Accessibility of Patients With Special Healthcare Needs to Dental Care in the Eastern Province of Saudi Arabia: A Multicentre Study From Perspective of Caregiver and Dental Care Providers.

Dental care accessibility is subject to a dentist's qualification, practice and intention to treat patients, regardless of whether those patients have special healthcare needs (SCN) and should receive treatment in a dental setting. This multicentre study aimed to evaluate the characteristics of patients with SCN, their access to dental care and behaviour towards dental care from their caregiver's perspective. In addition, the perspective of dental care providers who care for patients with SCN and the factors affecting the provision of treatment was also appraised. The Eastern Province of Saudi Arabia served as the site of this cross-sectional study from 1 February 2020 to 31 January 2022. Caregivers of 272 patients with SCN, regardless of age and gender, were recruited in the study. The caregiver's proforma sought information on the demographic characteristics, type of disability, cooperation, medical history, occupation of the parent and patient's behaviour towards oral hygiene and dental healthcare. The second proforma had the dental care provider's perspective about the common disabilities, factors that affect the decision to provide treatment, difficulties patients face in getting their dental treatment and, from the dentist's experience, recommendations to improve the access to dental care for patients with SCN. Statistical analysis was carried out by using SPSS version 22.0. The demographic features, caregiver's perception about oral healthcare accessibility and dental professional's point of view were presented as frequencies and percentages. Chi-square test was applied to compare the proportions. The majority of the caregivers were satisfied with the dental service providers (91.9%) for their patients with SCN. The dental care provider's survey results indicated a shortage of dentists (54.7%) in the region and other factors that pose challenges to special care, like the severity of the disability of patients with SCN (50%), family structure (46.7%), treatment cost (35.6%) and transportation (32.8%). Patients with SCN in Saudi Arabia had a high appraisal of access to dental care and were very satisfied with dental treatment results. However, the presence of a dental care provider in the same rehabilitation centre was a major concern. The severity of the disability and the patient's cooperation were the major factors that may have affected the decision of the dental care provider.

Ginkgo biloba leaves extract's cosmeceutical evaluation: a preliminary assessments on human volunteers towards achieving improved skin condition and rejuvenation.

BACKGROUND: Ginkgo biloba (GB) leaves extract is known to possess potent antioxidants and other bioactivities such as improved skin conditions and rejuvenation. OBJECTIVE: This study aimed to develop a cosmeceutical preparation to utilize the strong antioxidant potential of GB leaves as part of the skincare formulation. METHODS: Cream incorporated GB (GBC) was prepared by mixing the obtained extract with stearic acid-sodium hydroxide components in an emulsion format. The obtained GBC was characterized for GB contents, uniformity, pH, compatibility, stability, and skin's human application. RESULTS: A homogeneous, physically, and chemically stable, with pH near the skin pH and shiny cream, was obtained. The prepared cream was easy to rub and pearly in appearance. It was effective and safe during the two-week trial conducted on human volunteers according to clinical trial registry protocols. The cream scavenged free radicals in DPPH assay tests. The cream incorporated GB made the skin more spirited and tauter. Furthermore, the wrinkles were reduced and the skin was renewed vigor. CONCLUSION: The GBC worked at the topical level and provided benefits when applied daily for the trial duration. The formulation also provided visually observable anti-wrinkle effects on the skin, with visible improvements in the skin's shape and texture. The prepared cream can be used to rejuvenate the skin.

Impact of salicylic acid on the growth and physiological activities of parsley plants under lead toxicity.

Impact of spraying 50 µM salicylic acid (SA), lead nitrate soil treatments [1 and 2 mM Pb (NO3)2] and their combinations on parsley leaves (Petroselinum crispum L.) for 3 weeks was studied to evaluate leaf symptoms, photosynthetic pigments, anthocyanin, ultrastructure, malondialdehyde (MDA), soluble proteins, phenolic compounds, and guaiacol peroxidase activity (GPOX). Under Pb effect, parsley leaves showed chlorosis and decline in the content of photosynthetic pigments chlorophyll a (Chl a), chlorophyll b (Chl b) and carotenoid (Car) with increasing Pb treatments compared to the control. SA spraying helped to reduce chlorosis and increase photosynthetic pigments of Pb-treated plants compared to that of Pb treatment alone. Leaf anthocyanin content of SA-sprayed plants significantly increased compared to the control. On contrast, the anthocyanin content of Pb-treated plants with or without SA treatment decreased compared to the control. Parsley leaf chloroplasts were characterized by many and large starch grains. Deformations of chloroplast shape, increasing formation of plastoglobules and degeneration of chloroplast grana thylakoids were observed in Pb-treated plants. MDA and total phenolic compound contents increased in Pb-treated plants compared to the control. In contrast, soluble protein content decreased in Pb-treated plants. The decrease in leaf photosynthetic pigments and increase MDA contents was Pb-concentration dependent. The results as indicated by increasing lipid peroxidation confirmed Pb treatments generated reactive oxygen species (ROS) which caused oxidative stress. In contrast, SA application declined the extent of detrimental and harmful influence of Pb toxicity as indicated by the decrease MDA content, and increase in photosynthetic pigments, anthocyanin and phenolic compound contents of parsley leaves.

