Digital impression (intraoral scanners) and factors affecting its accuracy - an insight into knowledge and awareness amongst graduates, and clinical practitioners.

BACKGROUND: This study aimed to evaluate the knowledge, awareness, and practice of intraoral scanners (IOS) and the factors affecting their accuracy amongst dental interns and practitioners. METHODS: This was an observational cross-sectional study in which data was collected from a representative population in Saudi Arabia, with the help of online questionnaires. The forms were distributed to 500 dental interns and practitioners and the questionnaire's validity and reliability were evaluated for vetting and remarks. The questionnaire consisted of three parts: the participants' demographic details, questions on the awareness and knowledge of participants regarding IOS, and the factors affecting the accuracy in clinical use of IOS. Questions were to be answered with 'yes', 'no' and 'I don't know'. Descriptive statistical analysis was performed using the control chart technique and the chi-squared test, with statistical significance set at p < 0.05. RESULTS: Most of the participants (58%) knew about the IOS and its applications (47.5%), but the majority of the participants did not use IOS in their clinics (43.5%). The majority of males (57.39%) and females (50.86%) strongly agreed that cost was a barrier to purchasing an IOS. To better get more knowledge on IOS, the specialists 66 (16.5%) and interns 54 (13.5%) chose continuing dental education programs and workshops. There was a significant association (p < 0.05) of knowledge and awareness, perception, and factors affecting parameters with different categories and years of experience. CONCLUSION: Within the limitations of this study, most participants had a positive stance towards IOS but due to inadequate knowledge and understanding, its use and applications were minimal. IOS was well-received regardless of operator training and experience. There is a significant need to increase awareness of this concept, as it may increase treatment efficiency and effectiveness.

The Prevalence of Associated Autoimmune Diseases Among Adults With Type 1 Diabetes Mellitus: A Cross-Sectional Study.

Background The relationship between type 1 diabetes mellitus (T1DM) and other autoimmune diseases has been known; however, the actual prevalence in the adult population nor clinical symptoms has not been determined locally. Objectives We aim to determine the prevalence of associated autoimmune diseases (Hashimoto's thyroiditis, celiac disease (CD), and adrenal insufficiency (AI)) and evaluate the most reporting symptoms and glycemic control assessment, as well as microvascular complications and hypoglycemia episodes. Methods A cross-sectional study of 251 patients with T1DM at the diabetic clinic of King Abdulaziz Medical City in Riyadh (KAMC-RD), Saudi Arabia, was conducted. Autoimmune serologies including thyroid peroxidase (TPO) antibody and tissue transglutaminase IgA (tTG-IgA) antibody were checked with hormonal studies such as thyroid-stimulating hormone (TSH), morning serum cortisol, and short Synacthen test (SST) with duodenal biopsy results all were reviewed if present. Patients were directly interviewed to evaluate for the most common symptoms (including hypoglycemia episodes) for the preceding two weeks. Glycemic control was assessed by measuring glycated hemoglobin (HbA1c). Microvascular complications (i.e., nephropathy and retinopathy) were estimated by looking at the urine albumin/creatinine ratio (ACR) besides the ophthalmology's visit notes. Results The mean age was 26.3 ± 7.7 years, and the mean duration of diabetes at the time of data collection was 12.2 ± 7.6 years, whereas the mean HbA1c was 8.9% ± 1.8%. The prevalence of hypothyroidism was 16.3%, and TPO positivity was discovered in 58.6% of the tested patients (n = 70) with equal prevalence among both genders (p = 0.685). tTG-IgA were noticed among 16.4% of the patients (n = 164) without significant difference among gender. Serum cortisol test was performed among 128 patients; 28.1% had suboptimal levels, and 5.5% were deficient. Only four patients (n = 15) had suboptimal responses after SST. Nervousness and anxiety (p < 0.001), fatigue with weakness (p = 0.018), weight gain (p = 0.017), and cold intolerance (p = 0.005) were noted, which were statistically significantly higher among females. Weight gain was statistically significantly higher among the age group of >30 years (p = 0.036). For microvascular complication screening, ACR was collected in 199 (79.2%) participants, with a mean of 27.7 ± 155.9 mg/mmol. Only 10 (5%) patients had microalbuminuria, and 16 (8%) had macroalbuminuria; it was correlated significantly with diabetes duration (p = 0.045). A total of 132 (52.8%) patients were seen by ophthalmology, 28 (21.4%) had nonproliferative diabetic retinopathy (NPDR), and 10 (7.6%) has proliferative diabetic retinopathy (PDR) that significantly correlated with the duration of diabetes (p = 0.027). During patient interviews, 187 (74.5%) reported symptomatic hypoglycemia events that correlated significantly with glycemic control (p = 0.029). Conclusion Autoimmunity in Saudi adults with type 1 diabetes mellitus was significant with equal prevalence among both genders and age groups with no or slight difference. Clinical manifestations of autoimmunity were higher in women. Diabetes chronicity and poor glycemic control were the major complications; therefore, early glycemic control is advocated. Regular screening for autoimmunity and its complications is recommended for type 1 diabetic patients. Autoimmunity was found almost similar to previous literature.

