Crestal Bone Loss Around Submerged and Non-Submerged Dental Implants in Individuals with Type-2 Diabetes Mellitus: A 7-Year Prospective Clinical Study.

OBJECTIVE: In establishing an evidence-based rationale for the optimal use of implant therapy in patients with type 2 diabetes mellitus (T2DM), it is essential to first understand the impact of glycemic control on early healing and the success of dental implants. The objective of this study was to evaluate crestal bone loss (CBL) and stability around submerged and non-submerged dental implants in Saudi patients with well- and poorly controlled T2DM. SUBJECT AND METHODS: Thirty-five patients with well-controlled T2DM (24 males and 11 females) and 32 poorly controlled T2DM patients (19 males and 13 females) were included. CBL was measured on digital radiographs; resonance frequency analysis (RFA) measurements were made for each implant at the time of fixture placement and at 3 months in both the groups. A p value less than 0.05 was considered statistically significant. RESULTS: A total of 124 dental implants were placed. Mean RFA values between baseline and 3 months in poorly controlled T2DM patients was statistically significant (p = 0.048). CBL at first year (p = 0.047), second year (p = 0.041), third year (p = 0.046), and seventh year (p = 0.035) was significantly worse in poorly controlled T2DM. CBL around non-submerged dental implants showed statistically significant differences at all time-intervals (p < 0.05). CONCLUSION: Poorly controlled T2DM patients present worse peri-implant bone outcomes as compared to patients with well-controlled T2DM. We suggest that the predictability of successful dental implant therapy outcomes depends on the maintenance of optimal haemoglobin A1c levels.

Cerebellar Hemangioblastoma Mimicking Arteriovenous Malformation: A Case Report.

Hemangioblastoma (HBM) is a tumor distinguished by the presence of stromal cells and small vessels. These stromal cells represent stem cells, which, due to the influence of the neoplasm, proliferate and differentiate into "vasoformative elements" that create new blood vessels. Hemangioblastomas resemble arteriovenous malformation (AVM) in imaging features, characterized by an apparent vascular blush, the presence of multiple feeding vessels, and evident draining veins observed on digital subtraction angiography (DSA). Our study presents a case of HBM in the right cerebellar hemisphere mimicking AVM. The patient had been diagnosed with AVM in the same location two years ago and managed with endovascular embolization. One month prior, the patient experienced severe headaches, imbalance, nausea, left ear fullness, blurry vision, and high blood pressure. The imaging feature suggests HBM rather than AVM. The patient next underwent sub-occipital craniotomy and tumor resection with external ventricular drainage (EVD) insertion. The histopathological report of the excised mass confirmed HBM. In conclusion, AVM and HBM rarely occur together. Recent research indicates that HBM and AVM have exact embryologic origins and need later genetic alterations to develop into symptomatic lesions. Further research is required to clarify the uncommon combination of these lesions.

A lifestyle intervention to prevent hypertension in primary healthcare settings: A Saudi Arabian feasibility study.

Background: Hypertension is a leading cause of morbidity and mortality in Saudi Arabia, causing a significant public health challenge in the kingdom. In this study, we aimed to assess the feasibility of the Blood pressure LifeStyle Management (BLSM) program for preventing hypertension by making a significant changes in lifestyle interventions through controlling some risk factors such as behavior, diet, physical activities, and weight in Primary Care. Aim: The aim of this study is to evaluate the effectiveness of the Blood pressure LifeStyle Management (BLSM) program in reducing blood pressure. Methods: This is a cohort of three-month period feasibility study in a primary care setting in a before-and-after study design. Results: A total of 100 individuals were recruited for the study, and 73 have completed the program. The overall systolic (SBP) and diastolic (DBP) blood pressure showed an increment of 0.75 and 1.67 mmHg, respectively. The subgroup analysis exhibited a decrease in SBP (-6.5 mmHg) for patients with hyperlipidemia, while a DBP average increased (+2 mmHg). Females showed a decrease in SBP (-1.04 mmHg) compared to males, who increased in their SBP (+1.69). Smokers showed a significant improvement in SBP and DBP with p < 0.05. Conclusion: Lifestyle intervention can improve and control blood pressure in primary care settings. The program can be tailored to include more participants, the length of the program could be modified, and the frequency of follow-ups could be increased to enable participants to change their habits and incorporate better life choices in their daily routines.

Factors Affecting Length of Stay in Pediatric Emergency Department in a Teaching Hospital in Saudi Arabia.

