The Prevalence and Predictors of Atherosclerotic Coronary Artery Disease in Rheumatic and Non-rheumatic Valvular Heart Disease Patients.

OBJECTIVES: The paradox of concurrent coronary artery disease (CAD) among patients with rheumatic and non-rheumatic valvular heart disease (RVHD; non-RVHD) is unclear. We aimed to evaluate the impact of the RVHD and non-RVHD on the prevalence of CAD and various risk factors, assess the number of diseased coronaries, clinical profile and the possible predictors of CAD in these patients, which may clarify the paradox and provide an insight for the prevention of CAD. METHODS: The records of 106 valvular heart disease patients who had undergone valve replacement surgery at the King Faisal Cardiac Centre from January 2014 to October 2019 were evaluated. The clinical data and established risk factors were compared and logistic regression analyses were performed to identify plausible predictors of CAD. RESULTS: Transthoracic echocardiographic diagnosis of 106 patients confirmed, 43 had RVHD (56.4 ± 8 years), of whom six (13.9%) had CAD with the highest mitral valve regurgitation (p < 0.01), and 63 had non-RVHD (60.0 ± 12 years). Of these, 31 patients showed the highest CAD (49.2%). Single- and triple-vessel disease was most common in RVHD and non-RVHD patients with concurrent CAD (33.3%; 41.9%, respectively), while non-RVHD patients also had quadruple vessel disease. The mean age of the RVHD and non-RVHD patients with coexisting CAD was significantly higher (66.7 ± 5; 66.7 ± 8 years) than those without CAD (46.1 ± 12.0; 54.7 ± 20, respectively). RVHD patients showed a significantly lower prevalence of diabetes, dyslipidaemia, hypertension, inflammatory cells, hepatorenal function markers, ejection fraction, and regional wall motion abnormality compared to RVHD patients with coexisting CAD (p < 0.01). Bivariate analysis indicated white blood cells, monocytes, neutrophils, gamma-glutamyl-transferase (GGT), bilirubin and blood urea nitrogen (BUN) to be significantly lower in RVHD patients. Predictors of high risk of CAD were BUN and hyperlipidaemia for RVHD and BUN, creatinine and GGT for non-RVHD patients. CONCLUSIONS: The prevalence of CAD in Saudi RVHD patients was significantly lower than in the Western countries, whereas non-RVHD was higher. The low prevalence may partly be attributed to age, reduced mitral regurgitation, and low frequency of risk and inflammatory factors.

The Efficacy of Fat Grafting on Treating Post-Mastectomy Pain with and without Breast Reconstruction: A Systematic Review and Meta-Analysis.

Post-mastectomy pain syndrome (PMPS), characterized by persistent pain lasting at least three months following mastectomy, affects 20-50% of breast surgery patients, lacking effective treatment options. A review was conducted utilizing EMBASE, MEDLINE, and all evidence-based medicine reviews to evaluate the effect of fat grafting as a treatment option for PMPS from database inception to 29 April 2023 (PROSPERO ID: CRD42023422627). Nine studies and 812 patients in total were included in the review. The overall mean change in visual analog scale (VAS) was -3.6 in 285 patients following fat grafting and 0.5 in 147 control group patients. There was a significant reduction in VAS from baseline in the fat grafting group compared to the control group, n = 395, mean difference = -2.17 (95% CI, -2.95 to -1.39). This significant improvement was also noted in patients who underwent mastectomy without reconstruction. Common complications related to fat grafting include capsular contracture, seroma, hematoma, and infection. Surgeons should consider fat grafting as a treatment option for PMPS. However, future research is needed to substantiate this evidence and to identify timing, volume of fat grafting, and which patient cohort will benefit the most.

Computational Optimization of Sandwich Silicone Rubber Composite for Improved Thermal Conductivity and Electrical Insulation.

