Central obesity and fat-free mass are associated with a larger spleen volume in the general population.

Background and aim: As the spleen plays a significant role in immunity, the aim was to investigate the associations of different body composition markers derived from various sources with spleen volume in a general population sample. Materials and methods: Cross-sectional data of 1095 individuals (570 women; 52%) aged between 30 and 90 years were collected in the Study of Health in Pomerania (SHIP-START-2). We measured spleen volume by magnetic resonance imaging (MRI).Body composition markers were derived from classic anthropometry, bioelectrical impedance analysis, including absolute fat mass (FM) and fat-free mass (FFM), as well as from MRI, including visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and liver fat content. Sex-stratified-adjusted linear regression models were used to analyze the associations of body composition markers with spleen volumes. Results: We observed positive associations of body mass index, body weight, waist circumference, hip circumference, waist-to-height ratio, absolute FM, absolute FFM, and VAT and SAT with spleen volume in men and women. An 8.12 kg higher absolute FFM was associated with a 38.4 mL (95% confidence interval [CI]: 26.7-50.1) higher spleen volume in men and a 5.21 kg higher absolute FFM with a 42.6 mL (95% CI: 26.2-59.0) higher spleen volume in women. Conclusion: Our findings indicate that obesity-related body composition markers and FFM are associated with a higher spleen volume. Particularly, higher absolute FFM showed a strong association with a larger spleen volume in both men and women. Further studies are warranted to understand the clinical significance of body composition markers on large spleen volume.

Influences of Different Torques on the Size of the Microgap and Bacterial Leakage in Different Implant Systems: An In-vitro Study.

PURPOSE: To evaluate the adherence of three types of bacteria [Staphylococcus (S) aureus, Escherichia (E) coli, Pseudomonas (Ps) aeruginosa] and the size of the microgap of three different implant systems (JD, ORA, and Ankylos) under four different screw torque values. MATERIALS AND METHODS: Ten samples for each tested implant system were used under different torques to determine the width of the gaps. The abutments were connected to the fixtures using a universal digital wrench. A torque value of 10 N/cm was applied for all samples. After the assessment of the microgap, the fixture was repositioned into the Bench Vice, and the torque was increased to 20, 30, and, finally, 40 N/cm. The microgap assessment was done using a Scanning Electron Microscope. Before the torque increased to 40, eleven samples for each tested implant system were used under 30 N/cm torque to determine the leakage in the tested implants for S. aureus, E. coli, and Ps. aeruginosa. Data were analyzed with multiple one-way ANOVA, Post Hoc, and chi-square tests. RESULTS: The Ankylos system showed the widest gap under all torques (p < 0.005), whereas the JD system demonstrated the lowest (p < 0.005). Regarding the bacteria leakage, JD showed the highest adherence to the bacteria, and the adherence was mainly to the Ps. Aeruginosa, while the Ankylos system showed the lowest (p < 0.005). CONCLUSION: Within limits, the higher torque provides a higher fit to the IAI, offering more stability. Ankylos implant showed the widest gap, while JD showed the narrowest. Regarding the bacteria leakage, JD showed the highest adherence to Ps. Aeruginosa, while the ORA system showed the highest adherence to E. coli.

Body composition markers are associated with changes in inflammatory markers but not vice versa: A bi-directional longitudinal analysis in a population-based sample.

