Alström Syndrome: A Challenging Case Study of a Female Saudi Patient With Type 2 Diabetes Mellitus and Complete Vision Loss.

Alström syndrome is a genetic disease that impacts numerous systems in the human body. The symptoms can vary and appear gradually. Childhood obesity, heart disease (cardiomyopathy), abnormalities in vision, and hearing issues are the main symptoms of this disorder in children. Diabetes mellitus, hepatic issues, and renal dysfunction can all occur over time. Genetic alterations in the ALMS1 gene are the cause of Alström syndrome. It has an autosomal recessive inheritance pattern. We address the case of a Saudi woman in her 20s. She had been initially referred for type 2 diabetes, intellectual disability since early childhood, metabolic acidosis, and micrognathia; however, she also exhibited blindness, chronic kidney disease (CKD), and hearing loss, all of which are indicative of Alström syndrome. DNA testing showed that she has a homozygous pathogenic variant in the ALMS gene. Autosomal recessive Alström syndrome has been confirmed as a genetic diagnosis. No other clinically significant variations were found that are associated with the mentioned phenotype. By reporting this mutation, we hope to learn more about the genotypic range of the disease, particularly in the Saudi population. As each member of the family underwent genetic testing, we established a stringent follow-up schedule for our patient and her family.

Dental health status of children with diabetes in Riyadh, Saudi Arabia.

Objective: The impact of diabetes on oral diseases remains debatable. We aimed to determine the prevalence of dental caries, gingival health status and knowledge, and oral hygiene level and practice in children with type 1 diabetes mellitus in Riyadh, Saudi Arabia. Methods: The teeth of Sixty children with diabetes (33 males and 27 females; age 11.3 ± 2.2 [7-14] years) were examined for dental caries following the modified World Health Organization criteria. Data on age, sex, medical history, gingival health status and knowledge, and oral hygiene level and practice were collected from parents. Results: In this study, 53 % of the children had dental caries with decayed, missing, and filled primary and permanent teeth scores of 5.6 ± 3.8 and 3.6 ± 3.2, respectively, with similar scores for male and female children. Children with and without caries had similar oral hygiene practices and oral health knowledge but differed in the rates of good or fair oral hygiene status (89.2 vs. 56.6 %; P = 0.024) and normal gingival health status or mild gingivitis (96.5 vs. 81.3 %; P = 0.010). Conclusions: We found that the oral hygiene status and rate of gingivitis differed in children with type 1 diabetes mellitus with or without dental caries.

Adapting Laplace residual power series approach to the Caudrey Dodd Gibbon equation.

In real-life applications, nonlinear differential equations play an essential role in representing many phenomena. One well-known nonlinear differential equation that helps describe and explain many chemicals, physical, and biological processes is the Caudrey Dodd Gibbon equation (CDGE). In this paper, we propose the Laplace residual power series method to solve fractional CDGE. The use of terms that involve fractional derivatives leads to a higher degree of freedom, making them more realistic than those equations that involve the derivation of an integer order. The proposed method gives an easy and faster solution in the form of fast convergence. Using the limit theorem of evaluation, the experimental part presents the results and graphs obtained at several values of the fractional derivative order.

Knowledge, Attitude, and Practice of Foot Care and the Risk of Foot Ulcers in Diabetic Patients in Jeddah, Saudi Arabia: A Cross-Sectional Study.

BACKGROUND AND OBJECTIVE: Diabetic patients in Saudi Arabia are often underinformed about proper diabetic foot care. This study aims to determine the knowledge, attitude, and practice of the risk factors of diabetic foot ulcers among diabetic patients in the Jeddah region of Saudi Arabia. MATERIALS AND METHODS: A cross-sectional study was done on 210 diabetic patients attending the international diabetic center in Jeddah, Saudi Arabia, during the study period. A validated questionnaire was used to collect data about participants' demographics and knowledge, attitudes, and practices of diabetic foot care. RESULTS: Of the participants, 77 (36.7%) were aged 51-60 years; 161 (76.7%) were male; 153 (72.9%) had a university education; and approximately 138 (65%) had type 2 DM. A majority, 190 (90.5%), acknowledged that DM patients might have reduced foot sensation; 204 (97.1%) agreed that diabetics could develop gangrene; 188 (89.5%) concurred that poor foot sensation increases the risk of foot ulcers; and 193 (91.9%) agreed that poor blood flow to the feet heightens this risk. Among them, 152 (72.4%) demonstrated good knowledge about foot care and the risk of foot ulcers; eight (3.8%) exhibited a positive attitude; and 95 (45.2%) showed a good level of practice. Good knowledge was significantly higher among married patients, and good practice was notably higher among older patients (>50 years). A significant positive correlation was found between knowledge scores and both attitude and practice scores. CONCLUSION: The study revealed adequate knowledge and practice of foot care and the risk of foot ulcers among diabetic patients. However, a high percentage of negative attitudes toward these issues were observed.

