A cross-sectional analysis of the association between diabetes self-care practices and blood glucose regulation among Egyptian diabetic patients.

OBJECTIVE: Diabetes Mellitus (DM) is a main public health issue worldwide, with Egypt among the world's top countries with diabetic patients. Data on the degree of self-care behaviors of Egyptian diabetic patients is not fully reported. Therefore, the study aimed to assess the adequacy of diabetes self-management (DSM) habits among diabetic patients in Egypt and to identify associated socio-demographic factors that could negatively impact the patients' glycemic state, using a structured questionnaire. SUBJECTS AND METHODS: This study was a cross-sectional observational study. The diabetes self-management questionnaire (DSMQ) was used to assess diabetes self-care activities, which is a 16-item questionnaire. The statistical analysis was conducted on SPSS software, and the data were significant with a p-value <0.05. RESULTS: A total of 2,164 participants were included. The majority of the patients (83.8%) had type 2 DM. The mean glycated hemoglobin (HbA1c) of the study group was 8.44±1.99. Significant differences were found between different glycemic control groups both in terms of the DSMQ sum scores and the subscale scores, with the exception of physical activity. Moreover, there was a significant weak inverse correlation between the total DSMQ sum score and HbA1c ≥9.0% (ρ=-0.116, p<0.01). The overall internal consistency (Cronbach's alpha) was acceptable (0.756). CONCLUSIONS: The study indicated that patients with controlled blood glucose had significantly higher 'glucose management', and 'total DSMQ sum' scores compared to uncontrolled diabetic patients. All significant correlations between assessed parameters and DSMQ were weak.

Retention of different all ceramic endocrown materials cemented with two different adhesive techniques.

OBJECTIVE: The purpose of this in vitro study was to evaluate the influence of two adhesive techniques on the retentive force of four all ceramic endocrowns. MATERIALS AND METHODS: Forty maxillary first molars of approximately similar size and shape were collected. The teeth were all decoronated 2 mm above the level of proximal cement-enamel junction (CEJ) and were all endodontically treated. The teeth were then randomly divided equally into four groups (10 each) according to all ceramic material used, as follows: Group I (VE) - Ten prepared molars were restored with hybrid ceramic (Vita Enamic); Group II (LU) - Ten prepared molars were restored with resin Nano-ceramic (Lava Ultimate). Group III (CD) - Ten prepared molars were restored with zirconia-reinforced lithium di-silicate ceramic material (Celtra Duo); Group IV (LZ) - Ten prepared molars were restored with zirconia ceramic (Lava Zirconia). Each group was then subdivided into two equal subgroups (n=5) according to the type of cement (adhesive technique) used for cementation. Subgroup A (RX ARC): the endocrowns were cemented with a total-etch adhesive resin cement (RelyX ARC). Subgroup B (RXU): the endocrowns were cemented with self-adhesive resin luting cement (RelyX UniCem). The restorations were designed with an outer cylindrical handle located on buccal and palatal surfaces to provide a mean for the removal of the endocrowns during the pull-out testing. The cemented endocrowns were thermocycled and then removed along the path of insertion using a universal testing machine at 0.5 mm/min. The retentive force was recorded, and the stress of dislodgement was calculated using the surface area of each preparation. RESULTS: The highest mean dislodgement stresses were 64.3 MPa for Group I (VE), whereas there was no statistically significant difference between Group I, II and III and LZ showed the lowest values with significant difference between the other three groups. Regarding the type of cement, there was a statistically significant difference between RelyX ARC (mean=60.09 MPa) and RelyX Unicem (mean=49.73 MPa). CONCLUSIONS: Retention of Vita Enamic, Lava Ultimate, and Celtra Duo are significantly higher than Lava Zirconia.

Marginal gap distance and cyclic fatigue loading for different all-ceramic endocrowns.

