Photoacoustic imaging in prostate cancer: A new paradigm for diagnosis and management.

The global health issue of prostate cancer (PCa) requires better diagnosis and treatment. Photoacoustic imaging (PAI) may change PCa management. This review examines PAI's principles, diagnostic role, and therapeutic guidance. PAI uses optical light excitation and ultrasonic detection for high-resolution functional and molecular imaging. PAI uses endogenous and exogenous contrast agents to distinguish cancerous and benign prostate tissues with greater sensitivity and specificity than PSA testing and TRUS-guided biopsy. In addition to diagnosing, PAI can guide and monitor PCa therapy. Its real-time imaging allows precise biopsies and brachytherapy seed placement. Photoacoustic temperature imaging allows non-invasive monitoring of thermal therapies like cryotherapy, improving treatment precision and success. Transurethral illumination probes, innovative contrast agents, integration with other imaging modalities, and machine learning analysis are being developed to overcome depth and data complexity restrictions. PAI could become an essential tool for PCa diagnosis and therapeutic guidance as the field advances.

Impact of the Coronavirus pandemic on children's oral health and caregiver's attitude towards Teledentistry: A Kuwait-based survey.

OBJECTIVE: To evaluate the impact of the coronavirus pandemic on children's oral health and caregiver's attitude towards teledentistry. MATERIAL AND METHOD: A questionnaire was distributed to 583 caregivers of children aged between 3 and 10 years through electronic messages, which consisted of nine multiple choice questions divided into three parts. The first part included demographic data (age, gender, and educational level); the second part addressed the assessment of oral health of children by their caregivers during the lockdown, the reason and influence of the pandemic on the oral health of children; and the third part was related to caregiver's attitude towards healthcare system and teledentistry. Pearson's Chi-square test and Fisher's Exact test were used for analysis using SPSS (version 21.0). RESULT: Around 93.5% of caregivers were not satisfied with their child's oral health. Approximately 91.5% of caregivers agree that the coronavirus pandemic has negatively affected their child's oral health. Most of them think that alteration in sleep patterns is the main reason. Ninety-three percent of caregivers have been reported to utilize teledentistry during the pandemic period, but 53.2% did not know whether teledentistry could solve their child's oral healthcare problems. About 7% disagree that teledentistry can be helpful for the oral healthcare needs of children. CONCLUSION: Coronavirus disease has a negative impact on children's oral health. There is a need to increase awareness about teledentistry among caregivers in Kuwait.

CAN COMBINING LOW LEVEL LASER THERAPY WITH COMPUTER GUIDED FLAPLESS PIEZOSURGICAL OSTEOTOMY ACHIEVE A PAINLESS IMPLANT SURGERY? FINDINGS OF SPLIT MOUTH RANDOMIZED CONTROLLED TRIAL.

OBJECTIVE: Developing a safe and accurate surgical technique that offers higher patient satisfaction will be a great improvement in the field of oral implantology. This study was to investigate the effect of Low-Level Laser Therapy (LLLT) on pain and swelling after flapless computer guided implant site preparation utilizing a novel surgical guide designed to be used with piezotome. METHODS: A total of thirty patients were enrolled in this study having history of bilateral extractions in the lower molar area not less than 6 months ago. One side from each patient was randomly selected for the intervention group to receive LLLT immediately after insertion of bendable one-piece implant (Rough-B Implant, Monoimplant, Novodent SA, Swizerland) using diode laser with a wavelength of 980 nm and a 100 mW energy for 1 minute. The other side received placebo LLLT and was regarded as a control group. Piezo-surgical implant site preparation was done on both sides using a third generation piezotome (Surgic Touch, Guilin Woodpecker Medical Instrument Co., Ltd, China). Pain and swelling scores were measured by utilizing a Visual Analogue Scale (VAS) and a graded swelling scale respectively. The measurements were recorded on both sides after 2, 6 and 24 hour of the day of surgery then at 2, 3, 4 and 7 days post-surgically. RESULTS: In general, the overall scores were ranging from very mild to mild degree of pain and swelling. Females reported significantly higher pain score than males with a mean score of 20.3 ± 5.1 for females and 14.7 ± 3.1 for males (P < .05). Swelling showed no statistically significant results between females and males (P> .05). Pain scores were found to be significantly lower in the LLLT side after 2, 6, 24, 48 hour of implant insertion (P < .05). Moreover, Sweling scores were also found to be significantly lower in the LLLT side after 2, 6, 24, 48 hour, and at day 3 of implant insertion (P < .05). However, day 4 and day 7 showed very minimal if any pain and swelling with insignificant differences between the 2 sides (P > .05). CONCLUSIONS: LLLT was found to be an effective non pharmacological method for relieving pain after implant insertion. Piezosurgical flapless implant placement combined with LLLT is considered an effective, tolerable and minimally invasive procedure (ClinicalTrials.gov NCT01857804).

Analysis of chronic kidney disease patients by targeted next-generation sequencing identifies novel variants in kidney-related genes.

