Psychogenic Dysphagia in an Elderly: A Case of Eating Disorder Due to Trauma and Grief.

Psychogenic dysphagia is a swallowing condition caused by psychological factors rather than structural or physiological disorders such as neurological impairments or physical abnormalities. This condition has a significant impact on a patient's quality of life. Patients should undergo a thorough swallowing evaluation with the involvement of a multidisciplinary team as early intervention leads to satisfactory outcomes. This report presents a case of a 62-year-old female who had severe malnutrition due to psychogenic dysphagia. We evaluated organic and other functional causes of dysphagia, but no abnormalities were detected.

Effect of Treated Zirconium Oxide (ZrO2) Nanoparticles on the Color and Surface Properties of Interim Fixed Prostheses.

Objective: Zirconium oxide (ZrO2) nanoparticles addition to interim fixed prostheses (IFPs) was suggested to improve the mechanical properties. However, the effect of ZrO2 on the color and surface properties of IFP was neglected. Therefore, this study aimed to investigate the effect of ZrO2 on the color, hardness, and surface roughness of IFP. Materials and Methods: Customized split-press metal molds were used for the fabrication of forty disk-shaped acrylics (10 mm × 1.5 mm). The salinized ZrO2 particles were weighed using an electronic balance and added in concentrations of 1wt %, 2.5wt %, and 5wt % of auto-polymerized acrylic polymer powder. Based on ZrO2 concentrations, specimens were divided into one control group without ZrO2 and three ZrO2 study groups 1 ZrO2, 2.5 ZrO2, and 5 ZrO2, respectively. A double beam ultraviolet-visible reflection spectrophotometer was the instrument used for recording the color measurements (CIEDE2000). The Microhardness and surface roughness (Ra, µm) of all samples were tested. ANOVA test was used for data analysis (α = 0.05). Results: Notable changes were seen between the group containing 1% and the other two groups in Δa*, ΔΕ ab, and ΔΕ 00 parameters. Statistically significant differences were observed among the three groups for the ΔL* parameter. No notable changes were seen between the group containing 1% and the group containing 5% for the Δb* parameter. The 1% group showed a statistically significant difference in hardness in comparison to the 5% group. For surface roughness, the 2.5% group presented statistically significant higher surface roughness as opposed to the 0% control group. Conclusions: The addition of ZrO2 in high concentrations resulted in a noticeable color change in IFP. However, the surface properties did not change hardness and roughness with ZrO2 addition except roughness increased with 2.5% ZrO2. Low ZrO2 addition did not result in a change in color and surface properties of IFP.

Predicting Patients at Risk for Prolonged Hospital Stays Following Pediatrics Traumatic Head Injuries in High-Income Developing Country: A Retrospective Cohort Study.

BACKGROUND: Traumatic brain injuries (TBIs) in pediatrics are the most common cause of long-term morbidity and mortality, generating a considerable burden on the health care system. In the current retrospective study, we aimed to identify the predictors that contribute to prolonged hospital stays in pediatric TBI. METHODS: A retrospective cohort study including all pediatric cases (age younger than 14) who presented to Khoula Hospital with TBI and were seen from January 2015 to December 2019. The multivariate binary logistic regression analysis has been used to determine the independent predictors of prolonged hospital stay. Prolonged hospitalization was defined as mean ± 2 standard deviation days. RESULTS: A total of 866 cases of pediatric TBI were documented. The mean age was 4.33 years. The length of hospital stay ranged from <1 day to 90 days (mean = 3.65, standard deviation = 6.84). Prolonged hospitalization was calculated to be >17 days. Thirty-one patients had prolonged hospital stay out of the studied cohort, with an incidence proportion of prolonged stay = 3.6% (95% CI = 2.4%-5.0%). Prolonged hospitalizations were associated with motor vehicle collision injuries (odds ratio [OR]: 27.028, 95% confidence interval [CI] = 2.744-266.194, P = 0.005); pedestrian injuries (OR = 11.667, 95% CI = 1.017-133.805, P = 0.048), and Glasgow Coma Scale score on arrival of <9 (OR = 8.149, 95% CI = 1.167-56.921, P = 0.034). CONCLUSIONS: The current study identified motor vehicle collision and pedestrian injuries, as well as initial Glasgow Coma Scale score of <9 as independent predictors of prolonged hospitalization in pediatrics TBI.

Characteristics of Suture Materials Used in Oral Surgery: Systematic Review.

BACKGROUND: The aim of this review was to evaluate the most used suture materials with regards to their inflammatory response, their bacterial adhesion, and their physical properties when used to close oral wounds. METHODS: Four databases (PubMed, Scopus, Dentistry & Oral Sciences, and OVID) were searched to retrieve relevant studies from January 1, 2000, to January 31, 2020. RESULTS: Out of the 269 articles, only 13 studies were selected as they were relevant and met the systematic review's protocol. These studies showed that almost all suture materials studies (catgut, polyglycolic acid [PGA] sutures, nylon, expanded polytetrafluoroethylene, and silk sutures) caused bacterial adherence and tissue reaction. In nylon and chromic catgut, the number of bacteria accumulated was lowest. Silk and nylon were found to be more impacted than catgut and PGA in terms of physical characteristics such as tensile strength. PGA, on the other hand, was said to be the most susceptible to knot unwinding. CONCLUSIONS: Following an oral surgical operation, all sutures revealed varied degrees of irritation and microbial accumulation. Nonresorbable monofilament synthetic sutures, however, exhibited less tissue response and less microbial accumulation.