Prevalence of Acute Tonsillitis and Its Association With Oral Hygiene Among the Population of Taif City, Saudi Arabia.

Introduction  Dental surfaces have dense bacterial deposits, and poor oral hygiene can exacerbate bacterial infections, causing acute tonsillitis. The study aims to quantify acute tonsillitis prevalence and assess its association with oral hygiene practices. Methods  A descriptive cross-sectional study aimed to assess the prevalence of acute tonsillitis and its association with oral hygiene was conducted among adults aged 20 and above in Taif City, Saudi Arabia. Illiterates and those unwilling to participate were excluded. We employed an Arabic online self-administered questionnaire that was disseminated conveniently via Google Forms to social media assessing oral hygiene such as last dental visit, age at starting dental care, number of toothbrushes per day, frequency of toothbrush change, and duration of brushing teeth, and acute tonsillitis characteristics of the participants. Results About 393 participated in the study. Of them, 54% were aged 20-30, 53% were males, and 70% had a university education. The prevalence of acute tonsillitis was 64%. Approximately 28% reported dental clinic visits within three months, and 21% initiated oral hygiene practices at age 20. Among participants, 43% brushed twice daily, with 33% spending one minute and 43% two minutes. About 31% replaced toothbrushes every three months, while 23% acknowledged having bad breath. Experiencing bad breath, changing toothbrushes every three months, and having dental visits within less than three months were associated with having acute tonsillitis (p<0.05). However, regression analysis revealed that experiencing bad breath (OR: 2.11, 95% CI: 1.23, 3.70) was associated with a higher risk of acute tonsillitis, while less frequent toothbrush changes correlated with a lower risk (OR: 0.54, 95% CI: 0.30, 0.94). Conclusion  This study revealed a substantial prevalence of acute tonsillitis among adults in Taif City. Oral care practices need improvement. There are significant associations between oral hygiene practices, bad breath, and the occurrence of acute tonsillitis. Addressing oral hygiene practices could be a key focus for preventative measures.

A Global Bibliometric Analysis of the Top 100 Most Cited Articles on Carotid Body Tumors.

The carotid body, situated at the common carotid artery bifurcation, comprises specialized glomus cells responsible for sensing blood oxygen, carbon dioxide, pH, and temperature changes, crucial for regulating breathing and maintaining oxygen homeostasis. Carotid body tumors (CBTs), arising from these cells, are rare, representing only 0.5% of head and neck tumors, often presenting as benign, slow-growing, vascularized masses. In February 2023, this bibliometric analysis was conducted, which involved screening 1733 articles from the Web of Science database. The screening process was based on citation count, and articles were selected for inclusion based on specific criteria that focused on CBTs located within the carotid bifurcation. Rigorous selection involved independent screening and data extraction by four authors. The top 100 articles, published between 1948 and 2019, totaled 6623 citations and were authored by 98 unique first authors from 22 countries and 77 institutions, spanning 42 journals. Treatment articles were the predominant category, comprising 49% of the literature. This analysis offers insights into publication trends, identifies literature gaps, and outlines areas of research focus, providing a valuable resource to guide future studies on CBTs.

Experimental capabilities for liquid jet samples at sub-MHz rates at the FXE Instrument at European XFEL.