Despite the enormous economic and societal burden of chronic kidney disease (CKD), its pathogenesis remains elusive, impeding specific diagnosis and targeted therapy. Herein, we sought to elucidate the genetic causes of end-stage renal disease (ESRD) and identify genetic variants associated with CKD and related traits in Saudi kidney disease patients. We applied a genetic testing approach using a targeted next-generation sequencing gene panel including 102 genes causative or associated with CKD. A total of 1,098 Saudi participants were recruited for the study, including 534 patients with ESRD and 564 healthy controls. The pre-validated NGS panel was utilized to screen for genetic variants, and then, statistical analysis was conducted to test for associations. The NGS panel revealed 7,225 variants in 102 sequenced genes. Cases had a significantly higher number of confirmed pathogenic variants as classified by the ClinVar database than controls (i.e., individuals with at least one allele of a confirmed pathogenic variant that is associated with CKD; 279 (0.52) vs. 258 (0.45); p-value = 0.03). A total of 13 genetic variants were found to be significantly associated with ESRD in PLCE1, CLCN5, ATP6V1B1, LAMB2, INVS, FRAS1, C5orf42, SLC12A3, COL4A6, SLC3A1, RET, WNK1, and BICC1, including four novel variants that were not previously reported in any other population. Furthermore, studies are necessary to validate these associations in a larger sample size and among individuals of different ethnic groups.

Effect of canagliflozin and metformin on cortical neurotransmitters in a diabetic rat model.

BACKGROUND: The rapid economic development in the Arabian Gulf has resulted in lifestyle changes that have increased the prevalence of obesity and type 2 diabetes, with the greatest increases observed in Kuwait. Dyslipidemia and diabetes are risk factors for disruptions in cortical neurotransmitter homeostasis. This study investigated the effect of the antidiabetic medications canagliflozin (CAN) and metformin (MET) on the levels of cortical neurotransmitters in a diabetic rat model. MATERIALS AND METHODS: The rats were assigned to the control (C) group, the diabetic group that did not receive treatment (D) or the diabetic group treated with either CAN (10 mg/kg) or MET (100 mg/kg) for 2 or 4 weeks. Blood and urine glucose levels and cortical acetylcholinesterase (AChE) activity were assayed, and amino acid and monoamine levels were measured using HPLC. RESULTS: The diabetic group exhibited a significant increase in AChE activity and a decrease in monoamine and amino acid neurotransmitter levels. In the CAN group, AChE was significantly lower than that in the D and D + MET groups after 2 weeks of treatment. In addition, a significant increase in some cortical monoamines and amino acids was observed in the D + MET and D + CAN groups compared with the D group. Histopathological analysis revealed the presence of severe focal hemorrhage, neuronal degeneration, and cerebral blood vessel congestion, with gliosis in the cerebrum of rats in the D group. The CAN-treated group exhibited severe cerebral blood vessel congestion after 2 weeks of treatment and focal gliosis in the cerebrum after 4 weeks of treatment. Focal gliosis in the cerebrum of rats in the MET-treated group was observed after 2 and 4 weeks of treatment. CONCLUSIONS: We conclude that the effect of CAN and MET on neurotransmitters is potentially mediated by their antihyperglycemic and antihyperlipidemic effects. In addition, the effects of CAN on neurotransmitters might be associated with its receptor activity, and the effect of MET on neurotransmitters might be associated with cerebral metabolism.

Interventions by pharmacists in out-patient pharmaceutical care.

Interventions by the pharmacists have always been considered as a valuable input by the health care community in the patient care process by reducing the medication errors, rationalizing the therapy and reducing the cost of therapy. The primary objective of this study was to determine the number and types of medication errors intervened by the dispensing pharmacists at OPD pharmacy in the Khoula Hospital during 2009 retrospectively. The interventions filed by the pharmacists and assistant pharmacists in OPD pharmacy were collected. Then they were categorized and analyzed after a detailed review. The results show that 72.3% of the interventions were minor of which 40.5% were about change medication order. Comparatively more numbers of prescriptions were intervened in female patients than male patients. 98.2% of the interventions were accepted by the prescribers reflecting the awareness of the doctors about the importance of the pharmacy practice. In this study only 688 interventions were due to prescribing errors of which 40.5% interventions were done in changing the medication order of clarifying the medicine. 14.9% of the interventions were related to administrative issues, 8.7% of the interventions were related to selection of medications as well as errors due to ignorance of history of patients. 8.2% of the interventions were to address the overdose of medications. Moderately significant interventions were observed in 19.4% and 7.5% of them were having the impact on major medication errors. Pharmacists have intervened 20.8% of the prescriptions to prevent complications, 25.1% were to rationalize the treatment, 7.9% of them were to improve compliance. Based on the results we conclude that the role of pharmacist in improving the health care system is vital. We recommend more number of such research based studies to bring awareness among health care professionals, provide solution to the prescription and dispensing problems, as it can also improve the documentation system, emphasize the importance of it, reduce prescribing errors, and update the knowledge of pharmacists and other health care professionals.