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Gemination or a double tooth is a rare condition experienced in dental clinics, in which usually the tooth shows one root and two intertwined crowns. It is an incomplete separation for one tooth. The etiology of gemination is multifactorial, such as environmental factors, trauma, and genetics. The study aimed to find the prevalence rate of gemination in Karbala city population. In the present article, an orthopantomogram of 550 patients visiting the oral and maxillofacial private radiology clinic in Al-Mina Dental Center, Iraq/Karbala City was examined for the presence of tooth gemination. The results revealed that only one case of unilateral gemination of the upper first maxillary permanent molar in a male patient 32 years old was reported. The study concludes that the low prevalence rate of gemination confirms the role of racial factors.

Introduction Diagnosis of occipital condyle fracture (OCF) following a trauma needs high awareness among the trauma surgeons.

Municipal solid waste management is a major concern in developing economies, requiring collective international efforts to achieve carbon neutrality by diverting waste from disposal facilities. This study aims to highlight the importance of the waste sector as it has the potential to significantly contribute to climate change and its toxicity impact on the local ecosystem. Out of the total municipal solid waste generated, only 78 % is collected, either open dumped or thrown in sanitary landfills. The waste sector's ecological impact value is calculated for the Earth's regions, and it is very high at >50 % in Africa, Asia, Latin America and the Caribbean. This sectoral impact value is mainly responsible for greenhouse gas emissions and degradation of the local ecosystem health. Current business‒as‒usual practices attribute 3.42 % of global emissions to the waste sector. Various scenarios are developed based on waste diversion and related emissions modelling, and it is found that scenarios 3 and 4 will support the policymakers of the regions in attaining zero carbon footprints in the waste sector. Our findings conclude that cost-effective nature-based solutions will help low‒income countries reduce emissions from disposal sites and significantly improve the local ecosystem's health. Developed economies have established robust waste‒handling policies and implementation frameworks, and there is a need for collaboration and knowledge sharing with developing economies at the regional level to sustain the sector globally.

Third molar impaction is considered a prevalent issue. The research aimed to study the pervasiveness and pattern of impaction in Karbala/Iraqi population. Orthopantomograms were studied regarding its angulation, impaction depth, and correlation with ramus. The outcomes manifested that the prevalence of 3rd impacted molars was 34.71%, with the proportion of male to female as 0.83:1. Impacted mandibular 3rd molars were significantly encountered. The prevalence of vertical angulation, mesioangular, horizontal, and inverted were significantly associated with the impacted mandibular 3rd molars (P < 0.05). However, the prevalence of distoangular and bucco/lingual was significantly associated (P < 0.05) with the upper impacted 3rd molars. Level C of impaction was significantly (P < 0.05) the most typical level in the maxilla impacted the 3rd molar, and level A and level B of impaction were significantly (P < 0.05) the most prevalent level correlated with the mandibular 3rd molar impaction. Class II was significantly (P < 0.05) the frequently occurring condition subsequent to Classes III and I. In conclusion, the impaction of 3rd molars was significantly predominant in females and lower jaw. The vertical angulation, level C of impaction associated with maxillary 3rd molars and levels A and B of impaction related with mandibular 3rd molars, and Class II are the most encountered conditions.

Antimicrobial resistance is a global healthcare threat with significant clinical and economic consequences peaking at secondary and tertiary care hospitals where multidrug-resistant Gram-negative bacteria (MDR GNB) lead to poor outcomes. A prospective study was conducted between January and December 2019 for all invasive bloodstream infections (BSIs) secondary to MDR GNB in Qatar identified during routine microbiological service to examine their clinical, microbiological, and genomic characteristics. Out of 3238 episodes of GNB BSIs, the prevalence of MDR GNB was 13% (429/3238). The predominant MDR pathogens were Escherichia coli (62.7%), Klebsiella pneumoniae (20.4%), Salmonella species (6.6%), and Pseudomonas aeruginosa (5.3%), while out of 245 clinically evaluated patients, the majority were adult males, with the elderly constituting almost one-third of the cohort and with highest observed risk for prolonged hospital stays. The risk factors identified included multiple comorbidities, recent healthcare contact, previous antimicrobial therapy, and admission to critical care. The in-hospital mortality rate was recorded at 25.7%, associated with multiple comorbidities, admission to critical care, and the acquisition of MDR Pseudomonas aeruginosa. Resistant pathogens demonstrated high levels of antimicrobial resistance but noticeable susceptibility to amikacin and carbapenems. Genomic analysis revealed that Escherichia coli ST131 and Salmonella enterica ST1 were the predominant clones not observed with other pathogens.

