Clinical study of different composite resin systems in Class I cavities (an 18-month randomized clinical trial) / Estudo clínico de diferentes sistemas de resina composta em cavidades de Classe I (um ensaio clínico randomizado de 18 meses)

Objective: this double-blind randomized clinical trial evaluate the clinical performance of Thermo-Viscous Bulk Fill composite, Self-Adhesive Flowable composite, and Filtek Bulk Fill Composites restorations in Class I cavities over a period of 18 months. Material and Methods: twenty individuals between the ages of 30 and 45 participated in this research. Each patient should have at least three occlusal Class I carious lesions on their molars. They were dispersed at random, with n=20 teeth representing each tested material. Group I (Futurabond M+ and VisCalor Bulk Fill which heated in a viscolar dispenser at 68 °C for 30s and placed in a 4 mm thickness), Group II (Fusio Liquid Dentin self-adhesive composite which put in a thin layer (1mm increment)), and Group III (Single Bond Universal and Filtek Bulk Fill Posterior composite which applied in 4 mm thickness without heating). Using (USPHS) criteria, all restorations were assessed clinically at baseline, 6 months, 12 months, and 18 months. Using an inverse replica, the marginal seal of the investigated restorations was further evaluated under SEM. Statistical analysis was performed with Chi-square test for all USPH parameters. Results: the three tested groups recorded a one hundred percent retention rate after 18 months follow up period. Concerning marginal adaptation, marginal discoloration, anatomical form, surface texture, and color matching, there was a significant difference (p˂0.05) between the three tested groups after 12 & 18 months. After 12 & 18 months, SEM analysis of the marginal seal revealed a statistically significant difference between the three groups. Conclusion: Bulk fill resin composite restorations showed satisfactory acceptable clinical performance after 18 months of clinical service compared to self-adhesive flowable composites, and Viscalor Bulk Fill composite demonstrated excellent results with considerable changes in marginal integrity as a consequence of thermal viscous technology and increased adaptability of restorations toward cavity walls and margins (AU)

Objetivo: este ensaio clínico randomizado duplo-cego avaliou o desempenho clínico de restaurações de resina Bulk Fill Termo-Viscosa, resina autoadesiva Flowable e Filtek Bulk Fill Composites em cavidades Classe I durante um período de 18 meses. Material e Métodos: 20 indivíduos com idade entre 30 e 45 anos participaram da pesquisa. Cada paciente deveria ter pelo menos três lesões de cárie oclusais de Classe I nos molares. Eles foram divididos aleatoriamente, com n=20 dentes representando cada material testado. Grupo I (Futurabond M+ e VisCalor Bulk Fill aquecido em dispensador viscolar a 68 °C por 30s e colocado em uma espessura de 4 mm), Grupo II (resina composta autoadesiva Fusio Liquid Dentin colocada em uma camada fina (incremento de 1 mm)) e Grupo III (resina composta Single Bond Universal e Filtek Bulk Fill Posterior aplicado em espessura de 4 mm sem aquecimento). Usando os critérios (USPHS), todas as restaurações foram avaliadas clinicamente no início, 6 meses, 12 meses e 18 meses. Usando uma réplica inversa, o selamento marginal das restaurações investigadas foi avaliado em MEV. A análise estatística foi realizada com o teste qui-quadrado para todos os parâmetros USPH. Resultados: os três grupos testados registraram uma taxa de retenção de cem por cento após um período de acompanhamento de 18 meses. Em relação à adaptação marginal, descoloração marginal, forma anatômica, textura da superfície e combinação de cores, houve uma diferença significativa (p˂0,05) entre os três grupos testados após 12 e 18 meses. Após 12 e 18 meses, a análise SEM do selamento marginal revelou uma diferença estatisticamente significativa entre os três grupos. Conclusão: as restaurações de resina composta Bulk Fill apresentaram desempenho clínico aceitável satisfatório após 18 meses de atendimento clínico em comparação com as resinas compostas fluidas autoadesivas, e a resina composta Viscalor Bulk Fill demonstrou excelentes resultados com mudanças consideráveis na integridade marginal, como consequência da tecnologia viscosa térmica e maior adaptabilidade de restaurações nas paredes e margens da cavidade (AU)

Assessment of knowledge, attitude and practice of hand hygiene among health care workers in Arar City, Saudi Arabia

Background: Hand hygiene before and after each contact with any patient, is simple, easily implemented and an effective practice to prevent hospital acquired infection.This study aimed to assess the knowledge, attitude and practice of hand washing among health care workers [HCW] in health care units in Arar city, Northern Saudi Arabia, based on WHO?s "Five Moments of Hand Hygiene Questionnaire?