The Femtosecond X-ray Experiments (FXE) instrument at the European X-ray Free-Electron Laser (EuXFEL) provides an optimized platform for investigations of ultrafast physical, chemical and biological processes. It operates in the energy range 4.7-20 keV accommodating flexible and versatile environments for a wide range of samples using diverse ultrafast X-ray spectroscopic, scattering and diffraction techniques. FXE is particularly suitable for experiments taking advantage of the sub-MHz repetition rates provided by the EuXFEL. In this paper a dedicated setup for studies on ultrafast biological and chemical dynamics in solution phase at sub-MHz rates at FXE is presented. Particular emphasis on the different liquid jet sample delivery options and their performance is given. Our portfolio of high-speed jets compatible with sub-MHz experiments includes cylindrical jets, gas dynamic virtual nozzles and flat jets. The capability to perform multi-color X-ray emission spectroscopy (XES) experiments is illustrated by a set of measurements using the dispersive X-ray spectrometer in von Hamos geometry. Static XES data collected using a multi-crystal scanning Johann-type spectrometer are also presented. A few examples of experimental results on ultrafast time-resolved X-ray emission spectroscopy and wide-angle X-ray scattering at sub-MHz pulse repetition rates are given.

Epidermolysis Bullosa Simplex With Dystonin Gene Mutation: First Reported Case in Saudi Arabia.

We report a case of a 3-year-old Saudi female patient as the first case reported in Saudi Arabia who is homozygous for dystonin c.3370C>T, p.(Gln1124*). At the age of 3 months, the girl started to develop numerous vesicles and bullae involving the dorsum of the feet that were not on a pressure site, with remission and aggravation, but she had no mucosal lesions or nail affection. The patient was diagnosed with epidermolysis bullosa simplex.

Leveling the curve of Spee using different sized archwires: a randomized clinical trial of blood flow changes.

OBJECTIVES: To compare blood flow (BF) changes of teeth subjected to orthodontic forces during curve of Spee (COS) leveling using different archwires (AW). MATERIAL AND METHODS: Thirty subjects with COS > 5 mm were randomly assigned (1:1:1) into three groups based on the AW used: group 1: 0.017 × 0.025-inch stainless-steel (SS)AW, group 2: 0.019 × 0.025-inch SSAW, and group 3: 0.021 × 0.025-inch ß-titanium (TMA)AW. In the 3 groups, a 5 mm-depth reverse COS was placed in the AWs. A laser Doppler flowmeter was used to measure BF at different time intervals (T0-T4). RESULTS: In the 3 AWs group, BF of all measured teeth was reduced 20 min after force application. Afterwards, the BF values started to increase until the baseline values were almost restored within 1 week. Differences in BF changes between the extrusion and intrusion subgroups were observed within groups 1 and 3 during the first 20 min of force application (P < 0.05). Similar BF changes were recorded using the 3 different AWs. BF changes were associated with tooth type and the amount of COS depth change. CONCLUSIONS: During CoS leveling, similar BF changes were recorded using the 3 different AWs. Tooth type and the amount of COS depth change were associated with BF changes within the first 20 min of force application. Greater BF reduction was found in premolars compared to incisors during the first 20 min of AW placement. CLINICAL RELEVANCE: It is important to select a type of applied forces that minimally affect the BF. Intrusive forces appeared to have lower negative effects on the BF of teeth during COS leveling. TRIAL REGISTRATION: ClinicalTrial.gov (# NCT04549948).

Efficacy of lower arch leveling, lower incisors' root resorption, and pain associated with the correction of curve of Spee using different orthodontic archwires: a randomized clinical trial.

