The impact of X-ray scatter correction software on abdomen radiography in terms of image quality and radiation dose.

INTRODUCTION: The conventional anti-scatter grid is widely used in X-ray radiography to reduce scattered X-rays, but it increases patient dose. Scatter-correction software offers a dose-reducing alternative by correcting for scattered X-rays without a physical grid. Grids and software correction are necessary to reduce scatter radiation and improve image quality especially for the large body parts. The scatter correction can be beneficial in situations where the use of grid is challenging. The implementation of grids and advanced software correction techniques is imperative to ensure that radiographic images maintain high levels of clarity, contrast, and resolution, and ultimately facilitating more accurate diagnoses. This study compares image quality and radiation dose for abdomen exams using scatter correction software and physical grids. METHODS: An anthropomorphic phantom (abdomen) underwent imaging with varying fat and lean tissue layers and body mass index (BMI) configurations. Imaging parameters included 70 kVp tube voltage, 110 cm SID, and Automatic Exposure Control (AEC) both lateral and central chambers. AP abdomen X-ray projections were acquired with and without an anti-scatter grid, and scatter correction software was applied. Image quality was assessed using contrast to noise ratio (CNR) and signal to noise ratio (SNR) metrics. The tube current mAs was considered an exposure factor that affected radiation dose and was used to compare the VG software and physical grid. Radiation dose was measured using Dose Area Products (DAP). The effective dose was estimated using Monte Carlo simulation-PCXMC software. Paired t-tests were used to investigate the image quality difference between the Gridless and VG software, Gridless and PG, and VG software and PG approaches. For the DAP and effective dose, paired t-test was used to investigate the difference between VG software and PG. RESULTS: Images acquired with a grid had the highest mean CNR (71.3 ± 32) compared to Gridless (50 ± 33.8) and scatter correction software (59.3 ± 37.9). The mean SNR of the grid images was (82.7.3 ± 38.9), which is 18% higher than the scatter correction software images (70.4 ± 36.7) and 29% higher than in the Gridless images (62.9.3 ± 34). The mean DAP value was reduced by 81% when the scatter correction software was used compared to the grid (mean: 65.4 µGy.m2 and 338.2 µGy.m2, respectively) with a significant difference (p = 0.001). Scatter correction software resulted in a lower effective dose compared to physical grid use, (mean difference± SD = -0.3 ± 0.18 mSv) with a significant difference (P = 0.02). CONCLUSION: Scatter correction software reduced the radiation dose required but images employing a grid yielded higher CNR and SNR. However, the radiation dose reduction might affect the image quality to a level that impacts the diagnostic information available. Thus, further research needs to be conducted to optimise the use of the scatter correction software. IMPLICATION FOR PRACTICE: Objectively, X-ray scatter correction software might be promising in conditions where a grid cannot be applied.

In Vitro Evaluation of marginal adaptation of polyether ether ketone and zirconia copings.

Background: Polyether ether ketone (PEEK) has emerged as a new thermoplastic material with potential applications as a restorative material. Aim: This study aimed to evaluate the marginal adaptation of PEEK copings compared to zirconia copings using field emission scanning electron microscopy. Materials and Methods: A freshly extracted maxillary central incisor was prepared for a full-coverage restoration following standard principles of tooth preparation. The tooth was sent to a laboratory for fabrication of samples using computer-aided design and manufacturing (CAD/CAM). Twenty samples of polyether ether ketone (PEEK) copings (group A) and 20 of zirconia copings were fabricated (group B). The copings were scanned under a field emission scanning electron microscope and measurements were taken at four distinct points. The marginal adaptation over the buccal, lingual, mesial, and distal margins for both groups was evaluated. One-way analysis of variance (ANOVA) and independent t test were applied. Results: Our findings indicate that PEEK showed better marginal adaptation than zirconia at all measurement points. The mean marginal gap value of the PEEK group was 33.99 ± 8.81 µm and of the zirconia group was 56.21 ± 15.07 µm. On comparing marginal adaptation among the mesial, distal, buccal, and lingual aspects, PEEK showed better adaptation on all four margins, with the best adaptation on the buccal margin that had the lowest mean gap value of 29.27 ± 6.07 µm. The zirconia group adapted best at the distal margin, with a lowest mean gap value of 53.58 ± 15.25 µm (P ≤ 0.05). Conclusion: PEEK copings had better marginal adaptation and fit compared to zirconia copings. It may have applications as a restorative material in fixed prostheses.