The intake of toxic metals from cooking utensils through food is of growing concern to the medical community. This intake poses serious risk to human health. In many developing countries, different types of contaminated metals scraps are used to make cooking utensils. The leaching of both nutritionally essential and toxic metals in significant quantities from cookware during the cooking process results in food contamination and poses a substantial health risk. In the present study, the leaching of some toxic and potentially toxic metals from cooking utensils into different solutions and food was investigated. A preliminary survey indicated that the majority of individuals tend to use aluminum cookware due to its affordability, overlooking the potential health risks associated with these inexpensive and lower-quality cooking utensils. XRF analysis revealed that aluminum, steel, and copper cookware had K, Ca, Pb, Cd, Ni, V, Sn Mo, Zn, Bi, and Tb as contaminants. In addition, aluminum (3.2 ± 0.25 to 4.64 ± 0.20 g/kg) and copper cookware (2.90 ± 0.12 g/kg) were highly contaminated with lead. The time and pH-dependent study revealed that leaching of metals (Al, Pb, Ni, Cr, Cd, Cu, and Fe, etc.) into food was predominantly from anodized and non-anodized aluminum cookware. More metal leaching was observed from new aluminum cookware compared to old. Acidic food was found to cause more metals to leach during cooking. Blood metal analysis of the local population revealed the presence of high concentrations of Al, Pb, Cd, and Ni. In conclusion, leaching of toxic or potentially toxic metals from cookware into food, especially from anodized and non-anodized aluminum cookware, poses a potential public health risk. Practical applications: Cooking utensils are routinely used for the preparation of food. However, the harmful impact posed by these essential items is largely unknown. The current research briefly explains the toxic metals leaching from cookware in a pH-dependent manner and leaves a message to the public, especially in developing countries like Pakistan, regarding the type of cookware suitable for cooking purposes.

Aim: To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) that investigated the effectiveness of tranexamic acid (TXA) among patients undergoing arthroscopic rotator cuff repair (ARCR). Methods: Five databases were screened until December 18, 2022. The included RCTs were assessed for risk of bias, and the endpoints were summarized as mean difference/standardized mean difference (MD/SMD) or risk ratio (RR) with the 95% confidence interval (CI) in a random-effects model. Results: Seven RCTs with 510 patients (TXA = 261 and control/placebo = 249) were analyzed. The overall risk of bias was "low" and "unclear" in four and three RCTs, respectively. The mean operative time (n = 5 RCTs, MD = −9.64 min, 95% CI [−15.74, −3.54], p = 0.002) and mean postoperative pain score on postoperative day 1 (n = 5 RCTs, MD = −0.56, 95% CI [−1.06, −0.05], p = 0.03) were significantly reduced in the TXA group compared with the control group. However, there were no significant differences between both groups regarding visual clarity, amount of irrigation solution, and estimated intraoperative blood loss. Conclusion: Among patients undergoing ARCR, preoperative TXA did not reduce intraoperative blood loss or improve visual clarity. However, TXA administration correlated with significant reductions (statistically) in operative time and postoperative day 1 pain score compared with the control group. Level of evidence: Level I; Systematic Review and Meta-analysis of Randomized Controlled Trials [ABSTRACT FROM AUTHOR]

