Serum Collagen Triple Helix Repeat Containing-1 Levels are Related to Radiological Affection and Disease Activity in Rheumatoid Arthritis.

Background: Rheumatoid arthritis (RA) is a common systemic inflammatory disease. Collagen triple helix repeat containing-1 (CTHRC1) is a unique gene product able to reduce collagen deposition. The present study aimed to assess CTHRC1 level in RA patients and to uncover its relation to clinical, laboratory and radiological findings. Methods: The study included 60 adult RA patients. In addition, there were 60 control subjects who included patients with osteoarthritis (n = 20) and reactive arthritis (n = 20) and healthy controls (n = 20). Serum CTHRC1 levels were assessed by Enzyme-Linked Immunosorbent Assay (ELISA). Disease activity was calculated using the Disease Activity Score (DAS28-CRP). Radiological damage was evaluated using the Simple Erosion Narrowing Score (SENS). Results: There was significantly higher serum CTHRC1 levels in RA patients when compared to OA, ReA and control groups [median (IQR): 4.66 (1.68-11.7) versus 1.88 (1.14-2.94), 1.55 (0.98-3.15) and 1.14 (0.85-1.3) mg/dL, respectively, p < 0.001]. There was significantly higher CTHRC1 levels in patients with higher disease activity [median (IQR): 2.23 (1.4-4.73) versus 6.55 (4.66-12.0) mg/dL, p = 0.004]. Patients with higher SENS had significantly higher CTHRC1 [median (IQR): 1.99 (1.4-4.66) versus 9.75 (4.39-12.63) mg/dL, p < 0.001] and DAS28 [median (IQR): 4.25 (2.9-5.2) versus 5.4 (4.65-5.8), p = 0.01]. Conclusion: Serum CTHRC1 levels are related to disease severity and radiological affection in RA patients.

Mechanical traction from different knee joint angles in patients with knee osteoarthritis: A randomized controlled trial.

OBJECTIVE: To compare the effect of mechanical traction from different knee angles on pain, physical function, and range of motion in patients with knee osteoarthritis. DESIGN: A single-blinded, randomized controlled trial. SETTING: Outpatient public and governmental Hospital clinics. PARTICIPANTS: One hundred and twenty patients with knee osteoarthritis were randomly assigned into 4 equal groups with 30 patients in each group. INTERVENTIONS: Group (A) received conventional physiotherapy(CPT) treatment; group (B) received CPT with knee traction from full extension, group (C) received CPT with knee traction from 90° flexion, while group (D) received CPT with knee traction from 20° flexion. Interventions were applied 3 sessions a week for 4 weeks. OUTCOME MEASUREMENTS: Visual analog scale (VAS), knee passive range of motion and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were measured at baseline, immediately after 4 weeks of intervention, and after 4 weeks of no intervention as a follow-up. RESULTS: After eight weeks, the mean (SD) for VAS scores were 30.97 ± 8.68, 24.0 ± 8.8, 15.43 ± 6.31, and 16.17 ± 6.11 mm; for total WOMAC scores were 26.77 ± 9.19, 20.3 ± 8.52, 13.27 ± 6.25, and 13.43 ± 7.14 for groups A, B, C and D, respectively. The three traction groups showed statistically significant changes in pain scores, physical function, and total WOMAC, but not for knee passive range of motion, in favor of traction groups C and D than the conventional group (P < 0.05). CONCLUSIONS: Traction from 90°and 20° of knee flexion was found superior to full extension knee in improving pain and physical function, but not for knee passive range of motion, in patients with knee osteoarthritis.

Evaluation of Dental Crowding and Spacing in Relation to Tooth Size and Arch Dimensions in a Sample of Sudanese Adults.

