Assessing the Application and Effectiveness of Human Amniotic Membrane in the Management of Venous and Diabetic Ulcers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

This study aimed to assess the efficacy of human amniotic membranes (HAM) in treating venous and diabetic ulcers, which often pose challenges in healing. A systematic review and meta-analysis were conducted, evaluating 10 relevant studies involving 633 participants. Findings revealed that HAM treatment significantly accelerated ulcer closure, demonstrating over 90% complete healing compared to standard care. Despite moderate heterogeneity among studies, the results strongly suggested the effectiveness and safety of HAM therapy for venous and diabetic leg ulcers. Further research with larger study cohorts is recommended to bolster the existing evidence supporting HAM in managing these challenging wounds.

Klebsiella pneumoniae bacteraemia epidemiology: resistance profiles and clinical outcome of King Fahad Medical City isolates, Riyadh, Saudi Arabia.

BACKGROUND AND OBJECTIVES: Klebsiella pneumoniae (K. pneumoniae) is the second leading cause of community-acquired and hospital-acquired gram-negative bloodstream infection (BSI). This study aimed to assess the epidemiological and microbial-resistance characteristics and clinical factors associated with K. pneumoniae BSI in Saudi Arabia. MATERIALS AND METHODS: Data of 152 K. pneumoniae isolates diagnosed between January 2019 and January 2020 at King Fahad Medical City, Riyadh, Saudi Arabia were evaluated retrospectively. Clinical records of the patients were collected and analysed statistically. RESULTS: In total, 152 cases of K. pneumoniae BSI were identified. Adult patients (66.4%) were at a higher risk of developing the infection than paediatric patients (33.6%). The rate of infection was slightly higher in women than in men. Neurological disorders were the predominant underlying conditions for the acquisition of K. pneumoniae BSI, at all ages. Most of the deceased patients were adults with multi-organ dysfunction. Klebsiella pneumoniae showed disturbing resistance to amoxicillin-clavulanate and cefuroxime (72.4%), ceftazidime (67.8), cephalothin (76.3%), and to Carbapenems (36.1%). CONCLUSIONS: The impact of K. pneumoniae BSI was seen not only at the patient level, but also at the community level, and was related to multi-drug resistant infection. These findings provide a better understanding of microbial resistance and its association with patient clinical outcomes.

Knowledge, Perception, and Acceptance of HPV Vaccination and Screening for Cervical Cancer among Saudi Females: A Cross-Sectional Study.

Cervical cancer (CC) ranks as the eighth most prevalent malignancy in Saudi Arabian women of all ages. This cross-sectional study intends to assess women's knowledge, perceptions, and acceptance concerning HPV vaccination and CC screening in Saudi Arabia as well as the contributing variables to women's screening and vaccine acceptability. Data were collected between 1 April 2023 and 30 May 2023 through online questionnaires. Out of 421 responses, 70% of the studied sample had fair knowledge, and 30% had good knowledge related to cervical cancer screening and vaccine. Only 1.9% of the participants had a positive perception, while 41% of the participants had a negative perception toward cervical cancer screening and vaccine. A total of 38% of the participants were fearful of the side effects of the vaccine, while 22.2% doubted the effectiveness of the vaccine. Acceptance was much better correlated with perception (Rho = 0.47) than with knowledge (Rho = 0.177). However, this correlation remains weak. We conclude that Saudi women still have a poor understanding or impression of cervical cancer and prevention methods. Fear of the vaccination's negative effects and skepticism about the effectiveness of the vaccine/screening have recently been the most often-mentioned hurdles to vaccine uptake.

Radiographic Analysis of Morphological Variations of Sella Turcica in Different Skeletal Patterns Among Saudi Subpopulations.

Background: Size and shape of the sella turcica is considered vital for many radiographic analyses. Objectives: To assess and compare the linear dimensions and shape of sella turcica on digital lateral cephalograms in Saudi subpopulation with different skeletal patterns, age groups and genders. Methodology: A total of 300 digital lateral cephalograms were retrieved from the hospital archive. The selected cephalograms were grouped based on the age, gender, and skeletal types. The linear dimensions and shape of sella turcica were measured on each radiograph. Data were analyzed using an independent t-test and a one-way ANOVA. To test the inter-relationship of age, gender, and skeletal type with the dimensions of sella turcica, regression analyses were used. Statistical significance was set at P ≤ 0.01. Results: Significant differences in linear dimensions between the age groups (P < 0.001) and genders (P < 0.001) were noted. On comparing sella size with different skeletal types, a significant difference was found for all sella dimensions (P < 0.001). The mean length, depth and diameter among skeletal class III were significantly higher than that among classes I and II. On comparing age, gender, and skeletal type with size of sella, age and skeletal type were significantly related to the change of length, depth and diameter (P < 0.001), whereas gender was found to be significantly related only to a change in length of the sella (P < 0.01). For the sella shape, normal morphology was noted in 44.3% of patients. Conclusion: According to the findings of this study, the measurements of sella can be used as reference standards for future studies in Saudi subpopulation.