Performance of different dental age estimation methods on Saudi children.

AIM: To evaluate and compare the performance of six dental age estimation methods (Moorrees, Fanning and Hunt, Demirjian, Gleiser and Hunt, Nolla, Chaillet et al., and Nicodemo et al.) on a sample of Saudi children. METHOD: This cross-sectional study was based on the evaluation of a sample of 400 archived digital panoramic radiographs of healthy Saudi children (200 each from boys and girls) aged 6 to 15.99 years. Panoramic radiographs acquired during 2018-2021 were obtained from the information technology department of the dental clinics at King Saud University, Riyadh, Saudi Arabia. Dental age was evaluated using the six dental age estimation methods on the developing permanent dentition in both jaws of the left side. The accuracy of each method was assessed in relation to chronological age, and a comparison between these methods was made. RESULT: For all the tested methods, significant differences were found between chronological and dental age (P<0.001). The mean difference between dental and chronological age was (-2.19 years) for Chaillet et al. method, (0.15 years) for the Demirjian method, (-1.01 years) for the Moorrees, Fanning and Hunt method, (-1.72 years) for Nicodemo et al. method, (-1.29 years) for Nolla method, and (-1.00 years) for Gleiser and Hunt method. CONCLUSION: Among the tested methods, the accuracy in Saudi subjects was the highest for Demirjian's method, followed by the Moorrees, Fanning and Hunt method. The methods proposed by Nicodemo et al., and Chaillet et al., were the least accurate.

Vitamin C as a potential ameliorating agent against hepatotoxicity among alcoholic abusers.

OBJECTIVE: Drug and substance abuse remains a major medical problem globally. Alcohol consumption, particularly heavy drinking, is an important risk factor for many health problems and is a major contributor to the global burden of disease. Vitamin C has proven to be defensive against toxic substances and provides antioxidant and cytoprotective activity to hepatocytes. The aim of this study was to investigate vitamin C as a potential ameliorating agent against hepatotoxicity among alcohol abusers. PATIENTS AND METHODS: This study was a cross-sectional study that included eighty male hospitalized alcohol abusers and twenty healthy people as a control group. Alcohol abusers received standard treatment plus vitamin C. Total protein, albumin, total Bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), thiobarbituric acid reactive substances (TBARS), reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT) and 8-hydroxhguanosine (8-OHdG) were investigated. RESULTS: This study reported that, in the alcohol abuser group, there was a significant increase in the total protein, bilirubin, AST, ALT, ALP, TBARS, SOD and 8-OHdG; on the other hand, there was a significant decrease in albumin, GSH and CAT compared with the control group. The alcohol abuser group treated with vitamin C showed a significant decrease in total protein, bilirubin, AST, ALT, ALP, TBARS, SOD and 8-OHdG; on the other hand, there was a significant increase in albumin, GSH and CAT compared with the control group. CONCLUSIONS: This study's findings suggest that alcohol abuse induces significant alterations in various hepatic biochemical parameters and oxidative stress and that vitamin C has a partial protective role in countering alcohol abuse-induced hepatotoxicity. Using vitamin C as an adjunctive supplement to standard treatment may be helpful in minimizing the toxic side effects of alcohol abuse.

Can malocclusion among children impact their oral health-related quality of life? parents' perspective.

Background and Aim: Malocclusion can negatively impact the quality of life of children. Therefore, this study assesses the impact of proxy-reported malocclusion and oral health-related quality of life among children in Riyadh, Saudi Arabia, from the parents or guardians' perspectives. Materials and Methods: A self-administered electronic questionnaire was used to assess the correlation between proxy-reported malocclusion conditions during the early mixed dentition stage (children age 6-12 years) and oral health-related quality of life using the OHIP-14 measure. All collected data were analyzed using SPSS. Results: Among the 353 participants in the study, anterior open-bite was the most common proxy-reported malocclusion with a prevalence of 19%, followed by unilateral posterior cross bite (13.3%). Furthermore, 31% reported that their children sometimes experienced negative impacts on quality of life from malocclusions. The results also show that OHIP-14 scores were significantly associated with all proxy-reported malocclusion (p < 0.05). The highest OHIP-14 score was found to be significantly associated with the presence of deep-bite from parents' or guardians' perspective. Conclusion: The presence of some proxy-assessed malocclusion was associated with negative impacts on children's oral health-related quality of life. This is very important to consider when assessing the need for orthodontic intervention, especially at this stage as this age is critical in building a child's confidence and self-esteem.