Background: Decreasing the number of Emergency Department patient visits for treatment, especially in non-urgent cases, is an international healthcare goal. The same applies for pediatric emergency rooms where the utilization of ED is much more than adults. Objective: We aim to measure the length of stay for all pediatric patients and examine the factors influencing it. Methods: A retrospective chart review study was conducted at the pediatric ED of King Fahd Hospital in the Eastern Province of Saudi Arabia. The study included all patients presented to the pediatric ED, between January 1, 2018, and December 31, 2018, aged from 1 day to < 14 years old. Data included patient's age, sex, season in which the patient presented in, chief complaint, time of presentation, and whether admission to the hospital ward was collected. Results: The total number of patients was 37,613. The median LOS was 100, interquartile range (IQR) = 53 - 272 minutes. Male pediatric patients were (55.12%). Among all patients, (32.04%) were toddlers, followed by school aged children (25.05%). The ER received more patients during the winter months followed by summer (32.92% and 24.72%, respectively). Fever was the most common complaint for all patients combined. For prolonged LOS patients, the most common complaints were respiratory related (23.44%). Pre-school children and school aged children were found to have a 5.49% and a 7.93% increased LOS when compared to toddlers (95% CI = 2.52 - 8.53, and 95% CI = 5.01 - 10.93, respectively). Summer was associated with a statistically significant increased LOS (% change = 28.92, 95% CI = 25.53 - 32.40). Morning shift was found to have a 7.89% increased LOS when compared to the evening shift. The highest increase in LOS was attributed to haematology related complaints (% change = 108.32, 95% CI = 85.69 - 133.71). Conclusion: Several pediatric LOS predicting factors have been identified; morning arrival, and presentation during summertime. Systemic factors such as staffing, and infrastructure can be modified and may affect the length of stay of patients. The implementation of these strategies and the evaluation of their impact on the length of stay in the pediatric emergency department require further investigation.

Quality Assessment of Randomized Clinical Trials in Periodontal Research from 2015-2018 - A Cross Sectional Analysis.

OBJECTIVES: The objective of this study was to assess the quality of randomised clinical trials (RCT) published in the field of periodontology in compliance with CONSORT guidelines and also to identify any associated influencing factors. METHODS: Quality of reporting in accordance with the 2010 CONSORT checklist was assessed and scored for RCTs published between 2015-2018 in three major periodontal journals: Journal of Periodontology (JP), Journal of Periodontal Research (JPR) and Journal of Clinical Periodontology (JCP). Descriptive statistics and linear regression with univariate analysis were carried out to identify the variables associated with mean CONSORT score. Mean scores were compared between various variables. RESULTS: 177 RCTs were identified from1875 published scientific articles accounting for 9.4% of the total publications screened. Europe (54%) produced more than half of the RCTs followed by Asia (19.2%). A large number of RCTs failed to report satisfactorily many items from the CONSORT checklist with no significant difference between three journals. The mean CONSORT score for JCP was the highest, at 70.5% (95% CI: 68.8 to 72.1), followed by JOP, at 69.9% (95% CI: 68.1 to 71.7) and 68.8% (95% CI: 65.6 to 71.9) for the JPR at p=0.631. Though, the mean CONSORT score increased from 70.4% in 2015 to 71.0% in 2018 but differences were not significant at p=0.653. RCTs reported by more than six authors had better CONSORT score compared to RCTs reported by fewer than six authors at p=0.01. CONCLUSIONS: Inadequate reporting of several items of the CONSORT statement in published periodontal RCTs highlights the shared responsibility of researchers, journal reviewers and editors in maintaining the quality of reporting of RCTs.

Fertility behaviour of working women in Saudi Arabia: a special case of King Saud University, Riyadh.

Fertility levels and their determinants in Saudi Arabia have not been studied sufficiently for formulating family policy, although some attention has been paid to rapid fertility transitions in the context of socioeconomic and cultural change. This study focused on the fertility of a particular occupational category in the Kingdom of Saudi Arabia to assess determinants of fertility, measured as the number of children. The sample was drawn from the King Saud University staff - ever-married Saudi Arabian women. Results found that proximate factors (age, age at first marriage, intended number of children, length of marriage and contraceptive use) were significant in predicting fertility behaviour, whereas geographic, social and economic factors were insignificant. Thus, the fertility behaviour of this occupational group seems unique. This might be due to the special characteristics and lifestyle of this particular occupational group. The effect of the intended number of children on the actual number signified the fertility behaviour of this group of women. This, expectedly, should improve the influence of social and economic factors on fertility behaviour, in the future. Thus, advocates, policies and programmes (population and public health) at the societal and familial levels, should consider the demographic change in the social and economic context.