BACKGROUND AND AIM: Growing body of evidence consistently link obesity and inflammation, Although the direction of the association is still unclear. We aimed to investigate longitudinal associations of body anthropometric, composition and fat distribution parameters with inflammatory markers and vice versa. METHOD AND RESULTS: We used data from 2464 individuals of the SHIP-TREND cohort with a median follow-up of 7 years. Linear regression models adjusted for confounders were used to analyze associations of standardized body composition markers derived from classic anthropometry, bioelectrical impedance analysis (BIA) and magnetic resonance imaging (MRI) at baseline with changes in inflammatory markers (C-reactive protein (CRP), white blood cell (WBC), fibrinogen) and vice versa. Higher level of anthropometric markers at baseline were associated with an increase in the change of inflammatory markers. A 13.5 cm higher waist circumference (WC), 16.0 kg body weight and 7.76 % relative fat mass (FM) at baseline was associated with a change in CRP of 0.52 mg/L (95 % confidence interval [CI]: 0.29 to 0.74), 0.51 mg/L (95 % CI: 0.29; 0.74) and 0.58 mg/L (95 % CI: 0.34; 0.82) respectively. Absolute FM showed the strongest association with changes in serum fibrinogen levels (ß for 8.69 kg higher FM: 0.07 g/L; 95 % CI: 0.05; 0.09). Baseline inflammatory markers were only associated with changes in hip circumference. CONCLUSION: Our study indicates the importance of anthropometric, body composition and fat distribution markers as a risk factor for the development of inflammation. To prevent inflammatory-related complications, important is to take measures against the development of obesity.

Optimising barrier placement for intrusion detection and prevention in WSNs.

This research addresses the pressing challenge of intrusion detection and prevention in Wireless Sensor Networks (WSNs), offering an innovative and comprehensive approach. The research leverages Support Vector Regression (SVR) models to predict the number of barriers necessary for effective intrusion detection and prevention while optimising their strategic placement. The paper employs the Ant Colony Optimization (ACO) algorithm to enhance the precision of barrier placement and resource allocation. The integrated approach combines SVR predictive modelling with ACO-based optimisation, contributing to advancing adaptive security solutions for WSNs. Feature ranking highlights the critical influence of barrier count attributes, and regularisation techniques are applied to enhance model robustness. Importantly, the results reveal substantial percentage improvements in model accuracy metrics: a 4835.71% reduction in Mean Squared Error (MSE) for ACO-SVR1, an 862.08% improvement in Mean Absolute Error (MAE) for ACO-SVR1, and an 86.29% enhancement in R-squared (R2) for ACO-SVR1. ACO-SVR2 has a 2202.85% reduction in MSE, a 733.98% improvement in MAE, and a 54.03% enhancement in R-squared. These considerable improvements verify the method's effectiveness in enhancing WSNs, ensuring reliability and resilience in critical infrastructure. The paper concludes with a performance comparison and emphasises the remarkable efficacy of regularisation. It also underscores the practicality of precise barrier count estimation and optimised barrier placement, enhancing the security and resilience of WSNs against potential threats.

Impacts of kaolinite enrichment on biochar and hydrochar characterization, stability, toxicity, and maize germination and growth.

In this study, biochar (BC) and hydrochar (HC) composites were synthesized with natural kaolinite clay and their properties, stability, carbon (C) sequestration potential, polycyclic aromatic hydrocarbons (PAHs) toxicity, and impacts on maize germination and growth were explored. Conocarpus waste was pretreated with 0%, 10%, and 20% kaolinite and pyrolyzed to produce BCs (BC, BCK10, and BCK20, respectively), while hydrothermalized to produce HCs (HC, HCK10, and HCK20, respectively). The synthesized materials were characterized using X-ray diffraction, scanning electron microscope analyses, Fourier transform infrared, thermogravimetric analysis, surface area, proximate analyses, and chemical analysis to investigate the distinction in physiochemical and structural characteristics. The BCs showed higher C contents (85.73-92.50%) as compared to HCs (58.81-61.11%). The BCs demonstrated a higher thermal stability, aromaticity, and C sequestration potential than HCs. Kaolinite enriched-BCs showed the highest cation exchange capacity than pristine BC (34.97% higher in BCK10 and 38.04% higher in BCK20 than pristine BC), while surface area was the highest in kaolinite composited HCs (202.8% higher in HCK10 and 190.2% higher in HCK20 than pristine HC). The recalcitrance index (R50) speculated a higher recalcitrance for BC, BCK10, and BCK20 (R50 > 0.7), minimal degradability for HCK10 and HCK20 (0.5 < R50 < 0.7), and higher degradability for biomass and HC (R50 < 0.5). Overall, increasing the kaolinite enrichment percentage significantly enhanced the thermal stability and C sequestration potential of charred materials, which may be attributed to changes in the structural arrangements. The ∑ total PAHs concentration in the synthesized materials were below the USEPA's suggested limits, indicating their safe use as soil amendments. Germination indices reflected positive impacts of synthesized charred materials on maize germination and growth. Therefore, we propose that kaolinite-composited BCs and HCs could be considered as efficient and cost-effective soil amendments for improving plant growth.

