Water Sorption and Solubility of Highly Aesthetic Single-Shade Nano-Hybrid Resin Composites.

Background A single-shade resin composite is a new type of resin composite that was introduced in 2019. There is not much data regarding the water sorption (Wsp) and water solubility (Wsl) of this type of resin composite. Therefore, this study aimed to investigate Wsp and Wsl and their effects on the surface roughness of a single-shade nano-hybrid resin composite in comparison with a conventional nano-hybrid resin composite in accordance with ISO 4049:2019 (Dentistry - Polymer-based Restorative Materials). Material and methods An in vitro study was performed to investigate the Wsp and Wsl of a single-shade supra-nano-hybrid composite (Omnichroma) and a conventional nano-hybrid composite (Filtek™ Z250 XT) in accordance with ISO 4049:2019. Five disks were prepared of each material with dimensions of 15 ± 1 mm in diameter and 1 ± 0.1 mm in thickness, as per ISO 4049:2019. The results were calculated according to the ISO equations for Wsp and Wsl in µg/mm3. Atomic force microscopy (AFM) was used to analyze the surface roughness (Ra) of test specimens. Results The findings showed that the values of Wsl and Wsp of both materials are comparable and revealed no statistically significant difference (P > 0.05). The AFM images showed a higher Ra post-solubility testing, and the statistical analysis indicated a significant difference for both materials. Conclusions The study concluded that the single-shade resin composite (Omnichroma) and the conventional nano-hybrid composite (Filtek™ Z250 XT) are following the requirements of ISO 4049:2019. The AFM analysis indicated that resin composite surfaces are significantly affected when exposed to water for a prolonged period of time. However, the Ra variations of Filtek™ Z250 XT were higher than Omnichroma specimens. These results indicate that resin composite surfaces can be significantly impacted by prolonged water exposure. This knowledge is critical for enhancing the long-term clinical performance and durability of these dental restorative materials.

Adherence to Statin Among Diabetic Patients in Diabetic Centers in Qassim Region, Saudi Arabia.

Background Dyslipidemia affects approximately one-third of Saudi Arabia's adult population. Dyslipidemia, hypertension, diabetes mellitus (DM), smoking, and a familial predisposition to cardiovascular disease (CVD) are significant risk factors for CVD. It can be prevented effectively through lifestyle changes and lifelong statin therapy; however, poor adherence limits its effectiveness. This study is designed to assess the level of adherence to statin prescription in patients with DM in diabetic centers in the Qassim region and to assess the factors associated with neglecting to take medication. Methodology A cross-sectional study was conducted among 226 diabetic patients who were prescribed statins. Medication adherence was assessed using the eight-item Morisky Medication Adherence Scale (MMAS-8). Demographic and clinical data were collected, and multivariate logistic regression analysis was used to identify factors associated with medication adherence. Results Of the 226 patients, 29.7% had high adherence, 32.7% had medium adherence, and 37.6% had low adherence to statin medication. Patients diagnosed with diabetes for less than five years had the highest proportion of low adherence (41.2%). No significant associations were found between medication adherence and gender, nationality, or educational level. Conclusion The study found that medication adherence to statins in diabetic patients in the Al Qassim region of Saudi Arabia is suboptimal, with a significant proportion of patients having low adherence. Patients diagnosed with diabetes for less than five years had the highest proportion of low adherence, suggesting that patients with a shorter disease duration may require additional support or interventions to improve their medication adherence. Healthcare providers should emphasize the importance of medication adherence and work with patients to develop personalized treatment plans that include medication and lifestyle modifications to optimize lipid control and improve overall health outcomes in diabetic patients.

Assessment of osteoporosis in patients with type 2 diabetes mellitus: A study from the central region of Saudi Arabia.