OBJECTIVES: To compare between 3 archwires (AWs) for leveling curve of Spee (COS) in terms of efficacy of reduction, external apical root resorption (EARR), pain experienced, and the lower arch dimensional changes during COS leveling. TRIAL DESIGN: Randomized clinical trial. SETTING: Jordan University of Science and Technology Postgraduate dental clinics. MATERIAL AND METHODS: Fifty-three subjects with COS > 5 mm were included in this study. The subjects were randomly divided into three groups based on the AW used: group 1, 0.017 × 0.025-inch stainless-steel (SS) AW; group 2, 0.019 × 0.025-inch SS AW; and group 3, 0.021 × 0.025-inch ß-titanium (TMA) AW. The intervention was randomly allocated using the permuted random block size of 3 with a 1:1:1 allocation ratio. In the three groups, a 5-mm depth reverse COS was placed in the AWs. The following time points were defined for COS assessment: T1, before interventional leveling AW placement; and T2-T7, 1-6 months after interventional leveling AW placement. Records consisted of dental study models and periapical (PA) radiographs. Pain scores were recorded using visual analogue scale. Patients were followed up on a monthly basis until COS < 1.5 mm. MAIN OUTCOME MEASURES: COS depth reduction, lower incisors' EARR, pain scores, and arch dimensional changes. RESULTS: An overall reduction of 3.82 mm, 4.47 mm, and 3.85 mm of the depth of COS was achieved in groups 1, 2, and 3, respectively. The mean differences of 0.65 mm between groups 1 and 2 and 0.62 mm between groups 2 and 3 were significant at P < 0.05. Lower incisors' EARR during leveling COS ranged from 0.68 to 0.72 mm, from 0.63 to 0.82 mm, and from 0.53 to 0.88 mm in groups 1, 2, and 3, respectively (P > 0.05). Higher pain scores were reported by group 2 subjects during the first 24 h. Arch length and width increased significantly in groups 2 and 3 (P < 0.05). In all groups, COS leveling was achieved by lower incisor intrusion and proclination and lower molar extrusion. CONCLUSIONS: All investigated AWs were effective in leveling COS with minimal lower incisors' EARR (< 1 mm). COS was leveled by lower incisors' intrusion and proclination and lower molar extrusion. Pain scores were the highest in group 2 during the first 24 h. CLINICAL RELEVANCE: The 3 investigated leveling AWs were effective for the leveling COS and at the same time safe on the roots of the lower anterior teeth.

Assessment of Marginal Integrity and Color Stability of Provisional Restoration Fabricated from Different Autopolymerizing Acrylic Resins - A Comparative Study.

AIM: The present study is aimed to assess the marginal integrity and color stability of provisional restorations fabricated from different autopolymerizing acrylic resins. MATERIALS AND METHODS: Totally, 60 provisional crowns were fabricated. A mandibular first molar artificial typodont was mounted on a base of dental stone. The mandibular first molar which was mounted was prepared for full cast crown, using the tooth preparation standard principles with shoulder finish line of 1 mm and taper 6°. There were 20 samples in each acrylic resin group: Group I: Polyvinyl-ethyl methacrylate resin, Group II: Autopolymerizing bis-acrylic material, and Group III: Polymethyl methacrylate (PMMA) autopolymerizing resin. Crowns were verified for marginal adaptation using stereomicroscope at a ×40. The color stability was measured using spectrophotometer poststaining period. RESULTS: Autopolymerizing bis-acrylic material group showed minimum mean vertical marginal discrepancy (128.68 ± 18.036 µm) followed by PMMA autopolymerizing resin group (147.49 ± 20.128 µm) and polyvinyl-ethyl methacrylate resin group (172.89 ± 22.118 µm). Analysis of variance demonstrated a statistically significant difference between different autopolymerizing acrylic resins. The color change values did not show any significant difference between the groups on numerous comparisons between different autopolymerizing acrylic resin groups. A statistically significant difference was seen between Groups I and II, Groups I and III, and Groups II and III (P < 0.05). CONCLUSION: This study concluded that the autopolymerizing bis-acrylic material demonstrated significantly improved marginal integrity when compared to PMMA autopolymerizing resin and polyvinyl-ethyl methacrylate resin.

To Compare and Analyze the Potency of two Topical Anesthetic Gels in Reducing Inferior Alveolar Injection Pain in Children of 8-12 Years: A Double-Blinded Clinical Trial.

AIM: To compare and analyze the clinical adequacy of two topical anesthetic gels, Precaine (8% lidocaine + 0.8% dibucaine) and Precaine B (20% benzocaine) in children before intraoral local anesthetic injections. MATERIALS AND METHODS: This clinical study included thirty children who needed an inferior alveolar nerve block. They were divided into three groups: Group A: Precaine topical gel group, Group B: Precaine B topical gel Group, Group C: no anesthetic topical gel group (control group). These two effective topical gels were applied before giving intraoral local anesthesia, and afterward, the child's pain response was surveyed utilizing the Wong-Baker Faces Pain Rating Scale. The scores obtained were subjected to statistical analysis. RESULTS: Intergroup comparison showed a significant mean difference between the control group and Precaine group (P > 0.05) as well as Precaine B group (P > 0.05). However, there is no significant difference obtained between Group A and Group B (P < 0.05). CONCLUSION: It is psychologically and clinically beneficial to apply a topical anesthetic agent before injecting any intraoral anesthesia. In this study, both anesthetic gels showed a nonsignificant difference in reducing inferior alveolar injection pain, but Precaine B shows more promising results than Precaine.