Neonatal Single-Stage Surgical Management of Complicated Distal Vaginal Atresia: Revisiting an Appropriate and Feasible Technique.

BACKGROUND/PURPOSE: Hydrometrocolpos is distension of the vagina and uterus with fluid other than pus or blood. It is due to distal vaginal obstruction, and one of its possible causes is agenesis of the distal vagina. Patients with distal vaginal atresia may present in the neonatal period due to stimulation of uterine and cervical glands by maternal estrogen. In this study, we presented our results in managing neonates with complicated hydrometrocolpos due to distal vaginal atresia through a single-stage abdomino-perineal pull-through vaginoplasty. METHODS: During the period from July 2003 to June 2018, neonates presented to the Department of Pediatric Surgery, Faculty of Medicine, Ain Shams University with complicated hydrometrocolpos (complicated with obstructive uropathy, intestinal obstruction, urinary tract infection, or systemic sepsis) due to distal vaginal atresia were included in the study. All the patients underwent single-stage abdomino-perineal pull-through vaginoplasty with drainage of the accumulated fluid. The patients were followed up for re-accumulation of fluid or vaginal stenosis for at least 4 years after the procedure. RESULTS: During the specified period, 14 neonates with complicated hydrometrocolpos due to distal vaginal atresia (complicated with obstructive uropathy, intestinal obstruction, urinary tract infection, or systemic sepsis) presented to the Department of Pediatric Surgery, Faculty of Medicine, Ain Shams University and underwent single-stage abdomino-perineal pull-through vaginoplasty with drainage of the accumulated fluid. Their age ranged between 4 and 18 days (mean 10, median 8). Two patients (14%) developed vaginal stenosis, which responded well to dilatation, and none of the patients had re-accumulation of the fluid during the follow-up period. CONCLUSION: Single-stage abdomino-perineal pull-through vaginoplasty in neonates with complicated distal vaginal atresia (complicated with obstructive uropathy, intestinal obstruction, urinary tract infection, or systemic sepsis) is an appropriate and feasible technique with a satisfactory outcome. TYPE OF THE STUDY: Treatment study. LEVEL OF EVIDENCE RATING: IV.

A Digital Image Correlation Technique for Laboratory Structural Tests and Applications: A Systematic Literature Review.

Digital image correlation (DIC) is an optical technique used to measure surface displacements and strains in materials and structures. This technique has demonstrated significant utility in structural examination and monitoring. This manuscript offers a comprehensive review of the contemporary research and applications that have leveraged the DIC technique in laboratory-based structural tests. The reviewed works encompass a broad spectrum of structural components, such as concrete beams, columns, pillars, masonry walls, infills, composite materials, structural joints, steel beams, slabs, and other structural elements. These investigations have underscored the efficacy of DIC as a metrological instrument for the precise quantification of surface deformation and strain in these structural components. Moreover, the constraints of the DIC technique have been highlighted, especially in scenarios involving extensive or complex test configurations. Notwithstanding these constraints, the effectiveness of the DIC methodology has been validated as a strain measurement instrument, offering numerous benefits such as non-invasive operation, full-field measurement capability, high precision, real-time surveillance, and compatibility with integration into other measurement instruments and methodologies.

Microplastic-Assisted Removal of Phosphorus and Ammonium Using Date Palm Waste Derived Biochar.

