Knowledge of and Attitude Toward Preventive Care Among Iraqi Dentists and Senior Dental Students: A Cross-Sectional Study.

OBJECTIVES: Acquiring knowledge and maintaining a positive mindset are essential for dental care providers to offer optimal dental services. Dental professionals are expected to follow preventive dentistry principles to ensure the best oral health maintenance for their patients, as prevention is a key component of public health initiatives. This study aims to assess the knowledge and attitudes toward preventive dental care among Iraqi dentists and senior dental students. METHODOLOGY: A cross-sectional study, conducted from June to August 2023, involved 876 Iraqi dentists and 587 senior dental students in Baghdad, utilizing a physically paper-based self-administered questionnaire. Participants' level of knowledge was assessed based on a 5-point Likert scale to 12 statements on preventive dental care. Their attitudes were inquired by selecting one option from a 7-point Likert scale on four pairs of bipolar adjectives describing preventive dentistry. Higher scores were considered more accurate knowledge and more positive attitudes. Statistical evaluation included the Chi-square test and regression analysis. RESULTS: In total, data from 841 dentists and 567 students were analyzed (response rate: 96%). Around 90% of dentists (N=745) and students (N=502) acknowledged the impact of sugar, sealant, and water fluoridation on dental caries, but about 80% of dentists (N=662) and students (N=446) undervalued the role of fluoridated toothpaste. Women (OR=1.4, 95% CI: 1.02-2.1) and dentists, within one year of their graduation (OR=1.9, 95% CI: 1.1-3.5), exhibited higher levels of knowledge. More favorable attitudes towards preventive dentistry were associated with a higher level of knowledge among dentists (OR=1.6, 95% CI: 1.2-2.3). Regarding dental students, those from private dental schools showed higher scores of knowledge than their counterparts from public schools (OR=2.1, 95% CI: 1.3-3.4). The majority of participants held the belief that preventive dentistry is beneficial for the community but just about 60% of dentists (N=477) and students (N=300) exhibited a positive attitude toward the economic advantages of preventive dentistry for dentists, as well as the ease of engaging in preventive dental practices. CONCLUSIONS: The dentists and dental students in this study demonstrated satisfactory knowledge and a favorable attitude toward most aspects of preventive dentistry. However, deficiencies were noted in certain areas, such as the application of topical fluoride for preventing dental caries, as well as a substantial proportion of individuals who lacked a positive perspective on the economic benefits of preventive dentistry. Hence, there is a clear need for educational interventions during their undergraduate training and postgraduate continuing education to enhance their knowledge levels and cultivate a more positive attitude towards preventive dentistry.

Cochlear Aqueduct Post-Natal Growth: A Computed Tomography Study.

The cochlear aqueduct (CA) is a bony canal located at the base of the scala tympani of the cochlea. It connects the inner ear perilymph fluid to the cerebrospinal fluid of the posterior cerebral fossa. Its function is not well understood, as it seems to be patent in only a fraction of adult patients. Indirect observations argue in favor of the CA being more patent in children. To study the CA morphology in children, we performed a retrospective single-center study of 85 high-resolution temporal bone computed tomography (hrCT) scans of children with a mean age of 3.23 ± 3.07 years (13 days of life up to 18 years), and compared them with a group of 22 adult hrCT (mean age of 24.01 ± 3.58 years). The CA morphology measurements included its total length, its funnel (wider intracranial portion) length and width and its type (indicating its radiological patency), according to a previously published classification. The dimensions of the CA were significantly smaller in children compared with adults for the axial length (10.37 ± 2.58 versus 14.63 ± 2.40 mm, respectively, p < 0,001) and the funnel length (3.94 ± 1.59 versus 6.01 ± 1.77 mm, respectively, p < 0,001). The funnel width tended to be smaller but the difference was not significant: 3.49 ± 1,33 versus 3.89 ± 1.07 mm, p = 0,22. The repartition of types of CA was also statistically different. The CA appeared to be more identifiable in the children population. Type 1 (CA visible along its entire course) accounted for 42% (36/85) of children and only 5% (1/22) of adults, type 2 (visible in the medial two thirds) for 30% (25/85) versus 31% (7/22), type 3 (not visible completely along the medial two thirds) for 27% (23/85) versus 50% (11/22). Finally, type 4 (undetectable) was found in only 1% (1/85) of children and 14% (3/22) of adults (p < 0,001). Our study showed significant postnatal growth of the length of the CA, which was more rapid before the age of 2, and slowed after 6 years of age. Its width increased less, with children older than 2 years presenting a similar width to adults. The CA was more identifiable in hrCT in children, arguing for a more permeable tract. The number of completely ossified CA was significantly lower in the children population. These findings highlight the differences between the CA morphology in adults and children and raise the question of differences in function. Moreover, these differences may impact the pharmacodynamics of drugs or vectors delivered into the pediatric inner ear. Further studies are required, both on the anatomy of temporal bones and on the function of the CA in children.