L-carnosine mitigates interleukin-1α-induced dry eye disease in rabbits via its antioxidant, anti-inflammatory, antiapoptotic, and antifibrotic effects.

OBJECTIVE: To elucidate the implications of L-carnosine on interleukin-1α (IL-1α)-induced inflammation of lacrimal glands (LGs). MATERIALS AND METHODS: Forty rabbits were divided equally into four groups: control group (G1), IL-1α (G2), L-carnosine (G3), and L-carnosine plus IL-1α (G4). Several clinical, histopathological, immunohistochemical, morphometric, and biochemical investigations were performed, followed by statistical analysis to diagnose the presence of dry eye disease (DED). RESULTS: The LGs of G2 rabbits showed degeneration of the acinar cells, increased deposition of collagen fibers, and marked immunoexpression of FasL; elevated levels of interferon-γ, tumor necrosis factor-α, transforming growth factor-ß1, and malondialdehyde; and decreased levels of glutathione peroxidase, superoxide dismutase, catalase, and reactive oxygen species compared with those of G1 rabbits. In contrast, administration of L-carnosine to G4 rabbits revealed marked improvement of all previously harmful changes in G2 rabbits, indicating the cytoprotective effects of L-carnosine against IL-1α-induced inflammation of LGs. CONCLUSIONS: IL-1α induced inflammation of LGs and eye dryness via oxidative stress, proinflammatory, apoptotic, and profibrotic effects, whereas L-carnosine mitigated DED through antioxidant, anti-inflammatory, antiapoptotic, and antifibrotic effects on LGs. Therefore, this work demonstrates for the first time that L-carnosine may be used as adjuvant therapy for the preservation of visual integrity in patients with DED.HighlightsIL-1α induced dry eye disease through its oxidative stress, proinflammatory, apoptotic and profibrotic effects on the lacrimal glands of rabbit.L-carnosine has antioxidant, anti-inflammatory, antiapoptotic and antifibrotic effects.L-carnosine mitigated IL-1α induced dry eye disease via elevating the levels of FasL, IFN-γ, TNF-α, TGFß1 and MDA as well as reducing the levels of antioxidants (GPx, SOD, and catalase) and ROS in the lacrimal glands of rabbit.L-carnosine could be used as a novel adjuvant therapy for the treatment of dry eye disease.

Financial and economic analyses of the impact of cattle mastitis on the profitability of Egyptian dairy farms.