Microplastics (MPs) are emerging environmental pollutants worldwide, posing potential health risks. Moreover, MPs may act as vectors for other contaminants and affect their fate, transport, and deposition in the environment. Therefore, efficient and economical techniques are needed for the removal of contemporary MPs and contaminants from the environment. The present research study investigated the sorption of phosphorus (P) and ammonium (NH4+) onto date palm waste-derived biochar (BC) from an aqueous solution in the presence of polyamide (PA) and polyethylene (PE) MPs. The BC was prepared at 600 °C, characterized for physio-chemical properties, and applied for P and NH4+ removal via isotherm and kinetic sorption trials. The results of the sorption trials demonstrated the highest removal of NH4+ and P was obtained at neutral pH 7. The highest P sorption (93.23 mg g-1) by BC was recorded in the presence of PA, while the highest NH4+ sorption (103.76 mg g-1) was found with co-occurring PE in an aqueous solution. Sorption isotherm and kinetics models revealed that P and NH4+ removal by MP-amended BC followed chemisorption, electrostatic interaction, precipitation, diffusion, and ion exchange mechanisms. Overall, co-existing PA enhanced the removal of P and NH4+ by 66% and 7.7%, respectively, while co-existing PE increased the removal of P and NH4+ by 55% and 30%, respectively, through the tested BC. Our findings suggested that converting date palm waste into BC could be used as a competent and economical approach to removing P and NH4+ from contaminated water. Furthermore, microplastics such as PE and PA could assist in the removal of P and NH4+ from contaminated water using BC.

Associations of spleen volume with markers of blood count and lipid profile in a large population-based study.

Background: The aim of our study was to investigate associations of spleen volume with blood count markers and lipid profile in the general population. Materials & methods: Cross-sectional data from 1,106 individuals aged 30-90 years from the population-based Study of Health in Pomerania (SHIP-START-2) were analyzed. Blood count markers included red blood cell (RBC) counts, hemoglobin, platelet count, and white blood cell (WBC) counts. Lipid profile included total-cholesterol, high-density lipoprotein-cholesterol (HDL-C), and low-density lipoprotein-cholesterol (LDL-C) as well as triglycerides. Linear regression models adjusted for age, sex, body height, and weight were used to associate standardized spleen volume with blood counts and lipid profile markers. Results: Spleen volume was positively associated with RBC (ß = 0.05; 95% confidence interval [CI] = 0.03 to 0.08) and hemoglobin (ß = 0.05; 95% CI = 0.01 to 0.09) but inversely with platelet count (ß = -16.3; 95% CI = -20.5 to -12.1) and WBC (ß = -0.25; 95% CI = -0.37 to -0.14). Furthermore, spleen volume showed inverse associations with total cholesterol (ß = -0.17; 95% CI = -0.24 to -0.09), HDL-C (ß = -0.08; 95% CI = -0.10 to -0.05), and LDL-C (ß = -0.12; 95% CI = -0.17 to -0.06). There was no significant association of spleen volume with triglycerides. Conclusion: Our study showed that the spleen volume is associated with markers of the blood count and lipid profile in the general population.

Serial Killings and Attempted Serial Killings in Hospitals, Nursing Homes, and Nursing Care.

BACKGROUND: Serial killing by doctors or nurses is rare. When it occurs, it is generally only detected after multiple homicides by the same perpetrator have escaped detection in the past. The persons at greatest risk are multimorbid elderly patients whose sudden death for natural reasons would not come as a surprise. However, patients' risk of falling victim to homicide is increased only if such vulnerable patients are exposed to perpetrators with certain personality traits. In this situation, homicides can be committed in which little or no evidence of the crime is left behind. In this review, we address the frequency, nature, and circumstances of serial killings and attempted serial killings in hospitals, nursing homes, and nursing care. METHODS: This review is based on publications retrieved by a selective review of the literature in monographs, medical databases, specialty journals, general-interest media, and the Internet. RESULTS: An evaluation of searchable, published case descriptions of serial killings and attempted serial killings in hospitals, nursing homes, and nursing care, mainly from Europe and the English-speaking countries, enables identification of the type of patients at risk, the modes of homicide, and the personality traits of the perpetrators. Multimorbid, care-dependent and nursing-dependent persons are the main victims. The perpetrators (men and women) generally act alone and have often been working in patient care for many years. The most common method of homicide is by drug injection; violent physical homicide is rarer. In many cases, irregularities in drug stocks, erratic behavior of a staff member, and/or a cluster of sudden deaths are indeed noticed, but are too slowly acted upon. CONCLUSION: Irregularities in drug stocks, inexplicably empty drug packages and used syringes, erratic behavior of a staff member before and after a patient's death, or a cluster of unexpected deaths mainly involving elderly, multimorbid patients (detectable from internal mortality statistics) should always lead to further questioning and investigation.

