need for training about MIH. The survey consisted of two sections of questions regarding clinical features, etiological factors, prevalence, materials used in treating these teeth, factors affecting the choice of restorative materials, and their preferences regarding clinical training of MIH. Descriptive statistics was used for the data analysis by using SPSS® Statistics Version 26. RESULTS: About two-thirds of the respondents were familiar with MIH (69.2%). The vast majority of students (87.8%) had difficulty distinguishing MIH as a developmental defect that differs from other tooth conditions (p < 0.001); most commonly enamel hypoplasia. The most common defects seen by the respondents were yellow/brown opacities (59.1%). Nearly half of the students (45.2%) choose composite resin as the material of choice for the treatment of MIH-affected teeth with aesthetics being the most common factor affecting the selection of restorative material. Almost all students expressed their needs for further clinical training on MIH, especially on treatment aspects. CONCLUSIONS: Most students are familiar with MIH theoretically. However, there is an urgent need to include clinical training on MIH diagnosis in the practical sessions of pediatric dentistry courses.

Cross-Sectional Imaging Evaluation of Vascular Lesions in the Gastrointestinal Tract and Mesentery.

Gastrointestinal (GI) tract and mesenteric vascular lesions can have various clinical presentations, of which GI bleeding is the most common. This collection of pathology is highly variable in etiology ranging from occlusive disease to vascular malformations to trauma to neoplasms which makes for a challenging workup and diagnosis. The advent of multiple imaging modalities and endoscopic techniques makes the diagnosis of these lesions more achievable, and familiarity with their various imaging findings can have a significant impact on patient management. In this article, we review the gamut of GI tract and mesenteric vascular lesions and their associated imaging findings.

Post-operative complications of cholecystectomy: what the radiologist needs to know.

Cholecystectomy is one of the most performed surgical procedures. The safety of this surgery notwithstanding, the sheer volume of operations results in a notable incidence of post-cholecystectomy complications. Early and accurate diagnosis of such complications is essential for timely and effective management. Imaging techniques are critical for this purpose, aiding in distinguishing between expected postsurgical changes and true complications. This review highlights current knowledge on the indications for cholecystectomy, pertinent surgical anatomy and surgical technique, and the recognition of anatomical variants that may complicate surgery. The article also outlines the roles of various imaging modalities in identifying complications, the spectrum of possible postsurgical anatomical changes, and the implications of such findings. Furthermore, we explore the array of complications that can arise post-cholecystectomy, such as biliary system injuries, gallstone-related issues, vascular complications, and the formation of postsurgical collections. Radiologists should be adept at identifying normal and abnormal postoperative findings to guide patient management effectively.

A 1-year Clinical and Radiographic Assessment of Regenerative Endodontic Therapy for Necrotic Primary Molars: A Randomized controlled Trial.

Background: Preservation of necrotic primary teeth is important. Pulpectomy is the gold standard treatment in this situation. Reinfection is the main cause of failure in pulpectomy. The application of regenerative endodontic therapy in mature teeth has the rationale of restoring dental-pulp-like tissue and preventing reinfection. Aims and objectives: The current study was designed to clinically and radiographically assess regenerative endodontics therapy in necrotic primary molars in comparison to zinc oxide eugenol (ZOE) pulpectomy. Materials and methods: A double-blinded randomized controlled trial with three parallel arms and a 1:1:1 allocation ratio was conducted. A total of 54 necrotic primary molars in 39 healthy children aged 4-7 years old were randomly allocated as follows group I-control group, in which ZOE pulpectomy was performed. Group II and III-experimental groups, in which regenerative endodontic therapy (RET) was performed. Modified triple antibiotic paste (mTAP) and Metapex™ were used as intracanal medicaments in groups II and III, respectively. Clinical and radiographic assessments were recorded at baseline, 6 and 12 months. Chi-squared and Fisher's exact tests were used to compare the qualitative data, while Friedman's test was used to study the changes by time within each group. Results: Nonstatistically significant differences were reported between the three groups at the 6 and 12 months follow-ups regarding the clinical or radiographic assessment (p-value = 0.327 and effect size = 0.22), (p-value = 0.055 and effect size = 0.118), respectively. Conclusion: Regenerative endodontic therapy (RET) yielded comparable results to pulpectomy. However, the use of 5 mg/mL mTAP in RET represented the highest level of clinical as well as radiographic insignificant failure. Clinical significance: Regenerative endodontic therapy (RET) provides an acceptable biological alternative to pulpectomy. Trial registration: The protocol was registered at ClinicalTrial.gov with the registration number (NCT04190914). 12/5/2019. How to cite this article: Abdelmoneim DD, Abdelaziz AM, Allam GG, et al. A 1-year Clinical and Radiographic Assessment of Regenerative Endodontic Therapy for Necrotic Primary Molars: A Randomized controlled Trial. Int J Clin Pediatr Dent 2023;16(2):295-301.

