Aims: The purpose of this study is to understand healthcare students' knowledge of COVID-19 and the precautionary behaviors they practiced in Saudi Arabia during the MERS-CoV2 outbreak. Subjects and Methods: This cross-sectional study utilized an online questionnaire consisting of 29 items and three sections. The first section collected demographic information, including age, gender, location, and level of education. The second section assessed their knowledge of clinical characteristics, treatments, and disease prevention. The third section addressed the students' behaviors. Results: Respondents included 223 students, of which 37.2% were males and 62.8% were females. The largest group of respondents included medical students (44.8%), followed by dental students (41.3%). Overall, students demonstrated a thorough knowledge of disease transmission, diagnosis, prevention, and treatment of COVID-19. However, some of the respondents could not identify the full name of the disease, Coronavirus Disease 2019 (64.6%), or provide a current estimate of the number of cases diagnosed globally (49.8%). Additionally, most of the survey respondents (93.3%) reported that they had followed social distancing guidelines issued by the Ministry of Health. Conclusion: While most health students were knowledgeable about most aspects of COVID-19, others did not follow universal precautions during the outbreak, which identifies better incorporation of such information in students' academic programs.

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Choricarcinoma co-existing with pregnancy is rare often misdiagnosed with great potential for hemorrhagic complications and death. We present a case of a 34-year-old woman diagnosed with choriocarcinoma in her 3^rd pregnancy with vaginal and pulmonary metastasis. Her first episode of vaginal bleeding was in the third trimester which was misdiagnosed. She had spontaneous vaginal delivery at 34 weeks of a healthy neonate. She was refered to gyneoncology unit of our hospital 5 weeks into puerperium from a nearby State hospital due to continouos vaginal bleeding and a growth from the postero-lateral wall of the lower third of the vagina. She had five courses of EMA-CO regimen. Her beta-human chorionic gonadotropin (hCG) has fallen from pretreatment value of 168,266 mIU/ml to <5 mIU/ml by the 5^th course and the metastaic lesion regressed. She however developed WHO Stage III Oral Mucositis (with Oroesophageal Candidiasis) due to the side effects of chemotherapy which was co-managed successfully with the oral medicine specialist. She was subequently discharged home with follow-up visits. The quantitative beta-hCG has remained undetectable during her follow-up visits. Choriocarcinoma co-existing with pregnancy is rare, diagnosis often missed and confused with antepartum hemorrhage. Early and correct diagnosis can be life saving. High index of suspicion is needed to make the diagnosis. The role of chemotherapy and close follow-up with quantitative beta-hCG assays are key to survival.

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Aims: To investigate the root canal anatomy and the incidence of fused roots in maxillary first molar (MFM) and maxillary second molar (MSM) teeth in the Turkish population and compare them to teeth with separate roots using cone-beam computed tomography (CBCT). Methods: CBCT images of 616 MFMs and 703 MSMs were analyzed from 402 patients for the number of roots and the presence of fusion. The canal configuration of teeth with separate and fused roots was compared. Type of fusion and canal merging positions were determined. A P value of less than 0.05 was considered significant. Results: Five hundred and seventy-one (92.69%) MFMs had three separate roots, one (0.16%) had four roots and the incidence of root fusion was 7.14%. An additional mesiobuccal (MB) canal was present in 79.34% of the teeth with three separate roots. There was no merging of canals in 36 of 44 teeth with fused roots. The prevalence of fusion was higher in the MSMs (23.47%). The incidence of three and four separate roots in MSM teeth was 74.68% and 1.85%, respectively. The prevalence of additional MB canals in teeth with three separate roots was 53.14%. There was no canal merging in 60% of the fused rooted teeth. There were two-merged canals in 31.52% and multiple merged canals in 8.48% of the MSMs. Conclusions: In the Turkish population, the incidence of root fusion in the MFMs and MSMs was 7.14% and 23.47%, respectively, with more canal merging in the MSMs.

