Oral health status among recreational cannabis (marijuana and hashish) users in the USA: A NHANES-based cross-sectional study.

Background: As of November 2023, twenty-four states, two territories, and DC have legalized marijuana for non-medical use, leading to concerns about its potential oral health effects. This study investigated the association between marijuana use and clinical dental outcomes among adults in the US. Methods: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2015 to 2018 using a cross-sectional survey of non-institutionalized US civilians. Marijuana use was assessed among 18-59-year-old adults and categorized as never, former, or current frequent use. The dental outcomes included the prevalence of untreated coronal caries, root caries, and missing teeth. We employed logistic and negative binomial regressions to assess the crude and adjusted associations between marijuana use, dental caries, and tooth loss. Results: Of the 6,424 participants, 13.85% of US adults aged 18-59 years were current frequent marijuana users (21.67 million), with the highest prevalence among 18-29-year-olds (21.31%), males (17.54%), and non-Hispanic Black individuals (21.31%). Frequent marijuana users showed the highest prevalence of untreated coronal caries (33.4%). Before adjusting for socioeconomic confounders, current frequent marijuana users had 1.76 times higher odds of having teeth with coronal caries, whereas former frequent users had 1.47 times higher odds. However, the associations between marijuana use and all dental outcomes were attenuated after adjusting for socioeconomic confounders, tobacco use, and access to dental care. Conclusion: Although marijuana use was associated with worse dental health, socioeconomic factors, tobacco use, and access to dental care were more significant contributors to the prevalence of untreated dental caries and missing teeth than marijuana use alone.

Prognosis of Postoperative Pulmonary Embolism in High Altitude.

BACKGROUND: Pulmonary embolism (PE) is a common cause of death and serious disability, with risks that extend beyond the acute phase. Despite advances in diagnosis and treatment, high mortality rates remain a persistent problem. AIM: The current study aimed to investigate PE prognosis and its determinants among native highlanders in Taif City, Saudi Arabia. METHODS: This is a retrospective study where data was collected from the medical records of native high-altitude PE patients in Taif, Saudi Arabia, from 2017 to 2022. RESULTS:  The study included 154 native high-altitude PE patients with a mean age of 54±19 years. Most were females and nonsmokers (51.3% (n=79) and 89% (n=137), respectively). Of them, 28.6% (n=44) had undergone a previous surgery, and 61.4% (n=27) of these surgeries were within 1-3 weeks before hospital admission. The majority of patients had sub-massive PE (59.1% (n=91)), followed by non-massive PE (24% (n=37)) and massive PE (16.9% (n=26)). After management, 98 (63.6%) patients were improved, and 56 (36.4%) patients were not improved at the time of data collection. In terms of improvement after PE, patients who had undergone a previous surgery were less than those who had not, with no significant difference (56.8% (n=25) and 66.4% (n=73), respectively, p=0.266). All patients with heart rates (HRs) less than 70 bpm improved after PE compared to those with higher HRs (p=0.003). The thrombus location had no statistically significant association with patient outcomes (p=0.058). CONCLUSION: This study provides valuable insights into patient outcomes at high altitudes after PE and the prognostic factors influencing these outcomes. It was identified that a low HR was associated with positive outcomes.

Virtual reality simulation of panoramic radiographic anatomy for dental students.

PURPOSE: This work aimed to utilize virtual reality (VR) in dental radiographic anatomical interpretation in junior dental students and test if it can enhance student learning, engagement, and performance. METHODS: VR software for panoramic anatomy was developed. Sixty-nine first-year dental students were divided into a control group (lecture-based) and an experimental group (VR) to learn panoramic radiographic anatomy. Both groups were then tested on knowledge via a 20-question quiz. Student feedback on VR experience was collected via an online survey. RESULTS: There was a statistically significant difference between lecture-based and VR students in the correct identification of anatomical landmarks. Lecture-based students scored higher in identifying the ear lobe, hyoid bone, condylar neck, and external oblique ridge, whereas VR students scored higher in identifying zygoma (Chi-squared test, p < 0.005). The VR group reported high evaluation on all perception items of the online feedback survey on their experience (Student t-test, p < 0.005). CONCLUSIONS: Lecture-based students generally showed better performance in panoramic radiographic anatomy. Several structures were not correctly identified in both groups of novice students. The positive feedback of VR experience encourages future implementation in education to augment conventional methods of radiographic anatomy in dentistry with considerations to repeated exposures throughout undergraduate dental education.

Awareness and Knowledge of Women About Hormone Replacement Therapy in Taif City, Saudi Arabia.

