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1.
Saudi Dent J ; 36(5): 698-707, 2024 May.
Article in English | MEDLINE | ID: mdl-38766281

ABSTRACT

Albumin is the most abundant protein in human serum and a specific amount of albumin also can be found in the saliva. It has several physiological functions such as blood colloidal osmotic pressure, antioxidant activity, binding and transporting of endogenous and exogenous substrates. We conducted an electronic search across several databases such as PubMed, Scopus, Cochrane, Embase and Science Direct using the relevant MeSH terms and keywords like "albumin", "serum albumin", "salivary albumin", "oral health" "dental caries" and "epidemiology". Only the epidemiological studies published between 2010 and 2023 were included. After the application of the inclusion criteria, a total of 51 studied were included in this narrative review. Serum and salivary albumin tests have been used in various aspects of oral health as a diagnostic and prognostic factor. Some of the results point out to a pattern of association while some of them are inconclusive and even contradictory. This narrative review discusses the role, significance and impact of albumin in epidemiological oral health related studies including the categories of periodontal health and disease, dental caries, oral function and hypofunction, nutrition and malnutrition, tooth loss and its treatment, diabetes and cancer. In addition, it offers a short manual for the researchers on when, where and how to use albumin tests in planning their study designs whether investigating an association or measure them as a covariate.

2.
Shoulder Elbow ; 16(2): 152-158, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38655410

ABSTRACT

Background: The primary aim of this study was to assess the long-term patient reported outcomes of arthroscopic rotator cuff tear (ARCR) using a single anchor tension band (TB) technique for small and medium supraspinatus tears at minimum 5-years follow-up. Methods: A retrospective cohort study of consecutive ARCRs of small and medium supraspinatus tears using a knotless single anchor TB technique with minimum 5-year follow-up was carried out. Outcomes of interest included: range of motion (ROM) on examination under anaesthesia (EUA), visual analogue scale (VAS), American Shoulder and Elbow Surgeons (ASES) scores, Oxford Shoulder Score (OSS) and Short-Form (SF-12). Results: From 243 consecutive ARCR procedures, 82 patients with a mean age of 55 ± 9.5 years met the inclusion criteria at 6.7 ± 1.5 years follow-up. There were significant improvements in VAS (5.5 ± 2.2 vs. 0.7 ± 1.5), ASES (47.6 ± 16.8 vs. 92.8 ± 13.0), OSS (31.3 ± 7.2 vs. 45.3 ± 3.5) and SF-12 (37.6 ± 7.6 vs. 50.3 ± 7.7) post-operatively (all p < 0.001). Conclusions: The single anchor TB ARCR technique has excellent patient reported outcomes at a minimum of 5 years and is suitable for supraspinatus tears smaller than 20 mm in the sagittal plane. Level of evidence: Level IV; Consecutive Case Series.

3.
Am J Case Rep ; 25: e942032, 2024 Apr 19.
Article in English | MEDLINE | ID: mdl-38637976

ABSTRACT

BACKGROUND Congenital heart diseases (CHDs) are the most common form of birth defects, affecting the structure and function of neonatal hearts. Pulmonary valve stenosis (PVS) and ventricular septal defects (VSD) are 2 of the more prevalent forms, both of which can lead to significant morbidity if left untreated. The emergence of transcatheter techniques has revolutionized the therapeutic landscape, presenting minimally invasive yet effective alternatives to open-heart surgery and significantly reducing associated patient morbidity and recovery time. CASE REPORT The presented case details the management of a 19-year-old man with complex CHDs, highlighting the nuanced decision-making process that led to a transcatheter approach. The patient's clinical presentation, marked by symptoms reflective of significant cardiac compromise, demanded a tailored approach that utilized the latest advancements in non-surgical intervention. The successful closure of the VSD with an Amplatzer device and the resolution of PVS via balloon valvuloplasty were achieved without complications, showcasing the potential of these techniques in managing similar cases. The post-intervention period was marked by a noteworthy recovery, confirming the procedural efficacy and enhancing the patient's quality of life. CONCLUSIONS The favorable outcome of this case highlights the pivotal role of transcatheter interventions in treating complex CHDs and suggests a shift towards less invasive approaches in cardiac care. This case contributes valuable insights to the existing body of evidence, reinforcing the potential of transcatheter techniques to become the preferred treatment modality. With promising immediate and short-term results, these techniques highlight the need for continued research into their long-term efficacy and application across diverse patient demographics.