One-Pot Reaction between N-Tosylhydrazones and 2-Nitrobenzyl Bromide: Route to NH-Free C2-Arylindoles.

A one-pot Barluenga coupling between N-tosylhydrazones and nitro-benzyl bromide, followed by deoxygenation of ortho-nitrostyrenes, and subsequent cyclization has been developed, providing a new way to synthesize various C2-arylindoles. This method exhibits a good substrate scope and functional group tolerance, and it allows an access to NH-free indoles, which can present a potential utility in medicinal chemistry applications.

Applicability of waste foundry sand stabilization by fly ash geopolymer under ambient curing conditions.

Recently, utilizing industrial waste in the construction industry has gained significant attention to meet sustainability demands and mitigate the adverse environmental impacts caused by the construction industry. This study evaluates the engineering properties of waste foundry sand as a target material after stabilization with an environmentally friendly stabilizing agent (fly ash geopolymer), focusing on achieving adequate strength under ambient curing conditions as a feasible choice for road bases in geotechnical applications. While fly ash geopolymer application is typically linked with temperature curing, this research explores its application under ambient curing to enhance feasibility and reduce production costs. The fly ash geopolymer was synthesized by activating fly ash using a combination of sodium hydroxide and sodium silicate. The experimental program investigated the geopolymer-stabilized waste foundry sand at varying dosages of 7, 15, and 25 %, examining physical properties, non-destructive tests, mechanical properties, XRD phase analysis, and SEM observation. The results demonstrated that increasing fly ash dosage significantly enhanced the physical properties, mechanical properties, and microstructure of the geopolymer-stabilized waste foundry sand samples. Dry density improved from 1.75 to 2.02 g/cm3; longitudinal wave velocity increased from 897.3 to 2028.4 m/s, and unconfined compressive strength rose from 109 to 5261 kPa. Notably, only samples with 25% fly ash achieved the requisite strength to satisfy the road base limit (4100 kPa). These outcomes instill confidence in the potential use of waste foundry sand as a construction material and transition it from mere filling material to a valuable resource, furthermore encouraging the adoption of fly ash geopolymer as an environmentally friendly stabilizing agent in geotechnical applications.

Synthesis of enones, pyrazolines and pyrrolines with gem-difluoroalkyl side chains.

Starting from easily accessible gem-difluoropropargylic derivatives, a DBU-mediated isomerisation affords enones in fair yields with a gem-difluoroalkyl chain. These derivatives were used to prepare pyrazolines and pyrrolines with the desired gem-difluoroalkyl side chain by cyclocondensations in good yields and with excellent stereoselectivity. A one-pot process was also successfully developed for these sequential reactions. By carrying out various types of Pd-catalyzed coupling reactions for compounds with a p-bromophenyl substituent a route to focused chemical libraries was demonstrated.

Bilateral Knee Septic Arthritis in a Seven-Month-Old Girl.

Septic arthritis (SA) is a type of joint inflammation caused by an infection. It is an orthopedic emergency that requires immediate treatment to avoid serious complications such as joint destruction, osteomyelitis, and sepsis. We present a case of bilateral knee SA in a seven-month-old female who presented to our emergency department with left knee SA, followed by right knee SA one month later.

Retraction: Complete Lumbar Spine Dislocation With Full Neurological Recovery.

[This retracts the article DOI: 10.7759/cureus.19249.].

Prediction of the Compressive Strength of Fly Ash Geopolymer Concrete by an Optimised Neural Network Model.