Solid Waste Management (SWM) is a technical subject which requires comprehensive planning, execution, and effective operational monitoring under cost-effective modes compatible with environmentally sound technologies. The policymakers made some enormous efforts for the sustainability of this sector as well as setting a benchmark for other municipalities and Waste Management Companies (WMCs) in the country. Provincial Government prioritizes its focus on SWM, i.e., waste collection, transportation, treatment, and final disposal. The waste management sector in Lahore has achieved sustainability in waste collection and haulage components by gaining experience from international outsourcing and, now, sharing its knowledge with other municipalities to strengthen the sector in the country. Lahore has emerged with the highest collection efficiency (84%) in SAARC countries and placed fifth in rank in comparison to 54 low–middle-income countries/cities worldwide. The sectorial interventions in Lahore reveal an aspiration for the sustainability of the SWM sector in Pakistan. However, there is an urgent need to focus and invest in waste-related infrastructure development, i.e., permanent/mobile transfer stations, semi-underground containers for commercial and planned areas, material recovery facilities (MRF), and landfill. Environmental and economic sustainability in this sector can be achieved through public–private partnership (PPP) modality in compost, anaerobic digestion, recycling, and refuse-derived fuel (RDF) as it is a more feasible option to strengthen the industry in the country.

Introduction: Handling the COVID-19 outbreak is one of the most novelties modern work is facing by many countries today. Massive outbreak needs countries efficacy and talent in creating new approaches. These approaches need to prevent the spread of the outbreak and increase the citizens' belief as the outbreak will damage the countries' functional capacity. Technical efficiency is used maximally to gain total control of the conditions. This study aims to measure the relative efficiency level of Southeast Asian countries in dealing with COVID-19 pandemic over one year. Methods: The relative efficiency level of the most successful countries in Southeast Asia in managing COVID-19 infection was determined using Frontier 4.1 through Stochastic Frontier Analysis (SFA) and Excel software. The technical efficiency of the SFA model is defined as the ratio of observed output to maximum feasible production. If the country's technical efficiency (TE) is greater than 80%, it is the most effective in Southeast Asia at managing COVID-19 infection, but if it is less than 80% or close to 0, it is inefficient. Results: This research aims at the COVID-19 epidemic in a Southeast Asian country, where the country with the highest technical efficiency score is the most efficient and indicates the country's ability to deal with the COVID-19 outbreak without any complications. Laos was ranked first (TE = 0.99901), with a technical efficiency score that was higher than that of most other Southeast Asian countries. Singapore comes in second position with a technical efficiency score of 0.99882. Brunei is in third place for COVID-19, with a technical efficiency score of 0.99870. Cambodia is in last place, with a score of 0.84675 for technical efficiency. Conclusions: Laos is the highest technical efficiency score among the southeast Asian countries. Various things that can lead to inefficiency include lack of awareness about standard operating procedures (SOP) among the causes of COVID-19 case infection in the workplace, and the community continues to increase. This condition may also be due to the lack of medication or vaccines to cure COVID-19. All communities around the world are expected to adopt standard operating procedures (SOP) such as wearing face masks, hand sanitizers, and social distance to curb the increasingly violent spread of COVID-19.

This systematic literature review was conducted to better understand the epidemiology and burden of varicella across the Middle East, gain insight into the evidence to support using universal varicella vaccination (UVV), and identify potential data gaps. Both epidemiology and economic data on the burden of varicella were limited and varied significantly. Most of the data focussed on varicella burden in the absence of a UVV program. In the absence of UVV, varicella incidence is increasing across this region with varicella infection associated with substantial morbidity. Although limited, data on the impact of vaccination at a population level indicated UVV programs reduce varicella incidence and hospitalizations, in line with global experience. Further research and action are needed to better understand varicella epidemiology in the Middle East, increase awareness and understanding in the region, and provide local data to support national public-health decisions regarding the implementation of UVV programs.

