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BACKGROUND Maxillomandibular relationship records facilitate patient stomatognathic information transfer to dental laboratories, but new bite registration materials (BRMs) lack scientific evidence on linear dimensional accuracy. This in vitro investigation compared linear dimensional accuracy of 6 commercial scannable and transparent BRMs with a typical BRM at 1 h. MATERIAL AND METHODS Seven American Dental Association (ADA)-approved BRMs were categorized into 1 control and 2 experimental groups: control: Occlufast Rock; scannable group: Occlufast CAD, Virtual CADBite, and Flexitime Bite; and transparent group: Maxill Bite, Charmflex Bite, and Defend ClearBite. The study used modified ADA specification no. 19 to standardize bite registration record samples, which were examined using a stereomicroscope to compare with control group and standard die measurements. Median, interquartile range, and median rank scores were used for statistical interpretation. One-way ANOVA (Kruskal-Wallis rank test) and multiple-comparison Dunn test with Bonferroni correction compared between and within group differences at the probability P value ≤0.05. RESULTS The median linear differences varied in scannable, -0.06 (0.24%) to -0.11mm (0.44%), and transparent, -0.06 (0.24%) to -0.07 (0.28%), BRMs, with transparent BRMs showing more linear accuracy than scannable BRMs. A statistically significant difference from control at 1 h was observed for 3 different commercial brands. All transparent BRMs exhibited markedly reduced linear discrepancies, compared with the standard BRM (P<0.05). CONCLUSIONS All BRMs at 1 h showed a reduced linear dimensions, indicating shrinkage. All investigated BRMs demonstrated clinically acceptable linear discrepancies, with transparent BRMs exhibiting less change than scannable BRMs.

Purpose: Acanthamoeba spp. can colonize various freshwater habitats. They are the causative agents of granulomatous amoebic encephalitis and can harbor many microorganisms. We studied the presence of Acanthamoeba spp. in the water system of a hemodialysis unit and assessed the potential for transmission to hemodialysis patients., Methods: Water samples collected from pretreatment and posttreatment water of the treatment station and from input and output water of the dialysis machines were cultured on non-nutrient agar supplemented with Escherichia coli. Blood samples from dialysis patients in the unit and from a control group in the same hospital were tested for anti-Acanthamoeba IgG antibodies., Results: Acanthamoeba spp. were found in posttreatment water. They were more commonly found in the input water samples (79.2%), than in the output water samples (16.7%) (p = 0.001). Anti-Acanthamoeba IgG antibodies were present in 32.9% of patients and were absent in the control group (p = 0.002). The duration of hemodialysis was significantly longer in seropositive patients than in seronegative patients (p = 0.008)., Conclusion: The study highlights the presence of Acanthamoeba spp. in the dialysis system. The relatively high prevalence of anti-Acanthamoeba IgG antibodies and the link between dialysis duration and seropositivity emphasize the importance of rigorous water monitoring., Competing Interests: Declarations. Competing Interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Childhood hearing loss (CHL) is a condition that can have a variety of causes, including genetic and environmental and its prevalence is thought to be high in Saudi Arabian population mainly due to consanguineous unions. This systematic literature review aims to conclude the prevalence of hereditary hearing loss and its risk factors among the Saudi population., Methods: In September 2023, a thorough search was performed on the PubMed, CENTRAL, MEDLINE, and EMBASE databases. Two reviewers independently reviewed the literature and gathered data. The search criteria encompassed ethics and dissemination. The systematic review and meta-analysis utilized information sourced from openly accessible research articles, thereby avoiding the involvement of any individuals or animals in the study., Results: The search identified nine relevant studies. Consanguinity prevalence ranged from 21.1 % to 80.8 %, with first cousin marriages being common. The prevalence of CHL among offspring from consanguineous marriages was consistently higher than non-consanguineous unions. A meta-analysis was not feasible due to heterogeneity in study designs and outcomes. The risk of CHL in offspring from consanguineous marriages was significantly elevated, as evidenced by Almazroua's study (2020) reporting a 3.5 times higher risk. Genetic factors and hereditary influences were underscored by the studies, with variations in prevalence and risk factors., Conclusion: This systematic review reveals a substantial association between consanguinity and an increased risk of congenital sensorineural hearing loss in the Saudi Arabian population. The prevalence of consanguinity, coupled with the consistently higher prevalence of CHL among offspring from such unions, emphasizes the need for targeted public health interventions. Educational programs, genetic counseling, and expanded premarital screening programs are warranted to address the impact of consanguinity on hearing health in Saudi Arabia., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this manuscript., (Copyright © 2024. Published by Elsevier B.V.)

Humans expend more energy walking on uneven terrain, but the amount varies across terrains. Few experimental characterizations exist, each describing terrain qualitatively without any relation to others or flat ground. This precludes mechanistic explanation of the energy costs. Here we show that energy cost varies smoothly and approximately quadratically as a function of terrain amplitude. We tested this with healthy adults (N=10) walking on synthetic uneven terrain with random step heights of parametrically controlled maximum amplitude (four conditions 0 - 0.045 m), and at four walking speeds (0.8 - 1.4 m.s-1). Both net metabolic rate and the rate of positive work increased approximately with amplitude squared and speed cubed (R2 = 0.74,0.82 respectively), as predicted by a simple walking model. The model requires work to redirect the body center of mass velocity between successive arcs described by pendulum-like legs, at proportional metabolic cost. Humans performed most of the greater work with terrain amplitude early in the single stance phase, and with speed later in stance during push-off. Work and energy rates changed with approximately linear proportionality, with a ratio or delta efficiency of 49.5% (R2 = 0.68). The efficiency was high enough to suggest substantial work performed passively by elastic tendon and not only by active muscle. Simple kinematic measures such as mid-swing foot clearance also increased with terrain amplitude (R2 = 0.65), possibly costing energy as well. Nevertheless, most of the metabolic cost of walking faster or on more uneven terrain can be explained mechanistically by the work performed., (© 2025. Published by The Company of Biologists.)

Objectives:  Orthodontic bracket bond failure is an obstacle in clinical orthodontics. This study investigated the influence of pH cycling on the shear bond strength (SBS), adhesive remnant index (ARI), and survival probability of adhesive-precoated flash-free ceramic brackets., Materials and Methods:  Forty mandibular premolars were randomly divided into two groups ( n  = 20): C: noncoated orthodontic brackets, and F: flash-free adhesive-precoated orthodontic brackets. Each group was subdivided into two subgroups according to storage medium solutions ( n  = 10): in subgroup AS, specimens were immersed in artificial saliva for 24 hours, and in Subgroup ASL, specimens were recycled between a demineralizing solution and an artificial saliva for 42 days. Within each subgroup, specimens were subjected to SBS and ARI testing. SBS data were analyzed using one-way ANOVA (analysis of variance) and Tukey's post-hoc test. Weibull analysis was performed on the SBS data to determine the characteristic SBS and their survival probabilities., Results:  Flash-free adhesive-precoated brackets had higher significant ( p  < 0.001) SBS values in both the AS group (17.74 ± 1.74 MPa) and the ASL group (12.61 ± 1.40 MPa) compared with the noncoated bracket (10.67 ± 1.55 and 7.89 ± 1.39 MPa, respectively). The ARI scores for the noncoated brackets in the AS group were 70% occurrence for score 1, while 90% for score 1 in the ASL group. For the flash-free precoated brackets, ARI scores were 70% occurrence for score 2 in the AS group, while 80% for score 2 in the ASL group. Flash-free brackets had higher SBS in both AS and ASL groups (14.07 and 9.76 MPa, respectively), at 95% survival probability., Conclusion:  Flash-free orthodontic brackets performed better in terms of significantly higher bond strength and higher ARI scores. Meanwhile, noncoated brackets revealed acceptable SBS results in both storage medium groups. Flash-free brackets showed higher survival than the noncoated brackets in both storage medium groups at 90% survival probability., Competing Interests: None declared., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).)