AIMS AND OBJECTIVES: This study aimed to compare tooth size and arch dimensions between normal, crowded, and spaced groups in a Sudanese sample. MATERIAL AND METHODS: A sample of 312 university students, were selected and divided into normal, crowded, and spaced groups. Each group included 104 students with equal males to females ratios. Age was ranged from 16 to 26 years. Mesiodistal (MD) tooth width of all teeth (except molars), arch perimeters, and dimension at the level of intercanine, interpremolar, and intermolar were measured for each group. ANOVA and student t-test were performed for the comparison between groups. RESULTS: The MD dimensions of all teeth are greater in crowded arches as compared to the teeth in normal dental arches, except for the width of the maxillary, left second premolar in females, and mandibular left second premolar in male. Spaced arches were presented with significantly smaller MD width in all teeth when compared to normal arches, except for the width of maxillary right second premolar, maxillary left first premolar, mandibular right and left second premolars in female, and maxillary right second premolar in male. Crowded arches exhibit the largest total tooth material followed by normal and spaced dentition. Spaced arches show the widest arch dimension and perimeters followed by normal and crowded dentitions. CONCLUSIONS: Both tooth size and arch dimensions contribute to dental crowding and spacing. CLINICAL RELEVANCE: Since the size of the teeth and dental arches affect the space availability of the dentition. These factors should be considered in the initial stages of orthodontic treatment planning to avoid compromised treatment outcomes.

Association of Rs231775 Genetic Variant of Cytotoxic T-lymphocyte Associated Protein 4 with Alopecia Areata Disease in Males: A Case-Control Study.

BACKGROUND: Alopecia Areata (AA) is a common inflammatory immune-mediated non-scarring hair loss; however, the exact genetic susceptibility remains to be clarified. Cytotoxic T-lymphocyte Associated Protein 4 (CTLA4) has emerged as a central and critically important modulator of immune responses and is believed to play a crucial rule in AA pathogenesis. OBJECTIVES: To investigate the association of CTLA4 variant (rs231775) within codon 17 with AA risk and outcomes. METHODS: Genetic analyses of the rs231775 SNP of CTLA4 gene were performed in 186 males (93 AA patients and 93 controls). RESULTS: The rs231775 CTLA4 variant was significantly higher in AA patients in comparison with control subjects especially among heterozygous and dominant model. This association varied significantly with disease severity. CONCLUSIONS: Individuals with homozygosity of rs231775 CTLA4 variant represented AA disease risk and increased severity than their counterparts.Abbreviations: AA: Alopecia areata; CTLA4: Cytotoxic T-lymphocyte Associated Protein 4; SNP: Single nucleotide polymorphism; LADA: Latent autoimmune diabetes in adults; SLE: Systemic lupus erythematosus; SCU: Suez Canal University; SALT: Severity of Alopecia Tool; DNA: Deoxyribonucleic acid; RT-PCR: Real-time polymerase chain reaction, HWE: Hardy-Weinberg equation; RA: rheumatoid arthritis.

Bolton tooth size analysis in a sample of Sudanese adults / Análise de Bolton do tamanho dentário em uma amostra de adultos sudaneses

Introduction: A correct proportion between the upper and lower teeth is critical to achieving proper occlusal interdigitation, ideal overjet, and good molar intercuspation at the end of orthodontic treatment. Objectives: To determine the anterior and overall Bolton's ratio in the Sudanese population, investigate gender differences in tooth size ratios, and to compare these results with Bolton's original ratio norm. Material and Methods: The sample consisted of dental casts of 104 Sudanese University students with normal occlusion (52 females, 52 males), aged between 16-26 years randomly selected from AL- Neelain University. An electronic digital caliper was used to measure the mesiodistal tooth size of the maxillary and mandibular teeth anterior to the second molars. These measurements were then used to obtain Bolton's ratio. Mean, range, and standard deviation of the anterior and overall ratios were computed for each subject. T-Tests were used to compare gender differences and to investigate differences between the results of this study and Bolton's original ratio. Results: Anterior and overall Bolton ratios for males were 78.43 ± 2.44 and 93.901 ± 9.8 and for females were 78.29 ± 2.6 and 91.67 ± 3.3 percent, respectively. There were no statistically significant differences between males and females for the anterior and overall ratios (P>0.05). The anterior and overall Bolton's ratios among Sudanese University students were 78.37 ± 2.54, and 92.79 ± 7.43 percent, respectively. A statistically significant difference between this study and Bolton's study was found in both anterior and overall ratio (P≤ 0.05). Conclusion: Bolton's mean ratios may not be applicable to the Sudanese population. (AU)