Prevalence of color vision deficiency in medical students at a Saudi University.

BACKGROUND: Color vision deficiency (CVD) affects approximately one in 12 men and one in 200 women in the world. It is considered a problem in the medical field since the color is often used as a sign in the practice of medicine, in observational assessment, diagnosis, and follow-up. These conditions make the appreciation of color essential in doctors' lives, thus we aimed at finding the prevalence and predictors of CVD in medical students. MATERIALS AND METHODS: This cross-sectional study included 1115 medical students. A pretested questionnaire consisting of personal data, history of vision problems, familial color vision defect, eye surgery, bad trauma on the head or eyes, drugs taken or chemicals exposed to, other health problems, and whether sufficient amount of Vitamin A is taken was used. This was followed by the screening of the participants for CVD using the Ishihara 15-plates test. RESULTS: A total of 1115 students participated in the study; 52.2% were females and the mean age of the participants was 21.7 years (±1.4). The prevalence of definitive CVD was found to be 2.1%; all of which comprised males. Eighty-seven percent of the affected participants were not aware of their color vision problem. A highly statistically significant association was found between history of vision problems and CVD status (P < 0.008). No association were found for nationality, marital status, family history of CVD, history of eye surgery, and eye trauma. CONCLUSION: The percentage of CVD in the present study is lower than that reported by previous studies done in other countries. Many medical students with CVD remain unaware of their condition. Therefore, we recommend early screening of all school-age children, and proper counseling of medical students with definite CVD to take care of their own health and wellbeing.

Correlation of Outer Retinal Degeneration and Choriocapillaris Loss in Stargardt Disease Using En Face Optical Coherence Tomography and Optical Coherence Tomography Angiography.

PURPOSE: This study measured and correlated degeneration of the junction between the inner and outer segments (IS/OS), the retinal pigment epithelium (RPE), and the choriocapillaris (CC) in Stargardt disease (STGD). DESIGN: Prospective cross-sectional study. METHODS: This study was conducted at the Casey Eye Institute. A total of 23 patients with STGD were enrolled and underwent optical coherence tomography angiography (OCTA). Scans were centered on the fovea. OCT slab projections and en face boundary maps were used to create masks to measure total IS/OS loss or RPE atrophy as well as regions of isolated IS/OS loss, isolated RPE atrophy, and matched IS/OS and RPE degeneration or intact IS/OS junction and RPE. CC vascular density (CCVD) was quantified from the CC angiogram. Outcomes included the area of loss, and the CCVD of degeneration in different areas was quantified and correlated. RESULTS: The total area of IS/OS loss was strongly correlated with the total area of RPE atrophy (r = 0.96; P < 0.0001) by a 1.6:1 ratio (r2 = 0.90). CCVD within regions of matched degeneration (85.6% ± 2.7%; P < 0.0001), isolated IS/OS junction loss (93.6% ± 1.0%; P = 0.0011), and isolated RPE atrophy (94.1% ± 1.1%; P = 0.0065) were all significantly lower than normal (99.0% ± 0.17%). There was a trend for CCVD within intact areas (97.6% ± 0.38%) to decline as the area diminished (r = 0.68). CONCLUSIONS: Photoreceptor and RPE degeneration exhibited a strong relationship wherein the IS/OS loss was 1.6-fold greater than that of RPE atrophy, supporting the theory that photoreceptor degeneration precedes RPE in STGD. Both the photoreceptors and the RPE degeneration contributed synergistically to CCVD attenuation, but extralesional CCVD also tended to be abnormal. The findings and techniques in this study may be of utility in developing endpoints for clinical trials.