Accuracy of dental age estimations based on individual teeth and staging system comparisons.

AIM: To investigate whether a specific tooth or teeth provide the most accurate estimation of chronological age (CA), and determine which of the three staging systems studied represents dental development for an individual tooth. METHOD: Data were collected from 400 digital panoramic radiographs of healthy Saudi children aged 6.00-15.99 years. Each permanent tooth on the left side was evaluated to determine its developmental stage and dental age using the methods by Moorrees, Fanning, and Hunt (MFH) (1963), as adapted by Smith (1991), Gleiser and Hunt (1955), and Nicodemo et al. (1974). The accuracy (bias) of each tooth type and stage was assessed in relation to the CA, the teeth and the methods were compared, and the accuracy of age estimation using all teeth and the most accurate tooth in each method were compared. RESULTS: Regarding staging systems, comparatively, Gleiser and Hunt's method had the lowest bias for the lower first molar (-0.50 ± 1.05 years). Nicodemo et al.'s method had a lower bias for all other mandibular teeth compared to the MFH method. For individual teeth using the MFH method, the most and least accurate teeth for the combined sexes were the lower central incisor (-0.59 ± 0.77 years) and the lower first molar (-1.54 ± 0.93 years), respectively. No significant difference was found between the biases when using the lower central incisor alone and when using all teeth for the combined sexes. For individual teeth using Nicodemo et al.'s method, the most and least accurate teeth for combined sexes were the upper central incisor (-0.03 ± 1.01 years) and the lower first molar (-1.08 ± 1.59 years), respectively. A significant difference was found between the biases using the upper central incisor alone and all teeth for the combined sexes, with the upper central incisor exhibiting the lowest bias (P=0.028). CONCLUSIONS: Comparatively, Nicodemo et al.'s method had the lowest bias for all teeth except for the lower first molar, where Gleiser and Hunt's method had the lowest bias. This, however, should not be confused with precision. MFH's staging system was more representative of dental development for an individual tooth. For combined sexes, the lower central and lateral incisors were the most accurate teeth using the MFH method. The upper central incisor and lower first premolar were the most accurate teeth using Nicodemo et al.'s method. The lower first molar was the least accurate tooth using both methods.

Physical characterization and wound healing properties of Zamzam water.

The objective of the study was to evaluate the quality of Zamzam water, holy water for Muslims and consumed for its medicinal value. The present study demonstrates the physicochemical characterization and wound healing property of Zamzam water. The physicochemical characterization of Zamzam water samples was analyzed for dissolved oxygen, pH, conductivity, total dissolved solids, redox potential, zeta potential, polydispersity index, and zeta size. The microbial quality of Zamzam water was also assessed by exposing water samples to open air. In this work, Zamzam water was also screened for the medicinal value through wound healing properties in Wistar rats. Zamzam water exhibited a unique physicochemical characterization with high levels of dissolved oxygen, zeta potential, polydispersity index, redox potential, total dissolved solids, and conductivity before exposure to open air. After open air exposure, Zamzam water resisted the growth of bacteria. The wound healing properties of Zamzam water in vivo showed a 96% of healing effect on 12th day observation. The wound healing was achieved by modulating pro-inflammatory cytokine such as interleukin -1ß (IL-1ß), interleukin-6 (IL-6), and tumor necrosis factor -α (TNF-α). Followed by the level of apoptosis markers caspase-9 and caspase-3 were reduced. The present study proved that Zamzam water is a good-quality water and showed excellent wound healing property. Therefore, Zamzam water can be used for pharmaceutical formulations.

Wound-healing and cytokine-modulating potential of medicinal oil formulation comprising leaf extract of Murraya koenigii and olive oil.

