Diagnostic Utility of MOG Antibody Testing in Cerebrospinal Fluid.

OBJECTIVE: The aim of this study was to assess the diagnostic utility of cerebrospinal fluid (CSF) myelin oligodendrocyte glycoprotein antibodies (MOG-IgG) testing. METHODS: We retrospectively identified patients for CSF MOG-IgG testing from January 1, 1996, to May 1, 2023, at Mayo Clinic and other medical centers that sent CSF MOG-IgG for testing including: controls, 282; serum MOG-IgG positive MOG antibody-associated disease (MOGAD), 74; serum MOG-IgG negative high-risk phenotypes, 73; serum false positive MOG-IgG with alternative diagnoses, 18. A live cell-based assay assessed CSF MOG-IgG positivity (IgG-binding-index [IBI], ≥2.5) using multiple anti-human secondary antibodies and end-titers were calculated if sufficient sample volume. Correlation of CSF MOG-IgG IBI and titer was assessed. RESULTS: The pan-IgG Fc-specific secondary was optimal, yielding CSF MOG-IgG sensitivity of 90% and specificity of 98% (Youden's index 0.88). CSF MOG-IgG was positive in: 4/282 (1.4%) controls; 66/74 (89%) serum MOG-IgG positive MOGAD patients; and 9/73 (12%) serum MOG-IgG negative patients with high-risk phenotypes. Serum negative but CSF positive MOG-IgG accounted for 9/83 (11%) MOGAD patients, and all fulfilled 2023 MOGAD diagnostic criteria. Subgroup analysis of serum MOG-IgG low-positives revealed CSF MOG-IgG positivity more in MOGAD (13/16[81%]) than other diseases with false positive serum MOG-IgG (3/15[20%]) (p = 0.01). CSF MOG-IgG IBI and CSF MOG-IgG titer (both available in 29 samples) were correlated (Spearman's r = 0.64, p < 0.001). INTERPRETATION: CSF MOG-IgG testing has diagnostic utility in patients with a suspicious phenotype but negative serum MOG-IgG, and those with low positive serum MOG-IgG results and diagnostic uncertainty. These findings support a role for CSF MOG-IgG testing in the appropriate clinical setting. ANN NEUROL 2024;96:34-45.

Peripheral nervous system manifestations of MOG antibody associated disease.

Recent studies have reported the involvement of peripheral nervous system (PNS) in association with MOG-IgG, including isolated neuropathies. In this retrospective study we characterized the PNS involvement in MOG antibody associated disease (MOGAD). Six out of 215 MOGAD patients had PNS involvement (all polyradiculopathy) that occurred concurrently with a CNS demyelinating episode. We also demonstrated MOG expression in healthy human controls' proximal nerve root. Nine patients with true-positive MOG-IgG1 had PNS involvement temporally unrelated to a CNS demyelinating event. All these patients had an alternate etiology of PNS involvement. Isolated peripheral neuropathy is not a feature of MOGAD, but inflammatory nerve root involvement can occur concurrently with CNS demyelinating events.

Oral health knowledge, attitude, and practice of pregnant women in Deccan, South India: a cross-sectional prenatal survey.

Pregnancy is a unique condition for women, associated with physiological and emotional changes in the body. Various research showed an association between periodontal disease and adverse pregnancy outcomes. Importance to hygiene maintenance should be given during pregnancy and improve the wellbeing of the mother and child. This study assessed oral health knowledge, attitude, and practices among pregnant women in Hyderabad. The study design was cross-sectional and included 445 women who responded and completed the survey. Subjects were selected using a random sampling technique in gynecology clinics. The questionnaire form consisted of four sections: demographic data, knowledge, attitude, and oral hygiene practice. Out of the 482 pregnant females invited to participate in the study, 445 women completed the survey, giving a response rate of 92%. The majority of women showed good knowledge and attitude regarding oral hygiene and its relation to pregnancy. However, the participants showed poor compliance with the recommended protocol. There are certain myths and barriers to dental treatment that need to be considered in the prenatal education of women. If explained by the gynecologist, the importance of oral health and its correlation with systemic health will play a crucial role in improving oral hygiene practice and regular dental visits.

Structural Changes in Primary Teeth of Diabetic Children: Composition and Ultrastructure Analysis.