The efficient dissipation of heat has emerged as a crucial concern for modern electronic devices, given the continuous increase in their power density and consumption. Thus, the utilization of thermally conductive but electrically insulating silicone rubber composites as a thermal interface material has garnered significant interest. In this study, the effects of the filler volume fraction, filler orientation, layer volume fractions, layer configuration, and a number of layers on the thermal conductivity and electrical resistivity of silicone rubber composites were examined using a multiscale finite element modeling strategy. The results demonstrated that modification of the filler orientation can change the thermal conductivity by 28 and 21 times in the in-plane and through-thickness directions, respectively. The in-plane thermal conductivities of silicone rubber/boron nitride and silicone rubber/expanded graphite layers exhibit a percolation phenomenon at filler volume fractions of 35% and 30%, respectively. The electrical resistivity of the composite increases exponentially with a decrease in the number of layers.

Epidemiology and clinical characteristics of Morganella morganii infections: A multicenter retrospective study.

BACKGROUND: Morganella morganii is a Gram-negative, opportunistic pathogen that can cause a variety of infections, including bloodstream infections, especially in those with compromised immune systems. It is often resistant to antibiotics, making it a difficult organism to treat. Limited studies have addressed M. morganii, but the organism is becoming increasingly recognized as a public health threat. More research is needed to understand the epidemiology and virulence factors of M. morganii in Saudi Arabia, as well as to develop effective treatment strategies. METHODS: This retrospective study included all M. morganii bloodstream infections patients admitted to five tertiary care hospitals in Saudi Arabia between 2015 and 2022. RESULTS: The study population included 75 patients (45 males and 30 females) between the age of 53-72 with a 54% ICU admission rate. The most comorbidities were hypertension followed by diabetes. The most common symptoms were fever, cough, shortness of breath, vomiting, and fatigue. The study also found that M. morganii was often resistant to multiple antibiotics, including ciprofloxacin, trimethoprim/sulfamethoxazole, gentamicin, amoxicillin, nitrofurantoin, and colistin. The most common treatment for M. morganii bacteremia was carbapenems, followed by aminoglycosides, ciprofloxacin, and colistin. Source control measures, such as surgery, line removal, drainage, and tissue removal, were also used in some cases. The study found that the in-hospital mortality rate for M. morganii bacteremia was 41%. The risk of mortality was increased in patients who were admitted to the ICU, who were older than 65 years, and who had Klebsiella pneumoniae co-infection. CONCLUSION: M. morganii bacteremia is a serious infection that is often resistant to antibiotics. Elderly patients and patients with comorbidities are at increased risk of mortality. Source control measures and appropriate antibiotic therapy are important for improving outcomes.

Physical activity levels among undergraduate students at the College of Applied Medical Sciences, King Saud University, Riyadh: A prevalence study.

Physical inactivity and sedentary behavior pose significant health concerns, particularly among young adults like college students. However, little research exists on the attitudes towards physical activity among Saudi Arabian healthcare students. This study aimed to assess the prevalence of physical activity and determine the reason for being physically inactive among students and interns across all programs in the College of Applied Medical Sciences (CAMS) at King Saud University (KSU), Riyadh, Saudi Arabia. A cross-sectional online survey was conducted between March and May 2023. CAMS students aged 18 and above, fluent in Arabic or English, and willing to participate were included. The Global Physical Activity Questionnaire (GPAQ) was used to measure physical activity. Descriptive statistics were used for data analysis. Out of 433 respondents, 377 met the inclusion criteria (response rate: 89.3%). Physical activity prevalence was 54.60%, with walking being the most common activity (42.70%). Lack of time was the primary reason for inactivity (51.40%). On average, students engaged in 1.5 hours/day of vigorous-intensity activities and 1.3 hours/day of vigorous-intensity sports and fitness activities at work. Sedentary behavior, characterized by continuous sitting, averaged 5.37 hours per day. Approximately half of CAMS students are physically active, while 20% rely solely on short walks due to time constraints, limited activity hours, or sedentary habits. A lack of time was cited as the primary reason for inactivity by most students. Future research should focus on strategies to enhance physical activity among healthcare students. In addition, academicians and policymakers should propose time-efficient initiatives that accommodate the demanding and busy schedules of healthcare students.