Exploring the properties of formocresol in dentistry-a comprehensive review.

Due to concerns about formocresol's mutagenic and genotoxic potential, its use as a pulpotomy medication is currently debatable. The current paper aimed to review the properties of formocresol and concerns regarding its safety as a pulpotomy medicament for primary teeth. With reference to the context of the recently published literature, the alternatives to formocresol are discussed, together with their benefits and drawbacks. A literature search was conducted using multiple databases comprising of MEDLINE (via PubMed), EMBASE, and Web of Science. The terms used for the search were "formocresol", "pulpotomy", and "primary teeth". In total, 364 articles were obtained from the analysis of the databases. Unrelated articles from the available full text of 174 articles were excluded. The main reasons for excluding the articles were: they were usage and precautionary guidelines. A total of 68 studies were finally included in the review. The literature review in this paper supports the notion that formocresol continues to be the most often utilized pulp dressing agent in primary teeth pulpotomies despite offering no advantages over other pulp dressing chemicals that are currently on the market.

Factors Affecting the Adoption of Artificial Intelligence-Enabled Virtual Assistants for Leukemia Self-Management.

AIM AND PURPOSE: The purpose of this study is to analyze the various influencing factors affecting the adoption of artificial intelligence (AI)-enabled virtual assistants (VAs) for self-management of leukemia. METHODS: A cross-sectional survey design is adopted in this study. The questionnaire included eight factors (performance expectancy, effort expectancy, social influence, facilitating conditions, behavioral intention, trust, perceived privacy risk, and personal innovativeness) affecting the acceptance of AI-enabled virtual assistants. A total of 397 leukemia patients participated in the online survey. RESULTS: Performance expectancy (µ = 3.14), effort expectancy (µ = 3.05), and personal innovativeness (µ = 3.14) were identified to be the major influencing factors of AI adoption. Statistically significant differences (p < .05) were observed between the gender-based and age groups of the participants in relation to the various factors. In addition, perceived privacy risks were negatively correlated with all other factors. CONCLUSION: Although there are negative factors such as privacy risks and ethical issues in AI adoption, perceived effectiveness and ease of use among individuals are leading to greater adoption of AI-enabled VAs.

The Association Between Post-Traumatic Stress Disorder and Temporomandibular Disorders: A Systematic Review.

The purpose of this systematic study was to discover a connection between temporomandibular joint disorders and post-traumatic stress disorder. A systematic review of observational studies on post-traumatic stress disorder and the incidence of temporomandibular joint disorders (TMD) was conducted. Electronic searches of PubMed, the Saudi Digital Library, Science Direct, the Virtual Health Library (VHL), Scopus, Web of Science, Sage, EBSCO Information Services, and Ovid were performed. There was a consensus among the reviewing examiners. Only studies with the following Medical Subject Headings (MeSH) terms were included: "Posttraumatic stress disorder" combined with "temporomandibular joint disorder," "myofascial pain," "orofacial pain," "internal derangement," "disc displacement with reduction," or "disc displacement without reduction." Only full-text studies in the English language published between 2010 and June 2020 were considered. Of a total of 381 articles meeting the initial screening criteria, only eight were included in the qualitative analysis. Overall, pain is exacerbated in patients with PTSD; that is, their TMD is heightened in all aspects of pain, chronicity, decreased response to conventional therapies, and the need for more potent treatment options as compared with patients with just TMD. The evidence, albeit weak, obtained from the studies included in this review suggests a relationship between PTSD and TMDs.

Knowledge, Attitude and Practice towards the COVID-19 Pandemic: A Cross-Sectional Survey Study among the General Public in the Kingdom of Saudi Arabia.