Subject(s)
Cardiac Surgical Procedures , Heart Defects, Congenital , Heart Septal Defects, Ventricular , Pulmonary Valve Stenosis , Male , Infant, Newborn , Humans , Young Adult , Adult , Quality of Life , Cardiac Catheterization/methods , Heart Septal Defects, Ventricular/surgery , Heart Defects, Congenital/complications , Pulmonary Valve Stenosis/surgery , Treatment Outcome
4.
J Pharm Bioallied Sci ; 16(Suppl 1): S806-S808, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38595390

ABSTRACT

Background: Orthodontic treatment is a common dental procedure aimed at correcting malocclusions and improving dental aesthetics. However, one of the potential side effects of orthodontic treatment is root resorption, which can lead to permanent damage to the tooth's root structure. Materials and Methods: In this comparative study, 60 orthodontic patients were divided into three groups, each receiving a different orthodontic treatment approach: Group A-conventional fixed orthodontic appliances, Group B-self-ligating orthodontic appliances, and Group C-clear aligners. Digital radiographs were taken before and after treatment to assess root resorption. The extent of root resorption was quantified using a standardized measurement scale. Results: The results indicated that Group A exhibited an average root resorption of 0.2 mm, Group B showed an average root resorption of 0.1 mm, and Group C had the lowest average root resorption of 0.05 mm. These findings suggest that clear aligners resulted in significantly less root resorption compared to conventional fixed orthodontic appliances and self-ligating orthodontic appliances (P < 0.05). Conclusion: This comparative study highlights the differential effects of various orthodontic mechanics on root resorption. Clear aligners demonstrated the least amount of root resorption when compared to conventional fixed orthodontic appliances and self-ligating orthodontic appliances.

5.
J Pharm Bioallied Sci ; 16(Suppl 1): S809-S811, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38595540

ABSTRACT

Background: Regenerative endodontic procedures (REPs) have emerged as a transformative approach to treating immature permanent teeth with necrotic pulp tissue. Materials and Methods: A prospective study was conducted, enrolling 100 patients with immature permanent teeth requiring REPs. All procedures were performed by a single experienced endodontist following established protocols. Patients were followed up for a minimum of 5 years' post-treatment. Clinical examinations, radiographic assessments, and patient-reported outcomes were recorded at regular intervals. Data were analyzed using statistical methods to determine the success rates, complications, and factors influencing long-term outcomes. Results: The results of this original research reveal a significant and sustained success rate for REPs. After a minimum follow-up period of 5 years, an arbitrary value of 92% for tooth survival was achieved. Radiographic assessments demonstrated consistent healing of apical lesions, and continued root development was observed in the majority of cases. Patient-reported outcomes indicated a high level of satisfaction with the procedure. Complications such as crown discoloration and tooth fracture occurred in a minority of cases but were effectively managed without compromising the overall success of REPs. Conclusion: This original research provides strong evidence for the long-term success of REPs in the treatment of immature permanent teeth with necrotic pulp tissue. The high tooth survival rate, continued root development, and patient satisfaction support the efficacy of REPs as a reliable treatment option.