Awareness of Preeclampsia and Its Associated Factors Among Women in Al Baha Region, Saudi Arabia.

BACKGROUND: Preeclampsia is associated with the incidence of common fetal problems including intra-uterine growth restriction (IUGR), premature delivery oligohydramnios, placental abruption, fetal discomfort, and intrauterine fetal death. Pregnant women are not well-informed about preeclampsia, including its symptoms, risk factors, and consequences. The aim of the current study is to evaluate the awareness of preeclampsia and its associated factors among women in the Al Baha region, Saudi Arabia. METHODOLOGY: An observational cross-sectional design was employed to assess the awareness of preeclampsia and its associated factors among women in the Al Baha region of Saudi Arabia. Data was collected from April 2023 to September 2023. A questionnaire was designed to gather information on participants' sociodemographic characteristics (such as age, educational level, and residency) and their awareness of preeclampsia, including knowledge about signs/symptoms, risk factors, and complications. RESULTS: In the current study, we included 485 pregnant women. The majority of participants were aged 40 years or older (37.5%), followed by those aged 35-39 (20.4%). Among the participants, 70.9% confirmed that they had heard about pre-eclampsia before. The most common signs and symptoms were high blood pressure (47.4%), increased protein in urine (40.2%), continuous headache (39.2%), and vomiting/nausea (40.0%). Participants demonstrated awareness of obesity (29.7%), diabetes mellitus (35.5%), chronic hypertension (47.0%), and chronic kidney disease (31.3%) as major risk factors. Participants were aware of potential risks such as kidney disorders (34.6%), heart disorders (23.7%), and preterm delivery (50.9%). The analysis reveals that younger participants below 20 years old (3.3%) and lower educational levels (5.6%) had lower awareness of preeclampsia compared to older age groups. CONCLUSION: The findings of this study highlight a reasonable level of preeclampsia awareness and knowledge among Saudi Arabian women residing in the Al Baha region. While the majority of participants were familiar with preeclampsia, there were significant knowledge gaps regarding the precise symptoms, risk factors, and consequences of the condition.

Evaluation of Osteoporosis Perception Among Saudi Arabian Premenopausal Women: A Cross-Sectional Survey Study Using the Osteoporosis Knowledge Assessment Tool (OKAT).

INTRODUCTION: Osteoporosis is a major clinical problem that affects the whole population, especially women. It is a condition that is becoming more prevalent with aging. The increase in bone fragility associated with the disease can lead to fractures, even from minor trauma. Our goal is to evaluate the extent of knowledge about osteoporosis and perceptions of it among premenopausal women in Saudi Arabia. METHOD: This descriptive cross-sectional study was conducted among premenopausal women during the months of June and July 2021. We distributed an online questionnaire on social networking sites and applications that Saudi women use on a daily basis. We used the Osteoporosis Knowledge Assessment Tool (OKAT) to evaluate the responses. RESULT: A total of 661 women took part in our study; 159 of them were excluded because they had either reached the menopausal period or had already been diagnosed with the disease. The overall perception of osteoporosis is noticeably poor, as only 55% of respondents had an acceptable level of knowledge. In addition, we found a statistically significant association between education level and knowledge level (p-value = 0.044). CONCLUSION: The findings revealed that more than half the participants scored "acceptable" in terms of their understanding of the disease, which indicates a serious awareness gap. This outcome demonstrates the necessity of increasing community awareness about osteoporosis to reduce potential harm and the financial burden of healthcare.

Do-not-resuscitate (DNR) Orders' Awareness and Perception Among Physicians: a National Survey.

