Evaluation of stress distributions of calcium silicate-based root canal sealer in bulk or with main core material: A finite element analysis study.

This research aimed to assess the stress distribution in lower premolars that were obturated with BioRoot RCS or AH Plus, with or without gutta percha (GP), and subjected to vertical and oblique forces. One 3D geometric model of a mandibular second premolar was created using SolidWorks software. Eight different scenarios representing different root canal filling techniques, single cone technique with GP and bulk technique with sealer only with occlusal load directions were simulated as follows: Model 1 (BioRoot RCS sealer and GP under vertical load [VL]), Model 2 (BioRoot RCS sealer and GP under oblique load [OL]), Model 3 (AH Plus sealer with GP under VL), Model 4 (AH Plus sealer with GP under OL), Model 5 (BioRoot RCS sealer in bulk under VL), Model 6 (BioRoot RCS in bulk under OL), Model 7 (AH Plus sealer in bulk under VL), and Model 8 (AH Plus sealer in bulk under OL). A static load of 200 N was applied at three occlusal contact points, with a 45° angle from lingual to buccal. The von Mises stresses in root dentin were higher in cases where AH Plus was used compared to BioRoot RCS. Furthermore, shifting the load to an oblique direction resulted in increased stress levels. Replacing GP with sealer material had no effect on the dentin maximum von Mises stress in BioRoot RCS cases. Presence of a core material resulted in lower stress in dentin for AH Plus cases, however, it did not affect the stress levels in dentin for cases filled with BioRoot RCS. Stress distribution in the dentin under oblique direction was higher regardless of sealer or technique used.

Comparison of mechanical properties and color stability of various vacuum-formed orthodontic retainers: An in vitro study.

Vacuum-formed retainer (VFR) is the most used retainer due to its higher aesthetic properties and lower cost, their mechanical properties of are important in determining the stability and long-term use of appliances made out of them. AIM: This study aimed to evaluate and compare the flexural modulus, surface hardness, and color stability of three different VFR materials. METHODS: Three different VFR materials, namely Duran, Keystone, and Zendura, of 1 mm thickness, were tested after thermoforming for flexural modulus, hardness, and color stability. They were formed over a stainless-steel model of 12 mm diameter and 6 mm height. RESULTS: There were significant statistical differences (p = 0.000) in the flexural modulus and hardness of the three materials. Regarding color stability, Zendura exhibited significantly higher ΔE* values than Keystone and Duran (p < 0.05). CONCLUSIONS: Zendura had the highest flexural modulus and hardness compared with Duran and Keystone; however, it is more susceptible to color change compared to the other tested materials.

The effectiveness of mindfulness training in improving medical students' stress, depression, and anxiety.

INTRODUCTION: There is growing interest in Mindfulness-based Stress Reduction (MBSR) program to combat mental distress in medical students. In Saudi Arabia, literature is insufficient about MBSR and its effectiveness. This study aims to measure the effectiveness of MBSR in improving mindful state, stress, anxiety, and depression in medical students. Also, the study explores the association between the attendance rate of MBSR sessions and its effectiveness. Lastly, the study examines gender differences in response to MBSR. METHODS: This is a stratified randomized controlled study of 84 medical students from two medical schools in Riyadh, Saudi Arabia. They were recruited voluntarily from November 2018 to April 2021, and allocated to MBSR and waitlist groups using a stratified randomization method based on gender. MBSR group received eight weeks of sessions through audiovisual materials. An online survey utilizing validated questionnaires assessing stress, mindfulness, anxiety, and depression was used to evaluate both groups pre-program (time 0), post-program (time 1), and three months later (time 2). RESULTS: Seventy-one participants completed the post-test (time 1). There were no differences between study groups at time 0 and 1. However, in 41 subjects who completed the follow-up test (time 2), the anxiety dropped significantly in MBSR group (mean difference (MD), -3.935; 95% CI, -7.580 to -0.290). Furthermore, attending more MBSR sessions was inversely correlated with depression (r, -0.556; P, 0.002), and anxiety (r, -0.630; P, 0.000). Compared to their baseline, males in MBSR group improved in stress (MD, 3.08; 95% CI, 0.30 to 5.86), anxiety (MD, 4.91; 95% CI, 3.32 to 6.50), and mindfulness (MD, -0.58; 95% CI, -1.01 to -0.15), while females improved in stress (MD, 2.64; 95% CI, 0.02 to 5.26). CONCLUSION: Despite the study being interrupted by the stressful COVID-19 outbreak, the findings suggest that MBSR improved psychological outcomes when participants commit to the program.