This article presents a regression tool for predicting the compressive strength of fly ash (FA) geopolymer concrete based on a process of optimising the Matlab code of a feedforward layered neural network (FLNN). From the literature, 189 samples of different FA geopolymer concrete mix-designs were collected and analysed according to ten input variables (all relevant mix-design parameters) and the output variable (cylindrical compressive strength). The developed optimal FLNN model proved to be a powerful tool for predicting the compressive strength of FA geopolymer concrete with a small range of mean squared error (MSE = 10.4 and 15.0), a high correlation coefficient with the actual values (R = 96.0 and 97.5) and a relatively small root mean squared error (RMSE = 3.22 and 3.87 MPa) for the training and testing data, respectively. Based on the optimised model, a powerful design chart for determining the mix-design parameters of FA geopolymer concretes was generated. It is applicable for both one- and two-part geopolymer concretes, as it takes a wide range of mix-design parameters into account. The design chart (with its relatively small error) will ensure cost- and time-efficient geopolymer production in future applications.

Giant Cell Tumor of Tendon Sheath of the Distal Phalanx.

Giant cell tumor of tendon sheath (GCTTS) is a benign proliferative disorder of the synovial joints and tendon sheaths that typically manifests as a painless, firm, localized, and slow-growing mass. Commonly seen among women in the third to fifth decades, GCTTS can be diagnosed clinically; however, histopathological confirmation is required. The tumor is primarily removed surgically. Recurrence after excision is possible and occurs in up to 45% of cases.

Structural-Guided Identification of Small Molecule Inhibitor of UHRF1 Methyltransferase Activity.

Ubiquitin-like containing plant homeodomain Ring Finger 1 (UHRF1) protein is recognized as a cell-cycle-regulated multidomain protein. UHRF1 importantly manifests the maintenance of DNA methylation mediated by the interaction between its SRA (SET and RING associated) domain and DNA methyltransferase-1 (DNMT1)-like epigenetic modulators. However, overexpression of UHRF1 epigenetically responds to the aberrant global methylation and promotes tumorigenesis. To date, no potential molecular inhibitor has been studied against the SRA domain. Therefore, this study focused on identifying the active natural drug-like candidates against the SRA domain. A comprehensive set of in silico approaches including molecular docking, molecular dynamics (MD) simulation, and toxicity analysis was performed to identify potential candidates. A dataset of 709 natural compounds was screened through molecular docking where chicoric acid and nystose have been found showing higher binding affinities to the SRA domain. The MD simulations also showed the protein ligand interaction stability of and in silico toxicity analysis has also showed chicoric acid as a safe and nontoxic drug. In addition, chicoric acid possessed a longer interaction time and higher LD50 of 5000 mg/kg. Moreover, the global methylation level (%5 mC) has been assessed after chicoric acid treatment was in the colorectal cancer cell line (HCT116) at different doses. The result showed that 7.5 µM chicoric acid treatment reduced methylation levels significantly. Thus, the study found chicoric acid can become a possible epidrug-like inhibitor against the SRA domain of UHRF1 protein.

Comparative Analysis of the Impact of Urolithins on the Composition of the Gut Microbiota in Normal-Diet Fed Rats.

The gut microbiota consists of a community of microorganisms that inhabit the large intestine. These microbes play important roles in maintaining gut barrier integrity, inflammation, lipid and carbohydrate metabolism, immunity, and protection against pathogens. However, recent studies have shown that dysfunction in the gut microbiota composition can lead to the development of several diseases. Urolithin A has recently been approved as a functional food ingredient. In this study, we examined the potentials of urolithin A (Uro-A) and B (Uro-B) in improving metabolic functions and their impact on gut microbiota composition under a metabolically unchallenged state in normal rats. Male Wistar rats (n = 18) were randomly segregated into three groups, with Group 1 serving as the control group. Groups 2 and 3 were administered with 2.5 mg/kg Uro-A and Uro-B, respectively, for four weeks. Our results showed that both Uro-A and B improved liver and kidney functions without affecting body weight. Metagenomic analysis revealed that both Uro-A and B induced the growth of Akkermansia. However, Uro-A decreased species diversity and microbial richness and negatively impacted the composition of pathogenic microbes in normal rats. Taken together, this study showed the differential impacts of Uro-A and B on the gut microbiota composition in normal rats and would thus serve as a guide in the choice of these metabolites as a functional food ingredient or prebiotic.

Complete Lumbar Spine Dislocation With Full Neurological Recovery.