Introdução: Uma proporção correta entre os dentes superiores e inferiores é crítica para alcançar a interdigitação oclusal adequada, overjet ideal e boa intercuspidação molar ao final do tratamento ortodôntico. Objetivos: determinar a proporção anterior e geral de Bolton na população sudanesa, investigar as diferenças de gênero nas proporções de tamanho dos dentes e comparar esses resultados com a norma original de Bolton. Material e Métodos: A amostra foi constituída por modelos de gesso de 104 universitários sudaneses com oclusão normal (52 mulheres, 52 homens), com idades entre 16-26 anos, selecionados aleatoriamente na Universidade AL-Neelain. Um paquímetro digital eletrônico foi usado para medir o tamanho mesiodistal dos dentes superiores e inferiores anteriores aos segundos molares. Essas medidas foram então usadas para obter o índice de Bolton. Média, intervalo e desvio padrão das relações anterior e geral foram calculados para cada amostra. Os testes t foram usados para comparar as diferenças de gênero e para investigar as diferenças entre os resultados deste estudo e a proporção original de Bolton. Resultados: Os índices de Bolton anterior e geral para homens foram 78,43 ± 2,44 e 93,901 ± 9,8 e para mulheres foram 78,29 ± 2,6 e 91,67 ± 3,3 por cento, respectivamente. Não houve diferenças estatisticamente significativas entre homens e mulheres para os índices anterior e geral (P> 0,05). Os índices de Bolton anterior e geral entre os estudantes da Universidade sudanesa foram 78,37 ± 2,54 e 92,79 ± 7,43 por cento, respectivamente. Uma diferença estatisticamente significativa entre este estudo e o estudo de Bolton foi encontrada na proporção anterior e geral (P≤ 0,05). Conclusão: os índices médios de Bolton podem não ser aplicáveis à população sudanesa (AU)

Assessing the influence of parental anxiety on childhood anxiety during the COVID-19 pandemic in the United Arab Emirates

The COVID-19 pandemic originated in Wuhan, China on December 31st and spread into international borders, leading to a public health crisis and complete shutdown of countries. The strict quarantine measures taken by governments kept a large number of people, around the world, in isolation and affected many aspects of peoples lives. These unprecedented changes triggered a wide variety of psychological problems ranging from panic disorders, anxiety and depression. In this study, we aim to explore anxiety levels among parents, teachers and the general community amid the COVID-19 pandemic in the UAE, as well as identify emotional and anxiety disorders in children. Using a web-based cross-sectional survey we collected data from 2,200 self-selected assessed volunteers. Demographic information, knowledge and beliefs about COVID-19, generalized anxiety disorder (GAD) using the (GAD-7) scale, emotional problems in children using the strengths and difficulties questionnaire (SDQ), worry and fear about COVID-19, coping mechanisms and general health information were collected. The overall prevalence of GAD in the general population was 71% with younger people (59.8%) and females (51.7%) reporting the highest levels of anxiety. Parents who were teachers reported the highest percentage of emotional problems in children (26.7%) compared to parents only (14.6%) or teachers only (4.7%). Multivariate logistic regression for GAD-7 score showed that females, participants who felt public fear was justifiable, persons who worried about COVID-19, persons who intended to take the COVID-19 vaccine and smokers were all associated with anxiety. Multivariate logistic regression for SDQ showed parents who had severe anxiety levels were 7 times more likely to report more emotional problems in their children (OR=7.00, 95% CI, 3.45 to 14.0) than less anxious parents. Findings suggest the urgency of policy makers to develop effective screening and coping strategies for parents and teachers and more specifically for vulnerable children.

Increased levels of anxiety among medical and non-medical university students during the COVID-19 pandemic in the United Arab Emirates.

