The use of dental stem cells (DSCs) has emerged as a promising new approach for therapeutic purposes to treat dental and non-dental diseases. Thus, the aim of this systematic review was to compile all current information on the role and clinical applications of DSCs in modern regenerative medical therapy. PubMed and Google Scholar electronic databases were used to search the literature for relevant studies after applying specific inclusion and exclusion criteria. The search included articles that were published from 2009 to 2019. Several keywords were combined for the search: (1) “Clinical applications”, (2) “Dental Stem Cell”, and (3) “Medicine”. Only the 17 studies that fulfilled both the inclusion and exclusion criteria were included in this systematic review. These studies investigated different aspects of DSCs, including cell types, clinical applications, and updates of their use in regenerative medicine. All 17 studies favored the use of different DSCS in regenerative medicine to treat diseases, such as bone defects, neural and skin injuries, Parkinson's disease, ischemia, and others. None of the studies were conducted on humans. This systematic review demonstrated the growing body of evidence supporting the role of DSCs in the field of modern generative medicine. The noninvasive methods of isolating these cells compared to those for isolating non-DSCs make them promising potential sources for the treatment of chronic and devastating diseases. However, more studies are needed to develop the proper guidelines for cases in which DSCs could be considered an accurate and reliable tool for modern regenerative medicine in clinical trials.

Objective: To investigate the knowledge, perceptions, and attitude of young doctors and nurses at Kind Abdulaziz University Hospital (KAUH) Jeddah, KSA, regarding the effectiveness of telemedicine in dealing with the patients for either follow-up or continuous monitoring of chronic diseases. Material and Methods: This prospective cross-sectional study was carried out on the young doctors and nursing staff at KAUH. An online questionnaire addressing all the required fields, i.e., background essential demography, perceptions, acceptance, and knowledge regarding telemedicine's utility, was sent to the targeted population of health care workers. Completed responses were analyzed statistically as per study objectives. Results: The response rate in our study was 85%. A total of 335 participants responded to our questionnaire. One hundred seventy-one (51.1%) were doctors, whereas one hundred sixty-four (48.9%) were the nursing staff. Among doctors, 50 (29.4%) were recent graduates, whereas, in the nursing side, 77 (46.7%) were the senior nursing students. The knowledge and attitude of the young nursing staff were relatively better than the senior staff taking part in the study and the trends were found statistically significant. Conclusion: Our study participants, being young, were enthusiastic, had good knowledge regarding the advantages and limitations of telemedicine in managing the selected groups of patients. Their perception and attitude were quite positive. This is an encouraging trend in the promotion of telemedicine as an established way of managing patients with special requirements in an effective way. The ongoing COVID-19 pandemic has highlighted the importance of telemedicine in emergencies to protect both patients and health care workers by reducing chronic patients' avoidable hospital visits.

Objective: The aim of this study was to analyze the complications following secondary voice prosthesis insertion and impact of previous irradiation on their appearance. Methods: This study included 106 totally laryngectomized patients who underwent secondary Provox 2 voice prosthesis insertion. Among them, 79 (74.5%) were irradiated. Surgery, prosthesis, fistula, and voice-related complications were analyzed and presented. Results: Complications occurred in 23 (22%) patients. Fifteen of them were previously irradiated. There were no surgery-related complications. In the group of prosthesis-related complications, one patient had increased negative pressure during swallowing with extremely short prosthesis life time. There were 17 complications in the group of fistula related ones; 3 patients had excessive granulation tissue around the fistula and 14 patients experienced prosthesis displacement (7 had closed esophageal end of the fistula, 5 had the prosthesis turned sideways in an open fistula, one patient inhaled and one ingested the prosthesis). Tracheoesophageal voice was not established in 5 patients. Previous irradiation had no statistically significant influence on the complication rate (P = 0,251). Conclusions: The majority of complications following secondary voice prosthesis insertion are fistula-related ones, among which, displacement of the voice prosthesis is the most common. Previous irradiation does not significantly increase the risk of developing complications.