6.
J Stroke Cerebrovasc Dis ; 33(6): 107676, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38492657

ABSTRACT

INTRODUCTION: Posterior circulation stroke (PCS) may be less prevalent than its anterior counterpart but contributes to substantial morbidity and mortality. The aim was to characterize PCS's demographics, clinical presentation, management, and outcomes between younger and older adults in Saudi Arabia. METHODS: This retrospective cohort study was conducted at two tertiary medical centers in Saudi Arabia between March 2016 and December 2020. All patients who presented with symptoms of posterior circulation stroke and had positive brain imaging were included. RESULTS: The study involved 160 posterior circulation stroke patients, stratified into two age groups: 71 patients aged 18-59 years and 89 patients aged 60 years and above. The mean age of the entire cohort was 60.9 years, and 77 % were males. Hypertension was more prevalent in the older age group (88 % vs. 69 %, p=0.005), and smoking was significantly higher among younger patients (38 % vs. 15 %; p=0.0009). Only 22.4 % received thrombolysis and/or thrombectomy. Most strokes involved the posterior cerebral artery (45.6 %). Large artery atherosclerosis was the most common subtype. At discharge, younger patients had higher NIHSS compared to older patients. CONCLUSION: Our investigation of 160 PCS patients in Saudi Arabia uncovers notable trends: a mere 22.4 % received thrombolysis and/or thrombectomy and a significant prevalence of posterior cerebral artery involvement due to large artery atherosclerosis. The study further reveals younger patients disproportionately had severe outcomes. Highlighting the need for improved stroke care and heightened awareness, this research contributes vital data to an underexplored domain, urging further study to optimize care and understand PCS dynamics in Saudi Arabia.


Subject(s)
Thrombolytic Therapy , Humans , Male , Retrospective Studies , Female , Middle Aged , Saudi Arabia/epidemiology , Risk Factors , Adult , Young Adult , Adolescent , Age Factors , Aged , Treatment Outcome , Prevalence , Risk Assessment , Disability Evaluation , Thrombectomy , Time Factors , Aged, 80 and over , Infarction, Posterior Cerebral Artery/epidemiology , Infarction, Posterior Cerebral Artery/diagnosis , Infarction, Posterior Cerebral Artery/physiopathology , Infarction, Posterior Cerebral Artery/diagnostic imaging
7.
J Biomol Struct Dyn ; : 1-21, 2024 Mar 22.
Article in English | MEDLINE | ID: mdl-38517058

ABSTRACT

Chronic myeloid leukemia (CML) is a hematological malignancy characterized by the neoplastic transformation of hematopoietic stem cells, driven by the Philadelphia (Ph) chromosome resulting from a translocation between chromosomes 9 and 22. This Ph chromosome harbors the breakpoint cluster region (BCR) and the Abelson (ABL) oncogene (BCR-ABL1) which have a constitutive tyrosine kinase activity. However, the tyrosine kinase activity of BCR-ABL1 have been identified as a key player in CML initiation and maintenance through c-Abl kinase. Despite advancements in tyrosine kinase inhibitors, challenges such as efficacy, safety concerns, and recurring drug resistance persist. This study aims to discover potential c-Abl kinase inhibitors from plant compounds with anti-leukemic properties, employing drug-likeness assessment, molecular docking, in silico pharmacokinetics (ADMET) screening, density function theory (DFT), and molecular dynamics simulations (MDS). Out of 58 screened compounds for drug-likeness, 44 were docked against c-Abl kinase. The top hit compound (isovitexin) and nilotinib (control drug) were subjected to rigorous analyses, including ADMET profiling, DFT evaluation, and MDS for 100 ns. Isovitexin demonstrated a notable binding affinity (-15.492 kcal/mol), closely comparable to nilotinib (-16.826 kcal/mol), showcasing a similar binding pose and superior structural stability and reactivity. While these findings suggest isovitexin as a potential c-Abl kinase inhibitor, further validation through urgent in vitro and in vivo experiments is imperative. This research holds promise for providing an alternative avenue to address existing CML treatment and management challenges.Communicated by Ramaswamy H. Sarma.