Diabetes affects the developing enamel by altering the mineralization process, which can have a detrimental effect on oral health. The objectives of this study were to examine the ultrastructure and composition of surface enamel in primary teeth of diabetic children and its clinical implications. Hundred extracted primary teeth from diabetic children (Test group: n = 50) and healthy children (Control group: n = 50), between 6 and 12 years of age, were subjected to scanning electron microscopy to qualitatively examine the enamel surface. Energy dispersive X-ray (EDX) analysis was performed to investigate the mass percentage of calcium (Ca) and phosphorous (P) in the surface enamel. Ultrastructural aberrations of surface enamel were observed in the test group teeth. Additionally, prism perforations were seen at the junction of rod and inter-rod enamel and the prisms were loosely packed. An even aprismatic layer of surface enamel was evident in the control group teeth. There was a statistically significant difference (p < 0.05) of Ca and P mass percentage between the test and control group teeth. The mean mass percentage rates of Ca and P were 33.75% and 16.76%, respectively. A poor surface characteristic and elemental composition of the enamel surface of primary teeth is observed in diabetic children. Therefore, appropriate caries preventive measures are mandatory to maintain the structural integrity of the tooth in these patients.

Tinospora cordifolia (Thunb.) Miers (Giloy) inhibits oral cancer cells in a dose-dependent manner by inducing apoptosis and attenuating epithelial-mesenchymal transition.

BACKGROUND: Tinospora cordifolia (Thunb.) Miers (Giloy) has been applied successfully as an anti-inflammatory, anti-diabetic, and even as an anti-cancer agent. Yet, to date, the application of Giloy has not been explored concerning oral cancer. OBJECTIVES: To assess the effect of T cordifolia (Thunb.) Miers (Giloy) extract (TcE) on an oral cancer cell line. METHODS: AW13516 (oral cancer cell line) cells were treated with the prepared aqueous extract of TcE for 24 h at various concentrations ranging between 5 µg/ml and 100 µg/ml and compared with control (cells without treatment). Thee effect of the extracts on apoptosis was assessed by through Annexin V flow cytometry assay and Luminometry based assessment of Caspase 8, 9 and caspase 3/7 activity. RNA was isolated from treated cells and gene expression of selected metastatic genes (MMP1, MMP10, and CXCL8); epithelial-mesenchymal stem cell genes (TWIST1, SNAIL, ZEB1, Oct4) and stemness related genses (Nanog, Sox2) were analyzed by using a quantitative real-time PCR system. The experiments were performed in triplicates. RESULTS: Aqueous extract of TcE was found to induce apoptosis inducer in AW13516 cells in a concentration-dependent manner and was potent even at a low concentration of 5 µg/ml. The apoptosis induction was confirmed with the caspase activity assay. Treatment of the cells with the extract for 24 h exhibited a significant decrease in the expression of EMT genes in a dose-dependent manner without an effect on the metastatic genes. CONCLUSION: Aqueous extract of TcE induces apoptosis-mediated cell death in the oral cancer cell line AW13516 while attenuating its potential for epithelial mesenchymal transition.

Mental health awareness among adult attendees of Armed Forces Hospital Southern Region family and community center.

AIM OF STUDY: To assess mental health literacy among Saudi adults attending the Ahad Rufaidah extension of Armed Forces Hospitals, Southern Region, 2017. METHODOLOGY: Following a cross-sectional descriptive study design, 400 adult Saudi attendants of the Armed Forces Hospitals, Southern Region - Ahad Rufaidah extension were included in this study. An anonymous interview validated questionnaire was utilized for data collection. It included variables related to participants' personal characteristics, knowledge assessment, and attitude regarding mental illness. RESULTS: More than half of participants (55.3%) had poor knowledge regarding mental health, while 44.8% had satisfactory knowledge. Only 3.6% of participants had a positive attitude toward mentally ill persons, 43% were indifferent toward them, while 53.4% had a negative attitude toward them. Participants' attitudes toward mental health differed significantly according to their knowledge grades (P < 0.001), with the majority of those with positive attitudes having satisfactory knowledge (93.5%) and most of those who had negative attitudes had poor knowledge (66.8%). Participants' knowledge grades differed significantly according to their gender, with more satisfactory knowledge grades among males than females (50.8% and 22.4%, respectively, P < 0.001) and educational level, with more satisfactory knowledge grades among more educated participants (P = 0.002). Participants' attitudes toward mentally ill persons differed significantly according to their gender (P = 0.013) and their educational level, with the highest percentage of positive attitude among university-educated participants (35.3%, P < 0.001). CONCLUSIONS: There is widespread mental health illiteracy among attendants in the Ahad Rufaidah extension of Armed Forces Hospitals, Southern Region. Their attitude toward mentally ill persons is rarely positive but largely negative or indifferent.

