The Impact of Artificial Intelligence on Dental Implantology: A Narrative Review.

Implant dentistry has witnessed a transformative shift with the integration of artificial intelligence (AI) technologies. This article explores the role of AI in implant dentistry, emphasizing its impact on diagnostics, treatment planning, and patient outcomes. AI-driven image analysis and deep learning algorithms enhance the precision of implant placement, reducing risks and optimizing aesthetics. Moreover, AI-driven data analytics provide valuable insights into patient-specific treatment strategies, improving overall success rates. As AI continues to evolve, it promises to reshape the landscape of implant dentistry and lead in an era of personalized and efficient oral healthcare.

Liver Transplantation in a Child With Crigler-Najjar Syndrome Type I: A Case Report With Review of the Literature.

Crigler-Najjar syndrome (CNS) type I is a rare genetic disease caused by mutations in the UGT1A1 gene, resulting in a lack of Uridine 5'-diphospho-glucuronosyltransferase (UDPGT) enzyme. This enzyme is responsible for the glucuronidation and elimination of unconjugated bilirubin from the body. Here we report a two-month-old Saudi girl who presented with persistent unconjugated hyperbilirubinemia, reaching levels as high as 30 mg/dL despite ineffective phototherapy. The diagnosis was confirmed through sequencing, and the patient underwent a successful liver transplant at the age of two months. At the one-year follow-up, the patient is doing well. This case highlights the significance of early detection and appropriate management of CNS, emphasizing the need for prompt intervention to improve patient outcomes and prevent complications. While phototherapy offers some benefits, liver transplantation remains the only definitive treatment for this condition.

Prevalence and Determinants of Social Media Addiction among Medical Students in a Selected University in Saudi Arabia: A Cross-Sectional Study.

Social media addiction has become a serious public health concern due to its adverse psychological effects. Therefore, the purpose of this study was to assess the prevalence and determinants of social media addiction among medical students in Saudi Arabia. A cross-sectional study was designed. Participants (n = 326) from King Khalid University in Saudi Arabia completed the sociodemographic information, patient health questionnaire-9 scale, and the generalized anxiety disorder-7 tool to measure explanatory variables. The Bergen social media addiction scale (BSMAS) was used to measure social media addiction. A multiple linear regression model was fitted to investigate the predictors of social media addiction. The prevalence of social media addiction among study participants was 55.2% (mean BSMAS score: 16.6). According to the adjusted linear regression, male students had higher social media addiction scores than their female counterparts (ß = 4.52, p < 0.001). Students' academic performance was negatively associated with social media addiction scores. Moreover, students with symptoms of depression (ß = 1.85, p = 0.005) or anxiety (ß = 2.79, p = 0.003) had a higher BSMAS score compared to their counterparts. Further longitudinal studies are warranted to identify the causal factors of social media addiction, which would assist intervention initiatives by policymakers.

The Prevalence and Associated Predictors for Diabetes Mellitus in Adult Patients With Thyroid Nodules.

Background: Diabetes mellitus (DM) and thyroid nodules (TNs) with the risk of malignancy are increasing globally. Hence, we conducted this study to evaluate the prevalence and the associated predictors for DM among adult patients with TNs in Royal Commission Hospital, Kingdom of Saudi Arabia (KSA). Methods: A retrospective study was conducted between January 1, 2015 and December 31, 2021. Patients with documented TNs based on the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) were recruited. Then the prevalence and associated risk factors for DM were assessed. Result: Three hundred ninety-one patients who had TNs were recruited. The median (interquartile range (IQR)) age was 46.00 (20.0) years, and 332 (84.9%) of the patients were females. There was a high prevalence of DM (24.0%) among adult patients with TNs. In the univariate analysis, there were significant associations between diagnosed DM among adult patients with TNs and age, gender, 25-hydroxyvitamin D (25(OH)D) level, hypertension, bronchial asthma, free triiodothyronine (FT3), white blood cell count, low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglycerides. In the multivariate analysis, there were significant associations between diagnosed DM among adult patients with TNs and age (odds ratio (OR) 1.037 (95% confidence interval (CI) 1.012 - 1.062)), hypertension (OR 0.374 (95% CI 0.203 - 0.689)), FT3 level (OR 0.635 (95% CI 0.412 - 0.980)), LDL (OR 0.643 (95% CI 0.456 - 0.907)) and HDL (OR 0.654 (95% CI 0.465 - 0.919)). Conclusion: There was a high prevalence of DM among patients with TNs. Age, hypertension, FT3, LDL and HDL were significantly associated with DM and TNs.