Background: The novel coronavirus disease 2019 (COVID-19) is an infectious disease that has been spreading worldwide in an unprecedented manner. The knowledge, attitude and practices of the general population play a vital role in prevention of COVID-19. Objectives: The present study aimed to assess the COVID-19-related knowledge, attitudes and practices of the general public of Sakaka, Saudi Arabia, to identify which populations show low levels of knowledge, attitudes and practices towards COVID-19, making them highly likely to remain vulnerable during the pandemic. Methodology: For this study, a nineteen-item closed-ended questionnaire was hand delivered to the general public, including patients and other hospital attendees attending the Outpatient Department of the College of Dentistry, Jouf University, Saudi Arabia. The research questions focused on the demographic information, knowledge, attitude and practices related to COVID-19. Data analysis is presented through tables and descriptive methods. Results: A total of 722 participants took part in the survey questionnaire. The majority of the respondents belonged to the age group of 28-37 years (n = 320; 44.3%), with female participants (n = 419; 58.0%) outnumbering the male participants (n = 303; 42.0%). Most of the respondents had good knowledge, attitudes and practices towards COVID-19. Patients aged 28-37 years (p = 0.000) with a master's degree (p = 0.011) and government employees (p = 0.000) had significantly better knowledge than their counterparts. Significantly optimistic attitudes were noticed in participants aged 28-37 years (p = 0.000) with a master's degree (p = 0.000), the married (p = 0.047) and government employees (p = 0.000). Government employees (p = 0.014) had significantly better practices. Conclusions: Overall, the participants of this study had good COVID-19-related knowledge, attitudes and practices. These findings would be useful in motivating the general population to follow the precautionary measures that will aid in prevention of COVID-19. Furthermore, the findings may help policymakers identify the target populations, especially the less educated and older adults, for COVID-19 prevention and health education.

A National Survey Evaluating the Knowledge and Attitude of Health-Care Workers of Saudi Arabia about Coronavirus Infection.

Background and Objectives: Health-care workers (HCWs) are playing an instrumental role in combating coronavirus infection (COVID-19). While rendering their services, they also run the risk of cross-contamination. Hence, it is important to evaluate and correlate the knowledge and attitude of HCWs of Saudi Arabia about COVID-19. Materials and Methods: A prospective, nationwide, questionnaire-based survey was conducted after getting the approval from the institutional ethical board. A validated and reliable questionnaire was constructed, developed on the Qualtrics software, and circulated through an electronic medium across the country. The questionnaire had a total of 29 questions regarding knowledge and attitude about COVID-19. Through convenience sampling, the data were collected from a total sample of 1553 HCWs. Based on the primary area of expertise, the sample was categorized into three study groups with 1040 medical health-care professionals (MHCPs) (Group I), 318 dental health-care professionals (DHCPs) (Group II), and 195 allied health-care professionals (AHCPs) (Group III). Univariate and multivariate logistic regression analysis was done using SPSS v. 21, where P < 0.05 was considered statistically significant. Results: Female HCWs (P = 0.003) were shown to have a higher (adjusted odds ratio [aOR]: 1.46; confidence interval [CI]: 1.19-1.79) risk of inadequate knowledge in comparison to male HCWs. With respect to qualification, HCWs with doctorate qualification (P = 0.005) (aOR: 0.39; CI: 0.2-0.75) had shown to have adequate knowledge compared to their counterparts. AHCPs were shown inadequate knowledge (P < 0.001; aOR: 2.36; CI: 1.65-3.38), but adequate attitude (P < 0.001; aOR: 0.13; CI: 0.09-0.2) compared to MHCPs and DHCPs. Conclusion: MHCPs were shown to have the most appropriate level of knowledge, whereas AHCPs outscore other counterparts of HCWs with respect to attitude toward COVID-19. Emphasis should be directed to the whole community of HCWs in enhancing their awareness and practice attitude toward the novel infection of COVID-19.

Cone Beam Computerized Tomographic Analysis of Collum Angle of the Maxillary Central Incisors in Different Types of Malocclusion: Comparative Assessment in Saudi, Jordan and Egypt Subpopulation.

Background: The collum angle (CA) is an extremely significant for patients who are undergoing orthodontic, dental implant restoration, prosthodontic and periodontic treatments. Aim and Objectives: To determine and compare the mean CA for maxillary central incisor in different types of malocclusion utilizing 3D Cone Beam Computerized Tomography (CBCT) images. The additional objectives were to determine and compare the mean CA for maxillary central incisor based upon the demographic characteristics among Saudi, Jordan and Egypt subpopulation and to test for significant differences in the CA of maxillary central incisor with different molar malocclusions. Methodology: A total of 400 CBCT images were included from the radiology archive at the College of Dentistry, Jouf University (Sakaka, Saudi Arabia). The CBCT images were divided into four groups based upon molar classifications. The selected records were used for the measurement of CA of maxillary central incisor using the measurement tool built into 3D:OnDemand software. Statistical analysis was done using independent t test and ANOVA to examine the differences between gender and races. Results: The mean CA for Class II div 2 exhibited significantly higher crown-root variation as compared other groups (p < 0.0001). Males sample showed greater value of CA for each group as compared to the females and this difference was statistically significant for all the groups other than for Class I (p < 0.05). The post hoc pairwise comparisons between the races showed statistically insignificant findings (p > 0.05). Significant difference was found on pairwise comparisons among different malocclusion groups other than for group Class I/Class II div 1 (p < 0.05). Conclusion: The CA of Class II div 2 group was the greatest as compared to other malocclusion groups. Males sample showed greater value of CA for each group as compared to the females and this difference was statistically significant for all the groups other than for Class I. Statistically insignificant difference was noted for the mean CA among different races whereas significant difference was found on pairwise comparisons among different malocclusion groups other than for group Class I/Class II div 1.