Influence of long -term thermal cycling and masticatory loading simulation on bond strength of roots filled with epoxy resin and calcium silicate based sealers.

BACKGROUND: The aim of this study was to evaluate the effect of thermal and mechanical cyclic aging using a mastication simulator on push-out bond strength of mandibular premolars obturated with AH Plus and BioRoot RCS root canal sealers. METHODS: With REVO-S files up to SU/0.06 taper, 48 single-rooted premolar teeth were instrumented. The teeth were randomly divided into two main groups (n = 24) based on the two root canal sealers used (AH Plus and BioRoot RCS). All teeth were obturated with h matched-taper single-cone. Each main group was then subdivided into three subgroups (A, B, and C) (n = 8). Group A served as the negative control group (no-thermocycling aging). While groups B and C were subjected to thermal changes in a thermocycler machine (15,000 and 30,000 thermal cycles, respectively), followed by two different dynamic loading periods, 3 × 105 and 6 × 105 in a masticatory simulator with a nominal load of 5 kg at 1.2 Hz which represent roughly 1½ and 3 years of clinical function respectively. 2 mm slice at 3 levels, apical, middle, and coronal, to obtain 3 sections were prepared and subjected to push-out test using a universal testing machine. Statistical analysis was performed using analysis of variance (ANOVA) followed by a Tukey post hoc comparisons test and an independent T-test. A significance level of 5% was used. RESULTS: After thermal-mechanical cyclic aging, the two root canal sealers showed a significantly decreased in push-out bond strength (p < 0.05), however, AH Plus had significantly higher bond strength values than BioRoot RCS after cycling aging. CONCLUSIONS: It could be concluded that thermal-mechanical cyclic aging had a significant impact on the outcome of the dislodgment resistance of AH Plus and BioRoot RCS.

Three-dimensional analysis for detection of pulp stones in a Saudi population using cone beam computed tomography.

PURPOSE: To assess the prevalence and distribution of pulp stones in a Saudi population. METHODS: A cone beam computed tomography (CBCT) analysis of 150 upper and 150 lower dental arches was performed. The relationships between pulp stones and age, sex, tooth type, dental arch, orthodontic treatment, caries, and restoration were statistically examined (P < 0.05). RESULTS: A total of 295 dental arches (98.3%) had at least one pulp stone, and the prevalence was higher in the maxillary teeth (56.2%) than in the mandibular teeth (48.1%) (P = 0.0003). Men were more likely to have pulp stones than women (P = 0.011 for the maxilla, P < 0.0001 for the mandible). Furthermore, age and orthodontic treatment had no significant effects on the incidence of pulp stones (P > 0.05). A higher occurrence of pulp stones was observed in the first molars (>91%), and in carious and restored teeth when compared to intact teeth (P < 0.05). CONCLUSION: Pulp stones were more prevalent in the upper dental arches, first molars, and carious and restored teeth, as well as in the male population, and were not associated with age or orthodontic treatment.

Relationship Between Socio-Demographics, Study Skills and Distress Among Pakistani School Students: A Cross-Sectional Study in Riyadh, Saudi Arabia.

Purpose: The increasing prevalence of distress among students is of global concern. Several factors such as school and family environment and ineffective study skills could influence mental health. The study explored the rate of distress symptoms among school students' and its relationship with their study skills, stressors and demographic factors. Methods: In this cross-sectional analytical study, a sample of 215 students from a community school participated in the study. Three questionnaires, demographic questionnaire, Study Skills Inventory and the Kessler Psychological Distress Scale, were used for data collection. Data were analyzed using Student's t-test, ANOVA, Pearson's correlation coefficient and stepwise linear regression. Results: Response rate was 70% (n = 150). A high proportion of respondents (75%) was distressed (mean 27.28 ± 8.77). Correlation analysis showed that distress (K10 score) was negatively related to study skills (SSI total score) (r = -0.247, p = 0.002). The rate of distress symptoms was higher among female students (79%) compared to their male counterparts (72%). The factors associated with distress included negative association of teachers' level of help to develop competencies (p = 0.000, ß = -0.278, R2 = 0.249), unfavorable school environment (p = 0.000, ß = 0.285, R2 = 0.123), inability to cope with studies (p = 0.005, ß = 0.205, R2 = 0.038), family problems (p = 0.014, ß = 0.184, R2 = 0.173) and lower study skills (p = 0.031, ß = -0.164, R2 = 0.270). The overall regression analysis explained 33.6% of the variance (corrected R2 = 0.336). Conclusion: Higher than expected levels of distress (75%) was found in immigrant school students. Poor study skills have a significant relationship with distress. Learning environment and related stress factors were associated with distress among students. Based on the findings, it is recommended that stakeholders in education address the hidden curriculum, as it is usually unacknowledged and might affect students' wellbeing, and move from student centered to an interpersonal relation-centered education.

