Rehabilitation of Ectodermal Dysplasia Using CAD/CAM Mandibular Complete Denture and Maxillary Overdenture: A Clinical Report.

Ectodermal dysplasia is a genetic disorder characterized by the abnormal development of two or more ectodermally driven structures, leading to various clinical manifestations such as sparse hair, dry skin, and hypodontia or anodontia. The absence of teeth significantly impacts the quality of life for individuals affected by this condition. This article presents a clinical case report of a patient with ectodermal dysplasia who underwent full mouth rehabilitation using computer-aided design/computer-aided manufacturing (CAD/CAM) technology to fabricate a mandibular complete denture and a maxillary overdenture.

Effects of irritable bowel syndrome on the health-related quality of life among the Saudi population.

BACKGROUND: Irritable bowel syndrome (IBS) is a digestive system disorder. Patients with IBS have a significantly lower quality of life (QoL). In this study, we aimed to assess how IBS affects the Saudi Arabian population's health-related (HR)-QoL. METHODS: A cross-sectional Web-based survey was conducted with a representative sample (n = 1346) of patients who met the Rome IV criteria for IBS from all regions of the country between February and May 2021. The questionnaire surveyed participants' socio-demographic data (nationality, sex, age, region, marital status, level of education, and occupation) and included 24 questions on IBS divided into four categories: (1) diagnosis; (2) symptoms; (3) impact on patients' lives; and (4) management methods. The HR-QoL score was calculated using a five-point Likert scale, with higher scores indicating worse QoL. RESULTS: Most patients (83.3%) were diagnosed by a physician, and 66.7% had a family member or a friend with IBS. Mixed IBS was the most common type of IBS (26.4%). Factors associated with poor QoL and significantly associated with IBS included female sex, initial diagnosis by a general physician, intermittent symptoms, and being asymptomatic for weeks to months. CONCLUSIONS: Greater attention to the QoL of patients with IBS is required to help them deal with IBS and create supportive environments to reduce its psychological effects.

Tetraenone A: A New ß-Ionone Derivative from Tetraena aegyptia.

In this study, the chemical investigation of Tetraena aegyptia (Zygophyllaceae) led to the identification of a new megastigmene derivative, tetraenone A ((2S, 5R, 6R, 7E)-2-hydroxy-5,6-dihydro-ß-ionone) (1), along with (3S, 5R, 6S, 7E)-3-hydroxy-5,6-epoxy-5,6-dihydro-ß-ionone- (2), 3,4-dihydroxy-cinnamyl alcohol-4-glucoside (3), 3ß,19α-dihydroxy-ursan-28-oic acid (4), quinovic acid (5), p-coumaric acid (6), and ferulic acid (7), for the first time. The chemical structures of 1-7 were confirmed by analysis of their 1D and 2D NMR and HRESIMS spectra and by their comparison with the relevant literature. The absolute configurations of 1 and 2 were assigned based on NOESY interactions and ECD spectra. Conformational analysis showed that 1 existed exclusively in one of the two theoretically possible chair conformers with a predominant s-trans configuration for the 3-oxobut-1-en-1-yl group with the ring, while the half-chair conformer had a pseudo-axial hydroxy group that was predominant over the other half-chair conformation. Boat conformations were not among the most stable conformations, and the s-trans isomerism was in favor of s-cis configuration. In silico investigation revealed that 1 and 2 had more favorable binding interactions with Mpro rather than with TMPRSS2. Accordingly, molecular dynamic simulations were performed on the complexes of compounds 1 and 2 with Mpro to explore the stability of their interaction with the target protein structure. Compounds 1 and 2 might offer a possible starting point for developing covalent inhibitors of Mpro of SARS-CoV-2.

Herpes zoster vaccine awareness and acceptance among adults in Saudi Arabia: a survey-based cross-sectional study.

BACKGROUND: Herpes zoster (shingles) is caused by reactivation of the varicella-zoster virus. Despite the recommended herpes zoster vaccine for individuals aged ≥ 50 years, its uptake remains low in Saudi Arabia. METHODS: This cross-sectional study assessed knowledge and awareness of herpes zoster and its vaccine in individuals aged ≥ 50 years in Saudi Arabia. Data were collected through an online survey distributed via social media. RESULTS: Among 402 participants, 57.2% had heard of the shingles vaccine, but only 7.7% received it. However, 53.2% expressed willingness to be vaccinated. Multivariable analysis revealed that those aged 56-60 were 1.8 times more likely to accept the vaccine than those aged 50-55 years (p = 0.03). Men were 1.9 times more likely to accept the vaccine than women (p = 0.01). Additionally, participants with a primary education were 16.1 times more likely to accept the vaccine than those with a higher education (p = 0.01). CONCLUSION: This study highlights the need for increased awareness and education among healthcare providers and the public in Saudi Arabia regarding shingles and its vaccine. The low vaccine uptake calls for effective strategies, such as awareness campaigns and provider reminders. Primary education and vaccine hesitancy influence willingness to be vaccinated.