Duodenal Lipoma As Upper Gastrointestinal Bleeding Presentation: Case Report and Review of the Literature.

Duodenal lipomas (DLs) are rare benign nonepithelial tumors that account for 4% of all gastrointestinal (GI) lipomas. DLs can occur in any part of the duodenum but most commonly arise in the second part of the duodenum. They are usually asymptomatic and discovered incidentally but may present with GI hemorrhage, bowel obstruction, or abdominal pain and discomfort. The diagnostic modalities can be based on radiological studies and endoscopy with the aid of endoscopic ultrasound (EUS). DLs can be managed either endoscopically or surgically. We report a case of symptomatic DL presenting with upper GI hemorrhage along with a review of the literature.  We report a case of a 49-year-old female patient who presented with a one-week history of abdominal pain and melena. Upper endoscopy revealed a single, large pedunculated polyp with an ulcerated tip in the first part of the duodenum. EUS confirmed features suggestive of a lipoma, including an intense homogeneous hyperechoic mass originating from the submucosa. The patient underwent endoscopic resection, with excellent recovery. The rare occurrence of DLs requires a high index of suspicion and radiological endoscopic assessment to rule out invasion into the deeper layers. Endoscopic management is associated with good outcomes and a decreased risk of surgical complications.

Do learning style preferences influence the cumulative gross point average and self directed learning hours in dental students: a preliminary study.

BACKGROUND: Learning styles influence the outcome of the student performances based on preliminary data available. To evaluate whether the learning styles discriminate the cumulative gross point average (CGPA) scores and self-directed learning hours (SDL) in an integrated curriculum of dental students. METHODS: Participants in this blinded cross-sectional study were dental students enrolled in the Bachelor of Dental & Oral Surgery program at XXXX College of Dentistry. An online survey (Kolb Learning Style Inventory) was used to collect data. It has four sections: Concrete Experience (CE), Abstract Conceptualization (AC), Reflective Observation (RO), and Active Experimentation (AE). Questionnaire was distributed electronically to students of Academic level 1 to 5, selected by using non-probability quota sampling technique. In addition to learning style assessment the questionnaire also included measures to obtain data such as gender, academic level, CGPA score, and SDL hours of participants. The CGPA scores were categorized into average (3 to 3.6), good (3.7 to 4.2), excellent (4.3 to 4.7) and outstanding (> 4.7) as well as SDL in to three classes as, < 1 h, > 1 but < 3 h and > 3 h. Discriminant function test was computed to assess the effectiveness of discrimination by the learning styles in GPA and SDL. RESULTS: The study's questionnaire was completed by 198 participants (43% females and 57% males). Learning styles were discriminated by excellent category of CGPA scores that presented 72.1% group membership whereas in case of outstanding category presented the least as 17% group membership. Learning styles were discriminated by > 2 but < 3 h category of SDL hours that presented 69.7% group membership. CONCLUSION: Learning styles can be used to discriminate the student academic performances and self-directed learning hours. Among the different category of CGPA participants with outstanding performance represent a good prediction for learning styles preferences. Participants with varying SDL hours also influenced the learning styles.

Prospective case series on possible effects of local factors on the development of halitosis in new complete denture wearers.

