Arterial vascularization of the mandible and soft tissues. Anatomic study.

PURPOSE: The literature has for too long described the arterial supply of the mandible as coming from a single artery, the inferior alveolar artery, and being of the terminal type. Rather, it appears to come from an extensive and complex arterial network dependent on the lingual, facial, and maxillary arteries and their collateral branches. Our study aims to confirm and demonstrate the arterial vascular richness of the mandible and to establish arterial mapping. METHODS: The arterial vascularization of the mandible was revealed in six anatomic specimens after performing selective injections of the lingual, facial, and maxillary arteries with different dyes. A specimen was injected intra-arterially with colored latex at the level of the maxillary artery for a morphometric study. RESULTS: Eighteen selective arterial injections were performed on six anatomic specimens. The mucocutaneous, musculoperiosteal, and intramedullary vascularizations were analyzed. Each of the arteries has a defined and delimited cutaneo-mucous vascular territory. The facial and maxillary arteries supply the musculoperiosteal vascularization of the mandible from the condyle to the symphysis. The lingual artery supplies only the inner cortex of the parasymphyseal and symphyseal regions. The facial and maxillary arteries provide intramedullary vascularization from the angle of the mandible to the parasymphysis. The vascularization of the symphysis depends on the facial artery. No staining was found in the condyle region. Neoprene latex injection was performed on an anatomic specimen, revealing a permeable anastomosis between the inferior alveolar and facial arteries. CONCLUSION: The arterial vascularization of the mandible is dependent on the maxillary, facial, and lingual arteries. This is a network vasculature. This study makes it possible to establish an arterial map of the mandible. The presence of an anastomosis between the inferior alveolar artery and the facial artery confirms the existence of dynamic and borrowed vascularization. Knowledge of this arterial system makes it possible to adapt maxillofacial surgical care and to anticipate possible intraoperative complications.

Serological investigation of Coxiella burnetii infection (Query fever) in livestock in Makkah Province, Saudi Arabia.

Background and Aim: Query fever (Q fever) is an endemic zoonotic disease and ruminants are considered to be the primary source of infection in humans. It is caused by Coxiella burnetii which is an obligate intracellular bacterial pathogen with a worldwide distribution. This study estimated the prevalence of Q fever in livestock with a history of abortion in Makkah Province, Saudi Arabia. Material and Methods: Sera from 341 camels, 326 sheep, and 121 goats of either sex from various locations (Makkah, Jeddah, AL-Taif, AL-Qunfudah, AL-Laith, and AL-Kamil) were examined using a Q fever indirect enzyme-linked immunosorbent assay. Results: Among the 788 serum samples, 356 animals had anti-Coxiella burnetii immunoglobulin G antibodies with an overall seroprevalence of 45.4%. Significant differences were observed in seroprevalence between species and locations. Camels had the highest percentage of Q fever-positive sera, with a prevalence of 50.4%, followed by goats (44.6%) and sheep (36.8%), with a high significant difference between animals (p = 0.000). The prevalence was significantly higher in Makkah (65.4%) than in Jeddah (28.8%). Conclusion: C. burnetii infection is prevalent in agricultural animals, especially camels maintained at livestock farms in Makkah province. Therefore, these animals considered as the main source of Q fever infections in Saudi Arabia, which is also a reason for the abortion in these animals. Therefore, there is an urgent need for further studies on Q fever infection with interventional approaches for prevention and control.

Protective effect of sterubin against neurochemical and behavioral impairments in rotenone-induced Parkinson's disease.