This study aimed to understand how much people in Saudi Arabia know about shingles (herpes zoster) and the vaccine to prevent it. Shingles is a viral infection caused by the same virus that causes chickenpox. After having chickenpox, the virus can stay in the body and reactivate later in life, causing shingles. We conducted an online survey among adults aged 50 years and above to gather information. Many people had heard about shingles, but their knowledge about it was limited. Healthcare providers were not a significant source of information for most participants, showing the need for more awareness and education from healthcare professionals. We also looked at people's attitudes towards the shingles vaccine. Only a small percentage of participants had received the vaccine, but many expressed willingness to get vaccinated. However, certain factors like age, gender, and education level influenced people's willingness to take the vaccine. The low vaccine uptake is concerning because shingles can lead to serious health problems. To increase vaccine acceptance, we suggest implementing awareness campaigns and providing reminders to people and healthcare providers. It's also important to address concerns about vaccine safety and efficacy. In conclusion, our study showed the need for more awareness and education about shingles and its vaccine among adults in Saudi Arabia. By addressing the barriers to vaccine uptake and promoting its benefits, we can reduce the burden of shingles and its complications in the older population.

The Extent of Misconceptions, Negative Prejudices, and Discriminatory Behaviors Toward Psoriasis Patients: A Cross-Sectional Survey Study Among the Population of Jeddah, Saudi Arabia.

Background Psoriasis is a chronic inflammatory disease that affects around 2% of the population. The lives of psoriasis patients are greatly impacted by stigma and social exclusion, regardless of the severity of the condition. This is the first study of its kind to be conducted in Saudi Arabia. This study aimed to assess peoples' psoriasis-related misconceptions, negative prejudice, and discriminatory behaviors. Methodology A self-administered Google Forms survey was distributed between January and February 2023. The survey was conducted among residents of Jeddah, Saudi Arabia who were enrolled randomly via social media. We aimed to investigate their perception and awareness related to psoriasis, as well as how varying educational levels, age groups, and genders affected these variables. Results In total, 803 individuals participated in the survey. Results showed that 19.9% of the participants did not know about psoriasis. Only 5.1% of respondents stated that they were well knowledgeable about psoriasis. Moreover, psoriasis was more frequently perceived as a communicable disease by people in the age group of 18-29 years (p = 0.000). Surprisingly, only 43.5% of the participants reported that they would shake hands with someone with psoriasis without hesitation. Additionally, 40.7% of the participants were aware that psoriasis requires lifelong treatment. Moreover, the belief that psoriasis does not require lifelong therapy was more prevalent among university graduates (p = 0.000). Conclusions This study found that the residents of Jeddah need further education on skin disorders, in general, and psoriasis, in particular. Future studies should be conducted utilizing various approaches, with a greater emphasis on certain groups of people who engage physically with psoriasis patients.

Community Pharmacies in the Asian Countries of Developing Health System: Formation, Regulation, and Implication.

Community pharmacies (CPs) in Asian countries are often the first point of contact for patients withinthe healthcare system and their preferred place to purchase medicines. The number of CPs may vary across Asian countries, and each country has developed its own design and functioning. The regulatory environment plays a crucial role in shaping and governing CPs. The aim of this study was to conduct a comprehensive literature review in order to enhance understanding of the establishment and regulation of CPs. By undertaking this review, the researchers, policymakers, and practitioners sought to gain a deeper insight into the performance and functions of CPs and the regulatory frameworks that govern them. Moreover, this review shed light on implementation strategies, effects on patient outcomes, and the barriers and challenges associated with their establishment. A narrative literature review method was adopted with specific inclusion and exclusion criteria. Significant disparities can be observed when comparing the stated intentions of regulations with their actual implementation. Recently, there has been an inclusion of public health practices. Unfortunately, pharmacy procedures conducted in such environments have been characterized by inadequate understanding and inappropriate care. This poor performance can be attributed to employees' focus on maximizing profits. Several shortcomings can arise, including incomplete patient history documentation, failure to refer patients who require medical attention, unauthorized dispensing of prescription-only medicines (POM), dispensing clinically inappropriate or excessive medication doses, selling incomplete antibiotic courses, and inadequate information and counseling services. Regulatory interventions can help strengthen these services.