Methodology: A descriptive cross sectional study was carried out at health care unites in Arar city during the period from July to September 2017. The World Health Organization [WHO] "Hand Hygiene Knowledge Questionnaire"- revised 2009 edition was used

Results: In total, 116 respondents including 32 residents, 92 nurses and 37 nursing assistants enrolled in this study,68% of them were females and 32% were males, 41% were resident, 32.8% nurses, 12.9% Nursing assistant and 12.9% Technician. The mean score of HH knowledge in residents technicians, nurses and nurse assistants was 18 [ +/- 1.8], 17.7[ +/- 1.7], 18.3[ +/- 1.2] and 18.1[ +/- 1.4] respectively. While the mean score of attitude was the highest in nurses 6.9[ +/- 1.17] then the technicians 6.8[ +/- 1.6], and the lowest score was found in the nursing assistants 6.2[ +/- 0.56]. The mean score of practice was found to be 4[ +/- 1.6] in technicians, 3.9[ +/- 1.0] in nurses, 3.8[ +/- 0.9] in residents and 3.5[ +/- 0.6] in nurse assistants. The majority of the participants [90.5%] had a high level of knowledge of HH. The attitude level was found moderate in 81.9% and high in only 17.2%. Level of practice of HH was high in 23.3%, moderate in 75.9% and almost none of our participants was found with a low level of practice

Conclusion: This study highlighted the importance of applying the multimodal training program addressing providers' knowledge regarding hand hygiene, as well as strategies for emotional and behavioral methods such as patient engagement in hand-hygiene interventions

Underweight adolescents in northern Saudi Arabia a community based study

Background: Adolescence refers to the developmental period between childhood and adulthood, and the WHO defines adolescents as individuals between the ages of 10-19 years. They make up about 20% of the world population. Rapid development and urbanization of KSA has resulted in changes in nutritional and diet patterns that have affected the BMI of children and adolescents and led to nutritional transition. The objective of this study was to evaluate and estimate the weight status and prevalence of underweight in school-aged male and female adolescents in Arar city, Northern Saudi Arabia using the BMI

Methods: This was a cross-sectional study that has been conducted among school adolescents of both sexes, aged 12-18 years during the academic year 2015-2016 over a period of 9 months [October 1[st], 2015 to June 30[th], 2016]. Information obtained through an interviewer administered semi-structured questionnaire. Body mass index [BMI] was calculated as per the formula BMI = weight [kg] / height [m2]. Age and sex-specific BMI percentiles were computed based on the Centre for Disease Control [CDC]/National Centre for Health Statistics growth curves

Results: In the studied participants [n = 849], the male-female ratio was [48.1%:51.9%]. About half [50.4%] of the studied adolescents had normal BMI, 25.7% were underweight [below the 5th percentile], 18.1% were overweight and only 5.8% were obese [above 95[th] percentile]

In Conclusion; nutritional status among adolescents is not so well. Yet more work is needed to identify the more influential factors which can improve the nutritional status among adolescents in Arar beside nutritional education programs to the mothers and/or care givers

Osteoporosis: a common health problem in senior adult population of arar city, saudi arabia

Background: Osteoporosis is characterized by compromised bone strength predisposing to an increased risk of fracture, which has significant effects on human health, quality of life

Objective: To determine the prevalence and determinant factors of osteoporosis among elderly in Arar, KSA

Methods: The present cross sectional community based study was conducted in Arar city, the capital of Northern Borders Governorate on 229 adult people aged 60 years and more. Data were collected through personal interviews with the sampled population and filling the questionnaire which guided us to the data of socio-demographic status, smoking, chronic diseases, already previously diagnosed osteoporosis, after ensuring the diagnosis by reviewing the accompanied health reports and/or prescriptions and asking the accompanied caregivers about the case