The study investigated the wound healing effect of medicinal oil (MO) formulation prepared from Murraya koenigii leaves extract (methanolic) incorporated in olive oil. The MO was visually transparent, homogenous, smooth in texture, the viscosity grade was observed as 140 cP and easily spreadable. Pro-inflammatory cytokines IL-1ß, IL-6, and TNF-α were significantly reduced to 82.3 ± 3.5, 156 ± 6.2, 137.3. ± 5.5 pg/ml, respectively after treatment with MO when compared to disease control animals that showed IL-1ß, IL-6, and TNF-α levels of 170 ± 6, 265 ± 7, and 288.6 ± 11, pg/ml respectively. The level of pro-inflammatory cytokine in povidone iodine solution (PIS) group was 95.3 ± 3, 162 ± 6, 177.6 ± 8.9 pg/ml of IL-1ß, IL-6, and TNF-α respectively. Interestingly, the wound-healing efficacy of MO was found better as compared to povidone iodine treated standard group and concluded that MO has excellent wound healing effect.

Management of oral mucositis in children.

OBJECTIVE: Children undergoing chemotherapy or hematopoietic stem cell transplantation may suffer from Oral mucositis. Therefore, the aim of this systematic review was to find the protocols which are used in the management of oral mucositis (OM) in children. MATERIALS AND METHODS: A search was performed to find the related studies. After reading the searched articles, 15 studies were selected for this review. RESULTS: Good oral care, glutamine, some biological agents, and laser therapy, had a significant effect to reduce the pain sensation and occurrence of oral mucositis in children. CONCLUSIONS: It has been concluded that there are many types of management, such as oral care and laser therapy, which can be used to reduce the severity of oral mucositis.

Wound-healing and cytokine-modulating potential of medicinal oil formulation comprising leaf extract of Murraya koenigii and olive oil / Potencial de cicatrização de feridas e modulação de citocinas de formulação de óleo medicinal compreendendo extrato de folhas de Murraya koenigii e azeite de oliva

The study investigated the wound healing effect of medicinal oil (MO) formulation prepared from Murraya koenigii leaves extract (methanolic) incorporated in olive oil. The MO was visually transparent, homogenous, smooth in texture, the viscosity grade was observed as 140 cP and easily spreadable. Pro-inflammatory cytokines IL-1ß, IL-6, and TNF-α were significantly reduced to 82.3 ± 3.5, 156 ± 6.2, 137.3. ± 5.5 pg/ml, respectively after treatment with MO when compared to disease control animals that showed IL-1ß, IL-6, and TNF-α levels of 170 ± 6, 265 ± 7, and 288.6 ± 11, pg/ml respectively. The level of pro-inflammatory cytokine in povidone iodine solution (PIS) group was 95.3 ± 3, 162 ± 6, 177.6 ± 8.9 pg/ml of IL-1ß, IL-6, and TNF-α respectively. Interestingly, the wound-healing efficacy of MO was found better as compared to povidone iodine treated standard group and concluded that MO has excellent wound healing effect.

O estudo investigou o efeito cicatrizante da formulação de óleo medicinal (MO) preparado a partir do extrato de folhas de Murraya koenigii (metanol) incorporado ao azeite de oliva. O MO era visualmente transparente, homogêneo, de textura lisa, o grau de viscosidade observado foi de 140 cP e facilmente espalhável. As citocinas pró-inflamatórias IL-1ß, IL-6 e TNF-α foram significativamente reduzidas para 82,3 ± 3,5, 156 ± 6,2, 137,3. ± 5,5 pg/ml, respectivamente, após o tratamento com MO quando comparados aos animais controle da doença que apresentaram níveis de IL-1ß, IL-6 e TNF-α de 170 ± 6, 265 ± 7 e 288,6 ± 11, pg/ml, respectivamente . O nível de citocina pró-inflamatória no grupo solução de iodopovidona (PIS) foi de 95,3 ± 3, 162 ± 6, 177,6 ± 8,9 pg/ml de IL-1ß, IL-6 e TNF-α, respectivamente. Curiosamente, a eficácia de cicatrização de feridas de MO foi encontrada melhor em comparação com o grupo padrão tratado com iodopovidona e concluiu que a preparação de MO tem efeito de cicatrização de feridas.

The efficiency of alpha-lipoic acid in the treatment of burning mouth syndrome: a systematic review.