AIM: This study aimed to evaluate and quantify the different factors affecting the costs of mastitis in cattle, to quantify the annual and monthly financial losses attributed to mastitis, and to estimate production losses using average linear scores found on The Dairy Herd Improvement Association somatic cell count (SCC) sheets and bulk tank SCC per lactation number. MATERIALS AND METHODS: All data (bovine mastitis-associated costs and expenditures in Egyptian dairy herds) were analyzed using SPSS/PCT, 2001. A partial budget technique using spreadsheet software and the general linear model procedure was used to analyze the productive and financial measures. RESULTS: Mastitis was present in 57.1% of cows (240/420), while clinical mastitis (CM) was present in 19% of them (80/420). The geometric mean of SCC/ml in bulk tank milk samples of 150 cattle dairy farms was 556.3×103. The annual subclinical mastitis (SCM)-related economic loss was 21,933,258.6 LE, and the two most important cost components were the subsequent decrease in milk production and quality premium losses (93% and 7% of SCM costs, respectively). The quality premium loss was 1,369,602.1 LE. On the other hand, the annual economic loss due to decreased milk production as a result of SCM was 20,563,656.5 LE. The total cost of 80 CM cases, including the failure and preventive costs, was 1,196,871.4 LE, including 1,169,150.4 LE failure costs (106,336.0 LE in direct costs and 1,062,814.4 LE in indirect costs) and 27,721.0 LE preventive costs. The average cost per CM case was 28,760.9 LE, including veterinary time and consultation fees of 250.0 LE (1%), labor 562.5 LE (2%), premature culling 736,000.0 LE (77%), decreased milk production 4085.18 LE (13.7%), discarded milk 185.3 LE (1%), and drugs and treatments 328.9 LE (1%). The total costs of CM (expenditures) extra control and preventive measures, including the diagnosis of CM for 80 cows annually in 20 Egyptian dairy farms were 27,721.0 LE, representing 346.5 LE or 1% of the total cost of CM cases. The cost of monitoring and diagnostic measures was 8635.2 LE, representing 107.9 LE or 1% of the total cost of a case of CM. CONCLUSION: The method used for cost estimation, in this study, is highly adaptable to individual cattle farms and had a major role in assessing specific control and management measures. The concepts described in this paper help to improve our understanding of the full economic impact of clinical and subclinical mastitis in cattle in Egypt. Assessing the economic losses from mastitis to determine the economic costs and losses occurring in Egyptian dairy farms is critical for encouraging farmers to acknowledge the scale of the problem and implement effective management practices aimed at improving mastitis control and reducing the associated costs.

Prevalence of Dental Caries and Treatment Needs in Tibetan Monks and Nuns in Karnataka.

AIM: The aim of this study was to assess the prevalence of dental caries and treatment needs among Tibetan monks and nuns in Bylakuppe. MATERIALS AND METHODS: In this cross-sectional study, stratified random sampling was used to obtain desired sample for the study. The clinical examination was carried out to obtain data regarding dental caries status and treatment needs using World Health Organization (WHO) Oral Health Assessment Pro forma 1997. Statistical analysis was carried out using Statistical Package for the Social Sciences (SPSS) software program, version 20.0. The data were statistically analyzed by using descriptive statistics and chi-square test. RESULTS: The study population consisted of 345 Tibetan monks (men) and 35 Tibetan nuns (women). Prevalence of dental caries was 88.68% with mean decayed, missing, and filled teeth (DMFT) value of 6.06 ± 5.37. Assessment of dental treatment needs showed 82.3% of participants needed one surface filling, 11.9% of participants needed pulp care and restoration, and 9.3% of participants required extraction of teeth. CONCLUSION: The study population is characterized by high prevalence of dental caries and lack of awareness about treatment needs.

Quality of Life in Children With Diabetes Treated With Insulin Pump Compared With Multiple Daily Injections in Tertiary Care Center.

BACKGROUND: Continuous Subcutaneous Insulin Infusion (CSII) and Multiple Daily Injections (MDI) have been widely used as options in treating diabetes in childhood. Glycemic control is important to reduce diabetes complications; however, more focus needs to be on patients' Quality of Life (QoL). Diabetes and QoL have strong associations in terms of patients' overall health including their psychology, physical well-being, compliance with medication. A previous systematic review stressed that strong evidence to deny or prove the benefits of insulin pump therapy on health-related quality of life is deficient. The aim of this study is to assess the health-related quality of life and the psychological impacts of children with diabetes who use CSII and MDI treatment. METHODS: A cross-sectional study included 68 pediatric patients with type 1 Diabetes (T1DM) who were treated in a tertiary center in Jeddah, Saudi Arabia. We used the Pediatric Quality of Life Inventory 3.0 Diabetes Module and this module assesses the health-related quality of life of children with diabetes. RESULTS: Thirty-four (50%) participants found to be on MDI, of which 21 (61.8%) are males, compared to 34 (50%) patients using CSII, of which 12 (35.2%) are females. Participants using CSII had statistically significant better symptom control, less treatment difficulties but were more worrisome than MDI participants. CONCLUSION: CSII group had better quality of life in almost all aspects even though they were more worrisome. Further studies with a larger sample size are needed to give comprehensive generalizations.

Mortality and morbidity in patients with atrial fibrillation and liver cirrhosis.