Background: Noncommunicable diseases have become a new public health priority in low-and middle-income countries where urbanization and lifestyle changes have approached what obtains in developed countries. Aim: The aim of this study was to estimate the prevalence of noncommunicable disease risk factors among market traders in Jos North Local Government Area of Plateau State. Method: This was a descriptive cross-sectional study carried out among adult market traders who were selected through a two-stage sampling technique. Data were collected using a semi-structured interviewer-administered questionnaire adapted from the WHO STEP-wise tool. Anthropometric measurements were taken along with blood pressure readings. Data were analyzed using Epi Info version 3.5.4 and a value of P ≤ 0.05 was considered statistically significant. Results: A total of 271 respondents were studied with a mean age of 36.2 ± 13.3 years. Prevalence of hypertension was 26.6% and diabetes mellitus 9.6%. Overweight and obesity were observed in 26.2% and 31.0% of the population, respectively while inadequate intake of fruits and vegetables was reported by 88.9% and 69.4% of respondents respectively. Current alcohol and cigarette use was 25.5% and 0.7% respectively while 245 (90.4%) respondents were sedentary. Current alcohol use, inadequate fruit and vegetable intake and obesity were associated with hypertension just as current alcohol use, sedentary lifestyle and consumption of carbonated drinks were associated with diabetes mellitus. Conclusion: The prevalence of hypertension and diabetes mellitus and their associated risk factors was high among these market traders. Therefore, there is need for focused preventive interventions in this neglected group.

Objective: The aim of this study was to investigate the prevalence and types of hypercementosis and the frequency of possible etiological factors in a large sample of Turkish central Anatolian population. Subjects and Methods: A cross-sectional study was performed using panoramic radiographs of 1176 randomly selected adult patients with an age range of 18–96 years, who presented to the Department of Oral and Maxillofacial Radiology of the Faculty of Dentistry, Cumhuriyet University (Sivas, Turkey) for dental care. Patients were questioned about the presence of systemic diseases. Panoramic radiographs of the patients were examined for the presence and types of hypercementosis (diffuse, focal and shirt sleeve cuff) and the frequency of local factors that may be associated with hypercementosis. Chi-square and t-tests were used for statistical analysis. Results: Hypercementosis was detected in 128 of 1176 patients. In total, 85.6% of the teeth with hypercementosis had a diffuse, 7.5% had a focal, and 6.8% had a shirt sleeve cuff type. Hypercementosis was observed most frequently in the mandibular (P < 0.05) and the premolar region. Gender-related differences were nonsignificant (P > 0.05). Atherosclerosis, osteoporosis, and multiple diseases were reported more frequently in individuals with hypercementosed teeth (P < 0.05). While idiopathic origin (39.3%), bruxism (30%), and inflammation (24.37%) were the most prevalent local etiological factors, impacted teeth (1.25%) and history of trauma (0.62%) were less common. Conclusion: The prevalence of hypercementosis was 10.8% in the study population. The lesions were more common in the mandibule. Idiopathic origin was the most common factor associated with hypercementosis.

Aims: To investigate the accuracy of multidetector computed tomography (MDCT) findings, and the effect of tumor volume in determining the perinephric and renal sinus invasion in clear cell renal cell carcinomas (ccRCCs). Method: Fifty patients with ccRCCs underwent non-contrast and nephrographic-phase contrast-enhanced MDCT examination before total nephrectomy. The following MDCT features were used to diagnose perinephric fat tissue invasion: perinephric stranding, perinephric vascularity, and irregular contour. The following MDCT features were used to diagnose renal sinus fat invasion: elongation of tumor into renal sinus, invasion, or compression of pelvicalyceal system. Histopathologic examinations were used as a gold standard. Results: Fourteen out of 50 ccRCCs patients (28%) had histopathological-proven perinephric fat tissue invasion. The sensitivity, specificity, PPV, NPV, and accuracy of MDCT in the detection of perinephric fat tissue invasion were found 64%, 58%, 38%, 80%, and 60%, respectively. Seven out of 50 ccRCCs patient (14%) had histopathological-proven renal sinus invasion. The sensitivity, specificity, PPV, NPV, and accuracy of MDCT in the detection of renal sinus invasion were found 85%, 65%, 28%, 96%, and 68%, respectively. The area under of curve (AUC) value of tumor volume in the detection of perinephric fat invasion was 0.631. The AUC value of tumor volume in the detection of renal sinus invasion was 0.803. Conclusion: MDCT has a good sensitivity for detection of renal sinus fat invasion, but low PPV and specificity in patients with ccRCC. Tumor volume, and invasion into the pelvicalyceal structures can aid in the diagnosis of renal sinus fat invasion preoperatively.