This study was conducted to evaluate how sterubin affects rotenone-induced Parkinson's disease (PD) in rats. A total of 24 rats were distributed into 4 equal groups: normal saline control and rotenone control were administered saline or rotenone (ROT), respectively, orally; sterubin 10 received ROT + sterubin 10 mg/kg po; and sterubin alone was administered to the test group (10 mg/kg). Rats of the normal saline and sterubin alone groups received sunflower oil injection (sc) daily, 1 h after receiving the treatments cited above, while rats of the other groups received rotenone injection (0.5 mg/kg, sc). The treatment was continued over the course of 28 days daily. On the 29th day, catalepsy and akinesia were assessed. The rats were then euthanized, and the brain was extracted for estimation of endogenous antioxidants (MDA: malondialdehyde, GSH: reduced glutathione, CAT: catalase, SOD: superoxide dismutase), nitrative (nitrite) stress markers, neuroinflammatory cytokines, and neurotransmitter levels and their metabolites (3,4-dihydroxyphenylacetic acid (DOPAC), dopamine (DA), norepinephrine (NE), serotonin (5-HT), 5-hydroxyindoleacetic acid (5-HIAA), and homovanillic acid (HVA)). Akinesia and catatonia caused by ROT reduced the levels of endogenous antioxidants (GSH, CAT, and SOD), elevated the MDA level, and altered the levels of nitrites, neurotransmitters, and their metabolites. Sterubin restored the neurobehavioral deficits, oxidative stress, and metabolites of altered neurotransmitters caused by ROT. Results demonstrated the anti-Parkinson's activities of sterubin in ROT-treated rats.

Protective effect of sterubin against neurochemical and behavioral impairments in rotenone-induced Parkinson's disease

This study was conducted to evaluate how sterubin affects rotenone-induced Parkinson's disease (PD) in rats. A total of 24 rats were distributed into 4 equal groups: normal saline control and rotenone control were administered saline or rotenone (ROT), respectively, orally; sterubin 10 received ROT + sterubin 10 mg/kg po; and sterubin alone was administered to the test group (10 mg/kg). Rats of the normal saline and sterubin alone groups received sunflower oil injection (sc) daily, 1 h after receiving the treatments cited above, while rats of the other groups received rotenone injection (0.5 mg/kg, sc). The treatment was continued over the course of 28 days daily. On the 29th day, catalepsy and akinesia were assessed. The rats were then euthanized, and the brain was extracted for estimation of endogenous antioxidants (MDA: malondialdehyde, GSH: reduced glutathione, CAT: catalase, SOD: superoxide dismutase), nitrative (nitrite) stress markers, neuroinflammatory cytokines, and neurotransmitter levels and their metabolites (3,4-dihydroxyphenylacetic acid (DOPAC), dopamine (DA), norepinephrine (NE), serotonin (5-HT), 5-hydroxyindoleacetic acid (5-HIAA), and homovanillic acid (HVA)). Akinesia and catatonia caused by ROT reduced the levels of endogenous antioxidants (GSH, CAT, and SOD), elevated the MDA level, and altered the levels of nitrites, neurotransmitters, and their metabolites. Sterubin restored the neurobehavioral deficits, oxidative stress, and metabolites of altered neurotransmitters caused by ROT. Results demonstrated the anti-Parkinson's activities of sterubin in ROT-treated rats.

Synthesis and characterization of SnO2/rGO nanocomposite for an efficient photocatalytic degradation of pharmaceutical pollutant: Kinetics, mechanism and recyclability.

The SnO2 and SnO2/rGO nanostructures were successfully synthesized using the facile hydrothermal synthesis technique. The prepared nanostructures were well studied using different techniques such as XRD, XPS, UV-DRS, FT-IR, EDX, SEM and HR-TEM analysis. The crystalline nature of SnO2 and SnO2/rGO was confirmed by the XRD technique. The formation of highly pure SnO2 and SnO2/rGO nanostructures was confirmed by EDX analysis. The morphological results show the good agglomeration of several spherical nanoparticles. The optical properties were studied through the UV-DRS technique and the bandgap energies of SnO2 and SnO2/rGO are estimated to be 3.12 eV and 2.71 eV, respectively. The photocatalytic degradation percentage in presence of SnO2 and SnO2/rGO against RhB was found to be 96% and 98%, respectively. The degradation of TTC molecules was estimated as 90% and 88% with SnO2/rGO and SnO2, respectively. The degradation of both RhB and TTC molecules was well suited with the pseudo-first-order kinetics. The results of successive experiments clearly show the enhancement in the photocatalytic properties in the SnO2/rGO nanostructures.

Hyperlipidemia and its relation with tinnitus: Cross-sectional approach.