Results: The mean age of the participants [+/-SD] was 70.5 [+/- 9.4] years. Males were 48% and females were 52%. The overall prevalence rate of osteoporosis found in this study was 24.5%. There was significant relationship between osteoporosis and sex, presence of thyroid disease [P<0.05]. While there was an insignificant relationship between osteoporosis and age group, BMI group, presence of diabetes mellitus and presence of hypertension [P>0.05]

Conclusion: In conclusion, osteoporosis is a common health problem [24.5%] in the elderly population in Arar city, KSA. Conclusion: Osteoporosis is significantly higher in elderly females. Health education and preventive programs are highly recommended to protect and treat that vulnerable group

Prevalence and determinant factors of chronic calculous cholecystitis among senile population arar, ksa

Background: chronic calculous cholecystitis is an inflammatory disease which affects the gallbladder wall and causes motoric-tonic dysfunctions of the biliary system accompanied by gallstones in the lumen of the gallbladder and biliary pain. Among aging study groups, the prevalence of gallstone disease is likely to increase

Aim of the Work: to determine the prevalence and determinant factors of chronic calculous cholecystitis among senile population in Arar, KSA

Patients and Methods: the present cross sectional community based study was conducted in Arar city, Northern Border Province, KSA on 217 adult people aged 50 years and more. Data were collected through personal interviews with the study population and filling the questionnaire which guided us to the data of socio-demographic status, smoking, chronic diseases, already previously diagnosed with chronic calculous cholecystitis, after ensuring the diagnosis by reviewing the accompanied health reports and/or prescriptions and asking the accompanied caregivers about the case

Results: the mean age of the participants [+/- SD] was 69.9 [+/- 9.3] years; male to female ratio was 43.8 to 56.2. The overall prevalence rate of chronic calculus cholecystitis found in this study was 6.9%. There was a relationship between chronic calculus cholecystitis and age group, sex, DM, BMI group, Thyroid disease and Hypertension. The prevalence of chronic calculus cholecystitis was more in females compared to males [9.0% vs. 4.2%]

Conclusion: female gender, diabetes and obesity are significantly associated factors in the development of gallstones. Thus, understanding the gallstones pathogenesis would result in life style modifications and weight loss which would decrease the rates of the disease

Risk factors, post-operative complications and outcome of management of hip fracture in arar, northern saudi arabia

Background: Hip fractures are defined as any fracture of the femur between the articular cartilages of the hip joint to 5 cm below the distal point of the lesser trochanter. Hip fracture is a worldwide public health problem that primarily affects osteoporotic individuals and the elderly. Up to 30 % of the elderly patients with a hip fracture die within the first year

Objective: to show the risk factors and post-operative complications of hip fracture in cases attending orthopedic department of Arar Central Hospital in Arar city

Methods: a cross sectional study conducted during the period from 1 December 2017 to 31 March 2018. A predesigned questionnaire was used for data collection, and included inquiries about sociodemographic data of the studied patients, performing muscular exercise, osteoporosis, diminished vision and disorders in equilibrium, causes of fracture, type and site of fracture, occurrence of complications of surgery, postoperative care and the final outcome of treatment

Results: Most [70.1%] of the studied population aged 22-59 years, males constituted 59.8%. Causes of hip fracture were accident in 66.7% and fall in 25.0%. Among hip fracture cases, 43.9% were obese, 13.1% have osteoporosis, and 17.8% have disorders in equilibrium. Males reported insignificant higher percentage of hip fracture than females [25.0% Vs. 18.6%]. Osteoporosis, diminished vision, chronic diseases, continuous use of medications and smoking showed significant relation with hip fracture [P<0.05]. While BMI, disorders in equilibrium and performing muscular exercise showed insignificant relation. Complications after surgery was osteomyelitis in 12.6%, early fixation failure in 4.2%, wound infections in 8.4% and hospital acquires pneumonia in 4.2%. Only two thirds of the cases were completely cured