Detection of antibodies against paramyxoviruses in tortoises.

Sera from a total of 202 tortoises from six countries and nine species were tested for antibodies against four different reptilian paramyxoviruses (ferlaviruses, ferlaVs) by hemagglutination inhibition (HI) test. The viruses used were a tortoise PMV (tPMV) and three squamatid PMV isolates, each belonging to a different subgroup of ferlaV within the genus Ferlavirus. HI tests revealed that antibodies against ferlaVs occurred regularly in the tested samples (5.5%). One and a half percent of the tested samples have measurable antibody titers against the group A isolate, 3% had antibodies against the group B isolate, and 1% had antibodies against the group C isolate. The significantly highest number of positive reactions was detected against the tortoise isolate (5%). Most of the animals that tested positive for one of the snake isolates also tested positive in HI assays with the tortoise isolate. Of the samples from different origins, the sera from Great Britain showed the highest percentage of positive tested animals (10.3%, n = 39), followed by those from Spain (10%, n = 10), while none of the samples from Madagascar or Italy scored positive. Since in most cases animals from one country came from the same collection, this does not represent the real prevalence of ferlaV in tortoises in these countries but rather indicates that ferlaVs occur in a number of different countries and tortoise species.

The remission rate, metabolic changes, and quality of life assessment among patients with type 2 diabetes post-bariatric surgery in Riyadh, Saudi Arabia: A cross-sectional study.

OBJECTIVES: To assess the remission rate, metabolic changes, and quality of life after bariatric surgery among Saudi patients with type 2 diabetes (T2DM). METHODS: This cross-sectional study was conducted in 2 main centers in the Riyadh, Saudi Arabia. The study included patients with T2DM who underwent either laparoscopic sleeve gastrectomy (LSG) or Roux-en-Y gastric bypass (RYGB) surgery from 2014 to 2018. The remission rate was defined based on the American Diabetes Association (ADA) and the International Diabetes Federation (IDF) criteria. Quality of life was assessed using the World Health Organization Quality of Life (WHOQOL)-BREF. RESULTS: A total of 232 patients were included with a mean age of 44.3 ± 10.3 years. 93.4% of the patients had LSG, while only 6.6% had RYGB surgery. Among patients who underwent either LSG or RYGB surgery, there was a significant improvement in metabolic and glycemic markers compared to the baseline. According to the ADA criteria, 48.5% of the patients had complete remission, while 18.9% had partial remission. Overall, 7% of the patients met the IDF optimization criteria, while 5.7% met the IDF improvement criteria. The mean score for all the QOL domains exceeded 63 ± 13, with the environmental and physical health domains having the highest scores. CONCLUSION: Among Saudi patients, bariatric surgery was associated with high remission rates and a better quality of life.

Role of water fleas (Daphnia magna) in the accumulation of avian influenza viruses from the surrounding water.

OBJECTIVE: To determine the role of water fleas in accumulating avian influenza viruses (AIV) from the surrounding water and to estimate their role as a vector of AIV. METHODS: Water fleas were exposed to H4N6 and H5N1 AIV-contaminated water in a closed system. The potential of water fleas to take up and retain the viruses was estimated by quantitative real-time RT-PCR (qRRT-PCR) and titration on cell culture. RESULTS: Contamination trials showed that significantly higher amounts of viral RNA were detectable per gram of water fleas as compared to per milliliter of the surrounding water at 1, 4, and 6 days of incubation. Viral infectivity was only detectable in the water samples collected immediately after mixing the virus in water containing the water fleas, while no virus was detectable in any of the water fleas or water samples collected afterwards. CONCLUSIONS: Water fleas are able to accumulate AIV from surrounding water based upon the qRRT-PCR detection of viral RNA. Additional studies are necessary to investigate the inactivation potential of water fleas on viral infectivity.

Importance of preventive dentistry in the elderly: A personal approach.