OBJECTIVE: The aim of the study was to evaluate the effect of the fabrication techniques of two types of glass ceramics on the marginal gap distance and the fracture resistance of endocrown restorations after cyclic loading. MATERIALS AND METHODS: Forty extracted mandibular first molars were root canal treated. Decoronation was done for all the endodontically treated teeth 2 mm above the cemento-enamel junction. The teeth were individually fixed vertically into epoxy resin mounting cylinders. All teeth were prepared to receive endocrown restorations. The prepared teeth were randomly divided into four equal groups (n=10) according to the all-ceramic materials and technique used for endocrown construction as follows: Group I (n=10): Pressable lithium disilicate glass ceramics (IPS e-max Press), Group II (n=10): Pressable zirconia-reinforced lithium disilicate glass ceramics (Celtra Press), Group III (n=10): Machinable lithium disilicate glass ceramics (IPS e-max CAD), Group IV (n=10): Machinable zirconia-reinforced lithium disilicate glass ceramics (Celtra Duo). The endocrowns were cemented using dual-cure resin cement. All endocrowns were subjected to fatigue loading. The cycles were repeated 120,000 times to clinically simulate one year chewing condition. Marginal gap distance of all endocrowns was measured directly using a digital microscope with x100 magnification. The load required to failure was recorded in Newton. Data were collected, tabulated, and statistically analyzed. RESULTS: Fracture resistance testing of all-ceramic crowns revealed a statistically significant difference between all different ceramic materials used in this study (p-value <0.001). On the other hand, there was a statistically significant difference between all the four ceramic crowns for the marginal gap distance either before or after fatigue cyclic loading. CONCLUSIONS: After considering the limitation of the current study, the following conclusions were given: endocrowns are considered one of the promising minimally invasive restorations for root canal treated molars. CAD/CAM technology revealed better results than heat press technology regarding the fracture resistance of glass ceramics. Heat Press technology revealed better results than CAD/CAM technology regarding the marginal accuracy of glass ceramics.

Monte Carlo reference data sets for imaging research: Executive summary of the report of AAPM Research Committee Task Group 195.

The use of Monte Carlo simulations in diagnostic medical imaging research is widespread due to its flexibility and ability to estimate quantities that are challenging to measure empirically. However, any new Monte Carlo simulation code needs to be validated before it can be used reliably. The type and degree of validation required depends on the goals of the research project, but, typically, such validation involves either comparison of simulation results to physical measurements or to previously published results obtained with established Monte Carlo codes. The former is complicated due to nuances of experimental conditions and uncertainty, while the latter is challenging due to typical graphical presentation and lack of simulation details in previous publications. In addition, entering the field of Monte Carlo simulations in general involves a steep learning curve. It is not a simple task to learn how to program and interpret a Monte Carlo simulation, even when using one of the publicly available code packages. This Task Group report provides a common reference for benchmarking Monte Carlo simulations across a range of Monte Carlo codes and simulation scenarios. In the report, all simulation conditions are provided for six different Monte Carlo simulation cases that involve common x-ray based imaging research areas. The results obtained for the six cases using four publicly available Monte Carlo software packages are included in tabular form. In addition to a full description of all simulation conditions and results, a discussion and comparison of results among the Monte Carlo packages and the lessons learned during the compilation of these results are included. This abridged version of the report includes only an introductory description of the six cases and a brief example of the results of one of the cases. This work provides an investigator the necessary information to benchmark his/her Monte Carlo simulation software against the reference cases included here before performing his/her own novel research. In addition, an investigator entering the field of Monte Carlo simulations can use these descriptions and results as a self-teaching tool to ensure that he/she is able to perform a specific simulation correctly. Finally, educators can assign these cases as learning projects as part of course objectives or training programs.

Adipsic hypernatremia and bilateral renal stones in a child with ectrodactyly-ectodermal dysplasia-cleft lip-palate (EEC) syndrome.

EEC syndrome an autosomal dominant disorder with variable expression and cardinal signs of ectrodactyly, ectodermal dysplasia, and orofacial clefts. In this report, we describe a patient with EEC syndrome, adipsic hypernatremia without brain anomalies, and bilateral renal stones, two manifestations that were not reported before.

Psychological aspects of intersex in Saudi patients.

Four cases of male pseudo-hermaphrodism were seen post pubertal. All had been reared as females unambiguously since birth. Two cases developed male gender identity post pubertal, but failed to declare themselves to their families and society until a similar case had been publicized in the local newspaper. The third case did not reveal her problem to her family even after being informed by a doctor at the age of 15, and was discovered accidentally at the age of 22 on routine medical examination. The fourth was discovered accidentally at age 40 after having been married and divorced. The families of the four cases shared a strong desire for their children to be reassigned to the male sex including the third case, irrespective of being assured of her female gender identity by physicians. Psychiatric and social problems encountered pre- and post-operatively are discussed with particular emphasis on the role of culture and traditions.