Background: Malaria rapid diagnostic tests (mRDTs) are the preferred option for programmatic deployment. Aims: There are numerous mRDTs on the Nigerian market and there is a need to guide practitioners on the relative performance of the commonly used brands of mRDT in Nigeria. Subjects and Methods: The performance of three commonly used Histidine-Rich-Protein-2-based mRDTs (SD-Bioline™, Carestart™ and Paracheck-Pf™) against microscopy of Giemsa stained blood and polymerase chain reaction (PCR) was evaluated among 190 febrile under-5 children in Ibadan, Nigeria. We calculated the sensitivity, specificity, predictive values, accuracy, and agreements. Results: There were 53.2% males. The prevalence of malaria parasite by microscopy was 46.8% and 57.9% by PCR. Malaria parasite detection by SD-Bioline™ was 60.5%, Carestart™: 60.0% and Paracheck-Pf™ 60.0%. Using microscopy as the gold standard, the sensitivities of SD-Bioline™, Carestart™ and Paracheck-Pf™ mRDT were 97.8%, 96.7% and 97.8% respectively while the specificities were 73.0%, 72.0% and 74.0% respectively. Using PCR as the gold standard, the sensitivity for both SD-Bioline™ and Paracheck-Pf™ was 85.5% and for CareStart was 84.6% while the specificity of SD-Bioline™, Carestart™, and Paracheck-Pf™ was 73.8%, 72.4%, and 75.0% respectively. The test accuracy was 81.0% for both SD-Bioline™ and Paracheck-Pf™ and 80.0% for Caresatrt™. The kappa coefficient of agreement between PCR and each of SD-Bioline™, Carestart, ParaCheck™ and microscopy was 0.597, 0.578, 0.609 and 0.739 respectively. Conclusion: The performance of the three mRDTs is a proof that any of the three is suitable for use in the diagnosis of malaria in the southwest of Nigeria.

Objective: To evaluate the effect of varying ferrule height and distribution on the fatigue resistance and fracture strength of endodontically treated premolars. Materials and Method: Thirty-two extracted human premolars were endodontically treated and prepared to receive all-ceramic crowns. Teeth were randomly divided into two groups. The occluso-cervical height was reduced to 2 mm and 4 mm for the 1^st and 2^nd groups, respectively. According to the ferrule distribution, samples in each group were randomly divided into two subgroups with inadequate ferrule on 1 or 2 proximal walls, respectively. Coronal tooth structure was built-up to 4 mm using a core build-up material retained by a fiber post. The CEREC system (Sirona) was used to design and mill lithium-disilicate crowns. All posts and crowns were cemented to their respective teeth using self-adhesive universal resin cement. All crowns were subjected to cyclic loading in a universal testing machine (Instron) (20–100N, 100,000 cycles, 20Hz). After fatigue, crowns were loaded to fracture. Fracture load data were analyzed using two-way ANOVA at α = 0.05. Results: All crowns passed the fatigue testing without any signs of fracture or crack. Two-way ANOVA revealed a statistically significant effect of the number of missing walls (P < 0.05) on the fracture load, but not the ferrule height or the interaction terms. Samples with one missing wall showed higher fracture load in comparison to samples with two missing walls. Conclusion: The number of missing walls, not the ferrule height, has a significant effect on the fracture load of the lithium-disilicate crowns restoring endodontically treated premolars.

Background: Chronic limb-threatening ischemia (CLTI) is a complex disease caused by peripheral artery disease. It is associated with ischemic foot pain (rest pain) and tissue loss in the form of chronic nonhealing foot ulcers or gangrene. CLTI has a high short-term risk of limb amputations, postoperative sepsis, and cardiovascular-related events. Aims: The present study was conducted to assess the demographic and anthropometric profile of patients with CLTI and their postoperative outcomes after 2-year follow-up at Groote Schuur Hospital, Cape Town, South Africa. Methods: This prospective descriptive pilot study, nested in a prospective cohort study, included adult patients with CLTI admitted to Groote Schuur Hospital from 1^st January 2015 to 31^st December 2016. Demographic data, anthropometric markers of CLTI, and the postoperative outcomes were documented using piloted and pretested vascular questionnaire. Descriptive statistics were used for baseline data, and postoperative outcomes were presented using actuarial life-table method (Kaplan–Meier analysis). Odds ratio, 95% confidence interval, and P value < 0.05 were used to test the hypothesis. Results: Thirty-seven (50.6%) patients had a BMI >25.0. The mean waist: hip ratio was 0.96. Prevalence of smoking was 86%. Limb salvage and ambulation at 1 year were 79% and 67%, respectively. Majority of the patients who were ambulant preoperatively remained ambulant postoperatively. Conclusion: Most patients had truncal obesity with a high prevalence of smoking. High postoperative ambulatory recovery among ambulant preoperative patients was a significant outcome observed in our study.