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Background: Self-efficacy is defined as the ability of an individual to perform an action successfully or her/his perception of being able to control events. The self-efficacy perception of diabetes management may affect well-being of the patient. Aims: This study aimed to examine the relationships between self-efficacy of diabetes management and well-being in patients with type 2 diabetes. Subjects and Methods: The study used a descriptive correlational design. Sample of the study included 200 patients with type 2 diabetes. Sociodemographic and disease-related questionnaire form “Self-Efficacy Scale for Diabetes Management” and “Well-Being Questionnaire” have been used as data collection tools. Multiple linear regression analysis was performed to explore the predictors of well-being in patients with type 2 diabetes. Results: Self-efficacy level, age, level of compliance with treatment, and state of doing exercise were found to be statistically significant predictors of well-being in type 2 diabetic patients. Self-efficacy level for diabetes management was found to be the strongest predictor of well-being in patients with type 2 diabetes. Conclusion: Self-efficacy level of diabetes management is a factor that affects well-being in type 2 diabetes patients and it should be considered during interventions for improving the well-being of patients.

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Background: Dental plaque is a major oral health problem with severe consequences. Oral antiseptics provide important means for controlling dental plaque formation and are widely used by the public. However, some of these antiseptics have been shown to have side effects on oral tissues. Aim: In this study, we aimed to investigate the time and dose-dependent cytotoxic effects of various antiseptics on primary human gingival fibroblasts (HGF). Methods: HGF cells were obtained using primary culture techniques. The effects of various doses of 5 antiseptics containing Chlorhexidine-Gluconate (CHX), CHX with Benzydamine-Hydrochloride (Benzydamine-HCl), Povidone-Iodine (PVP-I), Benzydamine-HCl and Essential-Oil on HGFs were analyzed by using 2,3-bis (2-metoxy-4-nitro-5-sulfophenyl)-5-[(phenylamino) carbonyl]-2H-tetrazolium hydroxide cell viability assay after 30, 60, and 180 s of exposure. Results: Cell viability analyses showed that cell death increased in an application time and dose-dependent manner. There was a statistically significant difference in the effects of each antiseptic on live-cell densities compared to the control group and each other (P < 0.001). Antiseptic containing 0.2% CHX showed the highest cytotoxicity on cells. The remaining viable cell density after administration of 0.2% CHX at a dose of 12.5% for 30 s is 35.19%. The high cytotoxic effect of 0.2% CHX was followed by 0.12% CHX with 0.15% Benzydamine-HCl, PVP-I and 0.15% Benzydamine-HCl groups. The lowest cytotoxic effect was observed for the Essential-Oil containing antiseptic solution. Conclusions: The results of this study show that these five antiseptic agents have variable effects on in vitro HGF proliferation. The doses and administration times of antiseptics should be controlled carefully during dental applications.

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Background: Amount of bone covering the facial and palatal surface of the root and the sagittal root position are important parameters while considering an immediate implant placement. Aims: This study measures the distance from cement-enamel junction (CEJ) to alveolar crest and thickness of alveolar bone of maxillary anterior teeth facially and palatally at 5 different points. Materials and Methods: CBCT scans of 79 systemically healthy patients were evaluated by two calibrated and independent examiners. Measurements like: 1) distance from CEJ to Crest. 2) Thickness of facial and palatal alveolar bone at five different points a) Crest, b) 2 mm from the crest, c) mid root level, d) apical 3^rd, e) apex. 3) Sagittal root position. 4) Labiopalatal distance at the apex. 5) Length of the bone from apex to the nasal floor for incisors. 6) Presence of fenestrations and dehiscences were assessed. Results: Healthy maxillary anteriors were evaluated and less than 2 mm bone was seen at all five points, 0.5 to 1 mm bone is seen in all anteriors at crest, 2 mm from crest, midroot, apical 3^rd level. 1 to 2 mm is seen at apex. Labiopalatal width at apex ranged from 3 mm to 13 mm with a mean of 7.45 ± 2.24 mm for centrals, 7.69 ± 2.14 mm for lateral incisors, and 6.76 ± 2.42 mm for canines. Conclusion: The present study supports the finding of very thin facial bone over maxillary anteriors and frequent occurrence of fenestrations and dehiscences. Pre-treatment evaluation of alveolar bone surrounding the maxillary anteriors is important to avoid complications during implant placement.