Addition of Graphite Filler to Enhance Electrical, Morphological, Thermal, and Mechanical Properties in Poly (Ethylene Terephthalate): Experimental Characterization and Material Modeling.

Poly(ethylene terephthalate)/graphite (PET/G) micro-composites were fabricated by the melt compounding method using a minilab extruder. The carbon fillers were found to act as nucleating agents for the PET matrix and hence accelerated crystallization and increased the degree of crystallinity. TGA showed that carbon fillers improved the resistance to thermal and thermo-oxidative degradation under both air and nitrogen atmospheres. However, a poor agreement was observed at higher loadings of the filler where the composites displayed reduced reinforcement efficiency. The results demonstrate that the addition of graphite at loading >14.5 wt.% made electrically conductive composites. It was calculated that the electric conductivities of PET/graphite micro-composites were enhanced, above the percolation threshold values by two orders of magnitudes compared to the PET matrix. The minimum value of conductivity required to avoid electrostatic charge application of an insulating polymer was achieved, just above the threshold values. The addition of graphite also improved thermal stability of PET, accelerated its crystallization process and increased the degree of crystallinity. Microscopic results exhibit no indication of aggregations at 2 wt.% graphite, whereas more agglomeration and rolling up could be seen as the graphite content was increased in the PET matrix (in particular, above the percolation threshold value). Furthermore, based on the mechanical experimental characterization of the PET/graphite micro-composites, a large deformation-based mathematical model is proposed for material behavior predictions. The model fits well the experimental data and predicts other mechanical data that are not included in the parameter identification.

Prevalence and Perception of Shisha Smoking among University Students: A Cross-sectional Study.

AIMS AND OBJECTIVES: Understanding perceptions and factors behind the rise in the prevalence of shisha smoking is important for the development of prevention strategies and policies. The aim of this descriptive study was to assess the prevalence and perception of shisha smoking among university students. MATERIALS AND METHODS: The anonymous, self-structured 12-item questionnaire was administered to 450 male university students, with an overall response rate of 82.44% (n = 371). Prevalence, knowledge, and other associated factors regarding shisha smoking were compared between dental and other specialty students using SPSS software for descriptive statistical analysis. RESULTS: Among 371 university students, 40.43% (n = 150) were nonsmokers, 32.88% (n = 122) were shisha smokers, 12.94% (n = 48) were cigarette smokers, and 13.75% (n = 51) smoked both shisha and cigarette. The overall prevalence of shisha smoking (46.63%, n = 173) was higher than that of cigarette smoking (26.68%, n = 99). The percentage of those knowledgeable about the ill effects of shisha smoking was 44.2% with lesser knowledge among shisha smokers than cigarette smokers. There was no statistically significant difference in the mean total knowledge score between dental (5.65 ± 2.08) and other specialty (5.21 ± 2.3) students. CONCLUSIONS: A high prevalence of shisha use among university students is reported in this study as well as a general lack of understanding of the dangers involved with this behavior. Study authors recommend the development of policies targeted at preventing further rise in the prevalence of shisha smoking through the implementation of preventive strategies such as incorporating this topic into the school syllabus and encouraging research on shisha smoking.

Stability and bone loss around submerged and non-submerged implants in diabetic and non-diabetic patients: a 7-year follow-up.

To evaluate peri-implant bone loss (PIBL) and stability around submerged and non-submerged dental implants in patients with and without type 2 diabetes mellitus (T2DM). Thirty-five T2DM and non-diabetic (NT2DM) patients were included in this study. Demographic data were recorded using a questionnaire and PIBL was measured on digital radiographs. Resonance frequency analysis (RFA) was carried out for each implant at the time of fixture placement and at 3 months in both groups. P values less than 0.05 were considered statistically significant. One hundred and eighteen dental implants with a mean height of 10 to 12 mm and 3.3 to 4.1 mm in diameter were placed. The comparison of the mean RFA values at baseline and at 3 months was statistically significant (p = 0.008) in T2DM patients. The inter-group mean RFA values at baseline and at 3 months were not significant (p > 0.05). PIBL was significantly high in T2DM as compared to NT2DM patients at each follow-up (p < 0.05). At 2, 3, and 7 years, non-submerged dental implants showed significantly high PIBL in T2DM patients as compared to NT2DM individuals (p<0.05). The results of the present clinical study demonstrate increased PIBL around non-submerged single-tooth implant-supported restorations in T2DM patients, which may be due to the immune inflammatory status.