Clinical and radiographic outcomes of regenerative endodontic treatment performed by endodontic postgraduate students: a retrospective study.

Objectives: Regenerative endodontic treatment is a clinical procedure aimed at biologically regenerating damaged root canal tissue of immature permanent teeth. This study aimed to report the outcomes of regenerative endodontic treatment performed by endodontic postgraduate students. Materials and Methods: Clinical and radiographic data of 27 patients, aged 10-22 years, who underwent regenerative treatment of immature permanent teeth from 2015 to 2019 were followed up, wherein clinical and radiographic examinations were performed for each patient. Postoperative success rate and tooth survival were analyzed, and the postoperative radiographic root area changes were quantified. Results: A total of 23 patients attended the dental appointments, showing that all teeth survived and were asymptomatic. Specifically, 7 periapical pathosis cases were completely healed, 12 were incompletely healed, and 4 cases failed. Moreover, significant differences were found between discolored and non-discolored teeth, and between the presence or absence of periapical radiolucency. Additionally, 3 anterior teeth showed complete closure of the apical foramen, while the apical foramen width was reduced in 17 teeth and failed in 3 teeth. Root length was also found to have been increased in 7 anterior and 4 posterior teeth, and the average length ranged from 4.00-0.63 mm in the anterior teeth, 2.85-1.48 mm of the mesial root, and 2.73-2.16 mm of the molar teeth distal root. Furthermore, calcified tissue deposition was observed in 7 teeth. Conclusions: A favorable outcome of regenerative endodontic treatment of immature permanent teeth with necrotic pulp was achieved with a high survival rate.

Association Between Obesity and COVID-19 Disease Severity in Saudi Population.

Background: The persistent coronavirus disease 2019 (COVID-19) outbreak has placed a significant burden on the scientific and medical professions. The study examined the association between body mass index (BMI), stratified by category, and severe form of COVID-19, and to explore the influence of demographic characteristics and other known risk factors. Methods: This was a retrospective analysis based on COVID-19 data from the Saudi Arabian Ministry of Health. Data were collected for all patients admitted to three main hospitals in Riyadh region between March 1st and July 30, 2020. The effects of BMI, demographic characteristics, clinical presentation, and comorbidities on infection severity were investigated. Results: A total of 950 patients were included in the study (70% male, 85% aged younger than 60 years old). A total of 55 (5.8%) patients were underweight, 263 (27.7%) were normal weight, 351 (37%) were overweight, 161 (17%) were obese class I, 76 (8%) were obese class II, and 44 (4.6%) were obese class III. Cough, fever, and shortness of breath were the most common symptoms among overweight patients. According to the findings of a bivariate logistic regression study, class III obesity was significantly associated with a more severe form of COVID-19 (odds ratio, 2.874; 95% confidence interval, 1.344-6.149). Conclusion: This study revealed that patients with a BMI ≥40 kg/m2 had a higher risk of severe COVID-19 than those with normal weight. This suggests that obesity is a risk factor for severe COVID-19 and influences disease presentation.

Water Sorption, Water Solubility, and Rheological Properties of Resin-Based Dental Composites Incorporating Immobilizable Eugenol-Derivative Monomer.