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Background: Urological emergencies constitute a significant part of emergency presentations in various referral centers. Data on the prevalence of these emergencies in West African sub-region are sparse. Objective: The study is aimed at determining the pattern of urological emergencies in our center and is geared towards bridging the gap in knowledge of the epidemiology of urological emergencies in this sub-region as a means of achieving efficient use of scarce resources. Subjects and Methods: It was a retrospective study of all urological emergency cases that presented over six years in a Federal University Teaching Hospital in Nigeria. Data were collected from emergency register and theatre logs. Data analysis was done using SPSS version 25. Results: A total of 267 patients presented with urological emergencies during the period of study with 258 (96.6%) men and 9 (3.4%) women. The mean age of the patients was 50.6 ± 20.8 years. Urinary retention was the most common urological emergency accounting for 159 (59.6%) cases followed by Fournier's gangrene 23 (8.6%) and testicular torsion 23 (8.6%). Bladder and ureteral injuries accounted for 5 (55.6%) of the urological emergency presentations in women while both injuries accounted for only 4 (1.6%) in men (P = 0.000). Urethral catheterization was the most commonly performed procedure 139 (52.1%), followed by percutaneous suprapubic cystostomy (SPC) 31 (11.6%). Conclusion: Urological emergencies have varying presentations in both sexes. Urinary retention, and acute scrotum were the most common urological emergencies in our facility. This knowledge can be used in emergency preparedness planning which involves personnel training and resource allocation.

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Background: Proximal femoral geometry(PFG) plays a role in the biomechanics of the hip. During total hip replacement detailed efforts are made to restore this biomechanics in other to ensure patients satisfaction and implant survival. There are variations in these parameters. Ethnicity is one of the most influential factors accounting for these variations. Aim: To determine the values of the parameters of the proximal femoral geometry among the ethnic Igbos of the South Eastern Nigeria, determine any correlation between these parameters, and compare these values with known populations as well as discuss the clinical application in total hip replacement and other hip surgeries. Materials and Method: Seven hundred and sixteen (716) femoral bones taken from the osteology unit of department of anatomy of University of Nigeria Enugu Campus (UNEC) were screened and proximal femoral parameters measured using Vernier calipers. Results: There were 356 right and 360 left femoral bones with the following values: Femoral Neck Anteversion Angle (FNAVA): M=19.04°, SD=2.075°, Proximal Femoral Length(PFL): M=73.24mm,SD=7.622, Femoral Head Vertical Diameter(FHVD):M= 44.64mm, SD=3.134, Femoral Head Transverse Diameter(FHTD),M=44.55mm, SD=3.379mm, Femoral Head Diameter(FHD),M=44.60mm, SD=3.119mm, Femoral Neck Anterior Length(FNAL), M=31.86mm, SD=5.383mm, Femoral Posterior Neck Length(FPNL):M=22.23mm, SD=3.520mm, Femoral Neck Diameter (FND), M=32.71mm,SD= 3.315mm, Proximal Femoral Width Head to Side (PFWHS), M=89mm.80,SD= 10.331mm, Proximal Femoral Width Side to Side (PFWSS), M=31.47mm, SD=2.812mm, Femoral Neck Shaft Angle(FNSA), M=132.15°, 7.305°. Conclusion: The parameters of the proximal femoral geometry of the ethnic Igbos of the South East of Nigeria, differed from other populations and exhibited laterality.

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Background: Lymphedema of the arm is one of the most common complications following breast cancer surgery. Aims: The primary aim of this study was to evaluate the effects of complex decongestive physical therapy (CDPt) on upper extremity functions, activities of daily living (ADL), and quality of life (QoL), and secondly the effects of the degree of lymphedema on post-treatment differences in older patients with breast cancer-related lymphedema (BCRL). Subjects and Methods: Sixty-eight patients who had BCRL were included between 2015 and 2017. Arm function was evaluated with the Constant-Murley scale, while ADL was measured with the Lawton Instrumental Activities of Daily Living Scale, and QoL was measured with the Lymphedema Functioning, Disability and Health Questionnaire as pre- and post-treatment tests. The patients underwent a CDPt program for 6 weeks. Results: There were statistically significant improvements for all outcome measurements in older patients with Grade 1 and 2 lymphedemas after the treatment (P < 0.001). The Grade 1 patients had a greater difference at mobility, participation in the life and social activities, and their total scores of quality of life had a significance level of P < 0.001. Conclusion: Older patients with Grade 1 BCRL had better mobility, participation in the life, and social activities. CDPt provides enhancement of arm functions, ADL, and QoL in older patients with breast cancer-related lymphedema.