BACKGROUND: Atrial fibrillation (AF) is the most common cardiac arrhythmia encountered in clinical practice. However, the outcomes associated with AF in hospitalized patients with liver cirrhosis are unknown. AIM: To determine the outcomes of hospitalized patients with liver cirrhosis and AF. METHODS: In this study, we examined morbidity and mortality of patients with concomitant AF and liver cirrhosis from the National Inpatient Sample database, the largest publicly available inpatient healthcare database in the United States. RESULTS: A total of 696937 patients with liver cirrhosis were included, 45745 of whom had concomitant AF (6.6%). Liver cirrhosis patients with AF had higher rates of in-hospital mortality (12.6% vs 10.3%, P < 0.001), clinical stroke (1.6% vs 1.1%, P < 0.001), and acute kidney injury (28.2% vs 25.1%, P < 0.001), and less gastrointestinal bleeding (4.4% vs 5.1%, P < 0.001) and blood transfusion (22.5% vs 23.8%, P < 0.001) compared with those who did not have the arrhythmia. In addition, they had a longer length of stay (8 ± 10 d vs 7 ± 8 d, P < 0.001) and higher hospitalization costs (20720 ± 33210 $ vs 16272 ± 24166 $, P < 0.001). CONCLUSION: In subjects with liver cirrhosis, AF is associated with higher rates of inpatient mortality, stroke, and acute kidney injury compared to those who do not have the cardiac arrhythmia.

Fatty Acid Synthase (FASN) siRNA-Encapsulated-Her-2 Targeted Fab'-Immunoliposomes for Gene Silencing in Breast Cancer Cells.

PURPOSE: The overexpression of Her-2 in 25-30% breast cancer cases and the crosstalk between Her-2 and fatty acid synthase (FASN) establishes Her-2 as a promising target for site-directed delivery. The present study aimed to develop the novel lipid base formulations to target and inhibit the cellular proliferation of Her-2-expressing breast cancer cells through the silencing of FASN. In order to achieve this goal, we prepared DSPC/Chol and DOPE/CHEMS immunoliposomes, conjugated with the anti-Her-2 fab' and encapsulated FASN siRNA against breast cancer cells. METHODS: We evaluated the size, stability, cellular uptake and internalization of various formulations of liposomes. The antiproliferative gene silencing potential was investigated by the cell cytotoxicity, crystal violet, wound healing and Western blot analyses in Her-2+ and Her-2¯ breast cancer cells. RESULTS: The data revealed that both nanosized FASN-siRNA-encapsulated liposomes showed significantly higher cellular uptake and internalization with enhanced stability. The cell viability of Her-2+ SK-BR3 cells treated with the targeted formulation of DSPC/Chol- and DOPE/CHEMS-encapsulating FASN-siRNA reduced to 30% and 20%, respectively, whereas it was found to be 45% and 36% in MCF-7 cells. The wounds were not only failed to close but they became broader in Her-2+ cells treated with targeted liposomes of siRNA. Consequently, the amount of FASN decreased by 80% in SK-BR3 cells treated with non-targeted liposomes and it was 30% and 60% in the MCF-7 cells treated with DSPC/Chol and DOPE/CHEMS liposomes, respectively. CONCLUSION: In this study, we developed the formulation that targeted Her-2 for the suppression of FASN and, therefore, inhibited the proliferation of breast cancer cells.

Mutans streptococci growth on glass ionomer incorporated with chlorhexidine: in-vivo study / Crescimento de Estreptococos mutans em ionômero de vidro incorporado com clorexidina: estudo in vivo

Background: glass ionomer is one of the most frequently used restorative materials for primary teeth restoration. It has been in use for more than 30 years. Their restoration usefulness is preferential compared to other restorations due to their fluoride release and recharge, chemical adhesion to the structure of the dentin and their range of uses. Increasing the antibacterial efficacy of restorative materials is one of the primary goals to decrease the incidence of recurrent caries. Chlorhexidine is the gold standard antibacterial agent in dentistry. Objectives: the objective of this study is to evaluate the antibacterial effect of Chlorhexidine incorporated with glass ionomer on Streptococcus mutans. Methods: Thirty Children between ages ranged 6-9 years old were selected to participate in this study. Children with bilateral caries in lower second primary molars affecting the occlusal and proximal surfaces without pulpitis were included in the study. All cavities were divided into two groups; group (A) restored with Glass Ionomer and group (B) restored with Glass Ionomer Chlorhexidine mixture. The sound proximal surfaces in all cavitated teeth acted as a control. After one month, two months and three months' plaque samples were obtained and Streptococcus mutans counts were calculated. Results: The number of SM taken from sound proximal surfaces for all groups were not changed significantly in whole periods of study. At the all-time interval, the mean log10 of SM in group B was lower than group A and the difference was statistically significant. There is a significant difference in the mean log10 of SM in group B between the 1St month and the 3rd month. Conclusion: The growth of SM was found to be higher in the sound tooth than in GI groups and in GI group was higher than in CHX- GI mixture up to three months (AU)