Background: Epilepsy, a chronic brain disorder, predisposes children to low Health-Related Quality of Life (HRQOL). Objective: This study aimed at assessing the HRQOL in Nigerian children with epilepsy and compare it with that in healthy children. Methods: A cross-sectional study of 166 children with epilepsy (CWE), aged 5–18 years on anti-epileptic drugs (AEDs) for at least 6 months and 166 age and sex–matched apparently healthy children was conducted. A generic version of the Pediatric Quality of Life (Peds QoL version 4) scale was used to assess HRQOL. Results: There were significant differences in Quality-of-Life mean scores in the domains of social functioning, psychosocial combination, and psychosocial plus physical activities between cases and controls. The school function scores of <50, indicating low QOL, were significantly more (Chi square = 35.37) (P = 0.0001) among the cases (32.5%) compared to the controls (6.3%). Similarly, low quality of life in the psychosocial combination were observed significantly (P_ = 0.042) more among the cases (12.7%) compared to the controls (6.3%). Low quality of life in emotional feeling domain were noted significantly (Chi square = 12.9) (P = 0.0002) more in subjects aged between 8 and 12 (20%). QOL scores of below 50 in the social function domain were observed significantly (Chi square = 6.49) (P = 0.039) more in subjects aged between 5 and 7 years (44.8%). There was significant gender difference in Quality-of-life index in school functioning domain in subjects. (Chi Square = 6.49) (P value = 0.039). Children in the upper social class scored higher in the social functioning domain, and social class was significantly associated with scores in the social domain of functioning. (F = 3.75 and P = 0.03). QOL scores below 50 in the emotional domain were significantly more among subjects aged 8–12 years/13–18 year, s and QOL scores of <50 in the school function domain were significantly more in subjects aged 5–7 years. (P = 0.0002) (P = 0.039), respectively. Conclusion: HRQOL is reduced in CWE in all domains of Peds QoL. Significant predictors of reduced HRQOL include age, gender, and socioeconomic class. Beyond seizure control, epilepsy management should be oriented towards ensuring the optimal health-related quality of life.

Aim: The purpose of this study is to determine the thickness and limitation of the safe enamel for laminate veneers and orthodontic stripping applications. Enamel thickness (ET) was determined in detail for each tooth and also it was examined whether there was a relationship between the mesiodistal crown width of the teeth and the thickness of the enamel and whether there was a sexual dimorphism. Subjects and Methods: CBCT records of 101 subjects (mean age: 20.88 ± 2.48 years) were examined. ET was measured both mesial and distal region of maxillary and mandibular incisors, canines, and premolars in different levels as cervical, middle, and incisal (occlusal) 1/3. Paired t-test, student t-test, Mann-Whitney U-test and Pearson correlation coefficients a simple linear regression analysis used for statistical analysis. Results: ET of mandibular first premolars and canines was thicker at right side. Mesial enamel of maxillary first premolars, canines, lateral incisors and mandibular premolars and canines were significantly thicker than distal enamel. The mesial enamel of mandibular first premolars was significantly thicker in females. Also, males' maxillary laterals were significantly larger. All premolars had a correlation between mesio-distal crown widths and ET. Conclusions: Mesial and distal ET was unique for each one tooth at different levels. The relationship between ET and crown dimensions of all premolar teeth was also determined.

Aims: This study aimed to evaluate the perception, attitude, and awareness of dental practitioners (DPs) and intern DPs towards SARS-COV-2 by comparing the awareness-attitude score (AAS). Materials and Methods: An online survey was generated in Google Forms. An invitation email was sent to all DPs in Northern Cyprus (n = 270) and intern DPs at Near East University (n = 200). Data were blindly collected from March 2020 to May 2020. Participants received 1 point for each correct answer. By adding up all collected points, an AAS was determined. Data were statistically analyzed. Results: The questionnaire was answered by 228 DPs (84% response-rate). No statistically significant difference was detected between gender-groups in terms of AAS (P = 0.301). A significant difference was detected between occupation groups in terms of AAS (P = 0.006), and of these, dentist-academician-group exhibited superior score. Other tested variables (specialty, way of occupation, place of occupation, and duration of occupation) had no influence on the AAS (P > 0.05). Relation between age and AAS was statistically significant (P = 0.054, Spearmen Correlation). Increasing age increases AAS as linear relation was detected between these variables (P = 0.011, Linear Regression). The questionnaire was also answered by 182 intern DPs (91% response-rate). No significant difference was detected between gender-groups (P = 0.378). Correlation was insignificant between age and AAS (P = 0.933). Conclusions: Occupation is the only variable influencing AAS of DPs. Academicians exhibited superior knowledge regarding SARS-CoV-2. The AASs of DPs and intern DPs were analogous.