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Objective: This study aimed to compare the clinical efficacy and survival rates of the hall technique (HT), and conventional restoration (CR) for the management of occlusoproximal carious lesions in primary molars. Materials and Methods: This clinical study observed 35 children (aged 4–8 years). Exclusion criteria included symptoms of pulpal or periradicular pathology or systemic conditions requiring special dental considerations. For each child, at least one tooth was treated with HT and one with CR. The primary outcome measures were minor and major clinical failure rates. Plaque and gingival scores of the teeth were also evaluated. Friedman test and Wilcoxon signed ranks test were used to compare the plaque and gingival index scores for each arm. Chi-square tests were used for comparisons of clinical outcomes, plaque-gingival index, and distribution of ICDAS categories among treatment arms (P < 0.05). Results: Thirty-three of 35 (94.2%) participants returned for 1-year follow-up. HT showed statistically significantly higher treatment survival rate and fewer minor failures than CR (P = 0.040). The rate of major failures was minimal (2 of 84 teeth) and did not differ between treatments (P = 0.092). In both treatment groups, the gingival score and plaque score were significantly decreased at the 1-year follow-up (P < 0.05). Conclusion: HT was a more successful method for managing caries in primary molars than CR, both for symptoms of pulpal disease and longevity of the restorations. HT is a simplified method of managing carious primary molars using SSCs cemented with no local anesthesia, caries removal, or tooth preparation.

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During and after cardiac resynchronization therapy (CRT) implantation, many adverse events may occur. We present an interesting and important patient with hemoptysis and massive focal alveolar hemorrhage in a patient after a successful CRT implantation. CRT implantation was completed without any problems. In the follow-up, complaints of cough and hemoptysis began 1 h after the procedure. On the PA chest X-ray, a ground glass image was found in the left upper zone. Thorax CT revealed focal alveolar hemorrhage in the left upper lobe anterior segmental lung parenchyma. The patient was followed up with medical treatment and discharged in good health.

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Transcatheter aortic valve implantation (TAVI) is widely used in high-risk patients with severe symptomatic aortic valve stenosis (AS). The use of traditional surgical aortic valve replacement (SAVR) significantly increases the risk of complications in chronic liver failure with the release of many vasoactive and cytotoxic substrates. In patients with ischemic hepatitis or liver dysfunction along with the severe AS, TAVI may be advantageous due to its minimally invasive nature. However, there is limited information about the outcome of TAVI in a patient with both hepatic and multisystem dysfunction. We report this case demonstrating dramatic result of TAVI in a patient in extremely poor clinical condition due to ischemic hepatitis and hyperbilirunemia.

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Background: Bruxism is a parafunctional habit, usually performed in sleep, by rhythmic and involuntary teeth being squeezed or squeaked. The most common methods of treatment are the use of occlusal splints. Aims: The aim of this study was to compare the efficacy of occlusal splinting with botulinum toxin administration in the treatment of TMJ pain. Subjects and Methods: For this purpose, 40 patients with bruxism were divided into two groups and one group was treated with occlusal splint and the other group received masseter muscle botulinum toxin injection. Then, the participants in both groups were evaluated in terms of pain, functional movement, and maximum bite force change at 2 weeks, 6 weeks, 3 months, and 6 months. Mann–Whitney U test was used to examine the differences between two independent groups. While Friedman test was used for differences between dependent groups, the Wilcoxon test was used for the differences between two repetitive measurements. Chi-square test was used to examine the relationship between categorical variables. Results: When pain was evaluated, both methods were effective in pain reduction, botulinum toxin injection was found to be less effective in reducing pain but no difference was found between the two methods. The maximum bite force decreased in the 2^nd and 6^th weeks and increased in the 3^rd and 6^th months in patients receiving botulinum toxin. In patients using occlusal splints, there was no change until the 3^rd month and an increase was seen in the 6^th month. In this study, it was observed that low dose BTX-A and occlusal splint use were effective in eliminating bruxism-related pain but not superior to each other. Conclusions: According to these results, low dose botulinum toxin can be considered as an alternative treatment in patients who cannot use occlusal splint for various reasons.