8.
N Z Med J ; 137(1592): 77-89, 2024 Mar 22.
Article in English | MEDLINE | ID: mdl-38513205

ABSTRACT

AIM: We reviewed the last decade of literature to update a previous publication on this topic by the senior author. In New Zealand, traumatic causation has implications for entitlement for treatment though the Accident Compensation Corporation (ACC). Acuity and chronicity may also be relevant in determining repairability. METHODS: Literature was reviewed regarding acromial morphology, greater tuberosity (GT) cysts, acromiohumeral interval (AHI), fatty degeneration and atrophy, acromioclavicular (AC) arthrosis, tendinopathy, bursal changes and other features. RESULTS: Some factors can be considered normal for those middle aged and older, including AC arthrosis, type 1 and 2 acromion and tendinopathy. Some factors may indicate acuity, including haemorrhage and debris, GT oedema, mid-substance soft tissue tear, kinking of the tendon and isolated complete subscapularis tears. Other factors may be associated with chronicity, including significant fatty degeneration, positive tangent sign for atrophy, anterior GT cysts, type 3 acromion, critical shoulder angle (CSA) >35 degrees and acromial index (AI) <0.7. CONCLUSION: A multitude of factors on imaging may infer, to a varying degree, the likelihood of acuity or chronicity. The patient history is also of importance in determining causation.


Subject(s)
Cysts , Osteoarthritis , Rotator Cuff Injuries , Shoulder Joint , Tendinopathy , Middle Aged , Humans , Aged , Rotator Cuff Injuries/diagnostic imaging , Rotator Cuff Injuries/pathology , Shoulder Joint/pathology , New Zealand , Cysts/pathology , Atrophy/pathology
9.
J Vasc Surg Cases Innov Tech ; 10(3): 101453, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38510096

ABSTRACT

A 72-year-old man with peripheral arterial disease, an atrophic left kidney, and prior right renal chimney stent as part of a complex endovascular abdominal aortic aneurysm repair presented to our emergency department with right flank pain and anuria resulting from right artery occlusion. His serum creatinine on admission was 7.5 mg/dL. Computed tomography angiography 6 days after the onset of his symptoms revealed complete occlusion of the right renal artery stent. Percutaneous thrombectomy was performed restored renal blood flow. The urine flow started the following day, and his serum creatinine decreased to 3.5 mg/dL 7 days after discharge.

10.
Cureus ; 16(1): e53086, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38414687

ABSTRACT

Background Breastfeeding and complementary feeding are essential for baby health and nutrition. Concerning these feeding habits, there is a dearth of information on mother awareness and behaviors in Saudi Arabia. This study intends to evaluate maternal knowledge of breastfeeding and complementary feeding in Al Baha City, Saudi Arabia. Methodology This cross-sectional prospective study was conducted among mothers in Al Baha City, Saudi Arabia. Data were collected using a structured electronic questionnaire and analyzed using descriptive statistics and a chi-square test. Results We received 524 responses. The majority of participants (358, 68.2%) were found to have sufficient understanding of breastfeeding and complementary feeding. Four hundred and forty participants (84%) were aware that breastfeeding should begin immediately after birth, but only 250 (47.7%) participants knew the proper time to start complementary feeding. Three hundred and ninety-six (75.6%) participants were aware of the proper duration of exclusive breastfeeding, whereas 128 (24.4%) of them did not know. The study showed that factors such as occupation, family economic status, and educational level influence maternal knowledge of complementary feeding.  Conclusions The study revealed that the majority of participants had good knowledge about breastfeeding and complementary feeding. The study highlights effective training and public awareness initiatives aimed at improving mothers' knowledge and practices regarding feeding. Additionally, it sheds light on the healthcare providers' exemplary knowledge and attitudes toward appropriate feeding practices among mothers in Al Baha City.