Background: This study aims to perform a review by selecting, analyzing, and evaluating articles that discuss the accuracy of intraoral scanners (IOSs) in recording post space compared to conventional impression-making techniques., Methods: The review question framed using the PITR framework (participant, index test, targeted condition, and reference standard) is as follows: What is the dimensional accuracy (T) of impressions made using intraoral scanners (I) for post space (P) compared to impressions made using conventional techniques and digitalized using extraoral scanners (R)? Four electronic databases were searched using pre-set keywords. The guidelines and strategies recommended by PRISMA formed the basis for planning, executing, and documenting this systematic review. QUADAS-2 was used to critically analyze the quality of all the selected articles., Results: After excluding ineligible articles, the end synthesis has nine studies ( n = 9) for qualitative analysis. All nine evaluated studies were found to be at risk of bias, with high or unclear risk in one or more domains. Three out of nine evaluated studies had unclear concerns regarding the applicability, and the remaining six had low concerns. In all the included studies, the IOSs were reported to have deviations in accuracy compared to the conventional techniques for making digital impressions of post space., Conclusions: The accuracy of IOSs was found to be inversely proportional to the length of post space and directly proportional to the diameter of post space. IOSs, when used adequately in short post spaces, can be an alternative to conventional impression-making for making custom posts and cores.

BACKGROUND This study used an edentulous mandibular resin model with 6 parallel osteotomy sites and aimed to compare the accuracy (trueness and precision) of 10 digital impressions using 3 intraoral scanners, the 3Shape TRIOS 5, Medit i700, and Primescan, using Medit Link v3.3.2 software. MATERIAL AND METHODS A model simulating a patient's lower jaw was surgically prepared at 6 parallel sites (implant osteotomy), allowing placement of 6 implant analogues. Matrix-Direct transfer abutments were attached to the analogs, and a reference scan was obtained using a CeramilMap 600 extraoral scanner. Three intraoral scanners (3Shape TRIOS 5, Medit i700, and Primescan) made 10 digital impressions of each model. The data obtained were superimposed and compared using software (Medit Link 3.3.2) to evaluate accuracy. Mean values were statistically analyzed using one-way ANOVA and post hoc Tukey test. Differences were considered significant at a P value of less than 0.05. RESULTS The TRIOS 5 intraoral scanner displayed the lowest deviation for precision (37.8±4.53 μm) and trueness (54.9±11 μm), followed by Medit i700 (precision 40.6±4.17 μm, trueness 60.5±10.9 μm), whereas the highest deviation (precision: 49.1±8.31 μm, trueness: 72.3±10.4 μm) was reported when Primescan intraoral scanner was used for recording impressions of full arch implants. When the 3 intraoral scanners were compared, a statistically significant difference was observed in terms of precision (P<0.005) and trueness (P<0.005). CONCLUSIONS TRIOS 5 intraoral scanner displayed the lowest deviation values for precision and trueness (more accurate), followed by Medit i700 and Primescan intraoral scanners. However, deviation values of all scanners were within clinically acceptable limits.

Background: The implication of human Schistosoma mansoni ( S. mansoni ) infection in concomitance with other risk factors such as hepatitis C virus (HCV) and hepatitis B virus (HBV) in the development of hepatocellular carcinoma (HCC) is still under controversy. This work aimed. to evaluate the role of S. mansoni infection in association with hepatitis B virus (HBV), hepatitis C virus (HCV) and other risk factors in the development and/or progress of HCC., Methods: The present study was carried out on 90 HCC patients recruited from Kafr El-Sheikh Liver Disease Research Institute. After obtaining their informed consents, socio-demographic and clinical data were collected and patients were examined for S. mansoni by Kato-Katz and indirect hemagglutination (IHA) techniques. Alpha-fetoprotein (AFP) level was determined. The Child-Pugh scoring system and Barcelona Clinic Liver Cancer (BCLC) staging system were used to evaluate the pathological features of the studied patients., Results: All participants were negative for active S. mansoni by Kato-Katz. Based on IHA, the participants were categorized into two groups: group I: sixty-two patients negative for S. mansoni and group II: twenty-eight schistosomiasis positive. The patients' age ranged between 40->60, HCC was more prevalent in the age range of > 50-60 years in both groups. Males were more than females and rural participants were more than urban patients in both groups. Most of the patients (88.9%) had HCV while 7.8% had HBV. A higher proportion of HCC patients showed concomitant HCV and S. mansoni (92.6%) than the S. mansoni negative group. The frequency of upper gastrointestinal bleeding (GIB) was four-fold higher among HCC patients positive for schistosomiasis compared to negative schistosomiasis cases (64% vs. 16%). Alpha-fetoprotein (AFP) level was higher in group II than that in group I with no significant difference. Statistical analysis showed no difference between the two studied groups regarding Child scores. On the contrary, BCLC class D was significantly higher among HCC positive schistosomiasis cases compared to the negative group., Conclusion: Concomitant S. mansoni with HCV and HBV potentiate HCC progression., Competing Interests: Conflict of interestThe authors declare no conflict of interest., (© Indian Society for Parasitology 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: The prevalence of colorectal cancer (CRC) is on the rise among the younger population, with an anticipated increase in new cases for individuals aged 20-49 years by 2030. The accessibility of community pharmacists and their strong community connections present unique opportunities to enhance patient engagement in a population-based CRC screening program., Objectives: This study seeks to assess the effectiveness of a community pharmacist-led point-of-care CRC screening program utilizing fecal immunochemical test (FIT) kits to identify CRC prevalence in high-risk individuals., Methods and Materials: Over the course of a 10-month prospective intervention conducted in UAE community pharmacies, we evaluated the impact of a pharmacist-led point-of-care colorectal cancer screening program. Six pharmacies were selected based on their services and capabilities. Eligible participants were those identified during medication reviews as exhibiting colorectal cancer risk factors. Pharmacists provided communication materials, distributed FIT kits, and implemented reminders. Participants collected samples for hemoglobin analysis, which served as an indicator of colorectal bleeding. Collected data encompassed demographics, lifestyle, and health-related characteristics. Pharmacists performed medication reviews and offered recommendations., Results: A total of four hundred and one recruited int the study. The mean age of study cohort at baseline was 66.6 ± 11.3 years. In our study with 401 participants, 36.4 % had undiagnosed colorectal cancer (CRC). Univariate logistic regression identified older age, a history of Type 2 diabetes mellitus (DM), and inflammatory bowel disease (IBD) as significant factors associated with increased CRC prevalence, while aspirin users exhibited a lower likelihood of CRC. In the multivariate regression model, the history of Type 2 DM and IBD remained significant predictors for heightened CRC risk., Conclusion: This study strengthens the plausibility of cause-and-effect relationships between colorectal cancer and demographic variables using epidemiological evidence. The significant relationships found between prevalence of CRC and age, type 2 diabetes, IBD and aspirin use support the effectiveness of using FIT kits in community pharmacist-led point-of-care CRC screening program to identify high-risk individuals. The finding highlights the significance of improving efforts on colorectal cancer prevention and control., Competing Interests: Competing interests All authors declare that they have no conflict of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Myocardial deformation by speckle tracking echocardiography provides valuable information on the left ventricular function. The study aims to assess myocardial deformation in terms of left ventricular strain as an indicator of myocardial function in children after cardiac surgery at outpatient follow-up visits., Methods: The study design was a prospective observational cross-sectional study that included pediatric patients after biventricular cardiac surgery during the postoperative follow-up visits in the outpatient department. In addition to conventional echocardiographic examination, two-dimensional speckle tracking echocardiography was done to evaluate myocardial deformation in terms of left ventricular strain. Echocardiographic measurements were done offline and were compared to published reference normal values for age. Study subjects were divided according to age at follow-up into four groups (1 month-1 year, 1-2 years, 2-5 years, and 5-11 years)., Results: Over ten months, 100 patients (64 males and 36 females) were included in the study. The median age was 30.8 months (IQR 12.8-65.3 months), the median weight was 11.7 kg (IQR 8-17 kg) and the median duration after surgery was 7.3 months (IQR 3.2-30.8 months). Longitudinal strain values were significantly (p < 0.001) lower than reference values for different age groups. Global circumferential strain showed no significant difference from the reference values. The duration after surgery had a statistically significant effect on longitudinal strain values, with improvement of the strain values with increasing intervals after surgery., Conclusion: Using myocardial deformation method to evaluate cardiac function may detect underlying cardiac function abnormalities even with normal traditional functional parameters, which could have implications for patient management and follow-up., Competing Interests: Declarations Ethics approval and consent to participate The research study was performed in accordance with the Declaration of Helsinki. Qassim Regional Research Ethics Committee approved the study under reference number 607/44/10173. Informed written consent from parents/guardians was provided by all participants. Consent was taken for participation and anonymous use of data for research purposes and publication. Consent for publication Detailed informed written consent was taken from the parents/guardians for the echocardiographic study. Consent includes that the data could be used anonymously for research purposes and publication. Competing interests All authors have no conflict of interest relevant to this article to disclose., (© 2024. The Author(s).)