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Objectives: The aim of this study was to compare the formation of dentinal crack after root canal preparation performed with different heat treated single-file systems. Materials and Methods: Forty mandibular premolar teeth were randomly divided into four groups according to the file system to be used during the preparation (n = 10): Group 1: Reciproc Blue; group 2: One Curve; group 3: HyFlex EDM; group 4: (control group) hand files. During the cleaning and shaping, irrigation was performed with a total of 10 ml of 5.25% sodium hypochlorite and 2 mL of distilled water. Then sections were taken from the roots (3, 6 and 9 mm). Sections were examined on a stereomicroscope to determine the presence of cracks. Chi-square test was used for data analysis. Results: There was a significant difference between the groups in dentinal crack frequency (P <.05). HyFlex EDM (13.3%) caused less dentinal crack than One Curve (26.7%) and Reciproc Blue (30%). No cracks were observed in the control group. When 3, 6, and 9 mm were evaluated within themselves, dentinal crack formation did not differ according to the groups (P > 0.05). A statistically higher mean value was obtained in the control group compared to the other groups in terms of working time (P < 0.001). Conclusions: All the files used during root canal preparation formed dentin crack. Hy-Flex EDM caused less dentinal cracks than other file systems. The flexibility of nickel-titanium instruments because of heat treatment seems to have a significant influence on dentinal crack formation.

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Aims: To determine the prevalence of refractive errors and causes of visual impairment in school children in Enugu State, South-eastern Nigeria. Methods: A descriptive cross-sectional, school-based survey in children aged 5–15 years from selected primary and junior secondary schools (public and private) in both urban and rural communities of Enugu State was carried out. Ocular examinations were performed on them according to the Refractive Error in School-age Children (RESC) protocol. Results: A total of 1167 children were examined. The mean age (standard deviation) was 10.58 ± 3.0 years. Females were 653 (54.4%) of the study population. The uncorrected, presenting and best-corrected visual acuity of ≤20/40 (6/12) in the better eye of the children in this study were 3.6%. 3.5% and 0.4%. Among the children that had visual impairment, refractive error accounted for 33.3% of reduced vision while the overall prevalence of refractive error was 2.1%. Prevalence of myopia was 1.9% and hyperopia, 0.1%. The most prevalent astigmatism was ≤0.75 dioptre cylinder. Conclusion: The prevalence of refractive error in this study is low, with myopia being more common. Despite the low prevalence of refractive error, school vision screening is still important for African children as it serves as an opportunity to identify other ocular morbidities among the children.

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Background: Postpartum hemorrhage (PPH) is one of the emergency situations of obstetrics practice that constitutes of 1 to 5% of vaginal and cesarean deliveries. Uterine atony is the number one cause of PPH and is responsible for at least 75% of PPH cases. Uterine compression sutures have been regarded as an effective method in PPH cases, as well as preserving fertility by preserving the uterus. Aims: The main purpose of this study was to report on our results with a new uterine compression suture technique that was developed by us. Subjects and Methods: In this study we included all women who needed uterine compression sutures because of uterine atony while cesarean section from January 2014 to December 2018. Fifteen cases with PPH with uterine atony were reported, who were treated with our uterine compression suture technique after conservative medical and uterine massage treatment failure. Results: All of the cases in this study were managed successfully namely none of the patients needed a hysterectomy or reoperation because of bleeding again. One week, one month, three months later all patients were followed up. Six months later 11 patients were examined, four patients lost to follow-up, but they were reached by phone since they were outside of the city, they reported no complaints. Ultrasound examination was performed to follow up patients. Short-term follow-up revealed no complications such as pyometra, endometritis, reoperation, amenorrhea, or uterine necrosis. Conclusions: We described our practice with our uterine compression suture that is easy to learn and apply. All of the cases that participated in our study showed improvement to the compression sutures, so no other surgical interventions were applied. The same suture technique was applied by only one physician. This is a feasible and easy way to stop bleeding in uterine atony and in uterine preservation, especially in rural areas when help may not be available in case of complications.

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Background: Retina diseases including the diseases of the macular are underreported in developing countries of sub-Sahara Africa including Nigeria. Method: A retrospective review of retinal register of cases presenting to the retinal clinic of the University College Hospital, Ibadan within 4 years (December 2015, to November 2019). Demographics and clinical data of all patients with macula diseases were retrieved. Data were analysed using the Statistical Package for Social Sciences IBM (SPSS-IBM), version 22 (SPSS Inc., Chicago, Illinois, USA), and reported as frequency distributions and percentages. Results: A total of 1291 retinal cases were seen during the period under review, out of which 322 cases were diseases of the macula, representing 24.9% of retinal cases seen. The top 3 common causes of macular disease found in the study were dry Age-related Macular Degeneration (AMD) 63 (19.6%); Macula oedema 53 (16.5%) and Non-AMD atrophic maculopathy (from Retinitis Pigmentosa, chloroquine maculopathy and hereditary causes) 51 (15.9%) representing more than 50% of cases. Macular holes 48 (14.9%); Non-AMD macular scar (Toxoplasmosis, Trauma) 37 (11.5%) and choroidal neovascular membrane (CNVM) 26 (8.1%) are other important causes. Idiopathic Polypoidal Choroidal Vasculopathy (IPCV) 17 (5.3%) is an emerging cause of macular disease in the retina unit of the University College Hospital Ibadan. Conclusion: Age-related macular degeneration (AMD), Macular oedema and Non-AMD atrophic maculopathy are major causes of macular disease presentation in the retinal clinic of the University College Hospital Ibadan, Nigeria. CNVM and IPCV are emerging causes.