Background: Orbital cellulitis, also called postseptal cellulitis, is an infection of contents of the orbit (periorbital fat, neurovascular bundle, and the extraocular muscles). It should be differentiated from preseptal (periorbital) cellulitis which is a lesion of the anterior portion of the eyelid. However, both preseptal and postseptal cellulitis could present in a similar way with eye pain, edema, and erythema. Aim: The aim of the study was to review patients with orbital cellulitis as a complication of odontogenic cervicofacial infections seen in a Nigerian tertiary care facility. Patients and Methods: A retrospective analysis of cases of odontogenic cervicofacial infections complicated by orbital infections that presented at a Nigerian tertiary health facility between January 2006 and September 2019 was conducted. Results: A total of 10 patients with cervicofacial infections who presented with 11 orbital infections as a complication were retrieved for this study. They were six males and four females; male to female ratio was 1.5:1. Median age was 33.5 years (mean age was 34.3 years, range was 22–47 years). Based on clinical features and results of available imaging, orbital infections using the classification by Chandler et al., (1970), were one cases of type I (9.1%), seven cases (63.6%) of type II and two cases (18.2%) of type IV and one case (9.1%) of type V. There was no case of type III. Conclusion: Cervicofacial infections could arise from upper posterior teeth. These infections could spread into the orbit causing cellulitis especially type II.

Background: The method used in the first assessment of patients with veno-occlusive erectile dysfunction (ED) is penile color doppler ultrasonography (PCDU). However, cavernosography performed following intracavernosal pharmacostimulation is accepted as a more precise method for showing venous leakage. Aims: The objectives of this study were to compare results obtained from patients undergoing PCDU, and those undergoing cavernosography, and to investigate the diagnostic value of PCDU in the diagnosis. Methods: A total of 133 patients who presented at the urology clinic due to ED have veno-occlusive dysfunction (VOD) detected as a result of PCDU and underwent cavernosography for further assessment when scheduled for penile embolization. The results obtained were retrospectively evaluated. Results: The mean age of 133 patients with VOD identified as a result of PCDU was 48.7 ± 11.2 years. In cavernosography performed after PCDU, venous leakage was detected in 127 patients (95.49%), while no leakage was found in six patients (4.51%). Bilateral venous leakage was found in 91.34% (n:116), right venous leakage in 5.51% (n:7), and left venous leakage in 3.15% (n:4) of the patients with venous leakage. Conclusion: Evaluating the cavernosography results, PCDU alone is often sufficient to diagnose veno-occlusive ED. Cavernosography is a more invasive diagnostic method compared to PCDU that is adequate in cases where venous surgery or embolization is not considered, and cavernosography is not recommended in these patients.

Objective: The aim of this study is to evaluate the effects of different types of mouthwashes (Klorhexidin, Curasept ADS 205, Meridol, Listerine Cool Citrus) on the surface roughness and color changes of a microhybrid (Point 4), a bulk fill (SonicFill), and a nanohybrid (Nova Compo-N) resin-based composite (RBC). Materials and Methods: Disk-shaped specimens were prepared from tested RBCs and divided into four subgroups which immersed in four different types of mouthwashes. The specimens were subjected to immersion cycles in the mouthwashes and artificial saliva (n = 8). Each cycle consisted of complete immersion in a mouthwash for 21 min and afterwards in saliva for 12 h at 37°C, and this cycle was repeated 8 times. The surface roughness was evaluated using a profilometer and coloration was evaluated using a spectrophotometer before and after immersion time. One-way analysis of variance (ANOVA) for the evaluation of surface roughness data was performed, and interrelation between groups was identified with the Sheffe's multiple comparison test. Results: There were no significant differences between the Ra values of the RBCs before and after immersion in mouthwashes (P > 0.05). There were significant differences between ΔE value of the SF and NCN groups before and after immersion time (P < 0.05). Conclusion: Mouthwashes contribute to oral health, especially in patients at high risk of caries. However, in such patients, patient-specific recommendations should be made when using mouthwashes due to the large number of composite fillings.