Conclusion: in our study population in Arar city, males reported insignificant higher percentage of hip fracture than females. Osteoporosis, diminished vision, chronic illnesses, continuous use of medications and smoking were significant risk factors of hip fracture. Complications after surgery was included, osteomyelitis, early fixation failure, wound infections and hospital acquire pneumonia. Only two thirds of the cases were completely cured, the rest of cases showed disability and movement limitation

Epidemiology of extra pulmonary tuberculosis in Eastern Sudan

Objective: To investigate the epidemiological factors associated with extra pulmonary tuberculosis (EPTB) in Kassala, Eastern Sudan. Methods: Patients infected with TB (pulmonary and extra-pulmonary) documented at the hospital were interviewed with a structured questionnaire used to gather sociodemographic information. The diagnosis of EPTB cases was based on presence of tuberculous granulomas in the histological samples, positive PCR to DNA of mycobacterium tuberculosis, radiological findings and fluid analysis suggestive of EPTB and clinical diagnosis with adequate response to anti-tuberculous therapy. Results: A total of 985 patients with TB were enrolled in the study, including 761 (77.3%) with PTB and 224 (22.7%) with EPTB. The mean age (SD) of patients with PTB and EPTB was 33.2 (15.4) and 34.7 (14.6) years respectively. The prevalence of EPTB was at (22.7%), with TB lymphadenitis 79 (35.3%), marking the frequent form of EPTB followed by peritoneal TB 27 (12.05%). While residence and occupation were not associated with EPTB, those with lower level of education (OR = 0.3; confidence intervals (CI) = 0.2-0.5; P < 0.001), female (OR = 8.7, CI = 4.9-15.1, P < 0.001), non vaccination (OR = 70.3, CI = 34.2-144.3, P < 0.001), and non smoker (OR = 0.1; CI = 0.06-0.20; P < 0.001), were associated with high prevalence of EPTB. Conclusions: Around one quarter of patients with TB in this study were more likely to have EPTB. Therefore, effective strategic plans regarding diagnostic procedures and control measures are needed to reduce the burden of the disease in Sudan.

Modeling and Optimization of Cephalosporin C Production Using Streptomyces Gresiolus.

The objective of this study is to improve the cephalosporin C production through optimization of medium and culture conditions .The effect of agitation speed on CPC production in 3 l bioreactor was investigated with fed batch mode. The maximum CPC (0.79 g/l) , the biomass ( 35.4g was obtained at 400 rpm A statistical method was introduced to optimized the main culture medium constituents. Some medium constituents involving glucose, ammonium sulphate as inorganic nitrogen source and methionine were found to be the most effective factors for (CPC) production. The results showed the priority of fed batch culture than the batch one, since it increase the yield of the CPC by about 155 %.

Seroprevalence of the human immunodeficiency virus [HIV] among pregnant women in eastern Sudan

We conducted a cross-sectional survey to determine the prevalence of the human immunodeficiency virus [HIV] among pregnant women attending a major hospital in Kassala state, eastern Sudan. Unlinked anonymous testing of residual blood specimens, which were originally collected for other routine clinical purposes, was performed using rapid immunochromatographic assays. In total, 430 residual blood specimens were consecutively collected over a 6-week period [April-May 2010]. Specimens from the antenatal clinic [ANC] constituted 50.7% [218/430] of the total whereas specimens from the labour ward accounted for the remaining 49.3% [212/430]. The median age of pregnant women was 29 years [range 16-40]. The prevalence of HIV-1 infection was 0.23% [1/430] [95% confidence interval = 0.01-1.29%]. The only reactive specimen came from a 20-year-old ANC attendee. We report low HIV prevalence among pregnant women in eastern Sudan but further research is needed to confirm our findings. An integrated framework to diagnose and treat maternal HIV infection should be developed in order to prevent transmission to infants

RAPD analysis and antibiotic susceptibility for Mycobacterium tuberculosis strains isolated from different locations in Egypt