Background: The study of over the counter (OTC) vending machines is crucial given their growing popularity and potential impact on the pharmaceutical industry and consumer behaviour., Objectives: This study involves a bibliometric quantitative analysis of academic literature to evaluate OTC vending machines in terms of their evolution, current trends, and potential areas for future research ., Methods and Materials: The Scopus database was searched using its advanced search tool, focusing on papers that included the search query in their titles, abstracts, and keywords. Data analysis included bibliometric indicators such as publication counts, citation trends, and co-authorship networks, which were visualized using VOSviewer software (version 1.6.20) to highlight key research themes and collaboration patterns., Results: A total of 399 publications on OTC vending machines were found between 1833 and 2024. Over the last 20 years, there has been an annual increase in the number of publications related to OTC vending machines, rising from 1 in 2001 to 31 in 2023. The United States ( n  = 118; 29.57 %) led in productivity, followed by the United Kingdom (45; 11.27 %), India (30; 7.51 %), Australia (27; 6.76 %), Canada (16; 4 %), Italy (15; 3.75 %), and China (15; 3.75 %). A total of 35 institutions have been involved in research on OTC vending machines. The Dubai Municipality contributed the highest percentage of articles ( n  = 3, 0.75 %), followed by the Emirates Health Services (n = 3, 0.75 %), Al Ain University ( n  = 2, 0.5 %), and Baystate Medical Center (n = 2, 0.5 %). Before 2016, much of the research on OTC vending machines focused on terms related to healthcare policy and health promotion, indicating the early exploration of this field. Present trends highlight terms associated with pharmacy practice, such as pharmacists, pharmacy, and prescription-related subjects., Conclusions: This study emphasises the practical necessity for enhanced regulatory structures to mitigate risks such as medication abuse, unfavourable drug interactions, and incorrect dispensing practices. Additionally, the study highlights the need for interdisciplinary collaboration among technologists, policymakers, and healthcare professionals to maximize the benefits of OTC vending machines while addressing consumer behaviour and safety issues., Competing Interests: All authors declare that they have no conflict of interest., (© 2024 The Authors.)

Newborn jaundice (NNJ), especially due to ABO incompatibility, is a major global health concern. Phototherapy is standard treatment, with exchange transfusions reserved for severe cases. However, in some babies these therapies may be ineffective, requiring additional immunomodulatory treatments. Limited access to these treatments in developing countries creates a critical gap, worsening jaundice severity. A 22-hour old term neonate presented with rapidly progressive severe neonatal hyperbilirubinemia (NNJ) within 15 hours of life, consistent with ABO incompatibility based on discordant maternal and infant's blood types (mother: O, baby: B-positive). Despite aggressive initial management with phototherapy and exchange transfusions, the NNJ exhibited limited improvement. Sepsis and G6PD deficiency were considered as potential contributing factors, although confirmatory testing for G6PD deficiency was deferred due to unavailability of the diagnostic test in our setting. Given a sibling's documented successful response to methylprednisolone for a similar presentation, a brief course of low-dose intravenous methylprednisolone (1mg/kg/day in 2 divided doses) (off-label use) was cautiously initiated. This resulted in a rapid and significant improvement in the neonate's hyperbilirubinemia. Methylprednisolone was prescribed for 3 days after which it was discontinued. Following close observation for 3 days and confirmation of no neurological sequelae, the neonate was discharged home in stable condition. Managing severe, worsening NNJ, especially with multiple aetiologies, is complex. Standard therapies may be inadequate. While promising, immunomodulatory therapies like IVIG may be limited in resource-poor settings. Methylprednisolone shows potential but lacks strong clinical evidence. Well-designed studies are essential to explore its safety and efficacy, particularly in developing countries with limited treatment options., Competing Interests: The authors affirm that they have no competing financial interests or personal, (Copyright © 2024 Nigerian Medical Association.)

The biomechanics of walking are far less understood for uneven terrain than flat or even surfaces. This is due in part to a lack of ground reaction force and moment recordings from each leg. These are often obtained with split-belt instrumented treadmills, which are currently incompatible with uneven terrain, making it difficult to perform biomechanics analyses such as inverse dynamics. Here we show how a standard split-belt instrumented treadmill (Bertec, Inc., Columbus, OH) can be modified to accommodate a variety of uneven terrains. The principal design considerations are structural clearance to allow passage of an uneven treadmill belt and fabrication of the terrain. We designed mechanical components with sufficient clearance for terrains up to 0.045 m high, and formed the terrain from uneven strips of polystyrene. Measured ground reaction forces from each leg at typical walking speeds agreed well with an intact benchmark treadmill (minimum interclass cross correlation score = 0.97). The modifications had negligible effect on the treadmill's structural strength. The terrain produced some noise-like vibrations, but at much higher frequencies than fundamental to human locomotion. The uneven terrain treadmill can record many steps of the full complement of ground reaction forces and moments from individual legs., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: To determine the clinical effectiveness of different green tea extracts (GTEs) in reducing bleeding after extraction of mandibular molars., Study Design: Randomised controlled trial. Place and Duration of the Study: College of Dentistry, King Khalid University, Abha, Saudi Arabia, from October to December 2022., Methodology: A total of 64 patients were selected from those who attended dental clinics at the College of Dentistry, King Khalid University for extraction of their mandibular molars. They were equally and randomly divided into a control and three test groups by asking the patient to choose a numbered piece of paper. In the first group, normal saline-soaked sterile gauze was used after the tooth extraction while in the three test groups, different GTEs (methanolic GTE, aqueous GTE, and tannin isolated from the green tea) were applied. Monitoring of the bleeding by observing the extraction socket was carried out at regular intervals of five minutes until the oozing subsided, and then once an hour after that., Results: Each group had 16 patients. The mean of bleeding stop-minutes was significantly different among the groups (61.56 minutes for the control group, 7.50 minutes 8.44 minutes and 5.62 minutes for the test groups, p <0.001). The median of bleeding stop-minutes of the control group was significantly higher than all test groups (p <0.001). The number of patients in whom bleeding was continued one hour after surgery was significantly higher in the control group (p = 0.005). Moreover, tannin has the greatest haemostatic effect compared to aqueous and methanolic GTEs., Conclusion: Significant haemostatic effect has been shown by all GTEs. Tannin isolated from green tea has shown a significantly higher haemostatic effect than to the aqueous and methanolic extracts., Key Words: Bleeding, Green tea extracts, Haemostasis, Tannin isolate, Molar extraction.