Background: The concept of do-not-resuscitate (DNR) orders began when medical and surgical interventions increased the possibility of resuscitation in dying patients. Healthcare providers should start to care more about the quality of life rather than quantity. The acceptance of signing DNR orders varies among physicians owing to different reasons and conceptions. Objective: The aim of this national survey was to evaluate the extent of physicians' knowledge and attitude towards do-not-resuscitate (DNR) orders in different hospitals and specialties in Saudi Arabia. Methods: A cross-sectional study was conducted in Saudi Arabia and other Arab Gulf countries between March 2019 and May 2021. Results: A total of 409 physicians completed the questionnaire (53.3% male, 47% of the participants were less than 30 years of age). Most participants had their residency medical training in Saudi Arabia (73.6%, n=281); 33.5% were emergency medicine (EM) physicians. Among 409 patients, 92.7% (n=379 ) were familiar with the DNR (do-not-resuscitate) ter. Half of the participants had never discussed a DNR status with the patient or family (n=215, 52.6%), however, only 38.4% had read the policy. A total of 275 (67.2%) participants were aware that their institute had a DNR policy, and a lack of patient/family understanding was the most common barrier for the majority to initiate DNR orders (53.9%, n=222). Most of the participants (65.8%, n=269) acknowledged a lack of training and understanding of the concepts of DNR orders. Conclusion: Most physicians who participated in this study were aware of the DNR order concept; however, half of them had never discussed or signed a DNR order. Patients and their families' misunderstandings were considered the main barriers. In addition, the lack of training in the concepts of DNR orders was considered a major obstacle.

Assessment of Sleep Quality Among Adolescents and Adults With Self-Diagnosed Irritable Bowel Syndrome, in Jeddah, Saudi Arabia.

Background The frequency of irritable bowel syndrome (IBS) has increased significantly in the last ten years. Few studies were done in Saudi Arabia to assess the relationship between sleep quality and IBS. This study aims to assess the prevalence of IBS and its association with sleep quality among adolescents and adults in Saudi Arabia. Methods A cross-sectional study was done on 651 participants aged 15-65 years. An online questionnaire was used to collect data, including demographics; the Rome IV criteria (R4DQ) was used in the diagnosis of IBS, the IBS symptoms severity scale (IBS-SSS) assessed IBS symptoms and severity, and the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Results Based on the Rome IV criteria, 25.7% of the participants had IBS. Among them, 23.3%, 17.9%, 47.3%, and 11.5% had IBS types constipation (C), diarrhea (D), mixed bowel habits (M), and undefined subtype (U), respectively. Mild, moderate, and severe IBS were found among 43.1%, 39.5%, and 17.4% of IBS cases, respectively. About 46% had poor sleep quality, which was significantly higher among those with younger mean age, females, and students. Patients with IBS exhibited a considerably greater prevalence of poor sleep quality, and IBS-C had the highest prevalence. Conclusion A correlation was found between poor sleep quality and the positive status of IBS diagnosis among adolescents and adults. An evaluation of specific sleep disorders among IBS patients is needed.

Photo-induced photoacoustic streaming and pineapple peel extract as final irrigant on extrusion bond strength of root filling material to canal wall.

Objective: Photon-induced photoacoustic streaming (PIPS) with pineapple peel extract (PPE) and ethylenediaminetetraacetic acid (EDTA) as a final endodontic irrigant on the push-out bond strength (PBS) of root filling material to conventional irrigation NaOCl with EDTA. Methods: An in vitro study at Dar Al Uloom University was conducted over three months. Root canal preparation was performed. Based on final irrigation, all the specimens were divided randomly into four groups (n=10) Group 1: 2.25% NaOCl+ 17% EDTA (control), Group-2: 2.25% NaOCl+PIPS + 6.25% PPE, Group-3: 2.25% NaOCl+PIPS + 17% EDTA, Group-4: 2.25% NaOCl + 6.25% PPE. Canals were obturated and sealed with AH Plus sealer. Root sectioning was performed at 1mm thickness and PBS testing was performed using the universal testing machine. The debonded samples were analyzed for failure mode. ANOVA compared the means and standard deviations (SD) of all investigated group. Assessment of multiple comparisons was performed using Tukey's post hoc test. Results: The maximum PBS was demonstrated by the coronal section of Group-2 (2.25%NaOCl +PIPS+6.25%PPE) specimens (8.21±0.81MPa). The apical section of Group-1 (2.25% NaOCl+17% EDTA) specimens demonstrated minimum bond strength (2.80±0.18 MPa). The intergroup comparison revealed that Group-3 (2.25% NaOCl +PIPS +17% EDTA) and Group-2 demonstrated comparable outcomes (p>0.05). Group-4 (2.25% NaOCl +6.25% PPE) specimens established significantly lower values than Group-3 and Group-4 (p<0.05). Conclusion: Photon-induced photoacoustic streaming with pineapple peel extract and EDTA demonstrated better bond strength of root canal sealer and have the potential to be used as the final irrigant.