Rosai-Dorfman Disease Complicated by Autoimmune Hemolytic Anemia in a Child: A Case Report and Review of the Literature.

Rosai-Dorfman disease is a rare histiocytic proliferative disorder that commonly presents with a massive lymphadenopathy and a variety of constitutional symptoms. Severe hemolytic anemia is an infrequent complication of this disease. Although the etiology of the condition is unknown, infectious agents including viruses have been implicated. We describe a 2-year-old female child who presented with fever, pallor, and generalized lymphadenopathy complicated by the development of autoimmune hemolytic anemia. A review of the literature of this condition is also provided.

Seasonal variations in the body composition and bioaccumulation of heavy metals in Nile tilapia collected from drainage canals in Al-Ahsa, Saudi Arabia.

The body composition of Nile tilapia (Oreochromis niloticus) collected from drainage canals in Al-Ahsa, Saudi Arabia and the concentration of four heavy metals; zinc (Zn), cadmium (Cd), cobalt (Co) and lead (Pb) in both fish muscles and the water collected from this environment were assessed across the four seasons. The body composition was found to change with the seasons, with the best body composition being recorded in autumn and winter, where higher levels of protein (17.24, 17.65%), and fat (0.58, 0.71%) and lower water content (80.15, 79.86%) respectively were noted. The concentration of heavy metals in both fish muscles and the water body also varied significantly with the seasons. In the fish muscles, the highest content of Zn (0.409 mg/kg dry weight) and Cd (4.140 mg/kg dry weight) was recorded in winter, however, the highest concentration of Co (0.318 mg/kg dry weight) and Pb (1.96 mg/kg dry weight) was observed in spring and summer respectively. On the other hand, the water samples collected in autumn showed the maximum concentration of Cd (1.385 mg/L), Co (0.762 mg/L) and Pb (0.18 mg/L) however, the maximum concentration of Zn (0.0041 mg/L) was recorded in winter. With the exception of Cd, the accumulation of the studied heavy metals in fish muscles was within the safe limits for seafood recommended by various organizations.

Population distribution and household conditions in Saudi Arabia: reflections from the 2010 Census.

The Kingdom of Saudi Arabia, the largest nation in the Arabian Peninsula is divided into 13 regions, which are of different development levels in terms of both population and public utility infrastructure. More than the other regions, population is high in Al-Riyadh, Makkah Al-Mokarramah, and the Eastern Region, due to urbanization. The current analysis of census results is aimed at understanding (i) regional variations in population and households and (ii) house ownership, type of housing, and housing infrastructure. Saudi Arabia's population is 26,090,555, living in 4,655,127 households with higher concentration in Al-Riyadh, Makkah Al-Mokarramah, and the Eastern Region. One-fourth of the households are in Makkah Al-Mokarrammah while another one-fourth in Al-Riyadh. Households are small with 6 persons in each. The proportion of households in own houses is less than half - mostly Saudi households. Households in the Kingdom live in apartments, traditional houses, villas or floor in a villa with differing proportions across regions and between Saudi and non-Saudi. While apartments are the major type of housing (major regions), traditional houses (Jazan, Al-Baha, Hail, and Aseer regions) and villas (Al-Riyadh region) still exist that are built by concrete (less than four-fifths), block/brick (less than one-fifth), mud (rare), and stone (rare) with varying regional proportions. Infrastructure - electricity, water, and sewage - vary across regions. The major source of electricity is public station followed by private station and private generators. Water source is mainly the public water inside the pipe unit but catchment tank water and well water are used. Three types of sewage system are prevalent in the Kingdom - public sewage, ditch sewage, and private sewage. An inequitable distribution of population across regions shows urbanization, causing an emergence of the modern housing sector influencing house ownership. Developed regions have less ownership, more rentals and office quarters, thus, presuming that development level and migration status are driving house ownership. The impact of infrastructural variations is difficult to interpret as such variations affect the interest of the public sector and customers. A lesser dependence on the public sector requires caution when assessing the situation and when creating policies and provisions to improve quality of life.