Background: A skilled and experienced preceptor enhances nursing candidates' education. Students can acquire invaluable insights by observing and learning from the preceptor's professional nursing practice. Organizations must furnish sufficient support to guarantee the efficacy of preceptors in their responsibilities., Objective: To evaluate preceptors' perceptions of the preceptorship and the relationship between organizational support and preceptor perspective of preceptorship., Methods: A cross-sectional correlational design was deployed using purposive sampling of 90 nurses in the UAE. Between August 2023 and December 2023, a self-reported questionnaire with 40 items on preceptor perspectives of preceptorship (PPP) was distributed to nurses. The student's t-test, Chi-square, Monte Carlo, Fisher Exact, and Pearson coefficient were used., Results: The results revealed that most participants were female (71.1%), with 48.9% between 36 and 45 years old. The mean score for the PPP was high (73.81 ± 10.92). There was a significant association between age, years of nursing experience, work area, and overall PPP. A strong correlation was found between self-preparation ( r  = .675), preceptorship perception commitment ( r  = .762), and the benefits of preceptorship ( r  = .830), along with organizational support., Conclusion: The preceptors in this study had a positive perspective about preceptorship. Their acknowledgment of preceptorship's benefits to the organization shows their optimism and dedication. Future studies should analyze preceptor training programs and devise initiatives to improve clinical teaching., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Background: Erectile dysfunction (ED) and sex hormone profile disturbances are common in ESRD patients., Objective: To assess the effect of kidney transplant (KT) and Hemodialysis/peritoneal dialysis (HD/PD) on the serum sex hormone profile and sexual functions in ESRD patients with ED., Patients and Methods: A single-center, nonconcurrent cohort study included a hundred ESRD patients with ED, on regular HD/PD (group A, n = 50) and after KT (group B, n = 50) at Armed Forces Hospitals Southern Region, KSA., Results: the mean age of patients was 47.3 ± 7.01 and 56.8 ± 9.6 years in groups A and B, respectively. The cohorts were comparable regarding patient demographics, apart from a higher incidence of comorbidities in group B. After KT the mean testosterone level was higher in Group B (13.64 ± 3.21 nmol/L vs 10.26 ± 3.26 nmol/L, p < 0.001). Similarly, LH and prolactin levels were lower in group B than in group A (p < 0.05). As regards sexual function, ED was reported in 92% of patients in group A compared to 42% in group B (p < 0.001). In groups A and B, mild ED was found in 48% and 14% of patients, while moderate ED was found in 16% and 8%, respectively. The mean total IIEF-15 score was 36.42 ± 9.33 and 43.87 ± 9.146 in groups A and B, respectively (p = 0.0001). Sexual desire and orgasm were significantly better in Group B., Conclusions: Our study showed that kidney transplantation could improve erectile function and restore normal sex hormone levels in ESRD male patients with ED, with better outcomes compared to HD/PD.

Background: Methicillin-Resistant Staphylococcus aureus (MRSA) is both a human commensal and a pathogen that causes neonatal infection which is associated with significant morbidity and mortality. Its genetic flexibility and versatility have equipped it with the ability to develop resistance to numerous antibiotics. Outbreaks of infections in neonatal intensive care units as well as community infections have been reported mostly in developed countries. However, there is a paucity of data on neonatal MRSA infection in developing countries. The study aims to highlight cases of MRSA infection, describe the clinical presentation, and outline the antibiotic susceptibility pattern among term neonates in our facility., Methodology: It was a prospective cross-sectional hospital-based study carried out from October 2018 to July 2019. A total of 248 term neonates with suspected sepsis were enrolled in the study and had their blood samples taken for investigations including blood culture. Bacterial identification and antibiotic susceptibility patterns were carried out using MicrobactTM24E (Oxiod UK) and Staph ID and modified Kirby-Bauer disk diffusion technique respectively., Results: Out of the 248 subjects enrolled in the study, 34.2% had proven sepsis, with Staphylococcus species accounting for 56.4% of these cases. Among those with staphylococcal sepsis, 56.3% were found to have MRSA infection. Notably, the majority (94.4%) of cases originated from outside the hospital, presenting as neonatal sepsis with non-specific clinical features. Sensitivity testing revealed that ciprofloxacin and chloramphenicol were the most effective antibiotics against the identified pathogens., Conclusion: The presence of MRSA infections in neonates poses a critical public health threat. This trend underscores the emergence of antimicrobial resistance, potentially compromising treatment efficacy and jeopardizing neonatal well-being. Urgent and decisive measures are necessary to curb this trajectory., (Copyright © 2024 Nigerian Medical Association.)

Static Young's modulus ( E s ) is a critical property required in numerous petroleum calculations. Various models to forecast E s have been proposed in the literature. However, existing models, by and large, lack precision and are confined to specific data set ranges. This study proposes an alternative approach for E s determination, utilizing different machine learning methods, such as an adaptive neuro-fuzzy inference system (ANFIS). In these proposed methods, the predictor variables include bulk formation density (RHOB), shear wave velocity (DTs), and compressional wave velocity (DTc). The models were trained on a data set comprising 1853 hydrocarbon reservoir rock samples from globally diverse locations. They were evaluated using trend, group error, and statistical error analyses. To test the efficacy of the proposed models, the optimally performing model was identified and used to detect the rock types along with the previously published models. Results indicated that ANFIS is the optimum model and can predict E s with an average absolute percentage relative error (AAPRE) of 5.1% and a correlation coefficient ( R ) of 0.9602. The ANFIS method has some benefits over other machine learning approaches insofar as its superiority in reaching a quicker decision about the mapped relationship between the inputs and outputs because it combines artificial neural networks and fuzzy logic in one tool. The ANFIS can perform a highly nonlinear mapping and displays a better learning ability. The proposed ANFIS model demonstrates its ability to capture accurate physical relationships between input rock properties and E s through trend analysis, which shows that increasing the RHOB increases the E s . Contrarily, increasing the DTc and DTs reduces the E s . Furthermore, the ANFIS model can accurately detect the rock types based on its E s determinations. This research demonstrates the importance of accurately predicting E s for the proper identification of rock types. Thus, this study offers potential advancements in geological assessments of hydrocarbon reservoirs and improvements in many petroleum engineering applications., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

BACKGROUND Surgical extraction of impacted mandibular third molars is the most commonly performed procedure in oral surgery; its associated complications include sensory nerve damage, swelling, and trismus. This study aimed to evaluate the effects of hyaluronic acid (HA) on healing of the socket following extraction of the lower impacted third molar tooth in 40 dental patients. MATERIAL AND METHODS This prospective, double-blind, randomized, controlled study was carried out on 40 adult healthy patients indicated for surgical removal of bilateral impacted mandibular third molars with equal surgical difficulty (moderate surgical difficulty according to the Koerner index. Patients with right mandibular third molars were included into the study (HA) group and those with left mandibular third molars were included into the control group. Surgical removal of impacted teeth was performed at different times for each patient for proper measurement of postoperative clinical variables, including pain, swelling, and mouth opening. RESULTS Postoperative pain evaluation results using the visual analog scale (VAS) showed reduced pain levels at all observation periods. Postoperative swelling peaked in intensity within 12-48 hours, resolving between the 5th and 7th days, and there was no significant difference in pre- and postoperative measurements of interincisal opening between both groups (P>0.05). CONCLUSIONS We found that intra-socket application of hyaluronic acid after surgical extraction of impacted mandibular third molars promoted normal wound healing, and there was a clinical benefit of reduced postoperative pain and swelling.