Middle East and North Africa Registry to Characterize Rate of RAS Testing Status in Newly Diagnosed Patients with Metastatic Colorectal Cancer.

BACKGROUND: Rat sarcoma virus mutational status guides first-line treatment in metastatic colorectal cancer. This study was a multi center, multi-country ambispective, observational study in the Middle East and North Africa assessing regional rat sarcoma virus testing practices in newly diagnosed patients. METHODS: The retrospective arm (2011-2014) included adults with metastatic colorectal cancer who had initiated first-line therapy with ≥1 post-baseline visit and survival data. The prospective arm (2014-2019) enrolled newly diagnosed patients with histologically proven metastatic colorectal cancer with ≥1 measurable lesion per Response Evaluation Criteria in Solid Tumors, and tissue availability for biomarker analysis. Data look-back and follow-up were 2 years; the rate of RAS mutation was evaluated. RESULTS: RAS testing was ordered for patients in retrospective (326/417) and prospective (407/500) studies. In the former, testing was typically prescribed after first-line treatment initiation, significantly more in patients with stage IV disease (P < .005), resulting in the addition of targeted therapy (41.8% anti-epidermal growth factor receptor, 30.2% anti-vascular endothelial growth factor) in wild-type metastatic colorectal cancer, and significantly impacted the treatment of left-sided tumors (P = .037). In the latter, 58.4% were RAS wild-type; 41.6% were RAS mutant. Non-prescription of RAS testing was attributed to test unavailability, financial, or medical rea sons; predictors of testing prescription were older age, primary tumor in ascending colon, and high tumor grade. RAS status knowledge resulted in the addition of anti-vascular endothelial growth factor (20.4%) or anti-epidermal growth factor receptor therapy (21.2%). CONCLUSION: Before 2014, RAS testing in patients with colorectal cancer in the Middle East and North Africa was often performed after first-line treatment. Testing is more routine in newly diagnosed patients, potentially shifting early treatment patterns.

Effect of Ionizing Radiation on the Mechanical Properties of Two Dental Materials Commonly Used in Primary Teeth.

Aim: The purpose of this in vitro study was to evaluate the effect of radiotherapy on flexural strength, microhardness, and surface roughness of bulk fill composite (X-tra fil) and glass ionomer (EQUIA Forte HT). Materials and methods: A total of 40 specimens were prepared for each test and were divided into two groups according to the material used (composite or glass ionomer cement), and each group was divided into two subgroups (n = 10) according to radiation condition, irradiated subgroup, subjected to 50 Gy by multienergy linear accelerator delivered in one shot and control subgroup. Results: Control samples of flexural strength and microhardness had a significantly higher value than irradiated samples in both materials. Regarding the surface roughness, irradiated samples had a significantly higher value than the control samples in both materials. Conclusion: Irradiation with a linear accelerator had a negative impact on the flexural strength and microhardness of both materials. Moreover, it increased the surface roughness for both materials. Bulk fill composite is the dental restorative material of choice in head and neck cancer patients undergoing radiotherapy due to its high mechanical properties before and after radiation. How to cite this article: Nagi BM, El-Korashy DI, Amin A El-S, et al. Effect of Ionizing Radiation on the Mechanical Properties of Two Dental Materials Commonly Used in Primary Teeth. Int J Clin Pediatr Dent 2023;16(5):758-762.

Superabsorbent Wound Dressing for Management of Patients With Moderate-to-Highly Exuding Chronic Leg Ulcers: An Early Stage Model-Based Benefit-Harm Assessment.