Objectives: In this study, we retrospectively evaluated the orbital and ocular dimensions using computed tomography (CT) scans in healthy adults. Materials and Methods: This retrospective study included 302 Turkish adult individuals aged 20–76 years (158 males and 144 females), who underwent paranasal sinus or craniofacial CT due to headache or suspicion of sinusitis, but abnormal orbital or cranial CT findings were not detected. Linear and volumetric measurements of the orbital structures were performed in the sagittal, coronal, and axial planes on CT slices. The volume was estimated in cubic centimeters using the equation of the ellipsoid method. A total of 34 parameters were measured from both eyes of each individual using 14 different anatomical landmarks and analyzed by gender and age. Results: Parameter values of orbital structures in males and females are shown in millimeters or cubic centimeters. In most of the 34 parameters that we evaluated, it was seen that males had statistically significant higher mean values than females (P < 0.05). Also, there was no statistically significant difference between the measurements of right and left orbits. The correlation with age was varied according to the 34 parameters. Interestingly enough, there were no statistically significant differences between the two genders for extraocular muscles thickness (except superior muscles group thickness—SMT) and left optic nerve thickness (LOT) (p > 0.05). The mean right superior muscles group thickness was 5.35 ± 0.85 mm in the male subjects and 4.64 ± 1.10 mm in the female subjects (P < 0.001). The mean left superior muscles group thickness (LSMT) was 5.28 ± 0.88 mm in the male subjects and 4.67 ± 1.16 mm in the female subjects (P < 0.001). The mean LOT was 6.15 ± 0.97 and 5.88 ± 1.07 mm in males and females, respectively (P = 0.099). Conclusion: This study can be applied to the standardization of orbital morphometry in healthy adults.

Background: The timed up-and-go test (TUGT) is a quick, reliable, and valid assessment tool for evaluating functional mobility or dynamic balance. Aims: The purpose of this study was to establish the normative values for TUGT in children aged 4 to 11 years old in Surat, India. Methods: A total of 420 children (210 boys and 210 girls) were included. Subjects were divided into seven age groups. In each age group, 60 (30 males and 30 females) subjects were included. Subjects were randomly recruited from primary schools and underwent three trials of the TUGT. Then, the mean of the three TUGT trials was calculated for each participant. Results: We formulated normative reference values for each of the seven age groups. The mean and standard deviation of the TUGT score across the total population was 6.00 ± 1.15 seconds. TUGT scores were compared between age groups and genders. Between boys and girls, we found no significant differences. Among the age groups, however, we found significant differences, with a P value of less than 0.001. Thus, only age showed a moderate negative correlation with TUGT score. Conclusions: This study provides normative reference values for the TUGT among Indian children aged four to 11 years old. We found that no differences existed between the TUGT results according to genders. Conversely, age had a moderate negative correlation: a comparison of TUGT scores among the ages revealed significant differences between the age groups.

Aims: To establish normative values for functional, lateral, and Oblique Direction Reach Tests (ODRT) and to assess the validity and reliability of the ODRT in Saudi children of age 6–15 years. Methods: Three hundred Saudi children of age 6–15 years children were recruited by using snowball sampling. Children were measured for distance reached in forward, lateral, and oblique direction on a graph paper, which was mounted on a wall/cardboard. Results: The Mean ± SD for forward, lateral and oblique direction reach was 25.63 ± 6.95, 18.91 ± 5.66, 22.08 ± 5.98 cm respectively. The Intraclass Correlation Coefficient values of intra and inter-rater reliability of ODRT shown to be 0.94 and 0.91, respectively. Concurrent validity of ODRT with forward and lateral reach test is 0.87 and 0.84, respectively. Conclusion: We established the normal values for functional, lateral, and ODRT in 6–15 years of Saudi children. We found that ODRT is a valid and reliable for measuring limits of stability in oblique direction.

Background: Dental caries is a multifactorial disease that causes reversible decalcification and cavitation of susceptible teeth exposed to sugary substrates over a period of time in the oral cavity. It gives clinical and social burdens to the child patients and their parents/carers. Stainless steel crown (SSC) restoration is one of the restorative treatment options in the management of carious primary molars. Aims: The Hall technique is a biologic method of managing primary teeth by sealing in the caries with preformed metal crowns (SSCs). The objectives of this study were to assess and compare the primary and secondary treatment outcomes of stainless steel crown restorations using the conventional method and the Hall technique in primary molars immediately after placement and over a 12-month period using both clinical and radiological parameters. Methods: The study was a randomized control clinical trial using a split mouth approach. A total of 25 stainless steel crown restorations using the conventional method and 25 stainless steel crown restorations using the Hall technique were placed in 25 subjects aged 3–8 years with a pair or pairs of unrestored enamel or dentinal carious primary molars matched for tooth type, dental arch, and extent of caries. All subjects were monitored and reviewed every 3 months for 12 months. Results: Twenty three subjects returned for follow-up. There was no statistically significant difference (P-value > 0.05) between the conventional SSC restoration and the Hall technique for both the primary outcomes/major failures (irreversible pulpitis, dental abscess, peri-radicular radiolucency, and crown loss with tooth unrestorable) and secondary outcomes/minor failures (crown loss and tooth restorable, crown perforation, secondary/marginal caries, and reversible pulpitis). But, there was a statistical significant difference in the average time taken for the placement of the restorations between the two groups (P-value 0.001). Conclusion: Both the conventional SSC restorations and the Hall technique can be provided for all the subjects in this study. The Hall Technique compared favorably well with the conventional SSC restoration in clinical and radiological outcomes. The Hall Technique appears to offer an effective treatment option for managing dental caries in primary molar teeth especially in a resource challenged environment where electricity and treatment under general aaesthesia can sometimes be a problem.