Impact of the COVID-19 Lockdown on Children's Psychosocial Well-Being: A Cross-Sectional Study in Saudi Arabia.

Background The impact of COVID-19 on children is a vital topic to cover since the quarantine lasted for months, and limited research explored this effect locally in Arab countries. We studied the impact of the COVID-19 lockdown on the psychosocial well-being of children aged 1-18 years who were living in Saudi Arabia during the time of the pandemic. Method A total of 387 participants' responses were collected using online questionnaires (valid and reliable) composed of three sections with open and close-ended questions by the child's legal guardians. This cross-sectional study was conducted in Saudi Arabia and targeted children aged 1-18 years of both genders using a convenience sampling technique. One questionnaire assessed the child's behavior and sleep pattern, while the other evaluated child's activity and social skills. We analyzed the data using Statistical Package for Social Sciences (SPSS) version 20.0 (IBM Corp., Armonk, NY). Results Half of the children were 1-6 years (196; 50.6%), and the caregivers of more than half (225; 58.2%) were mothers. Two-thirds (234; 60.5%) of the children were male. Apart from a poor appetite for food and eating (non-nutritional) junk food, which was not significant (p-value > 0.05), all other factors, behavior, sleep patterns, activity, and social skills, all other factors were significantly affected by COVID-19 (p<0.05). Conclusion This study found that the COVID-19 pandemic had a negative impact on children's psychosocial well-being. It is recommended to implement actions that aim to enhance the ability of children to cope with challenges.

A novel intelligent agent-based framework for appropriate stream selection from perceptive of career counseling.

Picking a career stream profoundly influences people's abilities in different ways. Nowadays, choosing the correct career stream in advanced education is troublesome, as the number of people wanting to be in specific specializations is growing. Therefore, it is essential to be able to select the appropriate career path. This article proposes a system that can suggest streams in advanced education schools. This system is influenced by agent-based stream proposal systems (ASPS). The proposed system aims to make picking out the correct stream to study at school simpler for an individual. Different streams are evaluated based on seven pre-characterized models. In our system, three unique sorts of tests, learning styles, and coaching were coordinated in a way that caused the system to recognize an individual's interests and limits to an area of study. A sample of 238 participants was recruited for our questionnaire on accessibility, user-friendliness, accuracy, and satisfaction with the system. The incorporation of learning styles and coaching proved helpful in the study. The reliability and validity were proven in addition to incorporating a thinking-aloud protocol and immediate evaluation in the pre-, during and post-tests. To a large extent, respondents were satisfied with the model, as was revealed in the Likert scale response frequencies and percentages. The proposed system can be applied to undergraduates choosing engineering, medicine, arts and science degrees.

Studying the dimensions of m-interactivity and customers' engagement in m-commerce applications.

These days, technology has a significant role in the success of selling and buying goods through m-commerce applications. Therefore, this study aims to study the impact of dimensions of M-interactivity on customers' engagement in m-commerce and the effect of customers' attention in m-commerce on customer loyalty towards m-commerce applications. The questionnaire was distributed among Saudi citizens. The five hundred questionnaire links were distributed randomly among Saudi citizens. The partial least squares (PLS) were implemented to analyse the data to test the proposed hypotheses and get the rest of the results. The results revealed that the questionnaire used in this study was valid and reliable. Also, it revealed that active control, connectedness, responsiveness, and synchronicity positively impact customers' engagement in m-commerce applications. Furthermore, it showed that ubiquitous connectivity and personalization do not positively impact customers' attention in m-commerce. In addition, the results revealed that customer engagement positively impacts customer loyalty (LO) in m-commerce applications.