Antecedentes: o ionômero de vidro é um dos materiais restauradores mais utilizados na restauração de dentes decíduos. É usado há mais de 30 anos. Sua indicação como material restaurador em comparação a outros baseia-se nas propriedades de liberação e recarga de flúor, adesão química à estrutura da dentina e sua variedade de usos. Aumentar a eficácia antibacteriana de materiais restauradores é um dos principais objetivos para diminuir a incidência de cárie recorrente. A clorexidina é o agente antibacteriano padrão-ouro em odontologia. Objetivos: o objetivo deste estudo é avaliar o efeito antibacteriano da Clorexidina incorporada ao ionômero de vidro no Streptococcus mutans (SM). Métodos: Trinta crianças entre 6 e 9 anos foram selecionadas para participar deste estudo. Crianças com cárie bilateral nos segundos molares decíduos inferiores que afetavam as superfícies oclusal e proximal sem pulpite foram incluídas no estudo. Todas as cavidades foram divididas em dois grupos; grupo A, restaurado com Ionômero de Vidro e grupo B, restaurado com mistura de Ionômero de Vidro /Clorhexidina. As superfícies proximais sadias em todos os dentes cavitados atuavam como controle. Após um mês, dois e três meses, foram obtidas amostras de placa e as contagens de Streptococcus mutans foram realizadas. Resultados: O número de SM retirado da superfície proximal sadia para todos os grupos não foi alterado significativamente nos períodos do estudo. No intervalo de todos os tempos, o log10 médio da SM no grupo B foi menor que no A e a diferença foi estatisticamente significante. Há uma diferença significativa no log10 médio da SM no grupo B entre o 1º mês e o 3º mês. Conclusão: O crescimento da SM mostrou-se maior no dente sadio do que nos grupos A; e no grupo A foi maior que no grupo B até três meses.(AU)

Novel ambulatory glucose-sensing technology improves hypoglycemia detection and patient monitoring adherence in children and adolescents with type 1 diabetes.

PURPOSE: Glucose monitoring [GM] is a mainstay of diabetes control and management. Improving glycemic control is essential to prevent microvascular complications. However, adherence to GM can be a challenge in children and adolescents. Detecting hypoglycemia is essential for its prevention and treatment. We aim to study the impact of the flash ambulatory glucose monitoring in detecting hypoglycemia and enhancing adherence in children and adolescents with type 1 diabetes. METHODS: The study is prospective involving 3 hospital visits. Children and adolescents with diabetes were enrolled in the study which involved a period on conventional glucose self-monitoring [glucometers] followed by a similar period of monitoring using the flash glucose monitoring device (FreeStyle Libre). Frequency of GM, duration and frequency of hypoglycemia were compared on conventional and the flash monitoring. RESULTS: 75 subjects were studied. Age mean (range) was 11.9 years (2-19). Significant difference was seen in hypoglycemia detection between both testing devices. 68 (94%) and 65 (90%) patients detected nocturnal and diurnal hypoglycemia respectively on Flash monitoring compared to 12 (16.6%) and 30 (41%) on glucometer testing (p < 0.00). Mean (range) duration of hypoglycemia was 95 min (15-330). Statistically-significant difference was found between the frequency of GM on glucometer testing compared with Flash monitoring (2.87 and 11.6/day) (p < 0.001). CONCLUSIONS: Flash monitoring is a useful tool to improve adherence to GM and detecting hypoglycemia [diurnal and nocturnal] in children and adolescents with type 1 diabetes.