Background: Tinnitus is a common auditory complaint among individuals characterized by ringing, buzzing, hissing, chirping, whistling, or other sounds in the ear. Following a low-fat/low-cholesterol diet can help reduce the blood cholesterol and triglyceride levels, which aids improvement in tinnitus symptoms. High cholesterol and triglyceride levels in the bloodstream play a significant role in the development of tinnitus, hearing loss, and vertigo. Aim: This paper aims to test the association between hyperlipidemia and tinnitus among outpatients in King Khalid University (KKU) ENT clinic. Patients and Methods: A retrospective review of the medical records of patients who attended the ENT clinic at KKU was performed. An otological examination including pure tone audiometry, personal habits, and lipid profile was conducted. Patients were contacted by phone if there were any missing data. Results: The study included 300 patients who were treated in the outpatient clinic during the study period. About 80% of the patients were of age >45 years and 60.3% were males. Half of the cases (150 cases) had tinnitus and 13% had hyperlipidemia. Patients with high lipid profile recorded doubled risk for tinnitus (P < 0.05). Other risk factors found to be significantly associated with tinnitus include vertigo, young age, and wearing an earpiece. Conclusions: In conclusion, there was a significant association between hyperlipidemia and the incidence of tinnitus even after adjusting for all other risk factors. More large-scale researches are needed to assess in detail the association between different lipid components such as low-density lipoprotein, high-density lipoprotein, triglycerides, and tinnitus epidemiology.

The external jugular vein axis: a new anatomical landmark for pre-operative prediction of the location of parotid gland tumours.

The relationships between parotid tumours and the facial nerve determine duration of surgical procedure and risks involved. As the division of the facial nerve is not visible using standard imaging techniques, other anatomical landmarks are used to determine the pre-operative location of tumours. This retrospective study aimed to evaluate reliability of the 'external jugular vein axis' compared with other landmarks generally used in imaging, such as the retromandibular vein, Conn's arc, the facial nerve line and the Utrecht line. Forty-eight pre-operative imaging exams of patients who underwent parotid benign tumour surgery between 2010 and 2016 were examined. We determined the location of tumour using the five markers. A pre-operative simulation was compared with the description given by the surgeon intraoperatively, in terms of sensitivity and specificity for each marker. External jugular vein axis and retromandibular vein are the most sensitive markers for locating suprafacial tumours (Se = 1). External jugular vein axis and Conn's arc are the most specific markers for locating suprafacial tumours (Spe = 0.92). External jugular vein axis is reproducible and present on all radiological sections, thereby overcoming any anatomical and nomenclature variations. This landmark appears to be the most representative marker of the dividing branches of the facial nerve.

The current progress and critical analysis of three-dimensional scanning and three-dimensional printing applications in breast surgery.

BACKGROUND: Several attempts have been made to develop a tool capable of evaluating breast shape and volume to aid surgical planning and outcome assessment. More recently, newer technologies such as three-dimensional (3D) scanning and 3D printing have been applied in breast assessment. The aim of this study was to review the literature to assess the applicability of 3D scanning and 3D printing in breast surgery. METHODS: A literature search was carried on PubMed, Google Scholar and OVID from January 2000 to December 2019 using the keywords '3D', 'Three-dimensional', 'Three/four dimensions' and 'Breast'. RESULTS: A total of 6564 articles were identified initially; the abstracts of 1846 articles were scanned, and 81 articles met the inclusion criteria and were included in this review. Articles were reviewed and classified according to their aims, study subjects, the software and hardware used, main outcomes and major limitations. CONCLUSIONS: These technologies are fast and easy to use, however, high costs, long processing times and the need for training might limit their application. To incorporate these technologies into standard healthcare, their efficacy and effectiveness must be demonstrated through multiple and rigorous clinical trials.

Antifungal efficiency of wild plants against human-opportunistic pathogens.