Background: Oral diseases and their impact on health and quality of life have now evolved into a polarized epidemiological state in which their incidence is especially affecting the most vulnerable in the population: the elderly, especially those with low incomes economical. On the other hand, the noticeable increase observed in the proportion of older adults in developing countries such as Iraq during the last decades. Such a high proportion of older adults is causing an increase in their stomatological care needs that necessitate dentists to know precisely both the etiological factors, such as the pathogenesis and factors that determine the specificity of oral disorders at this stage of life. Only with this knowledge will professionals be able to face these patients with a modern dentistry based on prevention. The objective of the study was to show the impact of oral health on the quality of life of older adults in Iraq. Materials and Methods: A cross-sectional study was conducted in Iraqi adults focused on demographic characteristics factors, lifestyle, the Geriatric Oral Health Index, and Oral Health Diagnosis. Data were evaluated using ratios, the Chi-square analysis for the correlation among factors and odds ratios to verify statistical significance at P ≤ 0.05. Results: This research confirms the impact of oral health on the quality of life of older adults in Iraq. Endodontic problems compromise the quality of life of older adults. Conclusion: Oral health problems, especially those of traumatic, endodontic, and periodontal origin, negatively affect the quality of life of older adults in Iraq.

Emergency department presentations of alcohol and other substance misuse: first cross-sectional national study in Qatar.

OBJECTIVES: This study attempts the first in a series of investigations into the misuse of alcohol and substances in Qatar. This study explores the emergency presentations of alcohol and substance abuse to all the state funded emergency departments (EDs) in the country which serve around 90% of the population over a 22-month period. Due to legal penalties for alcohol and substance use, and lack of subsidised community-based facilities, ED presentations are a good starting point to explore this burden. DESIGN AND PARTICIPANTS: A retrospective population-based, cross-sectional study, analysing electronic patient records of all state funded EDs spanning a period of 22 months, from 1 January 2019 to 31 October 2020 was carried out. The study included all eligible individuals aged 18 or over. Primary reason/diagnosis for presentation containing any of the alcohol or substance use key words were included in the study using composite data capture forms by trained clinicians. RESULTS: An overwhelming majority (95.5%) of the total 1495 cases presenting to the EDs with substance abuse were using alcohol. Only 2.1% of the cases were females. Those of Asian (non-Arab) constituted 70% of this group. Qatari citizens presented with highest proportion of substance abuse other than alcohol (23%). Overall, 2.26% of all presentations to the EDs were related to alcohol and substance abuse and this amounted to 3 ED visits per 10 000 of population per year. 56.6% of the cases presented over the weekend. Less than 1% were referred to psychiatry and no other meaningful rehabilitative interventions were offered to others. CONCLUSION: As Qatar moves towards establishing community-based rehabilitative resources for alcohol and substances abuse, the findings from this study will help in shaping these developments. These can include ED-based routine screening for alcohol abuse and referral to rehabilitation services without fear of legal penalties.

Comparison of Some Salivary Characteristics in Iraqi Children with Early Childhood Caries (ECC) and Children without Early Childhood Caries.

BACKGROUND: Early Childhood Caries (ECC) is a unique form of caries that develops in temporary dentition. It has a multifactorial infectious disease. Saliva is one of the most important factors, which has an important protective effect against tooth decay when its multiple characteristics and functions are normal. The study aimed to compare some salivary characteristics in children with ECC and children without ECC. MATERIALS AND METHODS: Case-control, cross-sectional observational study. The 77 pre-schoolers aged 37 to 72 months (12 with ECC, 26 with ECC-S, and 39 without ECC) examined and we collected the stimulated saliva. The pH microelectrode was used to determine pH and buffer capacity; a formula that involves volume, collection time, and specific saliva weight was used to test the salivary flow rate. The potentiometric and phosphate methods were used to determine fluoride through spectrophotometric, colorimetric absorption techniques. RESULTS: The results got to show that there are no statistically significant differences in pH, buffer capacity, salivary flow rate, and levels of fluoride and phosphate, in children with ECC, ECC-S, and without ECC. The risk factors, such as mother's education, bottle use, brushing frequency, and previous dental care of the child are more important at the time of developing ECC than some salivary variables. CONCLUSION: The risk factors, such as mother's education, bottle use, brushing frequency, and previous dental care of the child are more important at the time of developing ECC than some salivary variables such as pH, buffer capacity, salivary flow rate, and levels of fluoride and phosphate.

Three genetically distinct ferlaviruses have varying effects on infected corn snakes (Pantherophis guttatus).