The thoracolumbar region is the most vulnerable segment of the spine to traumatic injuries. It represents a region of transition of the relatively fixed and immobile thoracic spine and flexible lumbar spine. Injuries to the thoracolumbar region often result from high-energy trauma. We present the case of a 24-year-old woman who was brought to the emergency department after a fall from a great height. She presented with severe back pain that was associated with the inability to move both of her lower limbs with absent sensation and loss of urinary and bowel continence. Otherwise, she was hemodynamically stable. The patient underwent a computed tomography scan of the abdomen and pelvis. It demonstrated a complete fracture-dislocation of the second lumbar vertebra relative to the first lumbar vertebra causing shortening of the vertebral column. The second lumbar vertebra had a complete lateral dislocation and appeared in the same axial plane as the first lumbar vertebra giving the appearance of a "double vertebrae" sign. The patient was prepared for emergency open reduction internal fixation with a posterior surgical approach. The operation was done under general anesthesia with the use of sensory-evoked potential responses to avoid any neurological injury. Good realignment of the thoracolumbar spine was achieved. Six months after the operation, the patient was asymptomatic and resumed her regular activities. Complete traumatic lateral dislocation of the lumbar spine is very rare. Early diagnosis of such fracture by computed tomography scan is crucial to avoid maneuvers that may cause unintended spinal cord injuries.

Prevalence of burnout syndrome and its related risk factors among physicians working in primary health care centers of the Ministry of Health, Al Ahsa region, Saudi Arabia, 2018-2019.

Burnout syndrome (BS) is a relatively common occupational problem. It is a psychological and behavioral syndrome described by three dimensions: emotional exhaustion (EE); depersonalization (DP); and low personal accomplishment (PA). OBJECTIVES: This study aims to calculate the prevalence of BS and its related risk factors among physicians of primary health care centers (PHCCs) of the Ministry of Health (MOH, Al Ahsa, Saudi Arabia. MATERIALS AND METHOD: A cross-sectional study was conducted in which 280 physicians working in PHCCs were selected as a comprehensive sample, the response rate was 80.7%. We excluded the trainee of residency programs, interns, and hospital physicians providing partial service in PHCCs. The data was collected by using two-part self-administered questionnaire including sociodemographic data, working conditions, and Maslach Burnout Inventory™-Human Services Survey for Medical Personnel-MBI-HSS (MP). This data was analyzed using Statistical Package for Social Sciences (SPSS) program. RESULTS: The mean score for EE was 24.99 ± 11.54 SD. The mean score for DP was 9.19 ± 6.13 SD. For PA, it was 29.41 ± 9.9 SD. The percentage of participants who scored high in EE was 47.3%. About one-half of the participants scored high DP and 59.7% had diminished PA. About one-quarter of the participants (24.3%) scored high burnout in all three dimensions. High EE was present in ages from 35 to 45 years, Saudi participants, rotating or covering physicians, and participants who were satisfied with their job. High DP was seen in Saudi physicians, family physicians, rotating or covering physicians, those who were not satisfied with their job, and physicians who work in rural areas. Low PA was seen in physicians who were not satisfied with their job, rotating or covering physicians, participants who do not have tasks other than clinical work, and physicians who work in Omran sector. CONCLUSION: There is a significant level of burnout among physicians working in PHCCs in Al Ahsa. High burnout was associated with some risk factors. Further research is needed to study this problem in depth.

A systematic review of variables used to assess clinically acceptable alignment of unilateral transtibial amputees in the literature.

Prosthetic alignment is a subjective concept which lacks reliability. The outcome responsiveness to prosthetic alignment quality could help to improve subjective and instrument assisted prosthetic alignment. This study was aimed to review variables used to assess clinically acceptable alignment in the literature. The search was done in some databases including: Google Scholar, PubMed, EBSCO, EMBASE, ISI Web of Knowledge and Scopus. The first selection criterion was based on abstracts and titles to address the research questions of interest. The American Academy of Orthotics and Prosthetics checklists were used for paper risk of bias assessment. A total of 25 studies were included in this study. Twenty-four studies revealed the critics of standing position or walking to locate clinically acceptable alignment, only one study measured outcomes in both situations. A total of 253 adults with transtibial amputations and mean age of 48.71 years participated in included studies. The confidence level of included studies was low to moderate, and before-after trial was the most common study design (n = 19). The joint angle, load line location with respect to joints and center of pressure-related parameters were reported as sensitive outcomes to prosthetic alignment quality in standing posture. The amount of forces at various parts of gait cycle and time of events were sensitive to prosthetic alignment quality during walking. Standing balance and posture and temporal parameters of walking could help to locate clinically acceptable alignment.