OBJECTIVES: To understand the impact of diabetes on bone mineral density and whether it increases the likelihood of osteoporosis. METHODS: This study was performed on 327 Saudis (aged >40 years) who were screened for osteoporosis and diabetes mellitus (DM). The levels of osteoporosis were determined by an estimation of Bone mineral density (BMD) using a DEXA scan examination. The data on BMD from diabetic subjects were compared with healthy nondiabetic controls. RESULTS: Out of 327 enrolled subjects, 38 (11.6%) were found to be osteoporotic, whereas 138 (42.2%) had DM. The data showed that the number of patients with osteoporosis in the DM group was 14 (36.8%), significantly lower than in nondiabetic patients, 21 (55.2%) (p=0.0015). Notably, the data showed no significant difference in the mean BMD of the femur in patients with DM (0.926 g/cm2) and non-diabetes (0.936 g/cm2) (p=0.280; T-score p=0.4746). The mean BMD levels in the spine of the DM study group (1.049 g/cm2) were significantly higher when compared with nondiabetic healthy controls (0.990 g/cm2) (p=0.0031). CONCLUSION: Patients with diabetes had higher lumbar BMD than nondiabetics, although femoral BMD was similar. Patients with diabetes have a lower osteoporosis risk than nondiabetics.

Quality of Life in Thyroid Cancer Patients.

Thyroid cancer ranks as the ninth most common cancer worldwide and third in Saudi Arabia. Given thyroid cancer's high incidence, thyroid cancer patients' quality of life (QoL) has been a concern for many years. However, no study has been dedicated to assessing thyroid cancer patients' QoL in Saudi Arabia. Thus, we aimed to fill this gap by assessing thyroid cancer patients' QoL in Saudi Arabia. This cross-sectional study was conducted among thyroid cancer patients attending outpatient clinics at the Diabetes and Endocrinology Centre, King Fahad Specialist Hospital, Qassim region, Saudi Arabia, from 2017 to 2023. The European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) assessed the patients' QoL through an individual interviewer-administered technique. We used RStudio to perform statistical analysis. Statistical differences between groups based on QoL scores were assessed using the Wilcoxon and Kruskal-Wallis rank-sum tests. Our results showed that for QoL scores of functional domains, the lowest was in social functioning, and the highest was in cognitive functioning. Regarding the subscales of symptoms, the highest scores were fatigue and insomnia. In conclusion, numerous factors affect thyroid cancer patients' QoL. Recognition and appropriate management of these factors will improve the overall QoL; there is a need to understand what is driving these factors in further clinical studies.

Association Between Subclinical Hypothyroidism and the Prognosis of Diabetes Mellitus and Subsequent Complications: A Retrospective Cohort Study.

Background Diabetes mellitus (DM) and subclinical hypothyroidism (SCH) are prevalent metabolic and endocrine disorders. Previous studies have suggested potential associations between SCH and metabolic disorders, including DM. This study aimed to explore the relationship between SCH and DM in patients from the Qassim Region in Saudi Arabia. Methods A retrospective cohort study was conducted on patients who attended the Qassim University clinics from December 2017 to December 2021. Participants were divided into two groups: SCH patients without a history of DM and age- and sex-matched controls without SCH or DM. Parameters, such as DM occurrence, DM duration, glycosylated hemoglobin (HbA1c) values, and metformin use, were evaluated. Results The prevalence of DM was 70.4% in the SCH group and 83.3% in the non-SCH group, with no significant difference between the groups (p=0.203). The mean HbA1c values and DM duration showed no significant variations between the two groups. However, metformin use was significantly higher in the SCH group at 74.1% compared to 50.0% in the non-SCH group (p=0.047). No correlation was observed between HbA1c and thyroid-stimulating hormone (TSH) levels. Conclusions While the study indicates a potential association between SCH and DM management, especially with regard to metformin usage, there does not appear to be a significant relationship between SCH and DM development or progression in this population.

Growth hormone therapy in short-stature patients with kyphoscoliosis: a literature review.

The aim of the study was to conduct a literature review on growth hormone therapy in short-stature patients with kyphoscoliosis. The search strategy was performed in which all the relevant papers published in 20 years were included on Pub Med, Central, and Google scholar by using keywords short stature, growth hormones, adverse events of growth hormones in kyphoscoliosis, safety. The study investigation supports the idea that giving human growth hormone (HGH) to a diverse population of short-statured children does not enhance the occurrence of scoliosis. Patients on HGH therapy for progressing scoliosis had syndromes in which scoliosis was more prevalent in an age-matched group. Short stature attributed to progressive growth failure is prevalent in all mucopolysaccharidosis (MPS) disorders, as per the existing research on growth and growth hormone in MPS. MPS should be explored in children who are being tested for short stature since growth failure might be the presenting symptom.