11.
Int J Biol Macromol ; 259(Pt 2): 129383, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38218274

ABSTRACT

This research paper presents a comprehensive investigation into developing biodegradable films for food packaging applications using chitosan (CN) in conjunction with three distinct types of cellulose (CE), each characterized by varying viscosities. The primary objective was to assess the influence of cellulose viscosity on the physical, mechanical, and barrier properties of the resulting films. The medium-viscosity cellulose imparted numerous advantageous qualities to the biodegradable films. These films exhibited optimal thickness (31 µm), ensuring versatility in food packaging while maintaining favorable mechanical properties, blending strength, and flexibility. Also, medium-viscosity cellulose significantly improved the films' barrier performance, particularly regarding oxygen permeability [1.80 × 10-6 (g.mm.m-2. s-1)]. Furthermore, the medium-viscosity cellulose contributed to superior moisture-related properties, including reduced water vapor permeability [14.80 × 10-9 (g.mm.m-2. s-1. Pa-1)], moisture content (13.22 %), and water solubility (22.87 %), while maintaining an appropriate degree of swelling (41.88 %). Moreover, the study employed advanced analytical techniques, including FTIR, XRD, and TGA, to provide critical insights into the films' chemical, structural, and thermal aspects. This research underscored the importance of the viscosity of film formulation materials as a crucial element in designing and efficiently producing films for food packaging.


Subject(s)
Cellulose , Chitosan , Cellulose/chemistry , Chitosan/chemistry , Viscosity , Tensile Strength , Food Packaging/methods , Permeability
12.
J Biomol Struct Dyn ; 42(3): 1307-1318, 2024.
Article in English | MEDLINE | ID: mdl-37139557

ABSTRACT

Ubiquitin specific protease 30 (USP30) has been attributed to mitochondrial dysfunction and impediment of mitophagy in Parkinson's disease (PD). This happens once ubiquitin that supposed to bind with deformed mitochondria at the insistence of Parkin, it's been recruited by USP30 via the distal ubiquitin binding domain. This is a challenge when PINK1 and Parkin loss their functions due to mutation. Although, there are reports on USP30s' inhibitors but no study on the repurposing of inhibitors approved against MMP-9 and SGLT-2 as potential inhibitors of USP30 in PD. Thus, the highlight therein, is to repurpose approved inhibitors of MMP-9 and SGLT-2 against USP30 in PD using extensive computational modelling framework. 3D structures of Ligands and USP30 were obtained from PubChem and protein database (PDB) servers respectively, and were subjected to molecular docking, ADMET evaluation, DFT calculation, molecular dynamics simulation (MDS) and free energy calculations. Out of the 18 drugs, 2 drugs showed good binding affinity to the distal ubiquitin binding domain, moderate pharmacokinetic properties and good stability. The findings showed canagliflozin and empagliflozin as potential inhibitors of USP30. Thus, we present these drugs as repurposing candidates for the treatment of PD. However, the findings in this current study needs to be validated experimentally.Communicated by Ramaswamy H. Sarma.


Subject(s)
Parkinson Disease , Humans , Parkinson Disease/genetics , Matrix Metalloproteinase 9 , Molecular Docking Simulation , Drug Repositioning , Protein Kinases/metabolism , Mitochondrial Proteins/chemistry , Thiolester Hydrolases/chemistry , Thiolester Hydrolases/genetics , Thiolester Hydrolases/metabolism , Ubiquitin-Protein Ligases/genetics , Ubiquitin-Protein Ligases/metabolism , Ubiquitin/metabolism , Ubiquitin-Specific Proteases/metabolism
13.
Int J Ophthalmol ; 16(12): 2125-2132, 2023.
Article in English | MEDLINE | ID: mdl-38111936

ABSTRACT

Despite its high risk of leading to permanent visual dysfunction, glaucoma remains underdiagnosed in primary care settings. About 11% of glaucoma patients in Saudi Arabia end up with bilateral blindness. This scoping review investigates and presents results on the glaucoma profile, including its prevalence, knowledge, attitude, and practice of Saudi Arabians towards the disease. An online search using four databases through online software (www.rayyan.ai) was performed to extract the relevant articles. Out of 76 records, 21 articles were eligible for the analysis. All included studies were published between the years 2014 and 2022. Most studies were in Riyadh city, followed by Jeddah. All participants (n=11 388) were adults >18 years old, and male participants were generally higher than females. The findings showed poor knowledge of glaucoma among the general population, while the knowledge among glaucoma patients was acceptable. The attitude was positive, while the compliance and practice were fair. More educational programs about glaucoma, its risk to the eyes, and the overall quality of life are highly recommended.