BACKGROUND: Fungal infection with opportunistic fungi can cause a serious problem for immunocompromised persons such as organ-transplant recipients, cancer, and HIV/AIDS patients. Control of these organisms using natural products is an interesting strategy to avoid the use of heavy chemotherapy in patients. OBJECTIVE: This study aimed to use the extract of Forsskaolea tenacissima L. and Xanthium spinosum L. to suppress the growth of Candida albicans and Geotrichum candidum and to investigate their potential mode of action. MATERIALS AND METHODS: Different plant extracts were tested for their antifungal activity using disc diffusion method and their mode of action was explored using the scanning electron microscopy (SEM) and gas chromatography-mass spectrometry (GC-MS). RESULTS: The results showed that chloroform extract of X. spinosum was the most effective against G. candidum, inhibiting its growth at very low concentration (38µg/mL). Chloroform extract of F. tenacissima was the most effective against C. albicans, with a minimum inhibitory concentration of 39µg/mL. SEM demonstrated the fungitoxicity of the plant extracts against both pathogens. C. albicans treated with plant extract were invaginated and ruptured and the treated mycelia of G. candidum were distorted and squashed. GC-MS analysis showed that the chloroform extract of both plants had 13 different compounds. CONCLUSION: Due to these promising results, these extracts should be further investigated and tested on different strains of C. albicans and G. candidum towards validation of their efficacy as a natural drug.

Contraindicated drug-drug interactions associated with oral antimicrobial agents prescribed in the ambulatory care setting in the United States.

OBJECTIVES: Antimicrobial agents are commonly used in ambulatory care settings. Our objective was to examine national-level patterns of contraindications between oral antibacterial or antifungal agents and patients' other oral medications in the US ambulatory care setting. METHODS: This cross-sectional study included multiple year pooled data (2003-2011) from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey (NHAMCS Outpatient Department). Visits by adults (age ≥18 years) in ambulatory settings in the United States who were prescribed oral antibacterial or antifungal agents were evaluated for potential drug-drug interaction (DDI) contraindications. Findings with relative standard error >30% or unweighted sample size <30 were not reported because these were deemed unreliable estimates. RESULTS: From 2003 to 2011, there were 1 235 000 outpatient visits (proportion = 0.52%; 95% confidence interval (CI), 0.29-0.74) in which a patient was prescribed an antimicrobial agent associated with a contraindicated DDI. The most prevalent antimicrobials with contraindicated combination among outpatients were simultaneous use of macrolide-containing products (erythromycin or clarithromycin) with statin medication-containing products (simvastatin or lovastatin) (841 864 visits, proportion = 1.91%; 95% CI, 0.96-2.86). The next most common combination was use of fluoroquinolones with antiarrhythmic agents (amiodarone, sotalol, quinidine or procainamide) (365 622 visits, proportion = 0.19%; 95% CI, 0.06-0.32). CONCLUSIONS: Providers should be aware of potential contraindicated DDIs when prescribing antibiotics, especially macrolides and fluoroquinolones.

Value of PET/CT 3D visualization of head and neck squamous cell carcinoma extended to mandible.

PURPOSE: To study an original 3D visualization of head and neck squamous cell carcinoma extending to the mandible by using [18F]-NaF PET/CT and [18F]-FDG PET/CT imaging along with a new innovative FDG and NaF image analysis using dedicated software. The main interest of the 3D evaluation is to have a better visualization of bone extension in such cancers and that could also avoid unsatisfying surgical treatment later on. PATIENTS AND METHODS: A prospective study was carried out from November 2016 to September 2017. Twenty patients with head and neck squamous cell carcinoma extending to the mandible (stage 4 in the UICC classification) underwent [18F]-NaF and [18F]-FDG PET/CT. We compared the delineation of 3D quantification obtained with [18F]-NaF and [18F]-FDG PET/CT. In order to carry out this comparison, a method of visualisation and quantification of PET images was developed. This new approach was based on a process of quantification of radioactive activity within the mandibular bone that objectively defined the significant limits of this activity on PET images and on a 3D visualization. Furthermore, the spatial limits obtained by analysis of the PET/CT 3D images were compared to those obtained by histopathological examination of mandibular resection which confirmed intraosseous extension to the mandible. RESULTS: The [18F]-NaF PET/CT imaging confirmed the mandibular extension in 85% of cases and was not shown in [18F]-FDG PET/CT imaging. The [18F]-NaF PET/CT was significantly more accurate than [18F]-FDG PET/CT in 3D assessment of intraosseous extension of head and neck squamous cell carcinoma. This new 3D information shows the importance in the imaging approach of cancers. All cases of mandibular extension suspected on [18F]-NaF PET/CT imaging were confirmed based on histopathological results as a reference. CONCLUSIONS: The [18F]-NaF PET/CT 3D visualization should be included in the pre-treatment workups of head and neck cancers. With the use of a dedicated software which enables objective delineation of radioactive activity within the bone, it gives a very encouraging results. The [18F]-FDG PET/CT appears insufficient to confirm mandibular extension. This new 3D simulation management is expected to avoid under treatment of patients with intraosseous mandibular extension of head and neck cancers. However, there is also a need for a further study that will compare the interest of PET/CT and PET/MRI in this indication.