IntroductionThe COVID-19 pandemic is likely to increase anxiety levels within the community and in particular medical students who are already considered psychologically vulnerable groups. Since the COVID-19 outbreak, no study has yet estimated the effect of this pandemic on university students in the UAE or its impact on the psychological well-being of medical students. MethodsIn this study, we surveyed 1485 medical (comprising medical and dental) and non-medical university students across 4 emirates within the UAE. We used an online platform to assess knowledge, sources of information, changes in hygienic behavior, perceptions of fear and worry and anxiety levels using the generalized anxiety disorder 7 (GAD-7) scale. The GAD-7 score was measured at three time points; during hospital visits for medical/dental students, before the introduction of online learning and after online learning for all students. ResultsThe majority of students demonstrated high levels of knowledge and utilized reliable sources of information. Non-medical students exercised higher compliance with social restrictions, while medical students practiced better hand hygiene. Almost half of students reported anxiety levels ranging from mild to severe with females reporting higher anxiety scores during hospital visits (OR=2.02, 95% CI, 1.41 to 2.91) and medical students reporting lower anxiety levels in comparison to dental students (OR=0.61, 95% CI, 0.45 to 0.84). Medical students reported higher levels of anxiety during their clinical rotations which decreased with the introduction of online learning, yet, non-medical students anxiety levels increased with online learning. ConclusionsThis is the first study to provide important information on the initial response and anxiety levels in university students across the UAE. The findings from our study can be used to support the development of effective screening strategies and interventions to build psychological resilience among university students during the COVID-19 pandemic or any other public health emergencies in the future.

Evaluation of the golden proportion and golden standard of maxillary anterior teeth in relation to smile attractiveness / Avaliação da proporção áurea e padrão-ouro dos dentes anteriores superiores em relação à atratividade do sorriso

Objective: The present study aimed to explore the existence of golden proportion (GP) between the widths of maxillary anterior teeth and golden standard (GS) for width to height ratio of maxillary central incisor in individuals with attractive and non-attractive smiles. Material and Methods: A total 82 females were recruited and divided into 2 groups: attractive smile (n=41) and non-attractive smile (n=41). Frontal photographs were taken, scanned, and saved in a personal computer. The apparent mesiodistal width of each anterior tooth was measured. The data were analyzed using the appropriate statistical tests at a P-value of 0.05). Conclusion: Frequency of the golden proportion was very low among the study population. Smile attractiveness was not greatly related to the proportions between the teeth. (AU)

Objetivo: O presente estudo teve como objetivo explorar a existência de proporção áurea (GP) entre as larguras dos dentes anteriores superiores e padrão-ouro (GS) para a relação largura-altura do incisivo central superior em indivíduos com sorrisos atraentes e não atraentes. Material e Métodos: Foram recrutadas 82 mulheres, divididas em 2 grupos: sorriso atraente (n = 41) e sorriso não atraente (n = 41). Fotografias frontais foram tiradas, digitalizadas e salvas em um computador pessoal. A largura aparente mesiodistal de cada dente anterior foi medida. Os dados foram analisados por meio dos testes estatísticos apropriados, com valor de p 0,05). Conclusão: A frequência da proporção áurea foi muito baixa na população estudada. Atratividade de sorriso não foi fortemente relacionada com as proporções entre os dentes. (AU)

Skeletal and Dentoalveolar Cephalometric Features of Anterior Open Bite among Yemeni Adults.

Objective. The aim of this study is to determine the cephalometric features for a sample of Yemeni adults with anterior open bite. Material and Methods. Lateral cephalometric radiographs were taken for 65 Yemeni university students (46 males and 19 females), 18-25 years old, with clinical anterior open bite (vertical overbite ≤ 0 mm) and no previous orthodontic treatment. The radiographs were manually traced; twelve angular, five linear measurements, and facial index were assessed, analyzed statistically, and compared to 194 Yemeni norms (89 males and 105 females) as well as cephalometric features of open bite subjects in previous studies. Results. Statistically significant differences were observed in skeletal and dental cephalometric values of Yemeni patients with anterior open bite when compared to Yemeni norms; mainly in the anteroposterior relation, the open bite individuals had higher significant value in SNA, SNB, and SNPg angles. In addition, a higher statistical significant difference was recorded in all variables of vertical relation when compared with norms. In contrast, NL-NSL angle revealed higher value among normal individuals. Dental variables among open bite individuals showed a greater degree of dental proclination, higher statistically significant value in [Formula: see text]-NA°, [Formula: see text]-NA mm and I-NB mm, and a lower significant value in U1-L1 in open bite group. Conclusion. Open bite Yemeni individual's skeletal and dentoalveolar variables significantly differ from Yemeni norms in the extent of the anteroposterior, vertical developmental pattern and dental relations.