Systemic Review and Meta-analysis of the Intellectual Integrity of Children with Neurofibromatosis Type 1.

BACKGROUND: Cognitive impairment is a common neurologic complication of neurofibromatosis type 1 (NF-1) in childhood. A great number of learning disabilities appear in 30%-65% of children with NF-1. The aim of the study is to compare intelligence quotient (IQ) scores between children with NF-1 and comparable control groups. METHODS: A literature review was conducted using the following databases: Cochrane, PubMed, Wiley, Microsoft Academic, and Google Scholar. We identified 180 papers. The pertinence of any study to the inclusion criteria was determined by assessing the title, key words, and abstracts. Data were extracted using multiple variables that were formulated incongruent with the study aim and then further analyzed. RESULTS: Eleven articles met our criteria, with the highest level of evidence of 3c. A total of 483 NF1 and 443 control participants were included in this meta-analysis. The average and standard deviation of the age was 9.15 ± 3.15 years with an age range of 3.3-18 including 488 male and 438 female. The pooled estimate of the mean difference in all 3 parameters used full-scale IQ, verbal IQ, and performance IQ. Statistically, there was a significantly lower IQ in the NF-1 group compared with the control group with a 95% CI and (P < 0.00001). CONCLUSION: The current meta-analysis illustrated a significant intellectual deficit in children with NF-1 compared with their typically developed peers who were matched by age. Performance IQ was significantly impaired compared with verbal IQ in NF-1 children. The current findings may guide experts to tailor individualized educational programs for children with NF-1.

Microleakage and Bacterial Adhesion with Three Restorative Materials Used to Seal Screw-access Channels of Implant Abutments: An In vitro Study.

BACKGROUND: Proper sealing of screw-access channels against microbial microleakage is advisable for the long-term success of screw-retained implant prosthesis. OBJECTIVE: This study aimed to compare the bacterial adhesion and microleakage with three restorative materials, namely, composite resin, acrylic resin and bis-acryl, that are used to cover the access channels of screw-retained implant prostheses, using polytetrafluoroethylene tape as a spacer material. MATERIALS AND METHODS: In this in vitro study, 18 titanium straight abutments (Hex-lock® Zimmer) were torqued into implant analogs, which were then subdivided into three groups. The samples of each group were filled with polytetrafluoroethylene tape and sealed with the three restorative materials (Group A: composite resin; Group B: acrylic resin; Group C: bis-acryl). Measurements of surface bacterial adhesion and internal microleakage were then recorded. The results were statistically analyzed using Kruskal-Wallis and Chi-square tests. RESULTS: No significant difference was found between the investigated materials in terms of their sealing effectiveness against microbial microleakage (P = 0.06). Regarding bacterial adhesion, composite resin showed the highest number of surface adhesion, but there was no significant difference between the three materials (P = 0.081). CONCLUSION: The results of this study suggest that composite resin, acrylic resin and bis-acryl materials could be used alternatively in sealing the implant access channel owing to no significant differences in terms of microleakage and bacterial adhesion.

Impact of the TiO2 Nanosolution Concentration on Heat Transfer Enhancement of the Twin Impingement Jet of a Heated Aluminum Plate.

Here, the researchers carried out an experimental analysis of the effect of the TiO2 nanosolution concentration on the heat transfer of the twin jet impingement on an aluminum plate surface. We used three different heat transfer enhancement processes. We considered the TiO2 nanosolution coat, aluminum plate heat sink, and a twin jet impingement system. We also analyzed several other parameters like the nozzle spacing, nanosolution concentration, and the nozzle-to-plate distance and noted if these parameters could increase the heat transfer rate of the twin jet impingement system on a hot aluminum surface. The researchers prepared different nanosolutions, which consisted of varying concentrations, and coated them on the metal surface. Thereafter, we carried out an X-ray diffraction (XRD) and a Field Emission Scanning Electron Microscopy (FESEM) analysis for determining the structure and the homogeneous surface coating of the nanosolutions. This article also studied the different positions of the twin jets for determining the maximal Nusselt number (Nu). The researchers analyzed all the results and noted that the flow structure of the twin impingement jets at the interference zone was the major issue affecting the increase in the heat transfer rate. The combined influence of the spacing and nanoparticle concentration affected the flow structure, and therefore the heat transfer properties, wherein the Reynolds number (1% by volume concentration) maximally affected the Nusselt number. This improved the performance of various industrial and engineering applications. Hypothesis: Nusselt number was affected by the ratio of the nanoparticle size to the surface roughness. Heat transfer characteristics could be improved if the researchers selected an appropriate impingement system and selected the optimal levels of other factors. The surface coating with the TiO2 nanosolution also positively affected the heat transfer rate.