Background: Community pharmacists are essential to pharmacogenomics implementation because they can help trainers, clinical advisors, and other medical professionals understand the importance of pharmacogenomics and encourage them to use it in their practice. This study is to evaluate the community pharmacists' understanding, attitudes, and perceptions of pharmacogenomics in the United Arab Emirates (UAE)., Methods: Professionals employed at community pharmacies in Abu Dhabi, Dubai, and the Northern Emirates participated in a cross-sectional study design. From July 2023 to February 2024, five pharmacy students in their last year conducted the survey. The study team employed a structured questionnaire to collect data in addition to conducting in-person interviews. The study questionnaire comprised three distinct sections namely, demographic information, knowledge of pharmacogenomics concepts, and perceptions regarding pharmacogenomics., Results: A total of 586 pharmacists enrolled in the study. The average knowledge score regarding pharmacogenomics was 75.1 % with a 95 % confidence interval (CI) of [72.4 %, 77.7 %]. The average attitude score toward pharmacogenomics was 67.5 % with a 95 % CI of [66.3 %, 68.7 %]. Better pharmacogenomics knowledge among several groups: independent pharmacies (OR 1.7; 95 % CI 1.2-2.4), Pharmacists in Charge (OR 1.4; 95 % CI 1.3-2.02), pharmacists with 11-15 years of experience (OR 2.1; 95 % CI 1.4-4.2), graduates from international universities (OR 4.6; 95 % CI 1.6-12.9), and those who received training on pharmacogenomics (OR 11.9; 95 % CI 3.3-14.5). Similarly, better attitude scores were observed among independent pharmacies (OR 1.5; 95 % CI 1.1-2.1), Pharmacists in Charge (OR 1.5; 95 % CI 1.07-2.1), pharmacists with 16-20 years of experience (OR 2.1; 95 % CI 1.16-3.7), graduates regional universities (OR 1.47; 95 % CI 1.05-2.1), and those who received training on pharmacogenomics (OR 4.8; 95 % CI 3.2-7.3)., Conclusion: The positive attitudes toward pharmacogenomics that we found in our research indicate that community pharmacists in the United Arab Emirates are beginning to realize the potential advantages of pharmacogenomics in terms of improving patient care. Policies ensuring the privacy and confidentiality of genetic information are also necessary in considering concerns about the availability of genetic test results to insurance companies and potential employers., Competing Interests: All authors declare that they have no conflict of interest., (© 2024 The Authors. Published by Elsevier Inc.)

The lignan secoisolariciresinol (SECO) diglucoside (SDG) is a phytoestrogen with diverse effects. LuUGT74S1 glucosylates SECO to SDG, whereby only small amounts of the monoglucoside SMG are formed intermediately, which exhibit increased activity. To identify critical amino acids that are important for enzymatic activity and the SMG/SDG ratio, 3D structural modeling and docking, as well as site-directed mutation studies, were performed. Enzyme assays with ten mutants revealed that four of them had identical kinetic data to LuUGT74S1, while three showed reduced and one increased catalytic efficiency k cat / K m . S82F and E189L substitutions resulted in the complete absence of activity. A17 and Q136 are crucial for the conversion of SMG to SDG as A17S and Q136F mutants exhibited the highest SMG/SDG ratios of 0.7 and 0.4. Kinetic analyses show that diglucosylation is an essentially irreversible reaction, while monoglycosylation is kinetically favored. The results lay the foundation for the biotechnological production of SMG.

Purpose: Respiratory distress syndrome (RDS) is potentially fatal in infants. The present study investigated the association of maternal serum vitamin D level with fetal pulmonary artery Doppler indices and neonatal RDS., Methods: This cross-sectional-analytical study was conducted on 260 mothers admitted for delivery. The maternal serum 25-hydroxyvitamin D level was measured and fetal main pulmonary artery Doppler indices were evaluated. The neonate's weight, apgar score, RDS, Umbilical cord arterial pH and neonatal intensive care unit admission were recorded., Results: There was a significant relationship between RDS and the low level of vitamin D in the mother's serum. Mothers with low vitamin D had higher fetal pulmonary artery pulsatility index (PI) and peak systolic velocity (PSV) and lower acceleration time (AT) to ejection time (ET) ratio. Also, in neonates with RDS, pulmonary artery PI was higher, and PSV and the ratio of AT to ET were significantly lower than neonates without RDS. Neonates with lower one and 5-min apgar scores were born from mothers with lower vitamin D levels., Conclusion: Serum levels of vitamin D in pregnant mothers as well as fetal pulmonary artery Doppler indices are correlated to RDS. There is a significant relationship between the serum level of vitamin D in pregnant mothers and fetal pulmonary artery Doppler indices., (© 2024 Wiley Periodicals LLC.)

Background: COVID-19 is the largest recorded pandemic in history. It causes several complications such as shock, pneumonia, acute respiratory distress syndrome, and organ failure. The objective was to determine COVID-19 outcomes and risk factors in the intensive care (ICU) setting., Methods: A retrospective review of prospectively collected data was conducted. Adult patients with a positive RT-PCR test for COVID-19 admitted to ICUs of a tertiary care hospital between 2020 and 2022 were included. Patients who had severe complex trauma were excluded. The outcomes examined included ventilation use and duration, length of stay (LOS), and mortality., Results: A total of 964 patients were included. The mean ( ± standard deviation, SD) age was 63.7 ± 16.9 years. The majority of the patients were males (59.0 %) and Saudi (75.7 %). Ventilation use was documented in 443 (57.1 %) patients, with a mean ( ± SD) ventilation duration of 9.7 ± 8.4 days. Death occurred in 361 (37.4 %) patients after a mean ( ± SD) of 33.3 ± 44.5 days from infection. The mean ( ± SD) LOS was 30.6 ± 54.1 days in hospital and 5.2 ± 5.4 days in ICU. Ventilation use was associated with older age, males, longer ICU LOS, mortality, and admission to medical-surgical ICU. Crude mortality use was associated with older age, longer ICU LOS, use of ventilator, shorter ventilation duration, and admission to medical-surgical or respiratory ICUs., Conclusions: COVID-19 patients admitted to adult ICUs are at high risk of death and mechanical ventilation. The crude risks of both outcomes are higher in older age and longer ICU LOS and are very variable by ICU type., Competing Interests: Declaration of Competing Interest This manuscript is an original work and is not under consideration for publication by other journals. Some of this study’s findings have been presented at a conference KSA ID week on 13 December 2022., (Copyright © 2024 King Abdulaziz Medical City. Published by Elsevier Ltd.. All rights reserved.)

Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Antibacterial medications are receiving the most attention due to hypersensitivity reactions and the emergence of bacterial mutants resistant to antibiotics. Treating Animals with uncontrolled amounts of antibiotics will extend beyond their lives and affect humans. This study aims to determine the concentration of the residues of sulfadimidine, sulfaquinoxaline, diaveridine, and vitamin K3 in the tissues of poultry (muscles and liver) after treatment with the combined veterinary formulation. A UPLC-MS-MS method was developed using Poroshell 120 ECC 18 and a mobile phase composed of acetonitrile and distilled water, containing 0.1 % formic acid, in the ratio of (85:15 v/v) at a flow rate of 0.6 mL/min. Sample extraction solvent was optimized using response surface methodology (RSM) to be acetonitrile: methanol in the ratio (49.8: 50.2 v/v), and the method was validated according to the FDA bioanalytical method validation protocol over the range (50-1000 µg/Kg) for sulfaquinoxaline and (50-750 µg/Kg) for the other 3 drugs. The greenness of the sample preparation and analytical method was assessed by applying Analytical Eco-scale (AES) and AGREE coupled with AGREEprep. The Competence of the study was evaluated via the EVG framework known as Efficiency, validation, and greenness, to achieve a balance point represented by a radar chart. The method was applied to decide the time required for poultry products to be safe for human use after administration of the studied drugs. It was found that, after the administration of the last dose, minimally 7 days are required till the levels of the drugs drop to the maximum residue limit determined by the FDA/WHO in animal tissues., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Antibiotic overuse in pediatric patients with upper respiratory tract infections (UR-TIs) raises concerns about antimicrobial resistance. This study examines the impact of antibiotics on hospital stay duration and fever resolution in pediatric patients diagnosed with viral infections via a multiplex polymerase chain reaction (PCR) respiratory panel. Methods: In the pediatric ward of Imam Abdulrahman Bin Faisal Hospital, a retrospective cohort analysis was conducted on pediatric patients with viral infections confirmed by nasopharyngeal aspirates from October 2016 to December 2021. Cohorts receiving antibiotics versus those not receiving them were balanced using the gradient boosting machine (GBM) technique for propensity score matching. Results: Among 238 patients, human rhinovirus/enterovirus (HRV/EV) was most common (44.5%), followed by respiratory syncytial virus (RSV) (18.1%). Co-infections occurred in 8.4% of cases. Antibiotic administration increased hospital length of stay (LOS) by an average of 2.19 days ( p -value: 0.00). Diarrhea reduced LOS by 2.26 days, and higher albumin levels reduced LOS by 0.40 days. Fever and CRP levels had no significant effect on LOS. Time to recovery from fever showed no significant difference between antibiotic-free (Abx0) and antibiotic-received (Abx1) groups ( p -value: 0.391), with a hazard ratio of 0.84 (CI: 0.57-1.2). Conclusions: Antibiotics did not expedite recovery but were associated with longer hospital stays in pediatric patients with acute viral respiratory infections. Clinicians should exercise caution in prescribing antibiotics to pediatric patients with confirmed viral infections, especially when non-critical.