The present study aimed to evaluate the properties of new dental formulations incorporating a new polymerizable-derivative of eugenol (EgGMA). The experimental composites were prepared (by weight) with 35% resin-based matrix (1:1, bisphenol A-glycidyl methacrylate/triethylene glycol dimethacrylate) and 65% reinforcing materials (4:3, hydroxyapatite/zirconium oxide). A portion of 0.0, 2.5, and 5.0% of the resins with respect to the total composite was replaced by EgGMA monomer to obtain TBEg0, TBEg2.5, and TBEg5, respectively. The complex viscosity (at 25 and 37 °C), degree of conversion (DC), and water sorption (WSP) and water solubility (WSL) (3 cycles of sorption-desorption process) were investigated. Data were statistically analyzed using one-way and Tukey post-hoc tests. The results revealed a viscosity reduction with shear-thinning behavior as the EgGMA amount and temperature increased. The average complex viscosities at a lower frequency (ω = 1.0 rad/s) and at 25 °C were 234.7 ± 13.4, 86.4 ± 16.5, and 57.3 ± 17.1 (kPa·s) for TBEg0, TBEg2.5, and TBEg5, respectively. The inclusion of EgGMA led to a lower DC and WSP but higher WSL, compared to those of the reference (TBEg0). However, no significant differences between TBEg2.5 and control were detected (p > 0.05). Therefore, the incorporation of EgGMA in a low quantity, e.g., up to 8.45 mol% of resins, within the matrix may enhance the composite's performance, including handling and solubility properties without any apparent effect on DC and water sorption, making it a promising monomeric biomaterial for various applications including restorative dentistry.

Personal factors associated with carpal tunnel syndrome (CTS): a case-control study.

BACKGROUND: Carpal tunnel syndrome (CTS) is one of the most common nerve entrapments in the upper limb. In Saudi Arabia, few studies have investigated CTS in the general population. This study aimed to determine the association between personal factors and CTS. METHODS: A case-control study involved adults aged 18 and above. Cases were recruited from electrophysiology lab records as consecutive case series, while controls were individuals who were free of CTS symptoms according to the Boston Carpal Tunnel Questionnaire (BCTQ). The electronic medical records of participants were reviewed to obtain age, height, weight, medical conditions, and mobile numbers. Cases and controls were contacted via phone to complete a questionnaire that was designed based on previous literature. We used multivariate binary logistic regression to identify the personal factors significantly associated with CTS. RESULTS: A total of 95 cases and 190 controls were included. Most of the participants were female (84.2%) and Saudi (93%). Most of cases were above 45 years of age (73.7%), while 84.7% were 45 year - old or younger among the control group. Stratified logistic regression showed that performance of household chores was significantly associated with CTS. While physical exercise associated with decreased odds of CTS. CONCLUSIONS: This study adds to the body of evidence on personal factors associated with CTS. However, the degree of differences in the age structure of the cases compared with the controls suggest that there is a considerable potential for residual confounding affecting the results. TRIAL REGISTRATION NUMBER: Not applicable.

Clinical characteristics and risk factors of patients with severe COVID-19 in Riyadh, Saudi Arabia: A retrospective study.

BACKGROUND: COVID-19 is newly emerging infectious disease that spread globally at unpredictable and unique pattern to the extent that the World Health Organization announced COVID-19 as a pandemic in the first couple months of 2020. This study aims to describe clinical and demographic features of COVID-19 patients and the influence of various risk factors on the severity of disease. METHODS: This research is a retrospective study based on Saudi Arabia's ministry of health's Covid-19 data. The analysis relies on data of all COVID-19 patients recorded in Riyadh between 1st, March 2020 and 30th, July 2020. Statistical analyses were performed to investigate the effect of demographic characteristic, clinical presentation, and comorbidities on infection severity. RESULTS: A total number of 1026 COVID-19 patients were identified based on the demographic data as follows: 709 cases (69% of cases) were males and 559 cases (54% of cases) were Saudi. Most of patients were diagnosed with mild signs and symptoms 697 (68% of cases), while 164 patient (16% of cases) demonstrated moderate signs and symptoms, and 103 cases (10%) were severe and 62 (6%) had critical febrile illness. Fever, cough, sore throat, and shortness of breath were the most common symptoms among patients with COVID-19. Among studied comorbidities in COVID-19 patients, diabetes mellitus and hypertension were the most prevalent. The results from the bivariate logistic regression analysis revealed that older age, diabetes mellitus, asthma, smoking, and fever are associated with severe or critically ill cases. CONCLUSION: The findings of this study show that old age, fever, and comorbidities involving diabetes mellitus, asthma, and smoking were significantly associated with infection severity.

Dental caries prevalence among Type 1 diabetes mellitus (T1DM) 6- to 12-year-old children in Riyadh, Kingdom of Saudi Arabia compared to non-diabetic children.