Assessment of maternal knowledge about infantile colic in Saudi Arabia.

INTRODUCTION: The infantile colic is a difficult experience met by parents in the first few months of an infant's life. This may lead to increased discomfort for infants as well as psychological distress for mothers. This study aimed at assessing the baseline knowledge of mothers in Saudi Arabia about infantile colic mainly in regard to the etiology and management. METHODS: In this cross-sectional study, a questionnaire was distributed among mothers in six primary healthcare centers (PHCC) in Riyadh, Saudi Arabia, during their visit for immunization clinics in 2016. The questionnaire consisted of two domains for determining the sociodemography characteristics and the maternal knowledge of participants about infantile colic. SPSS version 20 and chi-square test were used for data analysis. RESULTS: A total of 230 mothers completed the survey questionnaire. Of these, 208 participants were Saudis. The majority of the participants were in the age group of 18-29 years (42.6%). The average age of the infants in this study was found to be 5.75±4.26 months. Eighty percent replied that they did not have any previous knowledge of infantile colic; 42.6% mothers believed that the causes of infantile colic were unclear and might involve several factors; 36% of the participants perceived milk allergy as the attributing cause for infantile colic. The source of knowledge about infantile colic was mainly through experiences of dealing with previous siblings who have the same issue (34.4%); 27.4% of mothers prefer the use of herbal medicines to treat this condition. CONCLUSIONS: It is recommended that health education needs to be provided to mothers at outpatient clinics during their antenatal hospital visits. This reduces the discomfort of infant and distress in mothers.

The prevalence of anabolic androgenic steroid use amongst athletes in Riyadh (Saudi Arabia).

OBJECTIVE: The aim of this study was to determine the prevalence of anabolic androgenic steroid (AAS) use among athletes and examine the extent of their knowledge on the effects of AAS in Riyadh, Saudi Arabia. METHODS: This cross-sectional study was conducted at gyms in Riyadh, Saudi Arabia, during 2015. In total 600 athletes from three gyms participated in the study. The study included Saudi and non-Saudi athletes chosen by the simple random sampling method. A self-reported questionnaire was used for data collection. The questionnaire was designed to study the prevalence and assess the knowledge of athletes regarding AAS use. Frequency and percentage distributions were used to describe the data. Comparison between the subgroups was made with a chi-square test. RESULTS: The percentage of AAS users was 30.5%. The age of AAS users ranged from 15 to 49 years with the majority (52.5%) belonging to age group of 25-29 years. Approximately 20% of the users admitted using AAS due to body dysmorphia as their best motivational factor; in addition, they also believed that there are no side effects of the use. Among the nonusers, 40% had appropriate knowledge, while all the AAS-users had inadequate knowledge about the adverse effects of AAS. Moreover, 77% of the users would recommend AAS to their friends but none from the nonusers. A significant difference in age distribution (df = 5, p<0.001) and knowledge (df = 4, p< 0.001) between users and nonusers was observed. CONCLUSION: Most athletes were ignorant of the harmful side effects of the drug but still continued to use and promote it to other athletes. These athletes should intensify their knowledge and awareness regarding the use of AAS and its effects on the body.

Bilateral Cryptorchidism, a rare presentation for persistent Müllerian duct syndrome.

Persistent Müllerian duct syndrome (PMDS) is a rare, sex-limited, autosomal recessive disorder representing male pseudo-hermaphroditism. It is observed in males with the presence of female reproductive organs such as the uterus, cervix, and bilateral fallopian tubes along with normally developed male reproductive organs. It generally occurs during embryogenesis due to mutation in anti-Müllerian hormone (AMH) gene, i.e., AMH gene or AMH receptor (AMHR2) gene. The present case reports a male infant with inflammation in the right groin who was admitted to Security Forces Hospital in 2015. During surgery, his testis was pulled down to the scrotum in the normal anatomical position, but full orchidopexy was not performed due to fragile capsule and edematous area. After a year, a right orchidopexy was performed. During left testis laparoscopic exploration, a small left intra-abdominal gonad in a position similar to the ovary, Müllerian structures in the form of a small uterus and vagina in the midline were observed. Biopsy of left gonad showed immature testicular tissues. The MRI findings of the pelvis showed normal male urethra with the presence of a vagina and small uterus, but no definite ovaries or testicle. Based on the clinical, laboratory, imaging, and primarily operative findings, the boy was diagnosed with PMDS. This was confirmed using genetic testing, which revealed biallelic mutations in the AMHR2 gene. The patient is currently under clinical observation to decide further management of PMDS through left testis orchidopexy, either with or without surgical excision of persistent Müllerian duct structures. The key message, which needs to be spread from this case report, is that the infant with bilateral undescended testes or inguinal hernia on one side and cryptorchidism on the other side should be thoroughly investigated to exclude any underlying disorder of sex development (DSD) before any further intervention.