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Background: Vitamin D plays a vital role in the maintenance of bone health. The fetuses and exclusively breastfed neonates depend on maternal vitamin D store to meet their need. Widespread vitamin D deficiency among pregnant women have been reported with adverse fetal outcome. Nigeria lacks guideline on Vitamin D supplementation in pregnancy and infancy due to the paucity of data. We thus determined serum vitamin D of delivering mothers and their offsprings and other indicators of bone mineral health. Aims: This study aimed to determine serum Vitamin D and other indicators of bone mineral health of delivering mothers and their offspring. Material and Method: A cross-sectional study of delivering mothers and their newborns recruited consecutively until the minimal sample size was reached. Relevant information was obtained on a questionnaire. Maternal and cord serum vitamin D, calcium, albumin, phosphate, and alkaline phosphatase were determined. Data management was done using SPSS version 16.0. Results: Of the 84 newborn-mother pairs studied, 17 (20.2%) of the mothers were Vitamin D deficient and 23 (27.4%) insufficient. Seven (8.3%) of the mothers were hypocalcaemic and 3 (3.6%) hypophosphataemic, while 19 (22.6%) had elevated alkaline phosphatase. Only 15 (17.9%) of the neonates were vitamin D insufficient and none of them was vitamin D deficient, hypocalcaemic, hypophosphataemic nor had elevated alkaline phosphatase. There was strong positive correlation between cord and maternal blood vitamin D level (r = 0.740, P = < 0.001). Conclusion: Vitamin D deficiency and insufficiency is high among pregnant women in Maiduguri while insufficiency is common among the neonates. We recommend vitamin D supplementation to pregnant women and newborns in Maiduguri.

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Aim: The aims of this study are to investigate the prevalence of odontogenic cysts and tumors occurred in a sample of Turkish population in the last 10 years and to compare the data with latest reports. Methods and Material: The present retrospective study was carried out at Gazi University, School of Dentistry (GUSD) in Ankara, Turkey. All the data was retrieved from the GUSD archive on patients treated for various oral and maxillofacial lesions between 2008 and 2018. Patients' demographical data, main clinical features of the lesions along with histopathological findings were retrieved from the dental files of the patients. The type of lesions was evaluated according to the latest Head and Neck Tumor (HNT) classification published by the World Health Organization (WHO) in 2017. Data was analyzed by descriptive statistics and Chi-square test using SPSS version 21.0 software. Results: Among a total of 739 biopsy-conducted lesions, 467 (63.19%) were odontogenic cysts, 43 (5.82%) were benign odontogenic tumors, and 7 (0.95%) were malignant tumors. The rest of 222 cases were defined as others. Conclusions: The present study assessed the demographic and clinico-pathological characteristics of odontogenic cysts/tumors in a group of Turkish people, who visited GUSD for therapeutic purpose in the past 10 years. Results showed that male patients in their 5^th-6^th decades have the highest risk of odontogenic cyst/tumor, especially in the mandibular posterior region.

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Background: Pulmonary rehabilitation (PR) is a core component of the management of patients with chronic obstructive pulmonary disease (COPD). Although several types of PR programs are implemented for patients with COPD on the basis of patient preferences or clinical protocols, the clinical efficiencies of these programs may vary, with each program having its own unique purpose, procedures, benefits, challenges, and effectiveness. Aim: The aim of this study was to compare the effects of self-management and hospital-based PR programs in COPD patients. Materials and Methods: This study was prospective intervention research. Fifty-eight patients with stable COPD were randomly allocated to a hospital-based outpatient group and a self-management group before commencement of a 12-week PR program. Before and after the PR program, all patients were evaluated using the 6-min walk test, Modified Borg Scale, St. George's Respiratory Questionnaire, State–Trait Anxiety Inventory, and Standardized Mini-Mental Test. Results: Pulmonary functions, dyspnea, quality of life, and 6MWT distance were significantly improvement the hospital-based PR than self-management PR (P < 0.05). Moreover, cognitive function significantly improved after the PR program in both groups with no significant intergroup difference (P > 0.05). Conclusions: Our findings suggest that PR is useful for to improvement functional capacity, quality of life, cognitive function and anxiety, in patients with COPD. A hospital-based PR is more effective than a self-management PR program.