14.
Cureus ; 15(10): e46745, 2023 Oct.
Article in English | MEDLINE | ID: mdl-38022061

ABSTRACT

Background Diabetes mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia caused by a defect in the secretion or action or both of insulin. It has a complex pathogenesis. Benign prostatic hyperplasia (BPH) refers to an increase in the size of the prostate; it is one of the most common health problems in men that manifests with age. Lipoxygenase-12 (Lipox-12) is one of the enzymes in the Lipox 12/15 family, which plays a major role in catalyzing a variety of polyunsaturated fatty acids (PUFAs) that are capable of producing different metabolites. Lipox-12 has a significant effect on arachidonic acid metabolism, with PUFA, a pro- and anti-inflammatory mediator, as one of the enzyme isoforms. It also plays a major role in modulating inflammation at multiple checkpoints as diabetes progresses. The present study aims to measure Lipox-12 levels in patients with DM type 2 (DM2) and patients with DM2 + BPH. Methodology This study was conducted in Musayyib General Hospital, south of Baghdad, where a clinical examination was performed on 50 samples from controls (healthy subjects), 50 patients with DM2, and 50 patients with DM2 + BPH after taking each patient's history. The examinations performed included fasting blood sugar (FBS), hemoglobin A1c (HbA1c), prostate-specific antigen (PSA), triglycerides (TG), cholesterol (Chol), and Lipox-12. Results The results showed that both the DM2 and DM2 + BPH groups had higher FBS, HbA1c, TG, and Chol levels than healthy subjects; in contrast, Lipox-12 levels were the lowest in the DM2 group (sensitivity = 79% and specificity = 81%) but higher in the DM2 + BPH group (sensitivity = 80%; specificity = 82%) compared to the control group. Conclusions Lipox-12 had a high sensitivity and specificity in the DM2 and DM2 + BPH groups compared to the control group, and in both cases, it was used to monitor and diagnose DM2 and BPH.

15.
J Dent Sci ; 18(4): 1677-1684, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37799864

ABSTRACT

Background/purpose: Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication among dental patients undergoing treatment with antiresorptive medications such as bisphosphonate and denosumab. The present survey investigated the awareness and practice of dentists in the Gulf Cooperation Council (GCC) countries regarding MRONJ. Materials and methods: This questionnaire-based study was conducted among dental practitioners in all six GCC countries. A questionnaire was designed and distributed among all potential participants via different social media platforms. SPSS version 22 was used for data analysis, and P-value <0.05 was considered statistically significant. Results: Overall, 1685 dentists from the six GCC countries participated in the present study. The surveyed dentists revealed relatively fair practices and awareness regarding MRONJ and its prevention, with the majority reported asking their patients about history of anti-osteoporotic medications (67.8%), recording name of the medication (73.1%) and duration of treatment (75.5%). However, the majority of the participants were unconfident about the duration of drug holiday prior to dental surgical interventions (70.6%) and the overall good level of knowledge/practice related to MRONJ was just 50.6%. The regression analysis revealed that previous exposure to MRONJ cases and attending a seminar, course, meeting, or conference about osteonecrosis of the jaw were independent predictors for positive awareness/good practice regarding MRONJ (P < 0.05). Conclusion: The results show inadequate awareness and practices of dentists practicing in GCC countries regarding MRONJ, with significant variations among the countries. Therefore, appropriate interventions such as periodic continuous education courses are required to improve dentists' knowledge and practices regarding MRONJ.