OBJECTIVES: To assess the development of halitosis in participants wearing new removable complete dentures (RCD). METHOD AND MATERIALS: Seventy-five completely edentulous patients receiving RCD were recruited. Halitosis was assessed by means of FitScan Breath Checker on the day of denture insertion (T0), as well as after 1 month (T1), and after 2 months (T2). Risk factors were studied using a validated questionnaire about oral and denture hygiene, and tongue scoring followed for each participant. A modified plaque scoring technique assessed the percentage of newly formed biofilms accumulated on all surfaces of the RCD. RESULTS: At T0, 44% of the participants revealed halitosis. This percentage insignificantly increased at T1 (66.7%) and T2 (65.6%), respectively (P > .109). At T1, halitosis was significantly lower among persons who reported tongue brushing compared to refraining participants (14.3% vs 72.6%; P = .002). At T2, halitosis was significantly higher among patients suffering from moderate to heavy tongue coatings compared to those with no or only light coatings (83.3% vs 50.0%; P = .006), those who did wear their dentures during sleeping (77.5% vs 45.8%; P = .010), and those who did not brush their tongues at all (87.5% vs 29.2%; P < .0001). With a 16-fold increased probability (95% CI 10.0 to 23.31; P < .001), the multivariate analysis revealed that non-brushing the tongue was the only variable significantly linked to halitosis at both follow-ups. CONCLUSION: Non-brushing of tongues as well as sleeping with dentures seems to be the main causes of halitosis in new RCD wearers.

Associations of liver volume and other markers of hepatic steatosis with all-cause mortality in the general population.

AIMS: We examined the associations between liver volume and other quantitative and qualitative markers of hepatic steatosis with all-cause mortality in the general population. METHODS: We included 2769 German middle-aged individuals with a median follow-up of 8.9 years (23,898 person-years). Quantitative markers used were serum liver enzymes and FIB-4 score, while qualitative markers of hepatic steatosis included magnetic resonance imaging (MRI) measurements of liver fat content and total liver volume. Cox proportional hazards models, adjusted for confounding factors, were undertaken to investigate the associations of liver volume and other markers of hepatic steatosis with all-cause mortality. RESULTS: A larger MRI-assessed liver volume was associated with a nearly three-fold increased risk of all-cause mortality (Hazard Ratio = 3.16; 95% confidence interval 1.88; 5.30), independent of age, sex, body mass index, food frequency score, alcohol consumption and education level. This association was consistent in all subgroups considered (men vs. women; presence or absence of overweight/obesity, metabolic syndrome or diabetes). Higher serum liver enzyme levels and FIB-4 score were also significantly associated with higher all-cause mortality in the total population and in all subgroups. No independent associations were found between other quantitative and qualitative markers of hepatic steatosis and the risk of all-cause mortality. CONCLUSIONS: We showed for the first time that larger liver volume was associated with a three-fold increase in long-term risk of all-cause mortality. This association remained significant after adjustment for age, sex, alcohol consumption, obesity and other coexisting metabolic disorders.

Biomechanics in Removable Partial Dentures: A Literature Review of FEA-Based Studies.

The present study was aimed at reviewing the studies that used finite element analysis (FEA) to estimate the biomechanical stress arising in removable partial dentures (RPDs) and how to optimize it. A literature survey was conducted for the English full-text articles, which used only FEA to estimate the stress developed in RPDs from Jan 2000 to May 2021. In RPDs, the retaining and supporting structures are subjected to dynamic loads during insertion and removal of the prosthesis as well as during function. The majority of stresses in free-end saddle (FES) RPDs are concentrated in the shoulder of the clasp, the horizontal curvature of the gingival approaching clasp, and the part of the major connector next to terminal abutments. Clasps fabricated from flexible materials were beneficial to eliminate the stress in the abutment, while rigid materials were preferred for major connectors to eliminate the displacement of the prosthesis. In implant-assisted RPD, the implant receive the majority of the load, thereby reducing the stress on the abutment and reducing the displacement of the prosthesis. The amount of stress in the implant decreases with zero or minimal angulation, using long and wide implants, and when the implants are placed in the first molar area.

Biomechanical Stress in Obturator Prostheses: A Systematic Review of Finite Element Studies.