The aim of the research is to assess the benefit-harm of superabsorbent polymers wound dressings based on polyacrylate polymers (SAPs) compared with standard of care (SoC) dressing mix for patients with moderate-to-highly exuding hard-to-heal leg ulcers. The SoC dressings mix was composed of other superabsorbents in 29% of cases, antimicrobials 26%, foams 20%, alginates 5%, and other dressings 19% weighted according to their frequency. We have used the decision-analytic modeling method, Markov process, as an adequate analytical solution for medical prognosis. We have combined the systematic literature search to identify the most relevant inputs for the analysis, with available patient-level clinical data concerning benefits of superabsorbent to generate a robust prediction of patient-relevant outcomes, including healing rates and health-related quality of life. Besides, we have qualitatively described adverse events associated with those treatments. Our research indicates that SAPs when compared with SoC dressing mix in a patient with moderate-to-highly excluding leg ulcers are leading to an improved healing rate with an absolute risk difference of 2.20% in 6 months and a relative risk of 1.07 in favor of SAP dressings. The attributable fraction among those exposed to SAP dressings of 6.6%, meaning that 6.6% of the healed ulcers could be attributed to having had the SAP dressing treatment instead of the SoC dressing treatment. Besides, SAP dressings lead to improved quality of life measured as incremental quality-adjusted life weeks (QALWs) of 0.13 QALWs.

Pharmacy practitioners' practice, awareness and knowledge about herbal products and their potential interactions with cardiovascular drugs.

Background: Herbal medicine use is widespread among patients, as community pharmacies may provide such products. Therefore, pharmacy practitioners should be aware of potential herbal products' adverse effects and herb-drug interactions, particularly with medications for comorbid diseases, such as cardiovascular drugs, in which pharmacy practitioners need to have good knowledge to provide patients with relevant advice to get optimal and safe therapeutic outcomes. Accordingly, the study is designed to assess the knowledge and awareness of pharmacy practitioners regarding herbal product dispensing and cardiovascular drug interaction in Jordan and view their role in patients' counselling to set up safe and effective drug use. Methods: A cross-sectional study was conducted in Jordan using an online formatted questionnaire distributed to pharmacy practitioners working in community pharmacies. Descriptive and analytical statistics were performed for the responses using the Statistical Package for the Social Sciences (SPSS) software, version 26. Results: Out of 508 participants, 41.7% had medium knowledge of herbal products pertaining mainly to university education (68.1%); 55.1% of participants dispensed herbal products without prescriptions for obesity and weight reduction (72.8%) and gastrointestinal problems (70.9%); this is because respondents agreed that herbal remedies are safe (28.5%) and effective (38.4%). Whilst the knowledge level of respondents about herbal medicine interaction with cardiovascular medication was medium, with a mean of 1.94, as this interaction may result in potentially serious consequences, 40.7% of respondents strongly agreed to gain more knowledge about the side effects of herbal products and medicine interactions through educational courses. Conclusions: The pharmacy practitioners had medium knowledge of herbal products; however, more attention should be paid to herb-drug interactions in the pharmacy educational curriculum. Additionally, pharmacy practitioners need to refresh their knowledge by attending periodic educational courses and by using reliable resources for information about herbal products in order to provide effective and competent pharmaceutical care.

A hybrid multi-objective whale optimization algorithm for analyzing microarray data based on Apache Spark.

A microarray is a revolutionary tool that generates vast volumes of data that describe the expression profiles of genes under investigation that can be qualified as Big Data. Hadoop and Spark are efficient frameworks, developed to store and analyze Big Data. Analyzing microarray data helps researchers to identify correlated genes. Clustering has been successfully applied to analyze microarray data by grouping genes with similar expression profiles into clusters. The complex nature of microarray data obligated clustering methods to employ multiple evaluation functions to ensure obtaining solutions with high quality. This transformed the clustering problem into a Multi-Objective Problem (MOP). A new and efficient hybrid Multi-Objective Whale Optimization Algorithm with Tabu Search (MOWOATS) was proposed to solve MOPs. In this article, MOWOATS is proposed to analyze massive microarray datasets. Three evaluation functions have been developed to ensure an effective assessment of solutions. MOWOATS has been adapted to run in parallel using Spark over Hadoop computing clusters. The quality of the generated solutions was evaluated based on different indices, such as Silhouette and Davies-Bouldin indices. The obtained clusters were very similar to the original classes. Regarding the scalability, the running time was inversely proportional to the number of computing nodes.