Background It is crucial for women to have a good understanding of menopause from a young age, as this natural transition can have significant effects on their lives. Having this knowledge can help them handle the associated changes and improve their overall well-being. This study aimed to assess the level of awareness, attitude, and misconceptions regarding hormone replacement therapy (HRT) and menopause among women residing in the Taif region. Methodology This was a cross-sectional study conducted on the general population in Taif, Saudi Arabia, using an online self-administered questionnaire through Google Forms (Google Inc., Mountain View, CA, USA) from July 2022 to December 2022. The study included women aged between 40 and 65 years. A previously validated questionnaire was used for data collection, which assessed participants' awareness and knowledge of hormone replacement therapy in Taif. A 2-point system was used to grade each variable, where 2 points were given for a correct answer, 0 for an incorrect answer, and 1 for a neutral answer. Consistent with prior use of the questionnaire, participants who correctly answered 75% were considered to have good knowledge and understanding of HRT. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) (IBM SPSS Statistics, Armonk, NY, USA). Results A total of 383 participants were enrolled in this study. The mean age of the participants was 48 ± 6.2 years (ranging from 40 to 65 years). The mean knowledge score about hormone therapy during menopause was found to be 1.9 ± 2.4 (ranging from 0 to 9) out of 10. Of these participants, 63 (16.4%) were considered to have good knowledge, while 320 (83.6%) had poor knowledge. Additionally, 95 (24.8%) participants agreed to hormone replacement therapy during menopause, 136 (35.5%) believed that the advantages outweigh the disadvantages, 74 (19.3%) believed that it decreased the risk of cardiovascular diseases, and 113 (29.5%) believed that it decreased the risk of osteoporosis. The study also found that employment status, previous knowledge about hormone replacement therapy, and current use of it were significantly associated with awareness about hormone replacement therapy (p-value = 0.025, <0.001, and 0.003, respectively), with employed participants, those who heard about it, and those who currently use it tending to have higher awareness level compared to others. Conclusion Our study found that there is a poor level of knowledge and awareness about menopause and hormone therapy among the participants. Employment status was found to be associated with the level of knowledge.

Medication Adherence Among Multimorbid Patients With Polypharmacy and Its Relation to Social Support at National Guard Primary Health Care Centers, Riyadh.

OBJECTIVE: The aim of the present study was to estimate the prevalence of nonadherence to medication in multimorbid patients with polypharmacy and its relationship to social support in primary healthcare centers in Riyadh, Saudi Arabia. METHODS: We conducted a cross-sectional, convenience-sample, non-randomized study in three primary healthcare centers managed by National Guard Health Affairs. The participants included 417 adult patients - (a) with two or more chronic illnesses and (b) who were taking two or more medications. The primary outcome variable was the prevalence of medication nonadherence in multimorbid patients with polypharmacy as measured by the modified Morisky Medication Adherence Scale (MMAS-8). The second main variable was the impact of functional social support, as measured by the Duke-UNC Functional Social Support Questionnaire (FSSQ), on medication adherence. RESULTS: The level of medication adherence was low for 194 (46.5%) of the 417 patients, medium for 127 (30.5%), and high for 96 (23%). There were 256 (61.4%) male participants and 161 (38.6%) females, and their mean age was 59.15 (SD ± 11.186) years. Additionally, 171 (41%) participants used two or three medications, 127 (30.5%) used four or five medications, and 119 (28.5%) used more than five medications; 178 (42.7%) of the patients had two comorbidities, 136 (32.9%) had three comorbidities, 69 (16.5%) had four comorbidities, and 31 (7.5%) had five comorbidities. Some social support data from the Duke-UNC Functional Social Support Questionnaire (FSSQ) was missing for 58 (13.9%) of the participants. Among the rest of the sample, reported levels of social support levels were high for 246 (59%) patients, medium for 101 (24.2%), and low for 12 (2.9%) patients. None of the differences between social support and medication adherence were statistically significant. However, 61 (24.8%) patients reported both high social support and high medication adherence; 173 (48.2%) had low social support and low medication adherence (p = 0.470). CONCLUSION: We found that medication nonadherence in multimorbid patients with polypharmacy was high (46.5%). Although there were no statistically significant relationships between social support and medication adherence, certain patient characteristics were associated with low medication adherence - age over 60 years, male gender, and number of medications.

Rate of Cardiovascular Implantable Electronic Device-Related Infection at a Tertiary Hospital in Saudi Arabia: A Retrospective Cohort Study.

Introduction Cardiovascular implantable electronic devices (CIEDs) are long-term cardiac treatments that address a variety of cardiac diseases. In the recent years, a steady growth has been noticed in CIEDs, mainly due to expanding indications for their usage. Possible device-related infection, whether pocket or systemic, which leads to high morbidity and mortality, is one of the most worrying complications. In addition, there are limited studies conducted on the topic of CIED infection rate and their clinical presentation both regionally and locally. Methods In this retrospective cohort study, we reviewed the medical records of all patients with CIEDs who presented to our medical center (implanted, followed up, or referred to our hospital) between January 2016 and January 2019.The medical records were extracted from the BestCare electronic medical records system (ezCaretech Co, Seoul, Korea). All consecutive patients were included as we had no exclusion criteria. Results During the three years of the study period, a total of 612 patients with CIEDs were identified at our medical center. Among this cohort, 436 subjects (71.2%) were male and 176 (28.8%) were female. Thirty-four patients experienced device-related infections from among the total patient population (n = 612) who presented with CIEDs between January 2016 and January 2019, for a total rate of 5.6%. Of the infected patients, 29 (85%) presented with local infections and five (15%) presented with systemic infections. Conclusion The infection rate of 5.6% observed in this study was higher than expected. Therefore, we conclude that action should be taken to reduce infection rates at our medical center to at least that seen in prior studies or below that, if possible. Moreover, we found that CIED infections were often caused by Staphylococcus species and commonly affected the elderly and patients with chronic diseases such as diabetes and hypertension. Most of the identified cases were local infections, although systemic infections were common in those with renal disease. Further studies are needed to control the risk factors and to better understand the role of antibiotics, antiseptic prophylaxis, and other methods in avoiding CIED infection and associated complications.