The routine identification of mycobacterial strains isolated from patients in different locations in Egypt was confirmed by specific DNA fragment amplification. The susceptibilities of 72 Mycobacterium tuberculosis strains against the four antibiotics used in tuberculosis treatment (Isoniazid, INH; Rifampicin, Rif; Streptomycin, St and Ethambutol, E) were examined. Our results indicated that, multi drug resistant tuberculosis (MDR-TB) represents about 19.5% of the tested strains, whereas sensitive strains represented 26.4%. The genetic polymorphism of the tested strains was examined using RAPD analysis. Six selected strains represent the different antibiotic susceptibility groups were examined using RAPD fingerprinting. No difference between the strains was recorded using the RFLP analysis of amplified specific fragment. The discrimination power of RAPD analysis was inadequate to clarify the genetic correlation between the tested strains. MDR-TB was approximately double time in 2008 compared with the value in 2007. Most of the new MDR-TB was correlated with resident dense population regions.

Effects of metformin adminesteration during pregnancy in the polycystic ovarian syndrome

to evaluate the role of metformin during pregnancy in women with polycystic ovaray synderome [PCOS] about safety,early pregnancy loss and developmental gestational diabetes. sixty six women with PCOS conceived spontaneously on metformin only or with induction of ovulation by clomiphene citrate, hCG, HMG.in outpatient clinic in El-Hussein hospital and my private clinic, outcomes including numbers of early pregnancy loss, number of live births, gestational diabetes [G.D] and congenetal defects [CD] intrauterine or in neo-nates. Results.of the 66 pregnant women with PCOS, early pregnancy loss in metformin group 4/42 [9.5%], and in control group 10/24 [41.7%] P=<0.001. number of live births in metformin group and in control group 38/42 [90.5%],14/24 [58.3%], respectively [p= <0.001]. development of Gestational diabetes in metformin group and in control group 2/42 [4.8%],5/24 [20.8%] respectively,[p= <0.001].no advesre fetal outcome in both groups. serum testosterone in both groups not differ at base line but at 6-12 wks of gestation significantly lower in metformin than control group 1.42 +/- 0.12 vs 3.32 +/- 0.24 ng/dl respectively [p=<0.001].metformin therapy during pregnancy in women with PCOS was safely associated with reduction in spontaneous early pregnancy loss,gestational diabetes with no teratogenic effects

Hepatectomy for primary hepatocellular cancer

Twenty patients with hepatocellular carinoma were explored by laparotomy. Only in 9 patients the tumour was found suitable for resection. The extent of hepatic resection required for removal was related to the size and location of lesions. Right hepatic lobectomy was performed in 5, left lobectomy in 2 and left lateral segmentectomy in 2 patients. Although there was no mortality during surgery one patient died on the first postoperative night of haemorrhage that could be possibly related to coagulopathy. Nonlethal postoperative complications were not uncommon. Of the 8 patients who survived hepatic resection, 6 were alive and apparently tumour free at an average of 15 months follow-up. Recurrent disease was detected in the remaining 2 patients at 8 and 13 months post-resection. Compared with the natural history of the disease in untreated patients, it would seem reasonable to attempt resection whenever the anatomy of the tumour allows safe excision with a margin of normal liver

Bacteroides wound infection following gastrointestinal tract operations

Bacteroides infection was studied in 266 patients with postoperative wound sepsis following different types of surgery. The incidence of bacteroides infection was significantly greater following gastrointestinal operations compared with operations elsewhere [P <0.01]. Bacteroides fragilis were the most common bactcroides isolated from septic wounds after gastrointestinal surgery. A significant finding was the frequency of associated organisms [66.6%], particularly the gram-negative aerobic E. coli and Klebsiella. Postoperative bactcroides sepsis was .common following surgical procedures on the colon and appendix [40%]. The incidence was relatively higher after appendicectomy for perforated appendicitis [63.6%]. Several antibiotics including clindamycin, chloramphenicol, rifampicin and, to a less extent, metronidazole were found effective against bacteroides especially bacteroides fragilis. Proper culturing for aerobes and anaerobes seems therefore necessary for adequate management of wound sepsis that follows gastrointestinal surgery. As bacteroides infection is possibly initiated during operation, prophylactic administration of a suitable antibiotic, preferably commenced just before or at the time of surgery, may probably reduce the incidence of such infections