Prevalence and Associated Predictors of Hypertension in Adult Patients with Thyroid Nodules at the Royal Commission Hospital, Kingdom of Saudi Arabia.

Background: Hypertension and thyroid nodules (TNs) are common medical problems that are increasing in prevalence globally. Hence, we conducted this study to assess the prevalence and associated predictors of hypertension in adult patients with TNs at the Royal Commission Hospital, Kingdom of Saudi Arabia (KSA). Methods: A retrospective study was conducted between 1 January 2015 and 31 December 2021. Patients with documented TNs based on the Thyroid Imaging Reporting and Data System (TI-RADS) were recruited to assess the prevalence and associated risk factors for hypertension. Result: Three hundred ninety-one patients with TNs were recruited for this study. The median (interquartile range, IQR) age was 46.00 (20.0) years, and 332 (84.9%) of the patients were females. The median (IQR) body mass index (BMI) was 30.26 (7.71) kg/m2. There was a high prevalence of hypertension (22.5%) in adult patients with TNs. In the univariate analysis, there were significant associations between diagnosed hypertension in patients with TNs and age, sex, diabetes mellitus (DM), bronchial asthma, triiodothyronine (FT3), total cholesterol and high-density lipoprotein (HDL). In the multivariate analysis, age (OR = 1.076 [95% CI 1.048 - 1.105]), sex (OR = 2.28 [95% CI 1.132 - 4.591]), DM (OR = 0.316 [95% CI 0.175 - 0.573]) and total cholesterol levels (OR = 0.820 [95% CI 0.694 - 0.969]) were significantly associated with hypertension. Conclusion: There is a high prevalence of hypertension in patients with TNs. Age, female sex, DM and elevated total cholesterol are significant predictors of hypertension in adult patients with TNs.

Correction: Association Between Body Mass Index and Response to Disease-Modifying Therapies in Patients With Relapsing-Remitting Multiple Sclerosis at King Abdulaziz University Hospital: A Retrospective Study.

[This corrects the article DOI: 10.7759/cureus.32695.].

Association Between Body Mass Index and Response to Disease-Modifying Therapies in Patients With Relapsing-Remitting Multiple Sclerosis at King Abdulaziz University Hospital: A Retrospective Study.

Background Multiple sclerosis (MS) is an immune-mediated inflammatory disease that attacks myelinated axons in the central nervous system, destroying the myelin and axon to varying degrees and producing significant physical disability. So far, many studies have found that having a high body mass index (BMI) is associated with severe autoimmune and neurodegenerative disease course. However, the impact of BMI on disease-modifying therapy (DMT) response in terms of decreasing relapses and improving overall health remains unknown. Aims and objectives The study aimed to demonstrate the effect of BMI on DMT responsiveness in patients with relapse-remitting MS at a tertiary hospital. Methods and material A single-center retrospective study was conducted at a tertiary care center in Jeddah, Saudi Arabia. The study included 89 individuals with relapsing-remitting MS who had their BMI measured within six months of their first clinical relapse, as well as their clinical response to the DMT (number of relapses on a single DMT after six months of initiation) and MRI changes (development of new T2 lesions or gadolinium-enhancing lesions on single DMT six months after DMT initiation). Results Demographic data revealed a female predominance of 71.9%, and 51.7% of the patients had a normal weight. The most commonly prescribed DMT was Gilenya at 47.2%. A significant relationship was found between BMI and the total number of clinical relapses (p=0.038), with the co-existence of a positive correlation between BMI and the number of relapses after at least six months of initiation of DMT. Additionally, MS patients who had both positive MRI changes and obesity had a significantly higher BMI mean than non-obese. Conclusion Increased BMI appeared to be associated with a lower response to DMT, as overweight patients had a worse course than normal and underweight patients. Pharmacokinetic differences are the most likely factors implicated in medication responsiveness.