Ferlaviruses are important pathogens in snakes and other reptiles. They cause respiratory and neurological disease in infected animals and can cause severe disease outbreaks. Isolates from this genus can be divided into four genogroups-A, B, and C, as well as a more distantly related sister group, "tortoise". Sequences from large portions (5.3 kb) of the genomes of a variety of ferlavirus isolates from genogroups A, B, and C, including the genes coding the surface glycoproteins F and HN as well as the L protein were determined and compared. In silico analyses of the glycoproteins of genogroup A, B, and C isolates were carried out. Three isolates representing these three genogroups were used in transmission studies with corn snakes (Pantherophis guttatus), and clinical signs, gross and histopathology, electronmicroscopic changes in the lungs, and isolation of bacteria from the lungs were evaluated. Analysis of the sequences supported the previous categorization of ferlaviruses into four genogroups, and criteria for definition of ferlavirus genogroups and species were established based on sequence identities (80% resp. 90%). Analysis of the ferlavirus glycoprotein models showed parallels to corresponding regions of other paramyxoviruses. The transmission studies showed clear differences in the pathogenicities of the three virus isolates used. The genogroup B isolate was the most and the group A virus the least pathogenic. Reasons for these differences were not clear based on the differences in the putative structures of their respective glycoproteins, although e.g. residue and consequential structure variation of an extended cleavage site or changes in electrostatic charges at enzyme binding sites could play a role. The presence of bacteria in the lungs of the infected animals also clearly corresponded to increased pathogenicity. This study contributes to knowledge about the structure and phylogeny of ferlaviruses and lucidly demonstrates differences in pathogenicity between strains of different genogroups.

A novel type of paramyxovirus found in Hungary in a masked water snake (Homalopsis buccata) with pneumonia supports the suggested new taxonomy within the Ferlavirus genus.

During the course of a longitudinal survey on the occurrence of viruses in Hungarian exotic reptile collections a dead masked water snake (Homalopsis buccata) was submitted for virologic examination in September 2009. Based on history, gross pathological and histopathological findings paramyxovirus infection was suspected and later confirmed by RT-PCR and sequencing of the RNA dependent RNA polymerase (L), the hemaggluitinin-neuraminidase (HN) and the unknown (U) genes. Sequence analyses revealed that the detected virus, HoBuc-HUN09, belongs to the recently described "group C" within the genus Ferlavirus. Our paper presents the first description of this novel reptilian paramyxovirus from a homalopsid snake with mucopurulent pneumonia in Hungary.

A unique novel reptilian paramyxovirus, four atadenovirus types and a reovirus identified in a concurrent infection of a corn snake (Pantherophis guttatus) collection in Germany.

In 2009, 26 clinical samples (organs and oral/cloacal swabs) from a total of 24 corn snakes (Pantherophis guttatus) from a single owner were sent to our laboratory to be tested for the presence of viruses. Paramyxoviruses (PMV), adenoviruses (AdV) and reoviruses were detected by RT-PCR, PCR and virus isolation methods. Three snakes were infected with all three viruses at the same time, while two other snakes had a double infection (PMV and reo, AdV and reo) and nine other snakes had a single infection with any of the three viruses. No viruses were detected in 10 animals. All isolated reoviruses were identical to one another and to the reptilian orthoreovirus isolate 55-02 in the partial RNA dependent RNA polymerase (RDRP) gene sequence. AdV partial polymerase sequences represented four different types, one of which was first described here: most similar to SnAdV-1, while the other three were identical to known types: SnAV-1, -2 and -3. However, the detected single PMV differed distinctly from described reptile PMV and was a new type. According to partial L gene, HN gene and U gene sequences it may be the first described representative of a third squamatid PMV cluster: "group C" within the proposed reptilian PMV genus "Ferlavirus". Nucleotide identity values for the L gene of the new PMV compared to group A viruses range between 76.5 and 80.3%, and between 80.5 and 81.2% compared to group B viruses. For the HN gene, these values were similar: 78.2-80% (A) and 79.9-80.5% (B) and somewhat lower for the U gene: 72.7-75.4% (A) and 69.7-70% (B). No reports on the prevalence of concurrent viral infection in captive snake populations have been published so far. The possibility of concurrent infection with several different viruses and subsequent consequences for animal health should be kept in mind when testing reptile samples for viruses.

Use of filter carrier technique to measure the persistence of avian influenza viruses in wet environmental conditions.

A germ carrier technique was adapted for the determination of the persistence of influenza viruses in moist environments. The technique was employed with 3 low pathogenic avian influenza viruses (H4N6, H5N1, and H6N8), one human influenza virus (H1N1), and two model viruses (NDV and ECBO) in lake water at five different temperatures (30, 20, 10, 0, and -10°C). Viral quantitation was carried out at regular intervals on cell culture for a maximum duration of 16 weeks. Serial data were analyzed by linear regression model to calculate T-90 values (time required for one log reduction in the virus titer). Persistence of all of the viruses was highest at -10°C followed by 0, 10, 20, and 30°C. At -10°C, the single freeze-thaw cycle resulted in an abrupt decline in the virus titer, followed by long term persistence. Generally, influenza viruses persisted shorter than model viruses while ECBO has the highest survival time in lake water. Individual influenza viruses differed in their persistence at all temperatures. The findings of the present study suggest that AIV can remain infectious in lake water for extended periods of time at low temperatures.