16.
Ochsner J ; 23(3): 262-265, 2023.
Article in English | MEDLINE | ID: mdl-37711476

ABSTRACT

Background: Simple renal cysts typically produce no symptoms or signs and are usually detected incidentally on imaging studies for unrelated causes. Massive renal cysts are very rare. Case Report: A 77-year-old female with preexisting chronic kidney disease presented to our hospital for evaluation of hyperkalemia, abdominal distension, and right flank pain. Upon arrival, her vital signs and physical examination were normal. Laboratory data were pertinent for a serum creatinine of 4.8 mg/dL (6 months prior to presentation, serum creatinine was 1.5 mg/dL, and 1 month after discharge, it was 4.6 mg/dL), and hyperkalemia of 6.0 mmol/L. Computed tomography revealed a massive right renal cyst measuring 22 × 11 × 17.5 cm and displacing the intra-abdominal structures. Because of her symptoms, the patient was evaluated by urology for surgical management. The patient refused invasive procedures and chose pain control and monitoring. Conclusion: Noninvasive treatment options for a massive simple renal cyst are limited. Symptomatic treatment and monitoring the cyst size on a regular basis might be helpful for patients who refuse invasive treatment.

17.
Open Biol ; 13(9): 230122, 2023 09.
Article in English | MEDLINE | ID: mdl-37726093

ABSTRACT

KIF20A is a critical kinesin for cell division and a promising anti-cancer drug target. The mechanisms underlying its cellular roles remain elusive. Interestingly, unusual coupling between the nucleotide- and microtubule-binding sites of this kinesin-6 has been reported, but little is known about how its divergent sequence leads to atypical motility properties. We present here the first high-resolution structure of its motor domain that delineates the highly unusual structural features of this motor, including a long L6 insertion that integrates into the core of the motor domain and that drastically affects allostery and ATPase activity. Together with the high-resolution cryo-electron microscopy microtubule-bound KIF20A structure that reveals the microtubule-binding interface, we dissect the peculiarities of the KIF20A sequence that influence its mechanochemistry, leading to low motility compared to other kinesins. Structural and functional insights from the KIF20A pre-power stroke conformation highlight the role of extended insertions in shaping the motor's mechanochemical cycle. Essential for force production and processivity is the length of the neck linker in kinesins. We highlight here the role of the sequence preceding the neck linker in controlling its backward docking and show that a neck linker four times longer than that in kinesin-1 is required for the activity of this motor.


Subject(s)
Kinesins , Microtubules , Cryoelectron Microscopy , Kinesins/genetics , Binding Sites , Cell Division
18.
Injury ; 54(11): 110983, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37634999

ABSTRACT

The posterior sternoclavicular joint dislocation is a rare and potentially life-threatening injury, as massive haemorrhage can occur at the time of trauma, during reduction manoeuvres and drilling. These injuries are rare and a collective experience of managing them is of paramount importance. We present our multidisciplinary experience of managing several of these injuries in our centre, with learning points we have identified. Assessment should include Computerised Tomography Angiography (CTA) to assess the anatomy of the joint including the proximity to the underlying innominate vein and to identify any bleeding. Both closed reduction and open reconstruction have the potential for massive haemorrhage which can be controlled successfully with direct access to the underlying vessel. We recommend that all reductions should be performed in the presence of a cardiothoracic surgeon who can gain vascular control in the head, neck, and thorax. In specific high-risk cases, pre-emptive venous catheterisation can also be considered. We recommend that a discussion and rehearsal for intra-operative bleeding should be undertaken with the whole theatre team, with roles assigned pre-emptively and to allow identification of any deficiencies in staff expertise or equipment. Of the five recent cases managed in our centre one patient had a closed reduction and four had open reductions. Success of closed reductions within 48 h is high and these can be attempted up to 10 days after injury. Our patient undergoing closed reduction had a favourable outcome and returned to professional rugby at five months. Open reduction was performed in a physeal fracture as there was a delay to surgery and callus had begun to form and had the potential to adhere to the underlying vessel. In this case we performed open reduction and stabilised with tunnelled suture fixation. Our preferred method of reconstruction uses a palmaris graft with internal figure of eight bracing. One patient had a subsequent fracture of the medial clavicle around the drill holes that healed without further intervention. Despite good reduction and stability achieved following palmaris reconstructions, two patients are experiencing ongoing symptoms of globus and one with voice change without any objective underlying cause.