Background: Providing accurate and sufficient information is a crucial requirement for delivering effective diabetes care, making it essential for community pharmacists to possess adequate knowledge of diabetes mellitus (DM) and its management., Objective: To investigate community pharmacists' level of expertise and engagement in providing counseling and health promotion services for individuals with DM in the United Arab Emirates (UAE)., Methods: A cross-sectional study design was used. The community Pharmacies were chosen via random sampling and researchers then conducted face-to-face interviews with them using the structured questionnaire. The questionnaire included demographic data, 14 questions on the knowledge and 9 questions about the practice concerning pharmaceutical care for Diabetes Mellitus., Results: The average age ± SD was 31 ± 6.3. Of the total 516 community pharmacists recruited in the study, 37.2% (n=192) were male and 62.8% (n=324) were female. The average knowledge score about DM prevention and management was 9.7 with a 95% confidence interval (CI) [9.5, 9.9] and the average practice score about DM prevention and management was 7.1 with a 95% confidence interval (CI) [6.9, 7.2]. Better knowledge scores were observed in chief pharmacists (OR 1.29; 95% CI 1.08-1.56), pharmacists with 6-10 Years of experience (OR 6.92; 95% CI 3.43-8.86), pharmacist with > 10 years of experience (OR 1.99; 95% CI 1.67-2.36), when the number of patients the pharmacist serve is 5-10 (OR 1.27; 95% CI 1.06-1.53) and being trained on DM prevention and management (OR 2.18; 95% CI 1.92-2.47). Similarly, better practice scores were observed in older participants (OR1.02; 95% CI 1.001-1.03), chain pharmacies (OR 1.42; 95% CI 1.20-1.68), chief pharmacists (OR 1.56; 95% CI 1.18-2.06), when the number of patients the pharmacists serve was 5-10 (OR 12.26; 95% CI 7.26-16.19), when the number of patients the pharmacists serve was 11-20 (OR 4.23; 95% CI 3.54-5.06) and being trained on DM prevention and management (OR 1.33; 95% CI 1.11-1.59). The most commonly reported barriers to providing counseling and health promotion services for diabetes mellitus (DM) in community pharmacies include a lack of coordination with other healthcare professionals (77%) and insufficient knowledge or clinical skills (68.7%)., Conclusion: Our study revealed that community pharmacy staff members displayed a noteworthy level of involvement in providing pharmaceutical care services for patients with diabetes mellitus. Based on these findings, it is recommended to enhance pharmacy education by incorporating more advanced, evidence-based training and curricula focusing on disease management and appropriate therapies, particularly for diabetes., Competing Interests: All authors declare that they have no conflicts of interest in this work., (© 2024 Jairoun et al.)

Adherence to scheduled physician screenings for renal function monitoring in patients with chronic kidney disease (CKD) or those at high risk remains suboptimal despite the endorsement of regular screenings by several clinical practice guidelines. Our study aims to assess the effectiveness of a point-of-care CKD screening program led by these pharmacists using the PICCOLO device while recognizing the unique position of community pharmacists in primary care. We conducted an 11-month prospective point-of-care interventional research study in the United Arab Emirates to evaluate the performance of a community pharmacist-led CKD screening program for high-risk patients. Six diverse community pharmacies were selected based on staff availability, patient volume, and their offered range of services. Eligible individuals with risk factors for CKD were identified during medication evaluations. The PICCOLO Comprehensive Metabolic Panel facilitated on-site blood analysis, delivering estimated Glomerular Filtration Rate (eGFR) results within 10 to 15 min. Data also included eGFR categories, demographic information, and insights into lifestyle and health habits collected through a questionnaire. Pharmacists conducted comprehensive medication reviews and offered referrals and lifestyle guidance as part of the program. The study encompassed a total of 400 patients, with an average age of 69 ± 13.4 years within the study cohort. Notably, 38.8% (155 individuals) of the 400 patients were found to have undiagnosed CKD stages 3-5. Univariate logistic regression analysis revealed a significant association between a higher incidence of CKD stages 3-5 and factors such as older age, a history of hypertension, vascular disease, and diabetes mellitus. In the multivariate regression model, age and a history of diabetes mellitus emerged as significant predictors of an elevated risk of CKD. This study sheds light on the viability and impact of CKD screening programs conducted by community pharmacists, particularly in detecting CKD stages 3-5. The findings have implications for healthcare policies, as they can influence the enhancement of early detection and management of CKD. Moreover, these insights may catalyze focused screening initiatives and strengthen collaboration between community pharmacies and healthcare systems to benefit patients at high risk of CKD., (© 2024. The Author(s).)

Cancer is responsible for approximately 10 million deaths worldwide, with 70% of the deaths occurring in low- and middle-income countries; as such safer and more effective anti-cancer drugs are required. Therefore, the potential benefits of Ziziphus nummularia and Ziziphus spina-christi as sources of anti-cancer agents were investigated. Z. nummularia and Z. spina-christi extracts were prepared using chloroform, ethanol, ethyl acetate, and water. The extracts' anti-cancer properties were determined using the MTT Cell Viability Assay in four cancer cell lines: breast (KAIMRC2 and MDA-MB-231), colorectal (HCT8), and liver (HepG2). The ApoTox-Glo Triplex Assay and high-content imaging (HCI)-Apoptosis Assay were used to assess KAIMRC2 and HCT8 cells further. In addition, KAIMRC2 cells were tested for microtubule staining, and AKT/mTOR protein expression was determined by western blot analysis. Liquid chromatography-mass spectrometry (LC-MS) was performed to identify the secondary metabolites in the ethanol and ethyl acetate extracts, followed by in silico techniques to predict molecular targets and interactions, safety, and pharmacokinetic profile for identified metabolites. Out of the eight extracts, the ethanolic extract of Z. nummularia, exhibited the most potent activity against KAIMRC2 cells with an IC 50 value of 29.2 μg/ml. Cancer cell treatment with the ethanolic extract of Z. nummularia resulted in a dose-dependent decrease in cell viability with increased apoptosis and cytotoxic effects. Microtubule staining showed a disrupted microtubular network. The ethanolic extract treatment of KAIMRC2 cells led to upregulated expression of pAKT and pmTOR. In silico studies predicted luteolin-7-O-glucoside to be a ligand for tubulin with the highest docking score (- 7.686) and similar binding interactions relative to the native ligand. Further computational analysis of the metabolites showed acceptable pharmacokinetic and safety profiles, although ethanolic extract metabolites were predicted to have cardiotoxic effects. Ethanolic extraction is optimal for solubilizing active anticancer metabolites from Z. nummularia, which may act by causing M-phase arrest via inhibition of tubulin polymerization. Luteolin-7-O-glucoside is the lead candidate for further research and development as an anti-cancer agent. In addition, this study suggests that herbal treatment could switch on mechanisms of adaptation and survival in cancer cells., (© 2024. The Author(s).)