OBJECTIVE: Burning mouth syndrome (BMS) is generally characterized by oral mucosa burning in the absence of any medical and dental reasons. The findings of previous studies or reviews are generally ambiguous. Therefore, the aim of this study was to review the findings of previous studies of randomized controlled trials (RCTs) for pain as evaluated by Visual Analogue Scales (VAS). VAS is a validated, subjective measure for acute and chronic pain MATERIALS AND METHODS: A search of PubMed/MEDLINE/ScienceDirect and Embase up to 2020. RESULTS: By following the criteria of exclusion and inclusion, the papers were examined and divided into two categories, one based on BMS and the other that used alpha-lipoic acid to treat BMS. The reviewed results were compared in terms of methodology, size of sample, outcomes, and results. CONCLUSIONS: Some studies showed positive results of using ALA to treat the BMS, but these findings need more improvements, and more investigations are required.

Bariatric and Metabolic Endoscopy: A New Paradigm.

The prevalence of obesity, type 2 diabetes mellitus, and metabolic syndromes is increasing globally. Minimally invasive metabobariatric (MB) endoscopic therapies are adjunct treatments that can potentially bridge the gap between surgical interventions and medical therapy. A growing number of MB techniques are becoming available, allowing for more personalized and patient-targeted treatment options for specific disease states. MB techniques are less invasive than surgery and can precisely target different parts of the gastrointestinal tract that may be responsible for the pathophysiology of obesity and metabolic syndromes such as type 2 diabetes mellitus. These alternatives should be selected on an individualized patient basis to balance the expected clinical outcomes and desired anatomical targets with the level of invasiveness and degree of acceptable risk. Each MB intervention presents great flexibility allowing for a tailored intervention and different levels of patient engagement. Patient awareness and motivation are essential to avoid therapy withdrawal and failure. Differences between MB procedures in terms of weight loss and metabolic benefit will be discussed in this review, along with the insights on clinical decision-making processes to evaluate the potential of further evolution and growth of bariatric and metabolic endoscopy.

Rare case of COVID-19 presenting as acute abdomen and sepsis.

Coronavirus disease 2019 (COVID-19) may present as acute abdomen, although the pathophysiology remains obscure. We report the case of a 45-year-old-man with severe COVID-19 pneumonia with associated pulmonary embolism who presented with acute abdomen. He underwent emergency laparotomy and resection of an ischaemic area of the jejunum. Postoperatively, he had septic shock, acute respiratory distress syndrome and acute kidney injury necessitating continuous renal replacement therapy. We administered antibiotics and therapeutic anticoagulation along with two sessions of haemoadsorption by CytoSorb filter, in conjunction with continuous renal replacement therapy. The patient survived. Bowel ischaemia due to thromboembolic disease should be promptly treated. Extracorporeal blood purification may be useful in managing sepsis in severe COVID-19.

Response surface methodology-based optimization of ultrasound-assisted extraction of β-sitosterol and lupeol from Astragalus atropilosus (roots) and validation by HPTLC method

Objective: To optimize the ultrasonication method for efficient extraction of β-sitosterol and lupeol from the roots of Astragalus atropilosus using Box-Behnken design of response surface methodology (RSM), and its validation by high performance thin layer chromatography (HPTLC) method.Methods: Ultrasonication method was used to extract β-sitosterol and lupeol from Astragalus atropilosus (roots). RSM was used to optimize the different extraction parameters viz. liquid to solid ratio (10–14 mL/g), temperature (60-80 ℃) and time (40–60 min) to maximize the yield of β-sitosterol and lupeol. The quantitative estimation of β-sitosterol and lupeol was done in chloroform extract of Astragalus atropilosus by validated HPTLC method on 10 cm × 20 cm glass-backed silica gel 60F254 plate using hexane and ethyl acetate (8:2, v/v) as mobile phase. Results: A quadratic polynomial model was found to be most appropriate with regard to R1 (yield of total extraction; R2/％ CV = 0.9948/0.28), R2 (β-sitosterol yield; R2/％ CV = 0.9923/0.39) and R3 (lupeol yield; R2/％ CV = 0.9942/0.97). The values of adjusted R2/predicted R2/signal to noise ratio for R1, R2, and R3 were 0.9782/0.9551/48.77, 0.9904/0.9110/31.33, and 0.9927/0.9401/36.08, respectively, indicating a high degree of correlation and adequate signal. The linear correlation plot between the predicted and experimental values for R1, R2, and R3 showed high values of R2 ranging from 0.9905-0.9973. β-sitosterol and lupeol in chloroform extract of Astragalus atropilosus were detected at Rf values of 0.22 and 0.34, respectively, at λ max = 518 nm. The optimized ultrasonic extraction produced 8.462％ w/w of R1, 0.451％ w/w of R2 and 0.172％ w/w of R3 at 13.5 mL/g liquid to solid ratio,78 ℃ of temperature and 60 min of time.Conclusions: The experimental findings of RSM optimized extraction and HPTLC analysis can be further applied for the efficient extraction of β-sitosterol and lupeol in other species of Astragalus.