Subject(s)
Fractures, Bone , Joint Dislocations , Shoulder Dislocation , Sternoclavicular Joint , Thoracic Injuries , Humans , Sternoclavicular Joint/diagnostic imaging , Sternoclavicular Joint/surgery , Sternoclavicular Joint/injuries , Fracture Fixation, Internal/methods , Shoulder Dislocation/surgery , Joint Dislocations/diagnostic imaging , Joint Dislocations/surgery , Fractures, Bone/diagnostic imaging , Fractures, Bone/surgery , Hemorrhage
19.
Ann Med Surg (Lond) ; 85(7): 3353-3358, 2023 Jul.
Article in English | MEDLINE | ID: mdl-37427220

ABSTRACT

Cerebral venous sinus thrombosis (CVST) is a common condition that, if not detected and treated promptly, carries a high risk of morbidity and mortality. CVST's most common aetiological associations are post-partum, pregnancy, and oral contraceptive pills. The purpose of this study was to look into the aetiology of CVST in Sudanese patients in neurological centres in Khartoum state. Methodology: This was a cross-sectional hospital bases study conducted on CVST patients at four neurological centres in Khartoum state in the period from March to October 2020. Patients were studied for the aetiological association of CVST using a standardized questionnaire including medical history, clinical examination, investigation, and treatment. Results: The study included about 60 patients, 50 of whom were female (83.3%) and 10 of whom were male (16.7%). In terms of clinical presentation, almost all patients had headache, followed by visual disturbances in 49 (81.7%), seizures in 46 (76%), disturbed consciousness in 12 (20%), and weakness in 12 (20%). The most common sign was abnormal speech, which was found in eight patients (13.3%), memory disturbances in eight patients (13.3%), evidence of CN VI lesion in three (5%), papilledema in 49 (81.7%), and hemiparesis in 46 (76.7%), while abnormal sensory signs were found in only one patient. The most common aetiological association were pregnancy in 15 (25%), oral contraceptive pills in 11(18.3%), and being in the post-partum period in 23(38.3%). All of the patients' magnetic resonant imaging/magnetic resonant venography results were abnormal. Six patients had extensive sinus involvement, 35 had superior sagittal sinus involvement, and 19 had transverse sinus involvement. After treatment, 45 patients (75%) fully recovered, 11 (18.3%) partially recovered, and 4 (6.7%) died. Conclusion: Post-partum, pregnancy, and oral contraceptive pills were the most common aetiological associations of CVST compared with other populations.

20.
Front Public Health ; 11: 1193475, 2023.
Article in English | MEDLINE | ID: mdl-37427282

ABSTRACT

Background: Smoking is a common problem in university students worldwide. Smoking is one of the most dangerous social phenomena and has a significant impact on public health. This study investigated the beliefs and attitudes of medical students toward smoking in Sudan. Methods: A cross-sectional study was conducted among medical students at Al Neelain University, Sudan, from March to June 2022 using a web-based questionnaire. The questionnaire consisted of eight items on demographic characteristics and 13 on the beliefs and attitudes toward smoking. Other data included smoking status, smoking habits, the number of cigarettes smoked per day, and smoking duration. Data analysis was performed descriptively, and chi-square test and logistic regression were conducted using SPSS version 24. Statistical significance was set at 0.05. Results: A total of 336 students participated in this study, and the smoking prevalence was 48.8% (41.1% in men and 7.7% in women). In total, 76.8% reported smoking daily at a rate of 5-10 cigarettes per day. In terms of students' beliefs about smoking, 86.8% disagreed with selling cigarettes at the university. Of the respondents, 68.4% did not approve smoking on campus. There was a relationship between smoking habits and the age group of 22-25 years, which was the highest smoking category among students (p-value = 0.01). Conclusion: The prevalence of cigarette smoking among medical students is disturbing, particularly as they are future doctors. There is a need to include plans to reduce smoking among students that can be incorporated into courses and special programs.


Subject(s)
Students, Medical , Tobacco Products , Male , Humans , Female , Young Adult , Adult , Cross-Sectional Studies , Prevalence , Sudan/epidemiology , Smoking/epidemiology
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