Infection Control in modern times includes the protection of patients against infections with health workers in all settings of healthcare. Evidence-based best practice in family medicine, nursing, dental, laboratory medicine, and surgical specialties is the very foundation of an effective Infection Prevention and Control program. Explicit communication, protocols, education of patients, and vaccination to minimize the chances of infection are also part of this. The nurses are on the first line in the practice of IPC, and microbial labs provide the all-important diagnostic information in infection surveillance. Further training, monitoring for compliance, integrating medical records and technology will reduce health care-associated infections and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Pseudomonas aeruginosa (P. aeruginosa) is a multidrug-resistant (MDR) environment associated microorganism that causes infections in animals and human. The present study aimed to determine antibiotic susceptibility patterns and molecular characteristics of P. aeruginosa. The molecular typing of P. aeruginosa isolates was also performed. Poultry meat and meat product samples (n=110) were collected. The samples were inoculated on MacConkey and cetrimide agar for cultural identification and isolation. Gram staining and biochemical tests were performed for confirmation. The confirmed isolates of P. aeruginosa were then used for antibiotic susceptibility testing against commonly used antibiotics including meropenem, amikacin, aztreonam, azithromycin, enrofloxacin, and gentamicin. The virulence genes including exoU, exoS, lasR, rhlR, algD, pslD, and blaTEM were detected in selected MDR isolates of P. aeruginosa. Among the poultry meat samples, P. aeruginosa was more prevalent (50%) in fresh meat samples than others [frozen meat (40%) and meat products (8%)]. Confirmed isolates were Gram-negative, catalase positive, oxidase positive, beta-hemolytic, and citrate-positive while colorless growth on MacConkey's agar and green color growth on cetrimide agar was observed. In antibiotic sensitivity testing, results indicated that in poultry meat and meat product isolates, all P. aeruginosa isolates were highly resistant to azithromycin (83%). High resistance rate was also observed for aztreonam (67%), gentamicin (58%) and enrofloxacin (50%) and all P. aeruginosa isolates were highly sensitive to meropenem (84%) followed amikacin (75%). In molecular detection of virulence genes, poultry meat samples, exoU, algD, and their genes showed comparable prevalence (80%). The prevalence of drug resistance genes in P. aeruginosa from poultry meat samples was as follows; blaTEM (95%), tetR (0%), exoU (25%), exoS (30%), algD (80%), pslD (85%), lasR (85%) and rhlR (80%). In summary, the presence of virulent genes in P. aeruginosa isolates enables them to harbor antibiotic resistance and acts as an MDR public health pathogen with the potential to transfer to humans via the food chain. [ABSTRACT FROM AUTHOR]

Simple Summary: Peste des petits ruminants (PPR), commonly referred to as goat plague or ovine rinderpest, is an infectious viral ailment that specifically targets wild or domesticated small ruminants, including sheep and goats. The study examined the information gathered from several sources such as research publications to evaluate the overall impact of PPR in Pakistan. The overall pooled prevalence in Pakistan was calculated to be 51%. Among various regions, the level of pooled prevalence of PPR presented a non-significant difference and was almost the same. Moreover, the investigation found other factors that influence the spread of PPR, including animal husbandry techniques, immunization, and geographical factors. In summary, the review of the literature provides significant information about the occurrence and distribution of PPR in Pakistan. There is a dire need to implement efficient management measures to reduce the negative effects of this disease on small ruminant populations. Peste des petits ruminants (PPR) is an extremely transmissible viral disease caused by the PPR virus that impacts domestic small ruminants, namely sheep and goats. This study aimed to employ a methodical approach to evaluate the regional occurrence of PPR in small ruminants in Pakistan and the contributing factors that influence its prevalence. A thorough search was performed in various databases to identify published research articles between January 2004 and August 2023 on PPR in small ruminants in Pakistan. Articles were chosen based on specific inclusion and exclusion criteria. A total of 25 articles were selected from 1275 studies gathered from different databases. The overall pooled prevalence in Pakistan was calculated to be 51% (95% CI: 42–60), with heterogeneity I2 = 100%, τ2 = 0.0495, and p = 0. The data were summarized based on the division into five regions: Punjab, Baluchistan, KPK, Sindh, and GB and AJK. Among these, the pooled prevalence of PPR in Sindh was 61% (95% CI: 46–75), I2 = 100%, τ2 = 0.0485, and p = 0, while in KPK, it was 44% (95% CI: 26–63), I2 = 99%, τ2 = 0.0506, and p < 0.01. However, the prevalence of PPR in Baluchistan and Punjab was almost the same. Raising awareness, proper surveillance, and application of appropriate quarantine measures interprovincially and across borders must be maintained to contain the disease. [ABSTRACT FROM AUTHOR]