Background: p-Phenylenediamine (PPD) has been used over the past five decades as a primary precursor in the production of oxidative hair dyes. Numerous health dangers are associated with the short- and long-term use of PPD, raising concerns about its safety. For instance, mounting data suggests that PPD is linked to dermatitis and allergy cases., Objective: To quantify the PPD content in hair dyes by measuring the PPD concentration after mixing the ingredients of commercial hair dyes., Methods: A total of 290 permanent hair dyes were tested. RP-HPLC-DAD analysis was performed to determine and quantify the PPD content., Results: The estimated mean of the PPD limit was 0.89 (95% CI [0.81-0.96]). Of the 290 tested hair dyes, 7.2% (n = 21) exceeded the recommended PPD concentration after mixing. Significantly more hair dyes manufactured in India and China had a PPD content exceeding 2% after mixing compared to dyes from other regions (P = 0.001). Moreover, hair dyes manufactured in India and the UAE were more likely to have incomplete descriptions of the conditions of use and warnings on the label (P = 0.002)., Conclusion: The effectiveness of the current regulations relevant to these products should be reevaluated. Moreover, through the use of good manufacturing procedures (GMPs), research, and the reporting of adverse reactions, hair dyes should be subjected to better control and monitoring in terms of their safety and quality., Competing Interests: All authors declare that they have no conflict of interest., (© 2024 Jairoun et al.)

Background: Several studies indicate a correlation between consanguinity and genetic disorders, congenital malformations, harm to reproductive health, and increased child mortality., Objective: To assess students' knowledge and attitudes about risks and prevention of consanguineous marriage., Methods: Demographic details of the participants and data on knowledge and attitudes concerning the risks and prevention of consanguineous marriage were obtained using an online self-administered questionnaire. The factors associated with good knowledge and attitude toward consanguineous marriage were investigated by logistic regression analysis., Results: A total of 667 participants enrolled in the study. The average knowledge score about consanguineous marriage risk and prevention was 78.6% with a 95% confidence interval (CI) [77.3, 79.8], and the average attitude was 79.7% with a 95% confidence interval (CI) [79, 80.6]. A better knowledge score was observed in older participants (OR 1.01; 95% CI 1.004-1.024), females (OR 1.69; 95% CI 1.48-1.94), participants with parental history of consanguinity (OR 1.33; 95% CI 1.17-1.52), participants with family history of consanguineous marriage (OR 5.18; 95% CI 2.19-7.10), and participants with family history of inherited disease (OR 1.52; 95% CI 1.25-1.86)., Conclusion: In general, the overall level of knowledge and attitudes toward consanguineous marriage risk and prevention was good among university students. To efficiently control and manage the adverse health impacts associated with consanguineous marriage, there is an urgent need to develop and implement evidence-based counseling and screening programs for consanguineous marriage that would significantly reduce the number of at-risk marriages., Competing Interests: The authors report no conflicts of interest in this work., (© 2024 Jairoun et al.)

BACKGROUND The advent of digital impressions using computer-aided design and manufacturing technology (CAD/CAM) has simplified and improved the fabrication of implant prostheses in dentistry. The conventional impression has several drawbacks, including tray selection, material type, impression technique, impression disinfection, and cast model storage. The inaccuracies caused by distortion and contraction of impression material can be minimized with digital impressions. This study aimed to compare digital dental impressions of 10 working casts made using the Pindex laser removable die system to fabricate parallel drill channels vs 10 working casts made using the Di-Lok plastic tray removable die system. MATERIAL AND METHODS An implant master die with 2 dental implant analogs was fabricated. Ten working casts using the Pindex laser removable die system with parallel drill channels and 10 working casts using the Di-Lok plastic tray removable die system were fabricated. The working casts were scanned using an extra-oral laboratory scanner and the implant master model was scanned with an intra-oral scanner. RESULTS The properties of the casts made using the 2 systems were evaluated and analyzed with ANOVA and post hoc Tukey test. The mean horizontal linear distances between A1B1 (P<0.021), A2B2 (P<0.018), C1D1 (P<0.026), C2D2 (P<0.03), B1C1 (P<0.01), and mean vertical distances between B1A2 (P<0.015), C1D2 (P<0.001), B1B2 (P<0.028), and C1C2 (P<0.001) were significantly different between the Pindex system and Di-Lok tray system as compared to intra-oral scans. CONCLUSIONS Complete digital workflow with intra-oral scans were more than the partial digital workflow with extra-oral scans for the Pindex system and Di-Lok tray systems.

Background: The use of ChatGPT and artificial intelligence (AI) in the management of metabolic and endocrine disorders presents both significant opportunities and notable risks., Objectives: To investigate the benefits and risks associated with the application of ChatGPT in managing diabetes and metabolic illnesses by exploring the perspectives of endocrinologists and diabetologists., Methods and Materials: The study employed a qualitative research approach. A semi-structured in-depth interview guide was developed. A convenience sample of 25 endocrinologists and diabetologists was enrolled and interviewed. All interviews were audiotaped and verbatim transcribed; then, thematic analysis was used to determine the themes in the data., Results: The findings of the thematic analysis resulted in 19 codes and 9 major themes regarding the benefits of implementing AI and ChatGPT in managing diabetes and metabolic illnesses. Moreover, the extracted risks of implementing AI and ChatGPT in managing diabetes and metabolic illnesses were categorized into 7 themes and 14 codes. The benefits of heightened diagnostic precision, tailored treatment, and efficient resource utilization have potential to improve patient results. Concurrently, the identification of potential challenges, such as data security concerns and the need for AI that can be explained, enables stakeholders to proactively tackle these issues., Conclusions: Regulatory frameworks must evolve to keep pace with the rapid adoption of AI in healthcare. Sustained attention to ethical considerations, including obtaining patient consent, safeguarding data privacy, ensuring accountability, and promoting fairness, remains critical. Despite its potential impact on the human aspect of healthcare, AI will remain an integral component of patient-centered care. Striking a balance between AI-assisted decision-making and human expertise is essential to uphold trust and provide comprehensive patient care., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

BACKGROUND Several auxiliary features have been proposed to achieve sustainable retention for short-prepared dental crowns; however, achieving retention is challenging. This study aimed to assess the impact of increased total occlusal convergence and auxiliary preparation factors like box and groove on the retention form of short tooth preparations. MATERIAL AND METHODS Eighty resin machine-milled dies with a height of 3 mm and a deep chamfer margin of 1 mm were prepared to mimic the short-prepared molar. Initially, 2 teeth were prepared following the guidelines, and the total occlusal convergence was kept at 10° and 20°, respectively. Auxiliary features such as the proximal box and buccal groove were prepared on separate 20° dies. Eighty dies were prepared with 10 samples each for 10°, 20°, 20° with proximal box and 20° with buccal groove for zirconia (n=40) and metal crowns (n=40). Cementation was done with glass ionomer luting cement, and a pull-off test was conducted. Data were analyzed using one-way analysis of variance and post hoc fisher least significant difference test (P<0.05). RESULTS The highest mean was observed in the proximal box group with the metal crown (14.59), and the lowest in the group with 20° zirconia crowns (9.12). Within groups, the highest retentive values were found for the 20° taper with proximal box preparation; the lowest was for the 20° taper group. CONCLUSIONS Within the study limitations, it could be concluded that incorporating a proximal box or buccal groove in short tooth preparations with an increased total occlusal convergence improved retentive values.

Objectives: To assess the characteristics of patients with heart failure with reduced ejection fraction (HFrEF) and heart failure with mid-range ejection fraction (HFmrEF), as well as the current application of guideline-directed medical therapy (GDMT) in Palestine., Methods: This retrospective cohort study involved a population of heart failure (HF) patients who visited cardiology clinics at An-Najah National University Hospital and the National Hospital, Palestine. The primary outcome measures of interest were the proportions of patients prescribed guideline-based cardiovascular medications (GBCMs), such as angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin II receptor blockers (ARBs), β-blockers, and mineralocorticoid receptor antagonists (MRAs), and the corresponding optimized doses at ≥ 50 % of targets and the reasons underlying the non-prescription of GDMT., Results: A total of 70.5%, 56.6%, and 88.6% of patients were on ACEIs/ARBs, MRAs, and β-blockers, respectively. Of all patients, 38.7% were on the triple GDMT regimen., Conclusion: Less than half the patients received the triple combination treatment. Age, diabetes mellitus, chronic renal disease, and admission to the hospital for HF all had significant independent relationships with the reduced utilization and inadequate dosage of GDMT., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier B.V. on behalf of King Saud University.)

