Morphometric Analysis of the Midline Mandibular Lingual Canal and Mandibular Lingual Foramina: A Cone Beam Computed Tomography (CBCT) Evaluation.

BACKGROUND: This study aimed to evaluate the midline mandibular lingual canals and foramina and their anatomic variations using CBCT scans. METHODS: This study used retrospective analysis. A total of 320 CBCT scans were used to evaluate the study parameters, which comprised the presence or absence of the mandibular lingual foramen (MLF)/mandibular lingual canal (MLC) and its category, the distance between the buccal cortex and the start of the MLC, the distance between the inferior border of the mandible and the superior border of the foramen at its lingual and buccal terminals. The length and diameter of each canal at its lingual and buccal terminals. RESULTS: MLC was found in all included CBCT scans. Out of 320 included CBCT scans, a single canal was represented by 30.9%, double canals (Supra with Infra -spinosum) configuration appeared in 54.7%, and triple canals (Supra-Inter-Infra) represented 14.7%. The supraspinosum canals averaged 5.81 ± 2.08 mm in length and 0.87 ± 0.30 mm in diameter at the lingual terminal. In terms of the number of canals, there was a significant difference between men and women (p ≤ 0.001), with 60% of the men in the sample having double canals and 43.1% of the women having single canals. Moreover, the male gender had a higher prevalence of triple canals (21.3% vs. 8.1%) than females. Males and females were distributed equally among the supraspinosum canals, with no statistically significant difference (p ≤ 0.7). A considerable increase in the finding of interspinosum and infraspinosum canals was seen in the male sample (p ≤ 0.001). CONCLUSIONS: midline mandibular canals were found in all investigated CBCTs of the sample of both sexes; however, the anatomy and location of the MLF and canals varied significantly among the Saudi population.

A label-free electrochemical magnetic aptasensor based on exonuclease III-assisted signal amplification for determination of carcinoembryonic antigen.

A novel label-free and exonuclease III (Exo III)-assisted signal amplification electrochemical aptasensor was constructed for the determination of carcinoembryonic antigen (CEA) via magnetic field-induced self-assembly of magnetic biocomposites (Fe3O4@Au NPs-S1-S2-S3). The magnetic biocomposites were acquired by modifying double-stranded DNA (S1-S2-S3) on the surface of Fe3O4@Au nanoparticles (Fe3O4@Au NPs). Among them, Fe3O4@Au NPs were used as carriers for magnetic separation, thiolated single-stranded DNA (S1) provided signal sequence, CEA aptamer (S2) worked as a recognition element, and complementary strand (S3) was used to form double strands. In the presence of CEA, S2 bonded with CEA competitively; the exposed S1 could not be cleaved since Exo III was inactive against ssDNA. The G-quadruplex/hemin complexes finally formed with the existence of K+, and the high electrochemical signal of G-quadruplex/hemin complexes was recorded by differential pulse voltammetry (DPV) at - 0.6 V. Conversely, in the absence of CEA, dsDNA was cleaved from the 3' blunt end by Exo III; the disappearance of G-rich sequence blocked the generation of the signal. This method exhibited good selectivity and sensitivity for the determination of CEA; the linear range was from 0.1 to 200 ng mL-1 and the limit of detection was 0.4 pg mL-1. Graphical abstract.

Awareness and Level of Knowledge About Surgical Site Infections and Risks of Wound Infection Among Medical Physicians in King Abdulaziz University Hospital: Cross-Sectional Study.

BACKGROUND: Surgical site infections (SSIs) are one of the leading causes of death, and its prevention is a key element of applying the concept of patient safety and quality care. OBJECTIVE: This study aimed to assess the level of knowledge about SSIs and risks of wound infection among medical physicians in King Abdulaziz University Hospital. METHODS: All surgical and medical consultants, specialists, residents, and medical interns were invited to participate in the study. A 20-Item multiple-choice questionnaire was developed by reviewing the previous literature and with the help of a group of certified surgeons to assess the level of knowledge in all participants. RESULTS: A total of 119 doctors were included in this study. Among all respondents, 92 (77.3%) were intern doctors, 16 (13.4%) were resident doctors, and 11 (9.2%) were specialist doctors. Moreover, 66 (55.5%) doctors knew the definition of SSI. Only one-quarter, that is, 30 (25.2%) doctors knew about the incidence of SSI. In addition, 8 doctors (6.7%) had good knowledge, 75 (63.0%) had fair knowledge, and 36 (30.2%) had poor knowledge regarding SSI according to this study. CONCLUSIONS: Level of knowledge about SSIs and risks of wound infections among medical physicians should be improved to ensure better wound care and quality care for the patients.