Cone-Beam Computed Tomography: A New Tool on the Horizon for Forensic Dentistry.

Teeth and bones of calvarium are important structures from a forensic point of view, as they are extremely resilient to destruction or decomposition, even under temperature variations. Radiology is inevitably an important tool in forensic investigations. Maxillofacial radiology provides a considerable amount of information for the identification of remains and evidence in case of legal matters. The advent of cone-beam computed tomography (CBCT) in the arena of maxillofacial 3D imaging has contributed immensely to forensic science such as the age estimation through teeth, analysis of bite marks, determination of race and sex, etc. The advantages of accuracy in imaging the anatomy, digitized technology favoring easier comparison of records and storage of records for a longer period, cost reduction, dose reduction, and easier portability have made it an unavoidable adjunct in forensic investigations. The aim of this paper is to review and highlight the importance of CBCT in successful forensic identification and analysis. This review is written to address the various aspects of CBCT as a recently developed technology that may be very useful in some forensic contexts, based on searches for current studies in the literature using PubMed, Scopus, Web of Science, and Google Scholar databases, to identify studies published since inception to December 2021, with no language restriction. In conclusion, CBCT is an accessible 3D imaging technology with many applications, one of them being in forensic sciences.

Association of High Immunohistochemical Expression of Minichromosome Maintenance 3 with Human Oral Squamous Cell Carcinoma-A Preliminary Study.

BACKGROUND: Oral squamous cell carcinoma (OSCC) may arise from premalignant oral lesions (PMOL) in most cases. Minichromosome maintenance 3 (MCM3) is a proliferative marker that has been investigated as a potential diagnostic biomarker in the diagnosis of oral cancer. OBJECTIVES: To evaluate the association of MCM3 expression, its clinicopathologic parameters and to identify snuff (also called naswar) as a potential risk factor for changes in MCM3 expression in PMOL and OSCC. METHODOLOGY: Immunohistochemistry (IHC) of MCM3 was performed on 32 PMOL, 32 OSCC and 16 normal controls after optimization of IHC methodology. Histoscore (0-300) was used as a scoring system and seven different cut-offs were identified for analyses. Data were analyzed using various statistical tests. RESULTS: Among the seven cutoffs, 40% strong positive cells were found to be a better cut-off as they were associated with many pathological variables (Broder's grade, Aneroth's grade, and mitotic activity). The differential MCM3 expression in oral lesions (PMOL and OSCC) was statistically significant (p = 0.03). Moreover, MCM3 expression is raised with increased duration and frequency of snuff use. CONCLUSION: High MCM3 expression is associated with disease progression and is a potential indicator of malignant transformations from PMOL to OSCC. Moreover, the use of snuff is associated with MCM3 over-expression.

Exosomes: Isolation, characterization, and biomedical applications.

Exosomes are nano-sized bioactive vesicles of 30-150 nm in diameter. They are secreted by exocytosis of nearly all type of cells in to the extracellular fluid. Thereby, they can be found in many biological fluids. Exosomes regulate intracellular communication between cells via delivery of their cargo which include lipids, proteins, and nucleic acid. Many desirable features of exosomes made them promising candidates in several therapeutic applications. In this review, we discuss the use of exosomes as diagnostic tools and their possible biomedical applications. Additionally, current techniques used for isolation, purification, and characterization of exosomes from both biological fluids and in vitro cell cultures were discussed.

ADMA: A Key Player in the Relationship between Vascular Dysfunction and Inflammation in Atherosclerosis.

Atherosclerosis is a chronic cardiovascular disease which increases risk of major cardiovascular events including myocardial infarction and stroke. Elevated plasma concentrations of asymmetric dimethylarginine (ADMA) have long been recognised as a hallmark of cardiovascular disease and are associated with cardiovascular risk factors including hypertension, obesity and hypertriglyceridemia. In this review, we discuss the clinical literature that link ADMA concentrations to increased risk of the development of atherosclerosis. The formation of atherosclerotic lesions relies on the interplay between vascular dysfunction, leading to endothelial activation and the accumulation of inflammatory cells, particularly macrophages, within the vessel wall. Here, we review the mechanisms through which elevated ADMA contributes to endothelial dysfunction, activation and reactive oxygen species (ROS) production; how ADMA may affect vascular smooth muscle phenotype; and finally whether ADMA plays a regulatory role in the inflammatory processes occurring within the vessel wall.