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Objective: This study investigated the relationship between hyoid position and vertical dental dimensions (overbite), and the influence of gender on the location of this bone. Methods: One hundred and seventy-four standardized lateral cephalometric radiographs were randomly selected from a pool of radiographs of patients seeking orthodontic treatment with ages ranging from 10 to 58 years. The subjects were divided into three groups according to their vertical dental dimensions (overbite) into reduced, normal, and increased overbite groups. The hyoid bone position was determined by four horizontal linear and three vertical linear line measurements. Associations between the position of the bone and different vertical dental patterns were analyzed using ANOVA and Tukey's multiple comparison analysis. Results: There was a progressive increase in the horizontal linear position of the hyoid bone parameters across the groups from the reduced through normal to increase overbite. Similarly, a statistical reduction in the vertical linear positions of the hyoid bone parameters was found across the groups from reduced overbite through normal overbite to increased overbite (P < 0.05). The vertical linear hyoid bone positions were located higher in the male than in female subjects. Tukey's multiple comparison analysis showed a highly statistically significant difference in the vertical linear hyoid bone positions between reduced and normal overbite groups and between reduced and increased overbite groups. Conclusion: The hyoid bone was positioned more antero-inferiorly and more postero-superiorly in subjects with reduced overbite and increased overbite, respectively.

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Background: Dental professionals are prone to carpal tunnel syndrome (CTS) and other nerve-related disorders as they perform repetitive wrist work with static physical position for long hours. Objectives: To evaluate the relationship of thumb radial abduction angle with handgrip strength, hand dexterity, and CTS susceptibility among Saudi senior dental students and interns. The study also intends to compare thumb radial abduction angle based on the gender. Methods: A convenient sample of 100 Saudi dental students and interns participated in the study. Their handgrip strength, dexterity, and thumb radial abduction angle were measured by the use of Jamar dynamometer, nine-hole peg test, and goniometer, respectively. Questionnaires were distributed among the participants to assess CTS susceptibility and its association with thumb radial abduction angle. Regression analysis, Pearson's correlation, and independent t-test were performed to analyze the data. Results: A significant correlation between thumb radial abduction angle and handgrip strength was observed. An association of handgrip strength with CTS susceptibility was also found. No significant relationships were drawn considering hand dexterity. Handgrip strength and dexterity were found to be higher in males when compared to females, however, females were observed to be more susceptible to CTS. Conclusion: The study concludes a significant association between thumb radial abduction angle and handgrip strength that is further related with CTS. The results of the study can be used as a foundation for several academicians' research in this domain.

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Background: Primary dysmenorrhea (PD) is characterized by symptoms including sweating, headache, nausea, vomiting, diarrhea, tremulousness, usually begins adolescence, those can be associated with autonomic dysfunction affecting pulmonary functions. Aim: The aim of the present study is to investigate the impacts of PD on pulmonary function tests. Subjects and Methods: A prospective cross-sectional design was selected. All subjects were invited to admit to the Department of Obstetrics and Gynecology outpatient unit for venous blood test detecting the levels of estrogen and progesterone during the follicular and luteal phase of their menstrual cycle. After drawing blood, women were taken to the pulmonary function tests laboratory to perform the test. The comparisons between Group PD and Group Control were performed by the independent samples t-test or Mann–Whitney U test. Intragroup comparisons were completed by paired samples t-test. Results: The comparisons between Group PD and Group Control among estrogen and progesterone in follicular and luteal phase, pulmonary function test results did not show any significance (P > 0.05). The intragroup comparisons of estrogen and progesterone levels, and pulmonary functions test results revealed no significant difference (P > 0.05). Conclusion: The present study showed that PD does not influence the spirometric measurements and also respiratory functions are not impaired by the different phases of menstrual cycle.

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