Association between type 2 diabetes mellitus and hypothyroidism: a case-control study.

OBJECTIVES: Type 2 diabetes mellitus (DM-II) is highly prevalent in Saudi Arabia and only few studies have assessed it as a risk factor for hypothyroidism. This study aimed to examine the association between DM-II and hypothyroidism. SUBJECTS AND METHODS: We conducted a hospital-based case-control study. As cases, we included all adults admitted to King Abdulaziz University Hospital (KAUH) with laboratory-confirmed hypothyroidism. As controls, we drew a random sample of patients admitted to the orthopedic clinic at KAUH with laboratory-confirmed absence of hypothyroidism. We extracted data from the medical records regarding age, sex, presence of DM-II, HbA1c, comorbidities, treatment, and complications. We used multivariate logistic regression to identify factors associated with hypothyroidism. RESULTS: We included 121 cases and 121 controls. In comparison to controls, cases were older (P=0.005), had higher prevalence of DM-II (P<0.001), had higher levels of HbA1c (P=0.03), used insulin (P<0.001) and oral hypoglycemic drugs (P<0.001) more often, and suffered more often from hypertension (P<0.001), coronary artery disease (CAD) (P<0.001), stroke (P=0.04), diabetic foot (P<0.001), and nephropathy (P<0.001). According to multivariate regression, the risk of hypothyroidism was significantly increased among patients with DM-II (OR=4.14; 95% CI=20.20-7.80; P<0.001) and CAD (OR=14.15; 95% CI=1.80-111.43; P=0.01). CONCLUSION: Patients with DM-II were at increased risk of developing hypothyroidism. Adequate management and control of DM-II might reduce the risk of developing hypothyroidism. Further research using a prospective cohort study design is needed to confirm these findings. KEY MESSAGES: Patients with DM-II had an increased risk of developing hypothyroidism.

Impact of liver cirrhosis due to chronic hepatitis C viral infection on the outcome of ovarian cancer: a prospective study.

BACKGROUND: This study was designed to investigate the impact of liver cirrhosis due to chronic hepatitis C virus (HCV) infection on the disease-free and overall survival of ovarian cancer patients undergoing a standard primary operation followed by standard chemotherapy. Attainment of the operative goals, intra- and postoperative events, possible complications under chemotherapy necessitating the termination of treatment, and the impact of ovarian cancer treatment on liver function were assessed. METHODS: This was a prospective observational study that included only patients with primary epithelial ovarian cancer. Only patients with Child-Turcotte-Pugh classification class A disease were recruited. Patients were divided into two groups according to whether they had liver cirrhosis. All the patients underwent primary debulking surgery followed by 6 cycles of chemotherapy, and were followed-up for 24 months after chemotherapy was completed. RESULTS: We recruited 77 patients, 19 of whom had liver cirrhosis. There were no significant differences between patients with or without liver cirrhosis with respect to tumor stage, histopathological type, tumor grade, or optimal operative debulking. There was no registered liver dysfunction-related mortality in the follow-up period, and there were no statistically significant differences between the groups with respect to disease-free or overall survival (p = 0.719 and p = 0.524, respectively). CONCLUSION: From the results of this study, we conclude that compensated liver cirrhosis (Child-Turcotte-Pugh class A) due to chronic HCV infection affects neither the disease-free nor the overall survival of ovarian cancer patients, regardless of their stage. This study shows that it is possible to treat ovarian cancer patients with cirrhosis caused by HCV infection the same as any other patient; treatment does not have to be adjusted as long as the patients have Class A disease.

The EXIT procedure: principles, pitfalls, and progress.

Although performing procedures on a fetus before severing the umbilical cord has previously been reported, the principles of the ex utero intrapartum treatment (EXIT) procedure were first fully developed for reversing tracheal occlusion in fetuses with severe congenital diaphragmatic hernia. The EXIT procedure offers the advantage of insuring uteroplacental gas exchange while on placental support. The lessons learned in the development of the principles that underlie the EXIT procedure have improved outcomes when applied in other conditions, most notably in cases of airway obstruction. The range of indications for the EXIT procedure has expanded and currently includes giant fetal neck masses, lung or mediastinal tumors, congenital high airway obstruction syndrome, and EXIT to ECMO (extracorporeal membrane oxygenation), among others. This review summarizes the underlying principles of the EXIT procedure, the expanding indications for its use, the pitfalls of management, and the progress that has been made in its successful application.