Development of a floating drug delivery system with superior buoyancy in gastric fluid using hot-melt extrusion coupled with pressurized CO2.

The present study aimed to develop a continuous single-step manufacturing platform to prepare a porous, low-density, and floating multi-particulate system (mini-tablet, 4 mm size). This process involves injecting inert, non-toxic pressurized CO2gas (P-CO2) in zone 4 of a 16-mm hot-melt extruder (HME) to continuously generate pores throughout the carrier matrix. Unlike conventional methods for preparing floating drug delivery systems, additional chemical excipients and additives are not needed in this approach to create minute openings on the surface of the matrices. The buoyancy efficiency of the prepared floating system (injection of P-CO2) in terms of lag time (0 s) significantly improved (P < 0.05), compared to the formulation prepared by adding the excipient sodium bicarbonate (lag time 120 s). The main advantages of this novel manufacturing technique include: (i) no additional chemical excipients need to be incorporated in the formulation, (ii) few manufacturing steps are required, (iii) high buoyancy efficiency is attained, and (iv) the extrudate is free of toxic solvent residues. Floating mini-tablets containing acetaminophen (APAP) as a model drug within the matrix-forming carrier (Eudragit® RL PO) have been successfully processed via this combined technique (P-CO2/HME). Desired controlled release profile of APAP from the polymer Eudragit® RL PO is attained in the optimized formulation, which remains buoyant on the surface of gastric fluids prior to gastric emptying time (average each 4 h).

Relationship between facial nerve damage and transbuccal trocar placement: an anatomical cohort study.

The surgical treatment of ramus and mandibular angle fractures is typically performed by intraoral and transbuccal approaches. As these approaches may result in nerve damage, this anatomical study was performed to establish the relationship between the transbuccal trocar position and the likelihood of inducing facial nerve damage. Twenty dissections of the parotid regions were performed after a simulation of surgical approaches aimed at addressing mandibular condylar and angle fractures. Two trocar tubes, ramic and angular, were inserted and left in position throughout the dissection. This procedure allowed the qualitative relationship between the various tube positions and facial nerve damage to be analyzed. The potential risk of contact between the ramic trocar and the facial nerve branches was 90%, while the angular trocar was in contact in 45% of cases. There was no contact with the trunk, cervicofacial division, or temporofacial division of the facial nerve. The contacts occurred at the level of secondary division branches, particularly pronounced for superior and inferior buccal branches, despite the absence of macroscopically visible trauma. Based on these findings, it is proposed that trocars should be used in procedures aimed at addressing subcondylar or angle fractures of the mandible.

FEV1 and FVC pulmonary function reference values among 6-18-year-old children: a multi-centre study in Saudi Arabia.

It is important to establish lung function reference values for each population. This study aimed to determine the spirometric reference values for healthy Saudi Arabian children and adolescents and to derive prediction equations for these. A cross-sectional study was conducted among healthy schoolboys and girls aged 6-18 years old, selected randomly from the 6 administrative regions of Saudi Arabia. Data were collected by questionnaire and physical examinations including spirometry. Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were significantly higher in males than females. Height was the anthropometric variable most strongly correlated with FEV1 (r = 0. 61), more so for males (r = 0.71) than females (r = 0.50). In males the multivariate linear regression model explained 53.9% of FEV1 and 35.1% of FVC variations. In females it explained 25.3% of FEV1 and 16.5% of FVC variations. All changes in R² were statistically significant.