Thyrotoxic periodic paralysis as an initial presentation of Graves' disease in a Saudi patient.

Thyrotoxic periodic paralysis (TPP) is a well-known complication of hyperthyroidism, characterised by recurrent flaccid paralysis with hypokalaemia. To date, only five cases of this rare disorder have been reported in Saudi Arabia. Here, we report an additional case involving a 25-year-old Saudi man who presented with lower limb paralysis and severe hypokalaemia. Clinically, he showed symptoms and signs suggestive of Graves' disease, which was confirmed by laboratory investigations. Carbimazole, a beta-blocker and potassium replacement were administered, resulting in dramatic improvement of the TTP. This case emphasises the importance of considering TPP in patients with acute muscle weakness and the importance of promptly initiating treatment and preventing relapse of TPP.

Patent ductus arteriosus in premature infants: to treat or not to treat?

OBJECTIVE: Closing patent ductus arteriosus (PDA) is a widely accepted approach in the management of very low birth weight (VLBW) infants. Our objective is to test the hypothesis that conservative management (no treatment) of PDA will not affect survival without chronic lung diseases (CLD). STUDY DESIGN: This retrospective study utilizes a prospectively collected database to compare two cohorts of VLBW infants. Infants in the first group (2001 to 2009) had their PDA treated with pharmacological and if necessary with surgical ligation. PDA in the second group (2010 to 2014) was not treated with medical or surgical intervention. The primary outcome was survival without oxygen requirement at 36 weeks. Pulmonary and non-pulmonary morbidities were also compared. Logistic regression analyses were performed to control for confounders. RESULTS: This study included 643 VLBW infants, of them 415 infants in the Treat group and 228 in the No-Treat group. The rate of survival without CLD did not differ between Treat and No-Treat groups (78.4% vs 83.9%, respectively; adjusted odds ratio (aOR)=1.72, confidence interval (CI): 0.92 to 3.23, P=0.09). Mortality declined in No-Treat group (15.2% vs 10.5%, aOR=0.51, CI: 0.25 to 0.99, P=0.049), but the two groups did not differ in the incidence of CLD among survivors (5.8% vs 5.0%,=P0.47). Pulmonary complications and non-pulmonary morbidities did not differ between groups. CONCLUSIONS: Conservative management (no treatment) of PDA may not compromise survival without CLD and is not associated with increased morbidities in VLBW infants. Prospective physiological studies are needed to determine the sector of VLBW infants, if any, who could benefit from PDA treatment.

Time to viral suppression is not related to achievement of SVR12 in HCV GT1-infected patients treated with ombitasvir/paritaprevir/ritonavir and dasabuvir with or without ribavirin.

High rates of sustained virologic response at post-treatment week 12 (SVR12) were achieved in six phase 3 trials of ombitasvir (OBV, an NS5A inhibitor), paritaprevir (an NS3/4A protease inhibitor) co-dosed with ritonavir (PTV/r) + dasabuvir (DSV, an NS5B RNA polymerase inhibitor) (ie, 3D regimen) with or without ribavirin (RBV) in adults with chronic genotype (GT) 1 hepatitis C virus (HCV) infection. We assessed whether time to first HCV RNA value below the lower limit of quantification in patients with and without cirrhosis was associated with achievement of SVR12. Data were analysed from GT1-infected patients enrolled in six phase 3 studies of 3D ± RBV. Patients who experienced non-virologic failure were excluded from analysis. HCV RNA was determined using the Roche COBAS TaqMan RT-PCR assay (lower limit of quantification, LLOQ =25 IU/mL). SVR12 was analysed by week of first HCV RNA suppression, defined as HCV RNA

Transporters as Drug Targets in Neurological Diseases.