Awareness of the Public about Celiac Disease in Children in Saudi Arabia

Background: Celiac disease is a chronic immune-mediated enteropathy that affects the small intestine of genetically predisposed individuals and is precipitated by the ingestion of food containing gluten. Treatment consists of a glutenfree diet to control the signs and classic symptoms of the disease and prevent complications. Objective: To determine the awareness of the public about celiac disease in children in Saudi Arabia. Methods: A cross-sectional communitybased study conducted during the period from 1st May to 31st July 2019. A systematic random sampling technique was used. The study included 1619 participants. Data collected using a pre-designed online questionnaire distributed among parents of children and adolescents. The questionnaire includes about 18 items that guide us to the awareness of the public about celiac disease in children. Results: Half of participants (50.1%) think that Celiac diseases are a form of allergy to wheat products. Less than half (46.7%) of cases think that there is a correlation between the presence of celiac and disease and other immunological diseases and 33.7% don’t know. The majority of participants 59.9% think that family history has a role in the occurrence of celiac diseases and 62.4% think that it affects humans at any age. Only 28.8% of participants think that celiac disease is more prevalent in the Middle East than in any other region and the majority 49.8% don’t know. The majority (35.2%) of participants don’t know if there was a relation between cough and asthma with celiac disease. About third (31.6%) of the participants agreed that CD is linked to diabetes and 26.3% think that the CD associated with genetic diabetes than acquired diabetes. More than half of participants 51.5% think that psychological disorders are among the causes of celiac disease but, 39% of them don’t think that pregnancy and childbirth are among the causes of CD and 40.6% don’t know if surgical operations are among the causes or not. The majority of participants 59% think that CD is treatable disease, and 49.7% think that a patient with CD should have food that is completely free of wheat and its products. More than half (52.3%) participants think that colon cancer is one of the consequences of CD. Conclusion: The general population of Saudi Arabia, has reasonable knowledge about celiac diseases in children. We recommend health education sittings to raise the awareness of the public about the disease.

Awareness of Saudi Population about the Role of the Emergency Rooms

Background: The hospital Emergency department (ED) is one of the most important components of the health delivery system. Objectives: To investigate the public awareness of the ERs in KSA, what the public knows about the provided services, and if they know the difference between the outpatient clinic and ERs. Methods: It is a cross-sectional descriptive community-based study carried out on 977 male and female, young and adult participants from all age groups, in different areas of the Kingdom of Saudi Arabia, during the period from 1st January to 31st July 2019. Data was collected through filling the pre-designed online questionnaire which guided us to the needed data. We utilized the SPSS program version 16. The X2 test was used as a test of significance, and differences considered significant at p-value less than 0.05. Results: Most of the participants (87.5%) reported that they know the difference between the outpatient clinic and ER. The majority (68.1%) of subjects said that ERs is meaning rapid and unplanned medical care, 17.3% said any needed health care is available there, 12.2% said that it means insufficient medical care and only 2.5% said it means availability of physician at any time for any purpose. As regards evaluation to the provided services in ERs; 32.5% of cases said it was very good followed by 28.5% good, 19.8% excellent, 10.2% accepted and 10% reported it was bad services. There were significant relations between the awareness and age (p=0.03) and education level (p=0.003), but no relation was found with the gender of the participant (p>0.5). Conclusion: In our study, Most of the participants reported that they know the difference between the outpatient clinic and ERs. The majority of subjects said that ERs is meaning rapid and unplanned medical care and/or availability of physician at any time for any purpose. There were significant relations between the awareness and age and education level, but insignificant relation was found with the gender of the participant.