Woodhouse-Sakati syndrome (WSS): A case report of 3 Saudi sisters with urogenital anomalies.

Woodhouse-Sakati syndrome (WSS) is a rare genetic condition of autosomal recessive inheritance pattern. The disease is characterized by a group of disorders, including diabetes mellitus, alopecia, hypogonadism, intellectual disability, and progressive extrapyramidal signs. This syndrome is related to an inherited neurodegenerative disorder's heterogeneous group characterized by the accumulation of iron in the brain, caused by a mutation in the DCAF17 gene. This report discusses the case of 3 Saudi sisters having WWS. The 3 sisters aged 18, 22, and 25 years took birth to consanguineous parents (first-degree cousins). The sisters initially had normal developmental growth with deprived scholastic performance because of the intellectual difficulties. At puberty, the secondary sexual characteristics were not developed in the patients, and they faced primary amenorrhea. They were found to have features typical of WSS, but they also had gynecological anomalies, which are considered unusual findings in WSS patients.

Impact of Illness Perception on the Health-Related Quality of Life of Patients Receiving Dialysis: A Cross-Sectional Study.

Background End-stage renal disease (ESRD) is a major health problem worldwide that is increasing in incidence, prevalence, and cost. Both the disease itself and negative illness perceptions negatively affect patients' health-related quality of life (HRQoL), morbidity, and mortality. This study assessed the relationship between illness perception and HRQoL. Methods This cross-sectional study was conducted among 342 patients at five dialysis centers in Jeddah, Saudi Arabia. We used a self-administered questionnaire that containing demographic questions, the Revised Illness Perception Questionnaire, and the Short Form 36 Health Survey Questionnaire. The data were analyzed using t-tests, analyses of variance, Pearson's correlation coefficients, and multiple linear regression analyses. Results The mean (SD) age was 46.1 (16.5) years and the majority were men (53.8%). Except for treatment control, all domains of illness perception were significantly correlated with HRQoL; however, the correlations were positive only for personal control and illness coherence. Identity, disease timeline (acute/chronic), consequences, illness coherence, and emotional representations were independent predictors of HRQoL; together explaining 35% of the variance. Lower emotional response was the only domain of illness perception significantly associated with better HRQoL in both dialysis modalities across all dialysis centers. Conclusion There were clear effects of illness perception on HRQoL, with emotional representations being the strongest predictor. As such, emotional representations should be targeted in interventions.

A clinical risk score to predict in-hospital mortality in critically ill patients with COVID-19: a retrospective cohort study.

OBJECTIVES: To identify factors influencing the mortality risk in critically ill patients with COVID-19, and to develop a risk prediction score to be used at admission to intensive care unit (ICU). DESIGN: A multicentre cohort study. SETTING AND PARTICIPANTS: 1542 patients with COVID-19 admitted to ICUs in public hospitals of Abu Dhabi, United Arab Emirates between 1 March 2020 and 22 July 2020. MAIN OUTCOMES AND MEASURES: The primary outcome was time from ICU admission until death. We used competing risk regression models and Least Absolute Shrinkage and Selection Operator to identify the factors, and to construct a risk score. Predictive ability of the score was assessed by the area under the receiver operating characteristic curve (AUC), and the Brier score using 500 bootstraps replications. RESULTS: Among patients admitted to ICU, 196 (12.7%) died, 1215 (78.8%) were discharged and 131 (8.5%) were right-censored. The cumulative mortality incidence was 14% (95% CI 12.17% to 15.82%). From 36 potential predictors, we identified seven factors associated with mortality, and included in the risk score: age (adjusted HR (AHR) 1.98; 95% CI 1.71 to 2.31), neutrophil percentage (AHR 1.71; 95% CI 1.27 to 2.31), lactate dehydrogenase (AHR 1.31; 95% CI 1.15 to 1.49), respiratory rate (AHR 1.31; 95% CI 1.15 to 1.49), creatinine (AHR 1.19; 95% CI 1.11 to 1.28), Glasgow Coma Scale (AHR 0.70; 95% CI 0.63 to 0.78) and oxygen saturation (SpO2) (AHR 0.82; 95% CI 0.74 to 0.91). The mean AUC was 88.1 (95% CI 85.6 to 91.6), and the Brier score was 8.11 (95% CI 6.74 to 9.60). We developed a freely available web-based risk calculator (https://icumortalityrisk.shinyapps.io/ICUrisk/). CONCLUSION: In critically ill patients with COVID-19, we identified factors associated with mortality, and developed a risk prediction tool that showed high predictive ability. This tool may have utility in clinical settings to guide decision-making, and may facilitate the identification of supportive therapies to improve outcomes.