Background and objective: Extraction of an impacted mandibular third lower molar tooth is one of the common surgical procedures that may lead to the damage of inferior alveolar nerve due to roots proximity to the mandibular canal. This study aimed to know the relative relationship and proximity of the mandibular third molar roots to the inferior alveolar canal in relation to gender, age, depth of impaction, relation with ramus, and type of angulation of the impacted tooth in Kurdistan population. Methods: A sample of 366 digital panoramic radiographs of patients with impacted mandibular third molar was studied. Panoramic radiographic signs images were evaluated for the presence of root contact with the superior border of the mandibular canal, darkening of the roots apex, deflected roots, narrow root, superimposition of the canal, interruption of the white line, diversion of the inferior alveolar canal, and narrowing of the inferior alveolar canal. The depths of impaction, relation with ramus, and type of angulation were also studied. Results: Significant relation of the proximity of the mandibular third molar roots to the inferior alveolar canal with the gender (P = 0.001) and age (P

OBJECTIVES:Alloyed metallic nanoparticles of silver and copper are effective against intracellular infection. However, systemic toxicity may arise due to the non-specific delivery of the nanoparticles. In addressing the issue, this study deals with the targeting of silver-copper-boron (ACB) nanoparticles to infected osteoblasts, which could decrease systemic toxicity and form the basis of targeting specific markers expressed in bone infections. METHODS:ACB nanoparticles were synthesized and conjugated to the Cadherin-11 antibody (OBAb). The effect of targeting nanoparticles against extracellular and intracellular S. aureus was determined by enumeration of bacterial growth. The binding of the targeting nanoparticles to infected osteoblasts as well as the visualization of live/dead bacteria due to treatment was carried out using fluorescence microscopy. MTT assay was used to determine the viability of osteoblasts with different concentrations of the nanoparticles. RESULTS:The ACB nanoparticles conjugated to OBAb (ACB-OBAb) were effective against extracellular S. aureus. The ACB-OBAb nanoparticles showed a 1.32 log reduction of intracellular S. aureus at a concentration of 1mg/L. The ACB-OBAb nanoparticles were able to bind to the infected osteoblast and showed toxicity to osteoblasts at levels ≥20mg/L. Also, the percentage of silver, copper, and boron in the nanoparticles determined the effectiveness of their antibacterial activity. CONCLUSION:The ACB-OBAb nanoparticles were able to target the osteoblasts and demonstrated significant antibacterial activity against intracellular S. aureus. Targeting shows promise as a strategy to target specific markers expressed on infected osteoblasts for efficient nanoparticle delivery, and further animal studies are recommended to test its efficacy in vivo.