OBJECTIVE: The aim of this study was to compare the prevalence of dental caries among groups of 6-12-year-old children with and without Type 1 diabetes mellitus (T1DM) in Riyadh, Saudi Arabia, taking into account oral health behaviour, diet, and salivary parameters. METHODS: The study was designed as a comparable study of dental caries experience between T1DM and non-diabetic groups of children. The total sample size of 209 participants consisted of 69 diabetic and 140 non-diabetic children. Oral hygiene, diet and socio-economic status were collected using a pre-tested questionnaire. Caries was recorded in terms of decayed and filled permanent and primary teeth (DFT/dft). Salivary microbial counts and pH levels were recorded using Caries Risk Test (CRT) kit. Student's t-test, the chi-squared test, linear regression and one-way analysis of variance were performed P-value of 0.05 considered significant. RESULTS: The mean dft scores for the diabetic and non-diabetic groups were 3.32 ± 0.78 and 3.28 ± 0.71 (mean ± SD), respectively (p = 0.458). The mean DFT scores for the diabetic and non-diabetic groups were 1.62 ± 0.65 and 1.96 ± 0.65, respectively (p = 0.681). Diabetic children visited dentists more often than non-diabetic children did (p = 0.04), and had lower consumption of both sweets (p = 0.003) and flavoured milk (p = 0.002) than the non-diabetic group. Furthermore, analysis showed that the diabetic children had medium oral pH levels (pH = 4.5-5.5), whereas the non-diabetic children tended to have high (pH ≥ 6.0) oral pH; this difference was statistically significant (p = 0.01). In addition, the diabetic group had higher Lactobacillus levels than the non-diabetic group (p = 0.04). CONCLUSION: The difference in caries prevalence between the diabetic and non-diabetic children was not statistically significant. The CRT analysis revealed a higher frequency of "critical" pH values (pH = 4.5-5.5) and higher Lactobacillus counts in diabetic children than in non-diabetic children, which indicated a higher caries risk in the former group.

Root and Canal Morphology of Mandibular Premolar Teeth in a Kuwaiti Subpopulation: A CBCT Clinical Study.

OBJECTIVE: To study the root and root canal morphology of mandibular premolars in a Kuwaiti subpopulation using cone-beam computed tomography (CBCT). METHODS: 152 CBCT images were obtained from the radiology department archives of four dental centers in Kuwait. A total of 476 mandibular premolar teeth were analyzed by two observers. The number of roots, root canal configuration types and canal curvature measurements were examined. The relationship between sex, tooth position, and incidence of an additional canal were compared using the chi-square test, and the level of significance was set at 0.05 (P=0.05). RESULTS: The number of roots in mandibular first premolars was one in 73.9%, two in 24.9%, three and four in 1.2%. On the other hand, the number of roots in mandibular second premolars was one in 79.2% and two in 20.8%. Based on Vertucci's classification system, 18.7% of the teeth were type II followed by type VI (14.3%). The majority of the examined teeth were straight (74.8%) and the incidence of distal root angulation was about 21%. Canal configurations not included in the Vertucci classification were reported in 102 teeth (21.4%). Variability was significantly higher in the second premolars compared to first premolar (P<0.05). CONCLUSION: The Kuwaiti population has complex root canal morphology in mandibular premolar teeth.

The prevalence of radix molaris in the mandibular first molars of a Saudi subpopulation based on cone-beam computed tomography.

OBJECTIVES: The purpose of this study was to determine the incidence of radix molaris (RM) (entomolaris and paramolaris) in the mandibular first permanent molars of a sample Saudi Arabian subpopulation using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: A total of 884 CBCT images of 427 male and 457 female Saudi citizens (age 16 to 70 years) were collected from the radiology department archives of 4 dental centers. A total of 450 CBCT images of 741 mature mandibular first molars that met the inclusion criteria were reviewed. The images were viewed at high resolution by 3 examiners and were analyzed with Planmeca Romexis software (version 5.2). RESULTS: Thirty-three (4.5%) mandibular first permanent molars had RM, mostly on the distal side. The incidence of radix entomolaris (EM) was 4.3%, while that of radix paramolaris was 0.3%. The RM roots had one canal and occurred more unilaterally. No significant difference in root configuration was found between males and females (p > 0.05). Types I and III EM root canal configurations were most common, while type B was the only RP configuration observed. CONCLUSIONS: The incidence of RM in the mandibular first molars of this Saudi subpopulation was 4.5%. Identification of the supernumerary root can avoid missing the canal associated with the root during root canal treatment.

