Prevalence of Middle Mesial Canal in Mandibular Molars of a Saudi Subpopulation: A Prospective Cone-Beam Computed Tomography Study.

BACKGROUND: Root canal treatment is compromised when one or more root canals are left unmanaged, especially in the case of multirooted teeth. Cone-beam computed tomography (CBCT) has the advantage of clearly recognizing the anatomical structures without any blurring and superimposition. There are few studies that assess the middle mesial canal (MMC) prevalence in the Saudi population using CBCT imaging. Thus, the present study was conducted to assess the MMC prevalence in the first and second mandibular molars in the Saudi population using CBCT imaging. MATERIALS AND METHODS: Data from 616 patients and 1014 teeth were assessed. The mesial roots of the mandibular first and second molars were examined using CBCT to assess the presence of the MMC in both axial and coronal sections. The potential correlation between the prevalence of MMC was assessed with gender and age. The data collected were subjected to statistical analysis using IBM SPSS version 20.0 software (IBM Corp., Armonk, NY). RESULTS: The mean age was 34.39 ± 12.12 years, showing male predominance. A total of 2.6% and 0.2% cases of MMC were found in the first and second molars, respectively. A significant difference (p-value < 0.05) was observed among both genders in relation to age groups and the presence of MMC. MMC in the first molar was seen mainly in patients aged <20 years and only one case was reported with MMC in the second molar among patients aged 41-60 years. CONCLUSION: A higher incidence of MMC was found in the first than the second mandibular molar. For accessing the MMC, the patient's age, high magnification, and troughing are some influential factors. In the future, clinical studies with long-term follow-ups are required to assess the influence of biomechanical preparation of MMC on the result of nonsurgical endodontic management in mandibular first as well as second molars.

Trans-scaphoid Lunate Dislocation Rare Injury: A Case Report.

Lunate dislocations are complex and uncommon wrist injuries, often resulting from high-energy trauma like road traffic accidents, falls, and industrial mishaps. Timely diagnosis and appropriate surgical management are critical to achieving favorable outcomes and minimizing long-term disability. Here, we present a case of a 22-year-old male who sustained a trans-scaphoid lunate fracture dislocation due to a motorcycle accident. Prompt wrist x-ray evaluation and subsequent surgical interventions led to the successful restoration of wrist function and stability. This case report highlights the importance of early recognition and discusses the accurate diagnosis and timely management of lunate fracture dislocations to avoid long-term complications and disability.

Design, synthesis and bioevaluation of new vanillin hybrid as multitarget inhibitor of α-glucosidase, α-amylase, PTP-1B and DPP4 for the treatment of type-II diabetes.

Diabetes mellitus (DM) is a real challenge to the recent era and is one of the major diseases for initiating life-threatening disorders. In current research, a compound was designed by combining vanillin, thiazolidinedione and morpholine. The goal of our designed work is to demonstrate the ability of our design compound (9) to modulate more than one target responsible for hyperglycemia at the same time. The synthesized compound was able to show good to moderate inhibition potential against α-glucosidase, α-amylase and protein tyrosine phosphatase 1B. However, it exhibited excellent in-vitro inhibition of Dipeptidyl peptidase-4 (DPP-4) with IC50 value of 0.09 µM. Antioxidant activity by using DPPH assay also showed its good antioxidant potential. In in-vivo experiments, the compound 9 was proved to be safe in experimental mice. The activity profile of the compound was observed for 21 days which showed that the compound was also effective in experimental mice. Binding orientations and Interactions with key amino acid residues of the selected targets were also studied by using docking studies. Overall, we were successful in synthesizing multitarget preclinical therapeutic by combining three pharmacophoric moieties into a single chemical entity that can modulate more than one target at the same time.

Saudi Experts Consensus on Diagnosis and Management of Pediatric Functional Constipation.

Although functional gastrointestinal disorders (FGIDs) are very common in pediatric patients, there is a scarcity of published epidemiologic data, characteristics, and management patterns from Saudi Arabia, which is the 2nd largest Arabic country in terms of area and the 6th largest Arabic country in terms of population, with 10% of its population aged <5 years. Functional constipation (FC) is an FGID that has shown a rising prevalence among Saudi infants and children in the last few years, which urges us to update our clinical practices. Nine pediatric consultants attended two advisory board meetings to discuss and address current challenges, provide solutions, and reach a Saudi national consensus for the management of pediatric constipation. The pediatric consultants agreed that pediatricians should pay attention to any alarming signs (red flags) found during history taking or physical examinations. They also agreed that the Rome IV criteria are the gold standard for the diagnosis of pediatric FC. Different therapeutic options are available for pediatric patients with FC. Dietary treatment is recommended for infants with constipation for up to six months of age. When non-pharmacological interventions fail to improve FC symptoms, pharmacological treatment with laxatives is indicated. First, the treatment is aimed at disimpaction to remove fecal masses. This is achieved by administering a high dose of oral polyethylene glycol (PEG) or lactulose for a few days. Subsequently, maintenance therapy with PEG should be initiated to prevent the re-accumulation of feces. In addition to PEG, several other options may be used, such as Mg-rich formulas or stimulant laxatives. However, rectal enemas and suppositories are usually reserved for cases that require acute pain relief. In contrast, infant formulas that contain prebiotics or probiotics have not been shown to be effective in infant constipation, while the use of partially hydrolyzed formula is inconclusive. These clinical practice recommendations are intended to be adopted by pediatricians and primary care physicians across Saudi Arabia.