Membrane transport proteins have central physiological function in maintaining cerebral homeostasis. These transporters are expressed in almost all cerebral cells in which they regulate the movement of a wide range of solutes, including endogenous substrates, xenobiotic, and therapeutic drugs. Altered activity/expression of central nervous system (CNS) transporters has been implicated in the onset and progression of multiple neurological diseases. Neurological diseases are heterogeneous diseases that involve complex pathological alterations with only a few treatment options; therefore, there is a great need for the development of novel therapeutic treatments. To that end, transporters have emerged recently to be promising therapeutic targets to halt or slow the course of neurological diseases. The objective of this review is to discuss implications of transporters in neurological diseases and summarize available evidence for targeting transporters as decent therapeutic approach in the treatment of neurological diseases.

Determinants of vitamin D deficiency among undergraduate medical students in Saudi Arabia.

BACKGROUND/OBJECTIVES: The objectives of our study were to determine possible factors associated with low vitamin D levels in medical students. SUBJECTS/METHODS: A cross-sectional study was performed among 255 first- to fifth-year male undergraduate medical students of one of the major universities in Saudi Arabia. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured using electrochemiluminiscence. Multiple logistic regression analysis was performed. RESULTS: Majority of Saudi medical students (75.2%) had 25(OH)D levels <30 nmol/l, defined as risk for deficiency by the Institute of Medicine. Multivariate analysis showed that the odds of having 25(OH)D serum levels of ⩾ 30 nmol/l were seven times higher both in students who took vitamin D (odds ratio (OR)=7.2, 95% confidence interval (CI)=1.8-29.9, P=0.006) or multivitamin supplements (OR=6.9, 95% CI=1.7-27.3, P=0.006) within 1 year. Students with a history of vitamin D testing >1 year before the study or moderate/vigorous physical activity (PA) had 4.4 (OR=4.4, 95% CI=1.7-11.4, P=0.003) and 2.7-fold (OR=2.7, 95% CI=1.3-5.3, P=0.006) higher odds of having 25(OH)D levels ⩾ 30 nmol/l, respectively. There was no significant association between 25(OH)D serum levels and average time spent outdoors per day (P=0.369) and type of clothing (long-sleeved vs short-sleeved; P=0.800). CONCLUSIONS: Vitamin D deficiency was highly prevalent in Saudi medical students. Modifiable factors such as vitamin D intake and PA could be targeted for intervention. Further studies with standardized laboratory measurements of 25(OH)D are needed to explore the role of vitamin D testing in behavioral change, which may lead to increased serum 25(OH)D levels.

Accuracy of dental age estimation charts: Schour and Massler, Ubelaker and the London Atlas.

Dental age estimation charts are frequently used to assess maturity and estimate age. The aim of this study was to assess the accuracy of estimating age of three dental development charts (Schour and Massler, Ubelaker, and the London Atlas). The test sample was skeletal remains and dental radiographs of known-age individuals (N = 1,506, prenatal to 23.94 years). Dental age was estimated using charts of Schour and Massler, Ubelaker, and The London Atlas. Dental and chronological ages were compared using a paired t-test for the three methods. The absolute mean difference between dental and chronological age was calculated. Results show that all three methods under-estimated age but the London Atlas performed better than Schour and Massler and Ubelaker in all measures. The mean difference for Schour and Massler and Ubelaker was -0.76 and -0.80 years (SD 1.27 year, N = 1,227) respectively and for the London Atlas was -0.10 year (SD 0.97 year, N = 1,429). Further analysis by age category showed similar accuracy for all three methods for individuals younger than 1 year. For ages 1-18, the mean difference between dental and chronological ages was significant (P < 0.05) for Schour and Massler and Ubelaker and not significant (P > 0.05) for the London Atlas for most age categories. These findings show that the London Atlas performs better than Schour and Massler and Ubelaker and represents a substantial improvement in accuracy of dental age estimation from developing teeth.