AIM: This systematic review is aimed at investigating the biomechanical stress that develops in the maxillofacial prostheses (MFP) and supporting structures and methods to optimize it. Design and Methods. A literature survey was conducted for full-text English articles which used FEA to examine the stress developed in conventional and implant-assisted MFPs from January 2010 to December 2020. RESULTS: 87 articles were screened to get an update on the desired information. 74 were excluded based on a complete screening, and finally, 13 articles were recruited for complete reviewing. Discussion. The MFP is subjected to stress, which is reflected in the form of compressive and tensile strengths. The stress is mainly concentrated the resection line and around the apices of roots of teeth next to the defect. Diversity of designs and techniques were introduced to optimize the stress distribution, such as modification of the clasp design, using materials with different mechanical properties for dentures base and retainer, use of dental (DI) and/or zygomatic implants (ZI), and free flap reconstruction before prosthetic rehabilitation. CONCLUSION: Using ZI in the defective side of the dentulous maxillary defect and defective and nondefective side of the edentulous maxillary defect was found more advantageous, in terms of compression and tensile stress and retention, when compared with DI and free flap reconstruction.

Periodontal Clinical Parameters as a Predictor of Bite Force: A Cross-Sectional Study.

OBJECTIVE: To investigate the correlation of periodontal parameters and bite force in different stages of periodontitis after phase I periodontal therapy. METHODS: Periodontal clinical parameters such as mobility, attachment loss, gingival recession, and percentage of bone remaining were recorded at the mandibular first molar region after phase I therapy in subjects categorized according to the stage of periodontitis. Corresponding bite force was recorded at the first mandibular molar region using a bite force device after phase I therapy. ANOVA test was used to assess the significant difference among different groups. Pearson correlation coefficient was used to assess the correlation between measured variables. RESULTS: The ANOVA test represents that there is no statistical significant difference between the bite force in stage I, stage II, and stage III type of periodontitis. A strong positive correlation was found (r = 0.537) between bite force and percentage of remaining alveolar bone support whereas negative correlation was observed in measured parameters such as mobility (r = -0.0181), attachment loss (r = -0.608), and gingival recession (r = -0.435). CONCLUSION: Among all periodontal clinical parameters, the percentage of remaining alveolar bone is the strong predictor of bite force and mobility; attachment loss and gingival recession cannot predict the bite force in the first molar region. Bite force is variable in different stages of periodontitis.

Evaluation of temporomandibular disorders among dental students of Saudi Arabia using Diagnostic Criteria for Temporomandibular Disorders (DC/TMD): a cross-sectional study.

BACKGROUND: Temporomandibular disorders (TMD) are a broad category of conditions arising from the various components of the temporomandibular joint complex. Bio-psychosocial model is the most accepted theory describing the etiopathogenesis of TMD. Dental students are vulnerable to psychological disorders, including anxiety, depression, and stress. Hence, the aim of the current study was to evaluate the prevalence and possible risk factors of TMD among dental students of various academic levels and explore the association of TMDs with demographic, academic, and psychosocial parameters. METHODS: A total of 246 students of a Saudi Arabia dental school were chosen for the study. After getting consent, all students were examined according to the Diagnostic Criteria for Temporomandibular Disorders, including Axis I and II components. RESULTS: The overall cross-sectional prevalence of TMD was found to be 36.99%. Pain arising from the jaw, temple, and the peri-auricular area were the most commonly reported symptoms and elicited signs during examination. Among the pain-related TMD, myalgia was the commonest diagnosed condition, whereas disc displacement with reduction was found prevalent in the intra-articular disorder category. Female (OR = 1.94; P = 0.004), married (OR = 1.74; P = 0.04), and students in clinical academic levels (OR = 1.65; P = 0.03) were found to have significantly increased risk of TMD. Among the psychosocial parameters, anxiety (OR = 1.55; P = 0.04) and parafunctional behaviours (OR = 2.10; P < 0.001) were shown to increase the risk of developing TMD. Students with any TMD reported to have significantly higher pain intensity levels (OR = 1.68; P = 0.01) and jaw functional limitations (OR = 1.45; P = 0.008). CONCLUSION: Dental students, especially in clinical levels were shown to pose a higher risk of developing TMD, hence strategies such as academic counselling and objective evaluation via rubrics should be planned to modify the administration of the curriculum, training methods and evaluation process.