Thermostable and O2-Insensitive Pyruvate Decarboxylases from Thermoacidophilic Archaea Catalyzing the Production of Acetaldehyde.

Pyruvate decarboxylase (PDC) is a key enzyme involved in ethanol fermentation, and it catalyzes the decarboxylation of pyruvate to acetaldehyde and CO2. Bifunctional PORs/PDCs that also have additional pyruvate:ferredoxin oxidoreductase (POR) activity are found in hyperthermophiles, and they are mostly oxygen-sensitive and CoA-dependent. Thermostable and oxygen-stable PDC activity is highly desirable for biotechnological applications. The enzymes from the thermoacidophiles Saccharolobus (formerly Sulfolobus) solfataricus (Ss, Topt = 80 °C) and Sulfolobus acidocaldarius (Sa, Topt = 80 °C) were purified and characterized, and their biophysical and biochemical properties were determined comparatively. Both enzymes were shown to be heterodimeric, and their two subunits were determined by SDS-PAGE to be 37 ± 3 kDa and 65 ± 2 kDa, respectively. The purified enzymes from S. solfataricus and S. acidocaldarius showed both PDC and POR activities which were CoA-dependent, and they were thermostable with half-life times of 2.9 ± 1 and 1.1 ± 1 h at 80 °C, respectively. There was no loss of activity in the presence of oxygen. Optimal pH values for their PDC and POR activity were determined to be 7.9 and 8.6, respectively. In conclusion, both thermostable SsPOR/PDC and SaPOR/PDC catalyze the CoA-dependent production of acetaldehyde from pyruvate in the presence of oxygen.

Favipiravir and Hydroxychloroquine Combination Therapy in Patients with Moderate to Severe COVID-19 (FACCT Trial): An Open-Label, Multicenter, Randomized, Controlled Trial.

INTRODUCTION: Antiviral drugs have shown limited effectiveness in treating patients with coronavirus disease 2019 (COVID-19). We aimed to assess the effects of a favipiravir and hydroxychloroquine combination on treating moderate-to-severe COVID-19 patients. METHODS: An investigator-initiated, multicenter, open-label, randomized trial at nine hospitals. Eligible patients were adults with moderate-to-severe COVID-19 defined as oxygen saturation (SaO2) of ≤ 94% while breathing ambient air or significant clinical symptoms with chest x-ray changes requiring hospital admission. Randomization was in a 1:1 ratio to receive standard care (control group) or standard care plus favipiravir and hydroxychloroquine. The primary outcome was time to clinical improvement of two points (from the status at randomization) on a seven-category ordinal scale or live discharge from the hospital within 14 days. Analyses were done in an intention-to-treat population. RESULTS: From May 2020 to Jan 2021, 254 patients were enrolled; 129 were assigned to standard of care and 125 to the treatment. The mean age was 52 (± 13) years, and 103 (41%) were women. At randomization, six patients were on invasive mechanical ventilation, 229 (90.15%) were requiring supplemental oxygen only (with or without non-invasive ventilation), and 19 (7.48%) were receiving neither. The time to clinical improvement was not significantly different between the groups: median of 9 days in the treatment group and 7 days in the control group (HR: 0.845; 95% CI 0.617-1.157; p-value = 0.29). The 28-day mortality was not significantly different between the groups (7.63% treatment) vs. (10.32% control); p-value = 0.45. The most prevalent adverse events were headache, elevation in ALT, and the prolonged QTc interval in the treatment group. CONCLUSION: The combination of favipiravir and hydroxychloroquine did not result in a statistically significant clinical benefit in patients with moderate-to-severe COVID-19. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov (NCT04392973).

Factors and Determinants of Choosing Pathology as a Future Career: Results From a Multi-Institution Study.