The relationship between study skills and depressive symptoms among medical residents.

BACKGROUND: The cost of depression among residents is staggering as it extends into the quality and safety of patient care. Finding an explanation to resident depression by investigating the associated factors is therefore important. Study skills can be a possible factor, and a clear gap in the literature exists in this regard. We sought to investigate the relationship between depressive symptoms among residents and their study skills. METHODS: This was a correlational study and a non-probability sample of 240 residents completed the Beck Depression Inventory II (BDI-II) and the Study Skills Inventory (SSI). Chi-square test was used to compare different categorical variables, while student t-test and ANOVA for continuous data. Pearson's correlation coefficient was performed to find the relationship between depressive symptoms and study skills and the association that these measures have with the demographic variables. RESULTS: Overall, 186 residents (76%) filled out the questionnaire. The SSI total score was found to have a significant negative association with the BDI-II depression score (Pearson correlation = - 0.447and p < 0.000). No significant association was found between the total SSI score and the residents' sex, age, marital status, smoking status, training years or specialties. CONCLUSION: Poor study skills were found to be correlated with higher depressive symptoms. Future studies are required to develop a deeper understanding of this relationship and reconfigure the approach to study skills for the well-being of the future physicians.

Assessment of knowledge and attitude toward stem cells and their implications in dentistry among recent graduates of dental schools in Saudi Arabia.

BACKGROUND: To evaluate the knowledge and attitude level of recent dental graduates in Saudi Arabia toward stem cells and their potential therapeutic applications. METHODS: In this cross-sectional study, a questionnaire was distributed among 606 recent graduates from 14 dental schools in Saudi Arabia. Fifteen statements were formulated to address the knowledge component with "yes" or "no" or "I do not know" answer and 10 statements were designed to assess the attitude level with Likert 5-point response scale. The level of knowledge for each respondent was designated as poor if the score value is (0-5), moderate (6-10), and high (11-15). To evaluate the attitude level for each respondent, a score of (1) was assigned for extremely negative answer and (5) for extremely positive answer for each statement. Based on the total score, attitude level was considered poor when the score value is (10-29), moderately positive (30-39), good (40-44), or excellent (45-50). RESULTS: Significant difference was found in the knowledge score between males and females (p = 0.004). Both males and females showed poor knowledge with a mean score of 5.06 ±â€¯2.5 and 5.63 ±â€¯2.4, respectively. There was an overall moderately positive attitude of participants toward stem cells and their therapeutic applications with a mean value of 33.15 ±â€¯5.92 with no significant difference between males and females (p = 0.53). A significant positive linear correlation was detected between knowledge and attitude for both males (r = 0.323, p = 0.00) and females (r = 0.392, p = 0.00). CONCLUSION: Updating dental curricula with topics on stem cell research and potential future applications in dentistry is demanded.

Effectiveness of oral health education intervention among female primary school children in Riyadh, Saudi Arabia.

OBJECTIVE: This study aimed to examine the effectiveness of oral health intervention on the improvement in knowledge and self-reported oral health behavior among 6-8 year old female primary school children in Riyadh, Saudi Arabia. MATERIALS AND METHODS: The sample consisted of 1661 girls in primary schools who are 6 to 8-year-olds (first, second and third graders). The children's level of knowledge was assessed by a self-administered questionnaire that was formulated for this specific age and divided into two parts; oral health knowledge and self-reported oral health behavior. There were seven multiple choice questions and one true/false question with five underlying parts in the questionnaire which contained basic information about oral health knowledge, oral hygiene practices and certain habits that affect teeth. The questionnaires were distributed before and six weeks after implementation of the oral health educational program to measure the level improvement of knowledge regarding oral health among these children. RESULTS: All the questions showed statistically significant improvement in knowledge and self-reported behavior in the post intervention group. There was a significant increase in the level of knowledge by 11.24% and level of self-reported behavior by 25% after intervention (P < 0.001). The highest net change in the knowledge due to intervention was noted among third graders (13.3%), whereas for self-reported oral health behavior, it was noted among first graders (28.3%). CONCLUSION: The results of this study showed that an easy-to-organize and inexpensive school-based intervention can, on a short-term basis, be effective in improving the knowledge and self-reported oral health behavior of children.