Relationship Between Heart Disease and Obesity Indicators Among Adults: A Secondary Data Analysis.

Background Body mass index (BMI), waist circumference (WC), and hip circumference (HC) determine obesity. Several studies have examined the association between obesity and many diseases, including heart disease, and found it to be a substantial risk factor. However, the relationship between heart disease and obesity has not been investigated. This study investigated the relationship between heart disease and obesity indicators among adults encompassing sociodemographic and lifestyle factors. Methodology This cross-sectional study included data from 3,574 individuals who participated in the 2011-2014 National Survey of Midlife Development in the United States refresher. The presence or absence of heart conditions such as irregular heartbeat, heart murmur, heart attack, and heart failure was determined using self-reported questionnaires. The association between heart disease and obesity indicators such as BMI, WC, HC, and waist-to-hip ratio (WHR) was investigated using linear regression. Results After controlling for all factors, the findings demonstrated a significant relationship between heart disease and BMI, WC, and HC high scores of 1.12 kg/m2, 0.63 inches, and 0.81 inches, respectively. A higher score in all obesity indicators was linked to being 65 years or older; male gender (for HC); having a school/college level of education; being unmarried, divorced, or widowed; having a history of smoking; and avoiding alcohol use. Conclusions Heart disease and sociodemographic and lifestyle factors are substantially associated with a high score in all obesity indicators. The findings of this study are important because they can assist healthcare providers in implementing different therapies to prevent high BMI, WC, HC, and WHR.

The 1-2-3 cm Advancement Flap Rule in Scalp Reconstruction.

Background Defects of the scalp are surgically challenging for several reasons: anatomical convexity limits tissue displacement, resistance to advancement is different at different points on the scalp, and there is also interindividual variation. For many patients, the idea of undergoing an advanced surgery such as a free flap is not preferred. Hence, a simple technique with a favorable outcome is needed. We hereby introduce our new technique: the 1-2-3 scalp advancement rule. Objectives The objective of this study is to discover a novel way to reconstruct scalp defects secondary to trauma or cancer, without having the patient undergo a big procedure. Material and Methods A total of nine cadaveric heads were used to test the idea of achieving greater advancement and increased scalp mobility to cover a 4×8 cm-sized defect using our proposed 1-2-3 scalp rule. Three steps performed were advancement flap, galeal scoring, and removal of the outer table of the skull. The measurement of advancement was recorded after each step, and the results were analyzed. Results The mobility of the scalp was calculated from the sagittal midline with identical arcs of rotation. With zero tension, we found that the total distance of advancement with a flap had a mean of 9.78 mm, while the advancement for the same flap after galeal scoring had a mean of 20.5 mm, and after removing the outer table, the mean advancement was 30.2 mm. Conclusion To create a tension-free closure necessary for optimal outcome for scalp defects, our study showed that increased distances were possible using galeal scoring and outer table removal, increasing the distance of advancement by 10.63 mm and 20.42 mm, respectively.

Intelligent Transportation Using Wireless Sensor Networks Blockchain and License Plate Recognition.

License Plate Recognition (LPR) is essential for the Internet of Vehicles (IoV) since license plates are a necessary characteristic for distinguishing vehicles for traffic management. As the number of vehicles on the road continues to grow, managing and controlling traffic has become increasingly complex. Large cities in particular face significant challenges, including concerns around privacy and the consumption of resources. To address these issues, the development of automatic LPR technology within the IoV has emerged as a critical area of research. By detecting and recognizing license plates on roadways, LPR can significantly enhance management and control of the transportation system. However, implementing LPR within automated transportation systems requires careful consideration of privacy and trust issues, particularly in relation to the collection and use of sensitive data. This study recommends a blockchain-based approach for IoV privacy security that makes use of LPR. A system handles the registration of a user's license plate directly on the blockchain, avoiding the gateway. The database controller may crash as the number of vehicles in the system rises. This paper proposes a privacy protection system for the IoV using license plate recognition based on blockchain. When a license plate is captured by the LPR system, the captured image is sent to the gateway responsible for managing all communications. When the user requires the license plate, the registration is done by a system connected directly to the blockchain, without going through the gateway. Moreover, in the traditional IoV system, the central authority has full authority to manage the binding of vehicle identity and public key. As the number of vehicles increases in the system, it may cause the central server to crash. Key revocation is the process in which the blockchain system analyses the behaviour of vehicles to judge malicious users and revoke their public keys.