Data-Driven Acid Fracture Conductivity Correlations Honoring Different Mineralogy and Etching Patterns.

Acid-fracturing operations are mainly applied in tight carbonate formations to create a highly conductive path. Estimating the conductivity of a hydraulic fracture is essential for predicting the fractured well productivity. Several models were developed previously to estimate the conductivity of acid-fractured rocks. In this research, machine learning methods were applied to 560 acid fracture experimental datapoints to develop several conductivity correlations that honor the rock types and etching patterns. Developing one universal correlation often results in significant error. To develop conductivity correlations, various data preprocessing methods were applied to remove the outliers and failed experiments. Features that did not contribute to precise predictions were removed through regularization. A machine learning classifier was built to predict the etching pattern based on the input data. We generated a multivariate linear regression model and compared it with other models generated through ridge regression. In addition to that, artificial neural network-based model was proposed to predict the fracture conductivity of several carbonate rocks such as dolomite, chalk, and limestone. The performance of the developed models was assessed using well-known metrics such as precision, accuracy, mean squared error, recall, and correlation coefficients. Cross-validation was also employed to assure accuracy and avoid overfitting. The classifier accuracy was 93%, while the regression model resulted in a relatively high correlation coefficient.

Serum Ghrelin Levels in Saudi Obese Asthmatic School-Children-Correlation with Interleukin-4, Interleukin-5, and Interleukin-21.

Ghrelin is a peptide hormone with direct or indirect effects on obesity and asthma. More data are required to understand the effect of ghrelin on the control and pathogenesis of these diseases. The aim of this study was to evaluate ghrelin levels in selected groups of children to identify the association between serum ghrelin, obesity, and the severity of asthma. The study included 401 school children selected from the Najran area and grouped into non-obese asthmatics, obese asthmatics, obese non-asthmatics and controls (non-obese non-asthmatics). Blood levels of ghrelin, interleukin (IL)-4, IL-5 and IL-21 were determined by ELISA. The mean ghrelin values were insignificantly increased in obese children compared with non-obese children. The highest blood ghrelin values were in the non-obese asthmatic group. Serum ghrelin, IL-4 and IL-21 levels were significantly increased in asthmatic children compared with non-asthmatic children (p < 0.05), and there were significant positive correlations between ghrelin and IL-4, IL-5, and IL-21 in asthmatic children. Furthermore, ghrelin, IL-4, and IL-21 levels were significantly higher in uncontrolled asthmatics compared with controlled-asthmatic children (p < 0.05). Asthma was the only significant risk factor for high ghrelin values. This study provides evidence supporting the anti-inflammatory role of ghrelin in the pathogenesis of asthma. Asthma might be considered as an important determinant of high ghrelin values in children.

Obesity and childhood asthma in male schoolchildren in Saudi Arabia: Is there a role for leptin, interleukin-4, interleukin-5, and interleukin-21?

BACKGROUND: Adiposity is associated with high serum levels of adipokines and chemokines which are possibly implicated in a co-existence of obesity and asthma. OBJECTIVES: Elucidate the possible roles of leptin, interleukin (IL)-4, IL-5 and IL-21 in linking obesity with childhood asthma. DESIGN: Cross-sectional, analytical. SETTING: Population of schoolchildren in a small Saudi city. SUBJECTS AND METHODS: The study included a representative sample of Saudi schoolchildren grouped as obese asthmatics, non-obese asthmatics, or obese nonasthmatics, with nonobese nonasthmatics as a control group. An asthma control test was done for the asthmatic groups. MAIN OUTCOME MEASURES: Serum levels of leptin, IL-4, IL-5, and IL-21. SAMPLE SIZE: 345 male schoolchildren with a mean (SD) age of 13.0 (2.3) years. RESULTS: Median serum leptin concentrations in obese asthmatics were significantly higher than in nonobese asthmatics ( P<.001). Uncontrolled asthmatics also had significantly higher leptin levels than controlled asthmatic children ( P<.002). Leptin levels were weakly but significantly correlated with the cytokines IL-4, IL-5, and IL-21. CONCLUSIONS: Leptin may contribute to a link between obesity and childhood asthma. Differences in IL-21 levels between nonobese and obese asthmatics suggest that the co-existence of asthma and obesity increased IL-21 levels. Leptin plus some proinflammatory cytokines especially IL-21 may be potential predictors for asthma control in children. LIMITATIONS: Blood sampling at different stages of asthma might influence cytokine expression. CONFLICT OF INTEREST: None.