Physiological and metabolic changes of Cucurbita pepo leaves in response to zucchini yellow mosaic virus (ZYMV) infection and salicylic acid treatments.

The changes of some physiological and biochemical parameters in pumpkin (Cucurbita pepo cv Eskandarani) leaves associated with zucchini yellow mosaic virus (ZYMV) infection and the effect of exogenous application of salicylic acid (SA) were studied in this paper. In comparison to the untreated leaves, ZYMV infected leaves showed many symptoms, including severe mosaic, size reduction, stunting and deformation. Results from analysis of physiological parameters indicated that viral infection and SA treatments affected metabolism. Viral infection decreased pigment, protein and carbohydrate levels. But with all SA treatments, the protein and carbohydrate contents are noticeably increased. Moreover, the other biochemical parameters showed variable alterations. The peroxidase (POX, EC 1.11.1.7) activity and proline contents were induced by both viral infection and SA treatments. In addition, protein patterns represent some newly synthesized polypeptides which reflect formation of pathogenesis related proteins in all treatments. SA treatment increases the plant resistance against ZYMV. This can be noticed through reduction of percentage of the infected plants, decrease in disease severity and virus concentration of the plants treated with SA then inoculated with virus. All results show significant changes in metabolism affected by either viral infection or SA treatments and also indicate that exogenous SA plays an important role in induction of defense mechanism against ZYMV infection.

A general synthesis of arylindoles and (1-arylvinyl)carbazoles via a one-pot reaction from N-tosylhydrazones and 2-nitro-haloarenes and their potential application to colon cancer.

A convergent and effective synthesis of 3-aryl-indoles, 2,3-diaryl indoles, and (1-arylvinyl)carbazoles from a one-pot sequence involving the coupling of N-tosylhydrazones with ortho-nitro-haloarenes followed by a cyclization has been developed. Compound 5i exhibits excellent antiproliferative activity in the low nM range against colon cancer cell lines.

Thiazole derivatives as inhibitors of cyclooxygenases in vitro and in vivo.

Cyclooxygenases (COXs) are important membrane-bound heme containing enzymes important in platelet activation and inflammation. COX-1 is constitutively expressed in most cells whereas COX-2 is an inducible isoform highly expressed in inflammatory conditions. Studies have been carried out to evaluate thiazole derivatives as anti-inflammatory molecules. In this study, we investigated the in vitro and in vivo effects of two novel thiazole derivatives compound 1 (N-[4-(4-hydroxy-3-methoxyphenyl)-1,3-thiazol-2-yl] acetamide) and compound 2 (4-(2-amino-1,3-thiazol-4-yl)-2-methoxyphenol) on prostaglandin E2 (PGE2) production and COX activity in inflammatory settings. Our results reveal a potent inhibition of both compound 1 (IC50 9.01±0.01µM) and 2 (IC50 11.65±6.20µM) (Mean±S.E.M.) on COX-2-dependent PGE2 production. We also determined whether COX-1 activity was inhibited. Using cells stably over-expressing COX-1 and human blood platelets, we showed that compound 1 is a specific inhibitor of COX-1 with IC50 (5.56×10(-8)±2.26×10(-8)µM), whereas compound 2 did not affect COX-1. Both compounds exhibit anti-inflammatory effect in the dorsal air pouch model of inflammation as shows by inhibition of PGE2 secretion. Modeling analysis of docking in the catalytic site of COX-1 or COX-2 further confirmed the difference in the effect of these two compounds. In conclusion, this study contributes to the design of new anti-inflammatory agents and to the understanding of cyclooxygenase inhibition by thiazole.

Adaptation and validation of a questionnaire assessing patient satisfaction with pharmacy services in general hospitals.

OBJECTIVE: The aim of this study was to cross-culturally adapt the Armando Patient Satisfaction Questionnaire into Arabic and validate its use in the general population. METHODS: The translation was conducted based on the principles of the most widely used model in questionnaire translation, namely Brisling's back-translation model. A written authorization allowing translation into Arabic was obtained from the original author. The Arabic version of the questionnaire was distributed to 480 participants to evaluate construct validity. Statistical Package for Social Sciences version 17.0 for Windows was used for the statistical analysis. RESULTS: The response rate of this study was 96%; most of the respondents (52.5%) were female. Internal consistency was assessed using Cronbach's α, which showed that this questionnaire provides a high reliability coefficient (reaching 0.9299) and a high degree of consistency and thus can be relied upon in future patient satisfaction research.