Spontaneous hemorrhage of an adrenal myelolipoma treated with transarterial embolization: A case report.

Adrenal myelolipoma is a benign tumor of the adrenal cortex composed predominantly of fat and hematopoietic tissue. These lesions are usually asymptomatic, and most often incidentally detected on imaging. Uncommonly, they present with retroperitoneal hemorrhage, and these have been traditionally treated with emergent surgery. Although, transarterial embolization has been effectively and safely used in patients presenting with active hemorrhage from acute traumatic and nontraumatic causes, literature specifically pertaining to adrenal artery embolization is scant, perhaps due to smaller size and variability of adrenal arteries. With recent advances in endovascular techniques and imaging, there are emerging case reports and series of adrenal artery embolization in acute and nonacute settings. We report a case of spontaneous hemorrhage within an adrenal myelolipoma in a 43-year-old male patient, successfully treated with transarterial embolization, thereby avoiding major surgery. Our report adds to the growing body of literature pertaining to adrenal artery embolization.

IgG4-related disease in the abdomen and pelvis: atypical findings, pitfalls, and mimics.

IgG4-related disease (IgG4-RD) is a systemic, autoimmune, fibroinflammatory disease that can cause multi-organ damage. Although there have been many trials and studies since its recognition in 2003, there is still much that is unknown. Furthermore, IgG4-RD can affect any organ in the body and often has many mimics and alternative diagnoses, which can make for a challenging workup. Imaging plays a substantial role in the diagnosis of IgG4-RD and is often the first occasion where IgG4-RD comes into consideration. Thus, knowledge about the imaging findings of various manifestations of IgG4-RD can aid in the diagnosis and have a significant impact on patient management. In this article, we review the wide array of imaging findings, both typical and atypical, as well as possible mimics of IgG4-RD in the abdomen and pelvis.

Afatinib in locally advanced/metastatic NSCLC harboring common EGFR mutations, after chemotherapy: a Phase IV study.

AIM: The current study evaluated the efficacy and tolerability of second-line afatinib in patients with EGFR mutation-positive (EGFRm+) non-small-cell lung cancer (NSCLC) following chemotherapy. PATIENTS & METHODS: In this open-label, single-arm Phase IV study, patients with EGFRm+ (Del19/L858R) NSCLC who had progressed following platinum-based chemotherapy received afatinib (starting dose 40 mg/day). The primary end point was confirmed objective response. RESULTS: 60 patients received afatinib for a median duration of 11.5 months. 50% of patients had a confirmed objective response, of median duration 13.8 months. Median progression-free survival was 10.9 months. The most common treatment-related adverse events were diarrhea (72%), rash (28%) and paronychia (23%). CONCLUSION: Our data support the use of afatinib (40 mg/day) as an effective and well-tolerated second-line treatment in EGFRm+ NSCLC.

Intra- and inter-examiner variability in evaluating preclinical pediatric dentistry operative procedures.

Many investigators have reported attempts to develop reliable laboratory and clinic evaluation systems. However, few studies, regardless of level of success, have used an analytic procedure to identify those components of the evaluation system that, if refined further, could improve reliability. The purpose of this study was to compare intra- and inter-examiner variability in two evaluation methods: glance and grade (global), and checklist and criteria (analytical). Three faculty staff members with more than ten years of clinical and teaching experience evaluated operative procedures performed on plastic teeth representing the primary teeth by thirty dental students in pediatric dentistry preclinical laboratory sessions. The preparations were graded blindly by each of the three evaluators (A, B, and C) three times without magnification. The values were statistically analyzed using Wilcoxon signed rank test and Friedman test setting value of significance at 5 percent. The study revealed that, among the three examiners, the intra-examiner variability was nonsignificant in most situations. On the other hand, there was statistically significant variability between evaluators (i.e., inter-examiner) for almost all preparations. Neither cutting off the scores nor using either evaluation method (glance and grade or criteria and checklist) caused an improvement in variability. The problem of inter-examiner reliability and variability still existed.