FEV1 and FVC pulmonary function reference values among 6-18-year-old children: a multi-centre study in Saudi Arabia

من المهم إقرار قيم مرجعية لوظائف الرئة لكل مجموعة سكانية. وتهدف هذه الدراسة إلى التعرف على القيم المرجعية للقياسات التنفسية لدى الأطفال والمراهقين الأصحاء في المملكة العربية السعودية، واشتقاق معادلات للتنبؤ بقيمها.وقد أجرى الباحثون دراسة مستعرضة شملت تلاميذ وتلميذات أصحاء تراوح أعمارهم بين 6 و 18 عاما، تم اختيارهم عشوائيا من ست مناطق إدارية في المملكة العربية السعودية. وجمع الباحثون البيانات من خلال استبيان ومن خال الفحص المادي باستخدام المقياس التنفسي. واتضح أن قيم حجم الزفير القسري خلال الثانية الأولى والسعة الحيوية القسرية كانت أعلى بمقدار يعتد به إحصائيا لدى الذكور مما هي لدى الإناث. وقد كان الطول هو المتغير الأكثر أهمية من حيث الترابط في القياسات البشرية ذات الصلة بحجم الزفير القسري خلال الثانية الأولى [معامل الارتباط r = 0.61]وهو أكثر قيمة لدى الذكور [معامل الارتباط r = 0.71]منه لدى الإناث [معامل الارتباط r = 0.5]وقد أوضح نموذج التحوف الخطي المتعدد المتغيرات لدى الذكور تفسر التفاوتات لدى 53.9 من حجم الزفير القسري خلال الثانية الأولى و35.1 % من السعة الحيوية القسرية، أما ما لدى الإناث فقد فسر التفاوتات لدى 25.3 % من حجم الزفير القسري خلال الثانية الأولى و16.5% من السعة الحيوية القصوى. وقد كانت جميع التغيرات في مربع معامل الارتباط R[2] ذات أهمية يعتد بها إحصائيا

ABSTRACT It is important to establish lung function reference values for each population. This study aimed todetermine the spirometric reference values for healthy Saudi Arabian children and adolescents and to deriveprediction equations for these. A cross-sectional study was conducted among healthy schoolboys and girlsaged 6–18 years old, selected randomly from the 6 administrative regions of Saudi Arabia. Data were collectedby questionnaire and physical examinations including spirometry. Forced expiratory volume in 1 second (FEV1)and forced vital capacity (FVC) were significantly higher in males than females. Height was the anthropometricvariable most strongly correlated with FEV1 (r = 0. 61), more so for males (r = 0.71) than females (r = 0.50). Inmales the multivariate linear regression model explained 53.9% of FEV1 and 35.1% of FVC variations. In females itexplained 25.3% of FEV1 and 16.5% of FVC variations. All changes in R2 were statistically significant.

RÉSUMÉ Il est important d'établir des valeurs de référence de la fonction respiratoire pour chaque population. Laprésente étude visait à déterminer les valeurs spirométriques de référence chez des enfants et des adolescentssaoudiens en bonne santé et à en déduire des équations pronostiques pour ces derniers. Une étude transversalea été menée auprès d'écoliers et d'étudiants des deux sexes en bonne santé et âgés de 6 à 18 ans, sélectionnésaléatoirement dans six régions administratives d'Arabie saoudite. Des données ont été recueillies au moyen d'unquestionnaire et d'examens cliniques, y compris la spirométrie. Le volume expiratoire maximal par seconde (VEMS) etla capacité vitale forcée (CVF) étaient nettement supérieurs chez les garçons que chez les filles. La taille était la variableanthropométrique la plus fortement corrélée au VEMS (r = 0, 61), et cette corrélation était plus forte chez les garçons(r = 0,71) que chez les filles (r = 0,50). Chez les garçons, le modèle de régression linéaire multivariée expliquait 53,9 %des variations du VEMS et 35,1 % des variations de la CVF. Chez les filles, le modèle expliquait 25,3 % des variations duVEMS et 16,5 % des variations de la CVF. Toutes les évolutions du R2 étaient statistiquement significatives.