Utility of Stimulated Thyroglobulin in Reclassifying Low Risk Thyroid Cancer Patients' Following Thyroidectomy and Radioactive Iodine Ablation: A 7-Year Prospective Trial.

Context: Following total thyroidectomy and radioactive iodine (RAI) ablation, serum thyroglobulin levels should be undetectable to assure that patients are excellent responders and at very low risk of recurrence. Objective: To assess the utility of stimulated (sTg) and non-stimulated (nsTg) thyroglobulin levels in prediction of patients outcomes with differentiated thyroid cancer (DTC) following total thyroidectomy and RAI ablation. Method: A prospective observational study conducted at a University Hospital in Saudi Arabia. Patients diagnosed with differentiated thyroid cancer and were post total thyroidectomy and RAI ablation. Thyroglobulin levels (nsTg and sTg) were estimated 3-6 months post-RAI. Patients with nsTg <2 ng/ml were stratified based on their levels and were followed-up for 5 years and clinical responses were measured. Results: Of 196 patients, nsTg levels were <0.1 ng/ml in 122 (62%) patients and 0.1-2.0 ng/ml in 74 (38%). Of 122 patients with nsTg <0.1 ng/ml, 120 (98%) had sTg levels <1 ng/ml, with no structural or functional disease. sTg levels >1 occurred in 26 (35%) of patients with nsTg 0.1-2.0 ng/ml, 11 (15%) had structural incomplete response. None of the patients with sTg levels <1 ng/ml developed structural or functional disease over the follow-up period. Conclusion: Suppressed thyroglobulin (nsTg < 0.1 ng/ml) indicates a very low risk of recurrence that does not require stimulation. Stimulated thyroglobulin is beneficial with nsTg 0.1-2 ng/ml for re-classifying patients and estimating their risk for incomplete responses over a 7 years follow-up period.

Exacerbation of N-nitrosodiethylamine Induced Hepatotoxicity and DNA Damage in Mice Exposed to Chronic Unpredictable Stress.

Psychological stress contributes to increased susceptibility to a number of diseases including cancer. The present study was designed to assess the effect of chronic unpredictable stress on N-nitrosodiethylamine induced liver toxicity in terms of in vivo antioxidant status and DNA damage in Swiss albino mice. The animals used in this study were randomized into different groups based on the treatment with N-nitrosodiethylamine or chronic unpredictable stress alone and post-stress administration of N-nitrosodiethylamine. The mice were sacrificed after 12 weeks of treatment, and the status of major enzymatic and non-enzymatic antioxidants, liver function markers, lipid peroxidation and the extent of DNA damage were determined in circulation and liver tissues of all the groups. The N-nitrosodiethylamine treated group showed significantly compromised levels of the antioxidant enzymes, lipid peroxidation, and the liver function markers with enhanced DNA damage as compared to chronic unpredictable stress or control groups. A similar but less typical pattern observed in the chronic unpredictable stress treated mice. All the measured biochemical parameters were significantly altered in the group treated with the combination of chronic unpredictable stress and N-nitrosodiethylamine when compared to controls, or chronic unpredictable stress alone and/or N-nitrosodiethylamine alone treated groups. Thus, exposure to continuous, unpredictable stress conditions even in general life may significantly enhance the hepatotoxic potential of N-nitrosodiethylamine through an increase in the oxidative stress and DNA damage.

A 94-year-old man with recurrent hypoglycemia caused by non-islet cell tumor hypoglycemia (NICTH).

Non-islet cell tumor hypoglycemia (NICTH) is a rare but serious paraneoplastic syndrome in which a tumor secretes the high molecular weight form of IGF-II, causing hypoglycemia and requiring early diagnosis and management. Here, I report a rare case of NICTH caused by fibrosarcoma in a 94-year-old male with recurrent hypoglycemia. This case report describes the clinical presentation and diagnostic and management issues involved in a case of NICTH that was diagnosed at a tertiary care institute.