Introduction: Testicular damage is one of the most deleterious effects whenever cisplatin (CP) is employed in cancer treatment. CP results in male infertility. L-carnitine (LC) is a vitamin-like substance with antioxidant activity. L-carnitine improves spermatogenesis, sperm maturation and motility. Aim of the Work: Assess the protective role of LC in cisplatin-induced testicular toxicity. Material and Methods: Forty adult male albino rats (200-250 grams each) were divided into four groups. The first group is control. Group II: LC was intraperitoneal (IP) injected (500 mg/kg/d) for fifteen days. Group III: CP was injected with only one dose of 7 mg/kg CP (IP) on the 6th day. Group IV: LC plus CP received treatment of both groups II and III. Semen analysis was performed to estimate sperm count and motility. Testicular sections were examined under light microscopy using H&E, PAS, and anti-inducible nitric oxide synthase (iNOS) stainings. A transmission electron microscope was also done. Results: Cisplatin caused a significant decline in the body weight, absolute and relative testicular weight, sperm count, sperm motility, seminiferous tubular diameter, and germinal lining height in relation to other groups, with a significant improvement in the CP plus LC group. Specimens from CP-treated animals showed thick and destructed seminiferous tubules (ST) basal lamina, obvious disorganized and atrophied ST, spermatogenic arrest, and atrophied Leydig cells. LC improves these changes with variable preservation of spermatogenic cells. Inducible NOS staining in the CP-treated group showed a moderate positive reaction, other groups showed a negative or weak reaction. Transmission electron photomicrography of the CP group showed large cytoplasmic vacuoles, small distorted mitochondria, and large lipid droplets in most spermatogonic cells; abnormally shaped spermatozoa. Conclusion: L-carnitine partially attenuates CP-related histological changes of the testicular tissue and improves the quality parameters of the sperm, ensuring the protective effect of LC. [ABSTRACT FROM AUTHOR]

The study explores the UAE's legal framework for the protection of digital applications, examining their compatibility with criminal policy, judicial assessment, and government role. The investigation intricately examines the multifaceted aspects of this protection, including its inherent connection with criminal policy, the scope of judicial discretion regarding electronic evidence, and the pivotal role played by the UAE government in upholding these protective measures. It delineates, assesses practical application, and identifies enforcement entities. The study compares legal systems in Anglo-Saxon countries such as the UK and the USA, as well as in Latin countries such as France and Egypt. This study aims to endeavor to unearth nuanced findings and insightful observations and to strengthen measures to protect digital applications by studying technical aspects, legal implications, and criminal policy implications, and contributing to ongoing discourse on the protection of digital applications. Furthermore, it extends its scope beyond the mere technicalities, suggesting significant recommendations at the end, for the protection of digital applications with the legal spectrum. [ABSTRACT FROM AUTHOR]

Summary: Salmonella enterica is one of the most commonly reported causes of bacterial foodborne illness around the world. Understanding the sources of this pathogen and the associated factors that exacerbate its risk to humans will help in developing risk mitigation strategies. The genetic relatedness among Salmonella isolates recovered from human gastroenteritis cases and food animals in Qatar were investigated in the hope of shedding light on these sources, their possible transmission routes, and any associated factors. A repeat cross-sectional study was conducted in which the samples and associated data were collected from both populations (gastroenteritis cases and animals). Salmonella isolates were initially analyzed using multi-locus sequence typing (MLST) to investigate the genetic diversity and clonality. The relatedness among the isolates was assessed using the minimum spanning tree (MST). Twenty-seven different sequence types (STs) were identified in this study; among them, seven were novel, including ST1695, ST1696, ST1697, ST1698, ST1699, ST1702, and ST1703. The pattern of overall ST distribution was diverse; in particular, it was revealed that ST11 and ST19 were the most common sequence types, presenting 29.5% and 11.5% within the whole population. In addition, 20 eBurst Groups (eBGs) were identified in our data, which indicates that ST11 and ST19 belonged to eBG4 and eBG1, respectively. In addition, the potential association between the putative risk factors and eBGs were evaluated. There was no significant clustering of these eBGs by season; however, a significant association was identified in terms of nationality in that Qataris were six times more likely to present with eBG1 compared to non-Qataris. In the MST analysis, four major clusters were presented, namely, ST11, ST19, ST16, and ST31. The linkages between the clusters alluded to a possible transmission route. The results of the study have provided insight into the ST distributions of S. enterica and their possible zoonotic associations in Qatar. Keywords: Salmonella enterica, Multi-locus sequence typing, STs, eBGs, Minimum spanning tree