Prevalence and determinants of undiagnosed hypertension in the Western region of Saudi Arabia.

Recent data regarding the prevalence and determinants of undiagnosed hypertension in Saudi Arabia are particularly lacking. This study aimed to investigate the prevalence of undiagnosed hypertension and to identify potential associates of hypertension risk among adults in the Western region of Saudi Arabia. Cross-sectional data for 489 Saudi adults were collected from public places in the cities of Madinah and Jeddah. Demographic, anthropometric (height, weight, waist circumference), and blood pressure (assessed by a digital sphygmomanometer) data were collected from all participants during face-to-face interviews. The American College of Cardiology and American Heart Association guidelines were used to evaluate blood pressure status. Sodium intake was assessed using a semi-validated food frequency questionnaire. The prevalence of undiagnosed, elevated blood pressure, stage I, or stage II hypertension was 9.82%, 39.5%, and 17.2%, respectively. The proportions of individuals with undiagnosed hypertension were higher among men and smokers (p < .001 for both). Blood pressure status was positively associated with weight, body mass index, and waist circumference among participants (p < .001 for all). Higher body mass index and waist circumference were associated with increased odds of stage I and stage II hypertension. Sodium intake was not associated with blood pressure status. A strikingly high prevalence of undiagnosed hypertension was observed among the study sample. National intervention programs are necessary to encourage regular screening and follow-up for the early detection and management of hypertension.

Soluble guanylate cyclase agonist, isoliquiritigenin attenuates renal damage and aortic calcification in a rat model of chronic kidney failure.

AIMS: Chronic kidney disease (CKD) is a growing fatal health problem worldwide associated with vascular calcification. Therapeutic approaches are limited with higher costs and poor outcomes. Adenine supplementation is one of the most relevant CKD models to human. Insufficient Nitric Oxide (NO)/ cyclic Guanosine Monophosphate (cGMP) signaling plays a key role in rapid development of renal fibrosis. Natural products display proven protection against CKD. Current study therefore explored isoliquiritigenin, a bioflavonoid extracted from licorice roots, potential as a natural activator for soluble Guanylate Cyclase (sGC) in a CKD rat model. MATERIALS AND METHODS: 60 male Wistar rats were grouped into Control group (n = 10) and the remaining rats received adenine (200 mg/kg, p.o) for 2 wk to induce CKD. They were equally sub-grouped into: Adenine untreated group and 4 groups orally treated by isoliquiritigenin low or high dose (20 or 40 mg/kg) with/without a selective sGC inhibitor, ODQ (1-H(1,2,4)oxadiazolo(4,3-a)-quinoxalin-1-one, 2 mg/kg, i.p) for 8 wk. KEY FINDINGS: Long-term treatment with isoliquiritigenin dose-dependently and effectively amended adenine-induced chronic renal and endothelial dysfunction. It not only alleviated renal fibrosis and apoptosis markers but also aortic calcification. Additionally, this chalcone neutralized renal inflammatory response and oxidative stress. Isoliquiritigenin beneficial effects were associated with up-regulation of serum NO, renal and aortic sGC, cGMP and its dependent protein kinase (PKG). However, co-treatment with ODQ antagonized isoliquiritigenin therapeutic impact. SIGNIFICANCE: Isoliquiritigenin seems to exert protective effects against CKD and vascular calcification by activating sGC, increasing cGMP and its downstream PKG.

Diagnostic Test Accuracy of Genetic Tests in Diagnosing Psoriasis: A Systematic Review.