Effectiveness of Morinda citrofolia, Sapindus mukorossi, and curcumin used in curry spice, to the radicular canal irrigant in improving bond integrity of glass fiber post.

AIM: Evaluation of the push-out bond strength (PBS) of glass fiber reinforced post (GFRP) bonded to root dentin after canal disinfection using food-based root canal irrigants i.e., Curcumin photosensitizer (CP), Riboflavin photosensitizer (RFP), Morinda ctrifolia juice (MCJ) and Sapindus mukorossi (SM) along with MTAD as a final irrigant. MATERIAL METHODS: Fifty human single-rooted premolar teeth were decoronated. Endodontic preparation was performed along with 2.25% sodium hypochlorite NaOCl solution followed by EDTA solution. Canals were dried and obturated followed by post-space preparation by removing GP. Specimens were allocated into five groups based on different food-based disinfection regimes (n = 10). Group 1: 2.25% NaOCl + MTAD (Control), Group 2: 6% MCJ + MTAD, Group 3: SM + MTAD, Group 4: CP + MTAD and Group 5: RFP + MTAD. All GFRP were bonded to radicular dentin. Root sectioning was performed followed by PBS and failure analysis using a universal testing machine (UTM) and stereomicroscope respectively. The data were analyzed using a one-way analysis of variance (ANOVA) test and the Post Hoc Tukey HSD test (p = 0.05). RESULTS: Samples disinfected with(MCJ+MTAD) at coronal third demonstrated maximum PBS (9.41 ± 0.51 MPa). However, the apical third of group 5 (RFP + MTAD) exhibited the minimum values (4.06 ± 0.23 MPa). Intergroup comparison analysis unveiled that group 2 (MCJ +MTAD) and group 3 (SM+MTAD) displayed comparable outcomes of PBS at all three-thirds. Similarly, samples in group 1 (2.25% NaOCl + MTAD), group 4 (CP + MTAD), and group 5 (RFP + MTAD) exhibited comparable PBS. CONCLUSION: Fruit-based irrigants Morinda citrifolia and Sapindus mukorossi have the potential to be used as root canal irrigants with a positive influence on bond strength.

Prevalence and Risk Factors of Asthma in Children and Adolescents in Rabigh, Western Saudi Arabia.

The worldwide prevalence of asthma in children is variable. The different epidemiological definitions of asthma, the use of various methods of measurement, and the environmental variations between countries are responsible for such different prevalence rates. This study has been performed to identify the prevalence/risk factors of asthma in Saudi children/adolescents in Rabigh. A cross-sectional epidemiological survey has been conducted using the validated Arabic version of the "International Study of Asthma and Allergies in Childhood questionnaire". Data on the sociodemographic characteristics of participants and risk factors of asthma have also been collected. Three hundred and forty-nine Children/adolescents with an age range of 5-18 years have been randomly selected for an interview from public places and houses in different regions of Rabigh City. The prevalence rates of physician-diagnosed asthma, any wheezing, and wheezing in the last 12 months among children/adolescents (mean age: 12.22 ± 4.14 years) have remarkably increased in association with the rapidly developing industrialization of Rabigh from previously recorded rates of 4.9%, 7.4%, and 6.4% in the only study that has previously been conducted in Rabigh in 1998 to 31.5%, 23.5%, and 14.9%, respectively. The univariate analysis has detected some significant risk factors for asthma. However, in younger aged children (5-9 years), allergic rhinitis, associated chronic illnesses, and viral respiratory infection-induced wheezing have remained significant risk factors of any wheezing. Drug allergy, exposure to dust, and viral respiratory infection-induced wheezing have persisted as significant risk factors for wheezing in the last 12 months. Eczema in the family, exposure to perfumes/incense, and viral respiratory infection-induced wheezing have remained as significant risk factors of physician-diagnosed asthma. The results of this survey should be useful in future targeted preventive plans/measures with special attention to improving air quality to limit the progressive increase in asthma prevalence in Rabigh, as well as in other similar industrial communities.