Aims: This study aimed to compare the clinical courses, complications, and clinical outcome scores of patients with perimesencephalic (PM) and nonperimesencephalic (n-PM) subarachnoid hemorrhage (SAH) with no vascular pathology observed on cerebral angiography. Materials and Methods: This retrospective study included 52 of 310 patients who underwent cerebral digital subtraction angiography for SAH between October 2016 and April 2018. The patients were categorized into PM and n-PM groups based on the type of hemorrhage observed on brain CT. The patients Fischer's grades, Glasgow Coma Scale scores, and World Federation of Neurosurgical Societies SAH grades were recorded. Hydrocephalus, vasospasm findings in both groups, and modified Rankin scale (mRS) scores were assessed, and vascular pathology factors (diabetes mellitus, hypertension, and smoking) were compared between the patient groups. Results: The PM group included 30 patients, the n-PM group 22 patients. Minimal hydrocephalus was observed in two patients in the PM group and six patients developed apparent hydrocephalus in the n-PM group. Angiographic vasospasm was observed in four patients in the n-PM group but none of the patients in the PM group. On discharge, all patients in the PM group had mRS scores of 0. One patient in the n-PM group become exitus and 18 patients were discharged mRS 0, 2 for two patients, and 3 for one patient. Conclusion: The patients with PM SAH experienced a benign course, whereas those with n-PM SAH showed a higher risk of vasospasm and hydrocephalus as well as worse exit scores.

Background: High-altitude disease prevalence varies according to types of exposure and the effects of hypoxic and hypobaric environments, with the result that people at high altitudes present many different physiological responses. Aims: The research aims to analyze the effects of resistance training (RT) exercises at high altitudes on obese subjects and to explain the determinants that make obese people more susceptible to various chronic illnesses such as diabetes mellitus, hypertension, asthma, etc., Methods: This study recruited 225 subjects living in the high-altitude region of Aseer, Saudi Arabia, and divided them into three groups. The first two groups consisted of obese people, out of which one group received RT and one did not. The third group consisted of average-weight individuals, according to their BMI, who received RT. Biochemical parameters were checked for all three groups before commencing with the RT and at the 4^th and 8^th week to measure the effects of the exercise. Results: Mean and standard deviations of the demographic variables: age was 34.2 ± 8.9 years, weight was 69.3 ± 8.5 kg, and height was 1.6 ± 0.06 meters. RT had a significant effect on the total levels of cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, adiponectin, interleukin-6, and testosterone. Post-hoc comparisons using the Fisher's Least Significant Difference test indicated that the mean scores between the groups differed significantly. Conclusion: Our findings show that RT would be a useful and practical substitute to improve the health status of obese patients. It helps to decrease body fat and to improve lipid profiles and hormonal control.

Background: Adiponectin (ApN) is a 244-amino acid protein mainly secreted from the adipose tissue and involved in various physiological functions. ApN exerts its metabolic effects by binding to two major receptors: adiponectin receptor-1 (Adipo-R1) and adiponectin receptor-2 (Adipo-R2). Recent studies have reported ApN's involvement in the progression of cancer. However, there are no studies evaluating the relationship between Adipo-R1/R2 expression and gastric intestinal metaplasia (IM), which is a predisposing factor in gastric cancer (GC) development, and Helicobacter pylori H. pylori infection. Aims: In this study we aimed to investigate the relationship between the Adipo-R1/-R2 expression and H. pylori infection in patients with GC and gastric IM. Materials and Methods: Forty patients that underwent gastric resection and 56 patients that developed gastric IM were included in the study. The Adipo-R1/-R2 expression and the presence of H. pylori were examined immunohistochemically. The univariate analyses showed that the expression of Adipo-R1/-R2 in GC patients was significantly lower compared to both complete metaplasia (CM) and incomplete metaplasia (ICM) patients (p <0.0001 for both). Results: According to multiple multinomial logistic regression analysis, Adipo-R1/-R2 expression in the CM group was significantly higher than in the GC group (p = 0.05, p = 0.014, respectively). Moreover, Adipo-R1/-R2 expression was significantly higher in ICM group compared to the GC group (p=0.012, p=0.045, respectively). However, in both analyses no significant difference was determined in terms of H. pylori positivity between the groups.Conclusion: The resulting data suggests that ApN plays a role in GC processes via Adipo-R1/-R2 receptors.