The pathogenesis of psoriasis involves the interaction of several environmental and genetic factors. Predicting the disease risk cannot depend on individual genetic alleles. Consequently, some studies have evaluated the use of genetic risk scores that combine several psoriasis susceptibility loci to increase the accuracy of predicting/diagnosing the disease. This meta-analysis summarizes the evidence regarding using genetic risk scores (GRS) in the diagnosis or prediction of psoriasis. A search of MEDLINE/PubMed, the Latin American Caribbean Health Sciences Literature (LILACS) database, Cochrane Library, Scopus, Web of Science, and ProQuest was conducted in July 2022. The primary objective was to record the area under the curve (AUC) for GRS of psoriasis. Secondary objectives included characteristics of studies and patients. The risk of bias (ROB) was assessed using the PROBAST tool. Five studies fulfilled the eligibility criteria of this review. None of the studies described the clinical criteria (reference standard) that were employed to diagnose psoriasis. The AUCs of the 11 GRS models ranged from 0.6029-0.8583 (median: 0.75). Marked heterogeneity was detected (Cochran Q: 1250.051, p < 0.001, and I2 index: 99.2%). So, pooling of the results of the included studies was not performed. The ROB was high for all studies and clinical application was not described. Genetic risk scores are promising tools for the prediction of psoriasis with fair to good accuracy. However, further research is required to identify the most accurate combination of loci and to validate the scores in variable ethnicities.

A Pituitary Abscess Caused by Morganella morganii: A Case Report.

BACKGROUND Pituitary abscess (PA) is a rare pituitary lesion accounting for less than 1% of all pituitary diseases and is associated with high mortality rates. The non-specific clinical symptoms and radiological features preclude accurate diagnosis of the disease. Hence, surgical intervention is still considered the criterion standard method for PA diagnosis. Most PAs occur as a primary disease or due to complications such as surgery, sepsis, and adjacent inflamed lesions. CASE REPORT A 53-year-old man presented to the Emergency Department with a headache associated with nausea, vomiting, and constipation. The patient had no visual disturbances, polyuria, polydipsia, nocturia, or abnormal discharges. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large suprasellar mass. The patient underwent left-side trans-nasal transsphenoidal microscopic surgery for mass removal. An abscess with discharge was noticed and sent for microbiological evaluation, revealing an infection with a commensal enteric bacterium that rarely causes nosocomial infection, known as Morganella morganii. The patient was discharged after completing the intravenous antibiotic course and was given oral antibiotics. CONCLUSIONS Pituitary abscess is a rare pituitary lesion. However, taking the history of recent meningitis, sinusitis, and/or surgery may help to reach an early diagnosis, prompt surgical intervention, and vital therapeutic steps to reduce mortality rates and improve patient's outcomes. PA should always be considered when patients demonstrate signs of pituitary dysfunction associated with signs of infection. Furthermore, antibiotics should be administered immediately once the PA case is confirmed and should last for at least 6 weeks postoperatively.

Association between periodontitis and COVID-19 severity in a tertiary hospital: A retrospective cohort study.

Introduction: Periodontitis is a chronic inflammatory disease caused by biofilm accumulation resulting in loss of periodontal attachment which could be linked to systemic implications. Coronavirus disease of 2019 (COVID-19) is a disease caused by SARS-CoV-2 that triggers damage to the lungs and other organs. COVID-19 and periodontitis share similar risk factors such as smoking, obesity, old age, and diabetes mellitus. Studies noted that periodontitis along with some systemic diseases has increased mortality. Thus, this study aims to examine the association of periodontitis with COVID-19 outcomes. Methods: This observational study included periodontitis group and non-periodontitis group for COVID-19 outcome assessment. Inclusion criteria were applied to select adults (≥18 years old) who showed at least one dental visit, and were isolated or admitted due to a COVID-19 complication (i.e. in-ward, ICU, or death). Exclusion criteria were patients with no active dental records. The periodontal status was examined from posterior bitewings and panoramic radiographs. The primary outcome assessed was COVID-19 complications versus no admission. Results and discussion: This study was the first of its kind as a retrospective cohort study to assess the association between periodontitis and COVID-19 severity in Riyadh, Saudi Arabia. Our findings revealed that periodontitis is statistically associated with COVID-19 severity. Periodontitis patients were three times more likely to have COVID-19 complications (p = 0.025). Diabetes (p = 0.004) and hypertension (p = 0.016) patients were 3.5 times more likely to have COVID-19 complications. Conclusion: Understanding the potential association between periodontitis and COVID-19 through systemic inflammation might be a pathway to achieve high quality medical care.

The use of orthopedic surgical devices for forensic identification: A systematic review.