Clinical efficacy of 5-aminolevulinic acid-mediated photodynamic therapy versus topical antifungal agent and surgical excision for the treatment of hyperplastic candidiasis.

BACKGROUND: Hyperplastic candidiasis (HC) is a chronic infection of oral mucosa caused by Candida. Owing to its potential for malignant transformation, its intervention requires attention. Conventional surgical resection might lead to irreversible damage and impact the patient's quality of life. Hence, this study aimed to evaluate the clinical efficacy of 5-aminolevulinic acid (5-ALA)-mediated photodynamic therapy (PDT) alone and in combination with topical antifungal therapy (i.e., nystatin [combination therapy]) in comparison with nystatin and surgical resection for the treatment of HC. METHODS: Forty subjects with clinical and histopathological diagnoses of HC were included in the study. Four study groups, with 10 participants each, were formed as follows: Group-I - receiving antifungal agent [nystatin]; Group-II - receiving surgical resection; Group-III - receiving PDT; and Group-IV - receiving 5-ALA-mediated PDT and nystatin [combination therapy]. Salivary and mucosal samples were collected for the quantification of Candida albicans and the treatment responses to different interventions were recorded at week-4, week-6, and week-8 after finishing therapies. RESULTS: At the 3rd follow-up (i.e., at end of the 8th week after the interventions), complete improvement in 3 (30%), 2 (20%), 1 (10%), and 5 (50%) patients in group-I, group-II, group-III, and group-IV, respectively was observed. A statistically significant difference was obtained when the intervention responses were compared at week-4 (p<0.01), week-6 (p<0.01), and week-8 (p<0.0001) follow-ups in group-I, group-II, and group-IV subjects. At the 8-week follow-up regarding the salivary and mucosal samples, the lowest colony-forming units/milliliter score of C. albicans was observed in group-IV subjects. CONCLUSION: The application of 5-ALA-mediated PDT in combination with nystatin gel possesses the potential as a well-tolerated and safe therapeutic modality for the treatment of patients with HC.

Beneficial effects of adding magnesium to desalinated drinking water on metabolic and insulin resistance parameters among patients with type 2 diabetes mellitus: a randomized controlled clinical trial.

There is evidence that increasing the consumption of water containing magnesium can improve glucose metabolism and insulin resistance in patients with type 2 diabetes mellitus (T2DM). This trial was undertaken with the objective of evaluating the effect of adding different concentrations of magnesium chloride to the desalinated drinking water on the glycemic, metabolic, and insulin resistance parameters among patients with T2DM. A randomized cross-sectional controlled clinical trial was conducted to evaluate the effects of adding magnesium chloride supplement to desalinated drinking water consumed by patients with T2DM on the glycemic and metabolic parameters and indicators of insulin sensitivity. The total number of patients with T2DM who successfully completed the trial is 102. Patients were randomly allocated into three groups: the first group received bottled water without added magnesium (0 mg/L) (Group A, n = 37); the second group received bottled water with a low level of magnesium (20 mg/L) (Group B, n = 33); and the third group received drinking water with a high level of magnesium (50 mg/L) (Group C, n = 32). The daily consumption of elemental magnesium for a period of 3 months resulted in significant improvement in HbA1C (8.0 vs 8.2%, p = 0.04), insulin level (7.5 vs 9.9 µIU/mL, p = 0.03), and homeostasis model assessment-estimated insulin resistance (HOMA.IR) (2.5 vs 2.9, p = 0.002) in group C. However, there was no significant improvement in fasting blood glucose (FBS) level or lipid profile. The results of this study suggest that oral magnesium supplementation at the given dose of 50 mg/L daily added to drinking water could improve long-term glycemic control indicators and reduce insulin resistance in patients with T2DM.