Aim: To assess the VHL gene expression as a prognostic marker in Renal Cell Carcinoma (RCC) and compare it with clinicopathologic features. Materials and Methods: This retrospective observational study was conducted in the department of Urology and Renal Transplantation in Sri Ramachandra Institute of Higher Education and Research, Chennai from August 2016 to August 2018. Thirty patients who have undergone a radical/partial nephrectomy with biopsy proven histological diagnosis of RCC during the study period were included in the study. Data was analyzed using Statistical package for Social Sciences version 17. Results: A complete loss and retained VHL expression were noted in 60% and 40% of the RCC specimens. Association between smoking and VHL expression was found to be statistically significant. There was no statistical significance found between age group, sex, chief complaints, BMI. ECOG score, hypertension, family history, location of tumor, calcification, venous system or lymphnode involvement. However, rT staging, nature of lesion and cut surface, HPE type, pT staging, HPE grade, necrosis and lympho-vascular invasion were also found to be statistically significant. Conclusion: Complete loss of VHL expression was noted in majority of the specimens that leads to the development of RCC. Smoking has been found to be statistically significant in tumors that retain VHL expression which may contributes to more aggressive form of tumor. Association between rT staging, nature of lesion and cut surface, HPE type, pT staging, HPE grade, necrosis and lympho-vascular invasion were also found to be statistically significant.

Background: Endodontic treatment failure is one of the most common problems encountered in dentistry. Aims: This study aimed to evaluate the causes of failure of endodontic treatment among patients in the Saudi Arabian city of Al-Kharj. Subjects and Methods: A total of 250 patients of both genders were involved in the study. Criteria confirming the failure of the endodontic treatment were pain, tenderness on pressure, periapical radiolucency, and sinus tract. Patients were selected by convenience sampling methods. A diagnostic chart was prepared to complete the investigation in three different hospitals, during a six-month period (October 2018 - March 2019). The results were analyzed statistically using Chi-square test and use of simple arithmetical methods to determine percentage and frequencies. Results: The main cause for endodontic failure was poor quality adjunctive treatment. 147 out of 179 male patients and 53 out of 71 female patients received poor quality treatment. There was a statistically significant difference between gender versus adjunctive treatment (P = 0.009) and between hospital versus adjunctive treatment (P = 0.005), and quality of adjunctive treatment between private hospital as compared to government hospital which was also statistically significant (P = 0.008). In quadrant wise distribution, first molars were the most commonly involved teeth. Inadequate filling of the root canal was (36.8%), missed canals (14.4), over-extension root canal fillings (12.8%), perforations (9.6%), instrumentation related (8.8%), and endodontic access preparation related (2.4%) in the decreasing order of frequency were seen as the most common causes of failure of endodontic treatment. Conclusion: First molars were the most commonly affected tooth in the failure of endodontic treatment. Poor adjunctive treatment and inadequate filling of the root canals were the most common causes of endodontic failure, more commonly seen in male than female patients and in private clinics/hospitals than government hospitals.

Renal cell carcinoma (RCC) can metastasize to various organs of the body. The skin is an uncommon site for metastasis. However, if metastasis to skin occurs, scalp is a common area. We present a 77-year-old male patient, with a 12-year history of RCC. In the current presentation, he was hospitalized due to hematuria, fatigue, electrolyte imbalance, and deteriorating kidney functions. After the patient was stabilized, he was referred to the plastic surgery clinic due to an unusual, extremely large, hemorrhagic, ulcerative, and vegetative mass on his scalp. Total excision of the scalp mass was performed and, it was noted that the calvarium was intact and the defect was grafted. Histology report of the specimen confirmed to metastatic RCC. Clinicians need to keep in mind that large cutaneous lesion can be a metastasis from an internal malignancy.