BACKGROUND AND AIM: Identification of human bodies is a necessary step in forensic practice. DNA analysis, fingerprints, and dental charting are considered conventional identification methods. However, these methods are not always applicable. Orthopedic surgical implantable devices provide valuable identity information when conventional methods of identification are not applicable or in challenging circumstances. This paper aims to review the usage of orthopedic implantable devices for forensic human identification. METHODS: A search for relevant articles using the PubMed database in January 2021 identified 8 articles that met the inclusion criteria.  Results: These articles highlighted the importance of the use of orthopedic implantable devices as an additional method for positive identification, especially in disaster situations. It is a method that needs antemortem and postmortem radiographs, comprehensive information of the orthopedic implantable device like company and serial number, logo, name, medical records of previous surgical intervention, and for the family member's history to match with the identification details. CONCLUSIONS: Efforts should be made to include all information pertaining to orthopedic implantable devices in the medical records. Educating and training forensic experts on the use of such devices in the identification process is essential, as this technique is practical, low-cost, and time-saving.

Correlation of High-Risk HPV Genotypes with Pap Test Findings: A Retrospective Study in Eastern Province, Saudi Arabia.

INTRODUCTION: High-risk human papillomavirus (HR HPV) is found to be responsible for 4.5% of cancer in general, primarily cervical cancer. We aim here to highlight the prevalence and genotypes of HR HPV and correlate its association with Pap tests' results, which are still not well known in the Eastern Province of Saudi Arabia. METHODS: Over 7 years (2013-2019), the results of 164 Saudi women coinvestigated for HR HPV along with Pap tests were collected from the archive of King Fahd University Hospital. Only women who had atypical squamous cells of undetermined significance (ASCUS) on the Pap test and those at elevated risk of infection were cotested for HR HPV; otherwise, the Pap test was the only screening modality for cervical cancer. Data were organized and statistically analyzed using IBM SPSS v26. RESULTS: Out of 164 Saudi women, 14.5% (n = 24/164) showed positive results for HR HPV (8 patients had HPV16 and 2 had both HPV16 and HPV18/45, while the remaining 14 had other HR HPV); among them, 41.5% (n = 10/24) had an abnormal Pap test (5 ASCUS and 5 LSIL), while 58.5% (n = 14/24) had a negative Pap test. On the other hand, 21% (n = 35/164) of patients, in the study, had an abnormal Pap test (24 ASCUS, 8 low-grade squamous intraepithelial lesion [LSIL], and 3 atypical glandular cell [AGC]). In 80% (n = 19/24) of ASCUS cases, HR HPV was not detected; however, 20% (n = 5/24) were positive for other HR HPV. Concerning LSIL cases, 62.5% (n = 5/8) were positive for HR HPV (1 case showed HPV16 and HPV18/45, 2 cases showed HPV16, and 2 cases showed other HR HPV), while in the remaining 37.5% (n = 3/8) LSIL cases, HR HPV was negative; similarly, all AGC cases were negative for HR HPV. Statistical analysis showed a significant correlation between HPV status and Pap test findings (p value <0.001). DISCUSSION/CONCLUSION: HR HPV frequency and genotype distribution, in this study, might reflect a different regional infection pattern. The high association of HR HPV with negative cytology emphasizes the need to add the HR HPV test to screening modalities of cervix cancer.

Development of an optimized febuxostat self-nanoemulsified loaded transdermal film: in-vitro, ex-vivo and in-vivo evaluation.

Febuxostat (FBX) is used to treat gout and chronic hyperuricemia. However, its bioavailability is moderate (49%) as a result of low solubility and first-pass metabolism. Therefore, the aim of our study is to improve FBX bioavailability by enhancement its solubility using self-nanoemulsifying drug delivery system (SNEDDS) technique in the form of transdermal film to avoid hepatic metabolism. To accomplish this goal, Eight SNEDDS formulae were prepared according to a three-factor, two-level D-Optimal mixture design to evaluate the effect of different ratios of the Lemon oil (X1), the surfactant Tween-20 (X2), and the co-surfactant PEG-400 (X3) on the globule size in order to reach smallest globular size. Results revealed that SNEDDS globule size ranged from 177 to 454 nm. The optimized formula consisted of 20% oil, 40% surfactant and 40% co-surfactant. Diffusion study showed improved enhancement in skin permeation that was confirmed by imaging using fluorescence microscope. In vivo plasma data showed significant (p < 0.05) difference in FBX plasma levels and pharmacokinetic parameters when compared with raw FBX loaded film. In conclusion, FBX-SNEDDS loaded transdermal film could be a successful way to improve solubility and skin permeability that would lead to improvement in patient's compliance.