Laparoscopic ureterolithotomy for large proximal ureteric stones: Surgical technique, outcomes and literature review.

INTRODUCTION: We evaluated the efficacy and safety of laparoscopic ureterolithotomy (LPU) for the treatment of large proximal ureteric stone. METHODS: A retrospective multicenter analysis for patients with solitary impacted proximal ureteric stone ≥15 mm who underwent LPU from 2016 to 2019 was performed. Primary outcome was to estimate the stone-free rate (SFR). SFR was defined as absence of residual stones on postoperative computed tomography scan. Secondary outcome was to assess the perioperative outcomes, as well as to review literature data of randomized controlled trials and meta-analyses comparing LPU to other treatment options. RESULTS: Forty-four patients were included in our study. Mean stone size was 22.9 ± 5.8 mm and median follow-up was 14 months. Three patients had previous abdominal surgery, one patient had severe degree of scoliosis and six patients failed primary therapy. All stones were extracted successfully (SFR = 100%) without need of auxiliary treatments. Mean operative time and estimated blood loss were 86.6 ± 14.1 minutes. and 11.9 ± 14.7 mL, respectively. No intraoperative complications or conversion to open surgery were reported. No major postoperative complications (≥grade 3) were reported. Mean length of hospital stay was 2 ± 0.8 days. CONCLUSIONS: For treatment of large ureteric stones, our study showed that LPU achieves 100% stone-free status. When performed by well-trained laparoscopic surgeons, it is safe and has no major perioperative complications. According to our results and literature data, when counseling patients with large impacted proximal ureteral stones, LPU should be advised as the procedure that has the higher SFR, lower auxiliary treatments, and comparable complication rates to other treatments.

Assessing the Prevalence and Association of Pulp Stones with Cardiovascular Diseases and Diabetes Mellitus in the Saudi Arabian Population-A CBCT Based Study.

The detection of pulp stone in a patient suffering from undiagnosed systemic diseases can be an early diagnostic indicator. Thus, the aim of the study was to assess the prevalence of pulp stones in the Saudi Arabian population with cardiovascular diseases and diabetes mellitus. In a retrospective study, we included cone-beam computed tomography (CBCT) scans of 73 patients with cardiovascular disease and 76 patients with diabetes mellitus as group I and II, respectively. Group III comprised of CBCT scan of 80 healthy controls. From a total of 229 scans, 4807 teeth were screened for pulp stones throughout the arches. A chi-square test was used for comparing the prevalence of pulp stones among the groups. Univariable and multivariable analysis was done to evaluate the independent risk indicators for pulp stones. The tooth-wise prevalence of pulp stones in group I, II, and III was found to be 16.65%, 9.01%, and 3.86%, respectively. Patient-wise (p < 0.01) and tooth-wise (p < 0.01) prevalence was recorded significantly highest in the cardiovascular group followed by the diabetic group. The control group had the least prevalence. Significantly (p < 0.01) higher number of pulp stones were found in cardiovascular patients with age > 50 years compared to other groups. Similarly, a significantly increased number of pulp stones were seen in the 1st molar (p < 0.05) and the maxillary jaw (p < 0.05) of patients with cardiovascular diseases. Subjects with cardiovascular disease and diabetes were found to have 2.94 times (p < 0.001; CI 1.54-3.10) and 1.81 times (p < 0.01; CI 0.48-2.06) higher risk of having pulp stones in comparison to healthy subjects. The first molar has 2.20 times (p < 0.001; CI 0.84-2.45) increased the risk of having pulp stones compared to other tooth types. Systemic disease such as cardiovascular disease and diabetes mellitus poses a higher risk for the development of pulp stones. Among the systemic disease group, patients in the cardiovascular group showed a higher risk for pulp stones and also reported the maximum number of pulp stones compared to the diabetic and healthy subjects.