Validation of a new study skills scale to provide an explanation for depressive symptoms among medical students.

BACKGROUND: Medical students are faced with enormous academic demands that may influence their emotional wellbeing. The high rate of depression among medical students and its negative impact is an impetus to find explanation for the factors associated with it. Study skills that students possess might be such a factor. The current tools for the assessment of the study skills may have certain limitations, particularly for different cultural settings. OBJECTIVES: This study aimed to develop and validate a Study Skills Inventory (SSI), and to investigate the relationship between the students' study skills and the extent (severity) of depressive symptoms, measured using the validated tool. METHOD: The first version of the SSI was developed through expert consensus. The inventory was then administered to a randomly selected group of medical students. Confirmatory factor analysis was conducted for the internal validity. External validation was conducted by comparing the results of the SSI with the "Approaches and Study Skills Inventory for Students" (ASSIST). After validation, the correlation between the SSI total score with the Beck Depression Inventory II (BDI-II) total score was investigated using the Pearson correlation coefficient. The means of the total study skills scores for each severity category of depression were compared using ANOVA. RESULTS: A total of 23 items, representing five sub-scales, were included in the inventory. Based on 372 student responses (response rate of 93%), the five-factor solution explained a cumulative variance of 52% and Cronach alpha was 0.84. The SSI total score had a significant negative association with the BDI-II depression score (Pearson correlation of -.348** and P<0.0001). CONCLUSION: This study showed evidence for acceptable reliability and validity of the newly developed SSI. Poor study skills were found to correlate with higher depressive symptoms. This association needs confirmation in future research and could open a new door for better understanding of student depression.

Effect of thyroidectomy with totally preserved recurrent laryngeal nerve on the objective vocal functions.

OBJECTIVE: To study the effect of thyroidectomy with totally preserved recurrent laryngeal nerve (RLN) on the objective vocal functions. METHODOLOGY: It is a prospective pilot study of 10 patients undergoing thyroid surgery on whom to study the effect of thyroidectomy with totally preserved RLN on the objective vocal functions. Patient history and demographic data were collected at the time of admission and in each period of assessment average fundamental frequency; absolute jitter, shimmer, and others were measured. Furthermore, one-way analysis of variance (ANOVA) repeated measurements statistical technique was used to test the difference among the 3 time period of measurements and P < 0.05 was considered significant (α = 0.05). RESULTS: The mean age was 39.5 ± 3.31 years. There were two males and eight females. Total thyroidectomy was performed on eight patients while one had left hemithyroidectomy and one completion thyroidectomy. Histopathology revealed papillary thyroid carcinoma in 50%. 34 acoustic voice analysis parameters were measured using the multidimensional voice program, which showed no significant differences at the end of 1st and 3rd month post-operative as compared to the pre-operative measurements. There was no significant difference in measurement for each factor over the time (P > 0.05). CONCLUSIONS: All the acoustic analysis parameters for 10 patients showed no significant differences in 1st and 3rd month postoperatively as compared to the pre-operative values. However, due to small sample size, our study may have failed to detect any significant difference.

The pattern of social media use and its association with academic performance among medical students.

BACKGROUND: There are concerns that the use of social media (SM) among medical students could affect academic performance. The objectives of the study were to investigate the pattern and reasons for SM use and their association with academic performance. METHODS: A stratified random sample, frequency distribution and comparison of categorical variables with Chi-square and Fisher exact tests were used. RESULTS: Of the 97% who responded, 98% used SM. The most popular were Whatsapp (87.8%), You tube (60.8%) and Twitter (51.8%) for general use; while You tube (83.5%), Whatsapp (35.5%) and Twitter (35.3%) for learning. For general use, there was a significant higher number of visits to You tube and Facebook among male students, while the reverse was true for Instagram and Path. Around 71% visited SM >4 times/day and 55% spent 1-4 hours/day. The main reasons for SM use were entertainment (95.8%), staying up-to-date with news (88.3%), and socializing (85.5%); for academic studies (40%). There was no significant association between Grade Point Average and the frequency of daily SM use or use during lectures. CONCLUSIONS: While almost all the students used SM, only a minority used them for academic purposes. SM use was not associated with academic performance.