Background: Vitamin D deficiency has reached epidemic proportions globally. Observational data link low vitamin D status to diabetes, dyslipidemia, and metabolic syndrome, but interventional trials on the effects of supplementation are limited., Objective: We investigated associations between serum 25-hydroxyvitamin D (25(OH)D) levels and metabolic markers in Saudi adults., Methods: This retrospective cross-sectional study analyzed the clinical records of 476 patients from Saudi Arabia, aged 15-78 years. According to 25(OH)D levels, participants were stratified as vitamin D-sufficient (≥30 ng/mL), -insufficient (21-29 ng/mL), or -deficient (≤20 ng/mL). The outcomes were diabetic status (fasting glucose, HbA1c) and lipid panel results., Results: Higher diabetes prevalence was significantly associated with lower 25(OH)D levels (10.1% in the sufficient group, 11.6% in the insufficient group, and 18.3% in the deficient group). Similarly, worse lipid profiles were associated with more severe hypovitaminosis D, including a total cholesterol level of ≥240 mg/dL (5.3% in participants with normal vitamin D levels vs. 18.9% in those with deficient levels) and LDL ≥ 160 mg/dL (6.9% in participants with normal vitamin D levels vs. 13.2% in those with deficient levels). Vitamin D deficiency disproportionately affected women and adults > 45 years old., Conclusions: Vitamin D deficiency is endemic in Saudi Arabia and strongly linked to worsened metabolic markers. Optimizing vitamin D status through screening and correcting the deficiency may provide a cost-effective approach to confronting the regional diabetes epidemic and reducing cardiovascular disease risk.

Purpose: To compare the physician and parental satisfactions between the two types of circumcision maneuvers used in our units, Gomco and Plastibell circumcision., Methodology: This study was performed from 2019 to 2021. A total of 190 children were circumcised either by Gomco or Plastibell procedure. Each child was evaluated during the procedure, immediately after the operation, and 1, 2, and 3 weeks after the procedure. Data were collected, statistically analyzed using SPSS version 25., Results: A total of 190 children underwent circumcision from 2019 to 2021. Of the total 190, 98 children (51.6%) underwent circumcision by Gomco, while 92 (48.4%) underwent circumcision by Plastibell. Bleeding was significantly higher in Plastibell method, while excess skin was significantly higher in Gomco method (p value 0.048). Physician evaluation results show no significant difference between both methods in late physician evaluation. 23/92 (28%) of parents were not satisfied after Plastibell circumcision, compared to 8/98 (8.2%) of parents who were not satisfied with the results of Gomco circumcision (p value 0.002)., Conclusion: Gomco needs a longer operative time, and Plastibell circumcision is less preferable by parents. There is no significant difference in physician satisfaction between the two procedures, but parents are less satisfied with Plastibell circumcision., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background and Objectives : Menstrual changes, including altered cycle length and bleeding patterns, have been reported following COVID-19 vaccination. This study aimed to determine the prevalence and types of menstrual changes occurring after COVID-19 vaccination among female students and staff at a university in Saudi Arabia. Materials and Methods : A cross-sectional study was conducted among women aged 18-39 years who received at least one dose of a COVID-19 vaccine. Eligible participants, including university students and staff, were recruited between May 2022 and November 2022. Participants completed a questionnaire detailing their sociodemographic characteristics, general medical and reproductive history, and menstrual characteristics before and after vaccination. The prevalence of various menstrual changes (cycle length, bleeding days, flow, and mid-cycle spotting) was calculated. The demographic factors associated with menstrual changes were analyzed using chi-squared tests. Results : The 472 included participants had a mean age of 20.9 years, and 95.3% were unmarried. Changes in menstrual cycle characteristics after COVID-19 vaccination were reported by 54.7% of respondents overall. The most common change was in cycle length, followed by the number of menstruation days and bleeding flow. Menstrual changes were not associated with age, BMI, occupation, marital status, or medical history. Changes in intermenstrual bleeding were more frequently reported after the third dose of the Pfizer vaccine compared to the Moderna vaccine ( p = 0.014). Conclusions : More than half of the recruited female students and staff reported menstrual changes following COVID-19 vaccination, with altered cycle length being the most common. The potential underlying mechanisms and implications of these menstrual alterations require further investigation. These findings provide evidence of the menstrual side effects of COVID-19 vaccines among women in Saudi Arabia.

BACKGROUND Childhood febrile seizures occur between 5 months and 6 years of age in children without a previous history of seizure and are associated with high temperature in the absence of intracranial infection. This retrospective study identified 71 children aged 6 months to 5 years with febrile seizures between 2017 and 2021 at a single center in Saudi Arabia and aimed to identify an association between common respiratory virus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. MATERIAL AND METHODS Pediatric nasopharyngeal specimens were tested using a multiplex PCR respiratory panel detecting human coronaviruses (NL63, 229E, OC43, HKU1), influenza A/B, human adenovirus, parainfluenza viruses 1-4, respiratory syncytial virus, human metapneumovirus, rhinovirus/enterovirus, Middle East respiratory syndrome coronavirus, and, as of September 2021, SARS-CoV-2, confirmed using the Cepheid Xpert Xpress SARS-CoV2 RT-PCR kit. RESULTS In a cohort of 71 pediatric patients (median age, 19 months; 54.9% female), dominant pathogens included human rhinovirus/enterovirus (23.9%), influenza A/B (26.8%), and SARS-CoV-2 (14.1%). Concurrent infections were noted in 28.2%. Simple seizures occurred in 69%, and complex seizures in 31%. Females exhibited an 8.18-fold increased risk for complex seizures. Each additional fever day reduced complex seizure risk by 36%. Familial seizure history increased risk 8.76-fold. Human rhinovirus/enterovirus or parainfluenza infections inversely affected complex seizure likelihood compared with adenovirus. CONCLUSIONS In Saudi children with febrile seizures, distinct viral etiologies, sex, and familial links play pivotal roles. Given regional viral variations, region-tailored diagnostic and therapeutic strategies are paramount. A multicenter prospective cohort study is essential for comprehensive understanding.

Background: Work life of individuals with diabetes differs from that of those without diabetes. Work may interfere with diabetes self-management tasks, resulting in intentional hyperglycemia at work (IHW) and poor glycemic control. Diabetes affects work productivity due to work-related diabetes distress (WRDD) and impaired work ability (WA)., Objectives: To estimate the prevalence and identify the predictors of always high, poor/very poor glycemic control, high WRDD and poor/moderate WA among workers with diabetes., Methodology: A cross-sectional study was done at the Specialized Medical Hospital Mansoura University, which included 323 working patients with diabetes. They were subjected to personal interviews to collect socio-demographic data, occupational, diabetes and other pertinent medical histories. Questionnaires for measuring IHW, WRDD and WA were completed. Clinical and A1c data were obtained from their records., Results: The prevalence of always high IHW, poor/very poor glycemic control, high WRDD and poor/moderate work ability was: 23.8%, 60.1%, 34.7% and 74.6%, respectively. The predictors of always high IHW were: 1) Below university education; 2) Treatment with insulin only or combined with oral drugs; and 3) High WRDD. The predictors of poor/very poor glycemic control were urban residence, always and almost high IHW. The predictors of high WRDD were mentallyrequiring jobs or both mentally- and physically-requiring jobs, duration of diabetes greater than 14 years and treatment with insulin. The predictors of poor/moderate WA were 'high' WRDD, 'almost high' and 'high a few times' IHW ratings., Conclusions: Most of the studied population suffered mainly from poor/very poor glycemic control and poor/moderate work ability, while a lower proportion had high WRDD. This highlighted the need for workplace modifications and interventions to help workers with diabetes control their diabetes, improve their work ability and reduce WRDD to increase productivity., Competing Interests: The authors declared no conflict of interest., (© 2024 Journal of the ASEAN Federation of Endocrine Societies.)