Background Globally, less than 10% of graduating medical students select pathology as a future career. Many factors were reported from different settings to influence the choice of pathology. The aim of this study was to investigate the factors that determine medical students' preferences in choosing pathology as a future career. Methods This cross-sectional study surveyed students from three governmental medical schools in Riyadh, Saudi Arabia. A self-administered questionnaire that contained demographic questions and items that addressed perceived factors that affect the choice of pathology was distributed to medical students. Collected data were analyzed using Statistical Product and Service Solutions (SPSS) Statistics for Windows, Version 25.0 (Armonk, NY: IBM Corp). A chi-square test was used to determine the association between independent variables and interest in pathology. Results Out of the 400 questionnaires distributed, 338 students completed the survey with a response rate of 84.5%. Overall, surgery (24%) and internal medicine (20%) were the most favored, specialties with only 5% of the students selecting pathology as their first choice. Patient-doctor interaction (72.2%) was perceived as the most important factor in not choosing pathology as a future career. Taking an elective course, younger age groups, and year in medical school were all significantly associated (p<0.001) with an interest in pathology. Conclusion In this study, most of the students indicated surgery and internal medicine as their first specialty choices. Only 5% of the students chose pathology as their first choice. Two-thirds of medical students perceived pathologists do not interact with patients. A significant association was found between younger age groups, enrolling for a pathology course, and having an interest in pathology.

Prevalence and Determinants of Multidrug-Resistant Tuberculosis in Makkah, Saudi Arabia.

BACKGROUND AND OBJECTIVES: Tuberculosis (TB) is a global public health issue. The emergence of multidrug-resistant (MDR) TB has further complicated the situation in the form of poor treatment outcomes and costs to individuals and health-care systems. We therefore aimed to measure the prevalence and associated risk factors of MDR TB among TB patients in Makkah city. PATIENTS AND METHODS: This was a cross-sectional study conducted at Al-Noor Specialist Hospital, a public-sector hospital in Makkah. We included records of 158 confirmed TB patients from the list of all patients admitted in the hospital from January 2009 to January 2019 by systematic random sampling. Data were collected on socio-demographics, clinical profile and drug resistance patterns. Analysis was done in SPSS version 21.0. RESULTS: The mean age of the participants was 43.4 ± 18.7 years, and two-thirds (66.5%) were male. About 40% of the patients had chronic disease while lung disease other than TB was present in 5% patients. About 13% of cases were extrapulmonary infections. Prevalence of drug resistance was found to be 17.1% among TB patients. Among the resistant cases, streptomycin (25.9%) and isoniazid (11.1%) were the drugs most commonly affected by resistance. Prevalence of MDR TB was 5% among TB patients. Age, smoking, lung disease and previous TB were significant factors associated with MDR TB. CONCLUSION: Prevalence of MDR TB, although comparable to current national estimates, is higher compared to previous reports. There is a need to reduce this burden through strengthening TB control programs to prevent further emergence of a public health threat of MDR TB. History of previous TB was the strongest risk factor in this study. This calls physicians, program managers and policy makers to focus on counselling and support of TB patients for compliance with the regimen to complete treatment without interruption.

The impact of law enforcement on dispensing antibiotics without prescription: a multi-methods study from Saudi Arabia.

Background: Dispensing of antibiotics without a prescription (DAwP) has been widely practised among community pharmacies in Saudi Arabia despite being illegal. However, in May 2018, the law and regulations were enforced alongside fines. Consequently, we wanted to evaluate the impact of these changes.Methods: A study was conducted among 116 community pharmacies in two phases. A pre-law enforcement phase between December 2017 and March 2018 and a post-law enforcement phase one year later. Each phase consisted of a cross-sectional questionnaire-based survey and a simulated client method (SCM) approach. In the SCM, clients presented with either pharyngitis or urinary tract infections (UTI). In SCM, for each phase, all 116 pharmacies were visited with one of the scenarios.Results: Before the law enforcement, 70.7% of community pharmacists reported that DAwP was common with 96.6% and 87.7% of participating pharmacies dispensed antibiotics without a prescription for pharyngitis and UTI respectively. After the law enforcement, only 12.9% reported that DAwP is still a common practice, with only 12.1% and 5.2% dispensing antibiotics without prescriptions for pharyngitis and UTI respectively.Conclusion: law enforcement was effective. However, there is still further scope for improvement. This could include further educational activities with pharmacists, physicians and the public.