Epidemiology is a science that studies contagion, that is, the multiplication of diseases that can be transmitted from one person to another. Our study is based on the field of public health, especially on pandemics of (diseases) that can affect an entire continent. For example, sexually transmitted diseases. We will also put special emphasis on the facts of the high risk spread of STDs around the world.
Botulinum toxin A injection into the detrusor can reduce detrusor contractility, improve bladder compliance, and resume urinary continence. While a urethral injection of BoNT-A may reduce the urethral resistance and facilitate bladder emptying reducing postvoid residual (PVR) and frequent urinary tract infections. This work aims to provide cumulative data about the efficacy of Botulinum Toxin A (BoNT-A) in treating patients with Detrusor External Sphincter Dyssynergia (DESD). A systematic search was performed of PubMed, Cochrane library Ovid, Scopus & Google scholar to identify Urology RCTs, clinical trials, and comparative studies, which studied the outcome of Baseline assessment versus Follow-up assessment of DESD patients. A meta-analysis was done using fixed and random-effect methods. The main outcome measures were average PVR (postvoid residual), MDP (mean detrusor pressure), dLPP (detrusor leak point pressure), and MUP (mean urethral pressure). A total of 8 studies were identified involving 500 patients. Regarding outcome measures, the random-effects model of the meta-analysis study showed a highly significant decrease in mean PVR and MUP in follow up assessment compared to baseline assessment (p=0.001). The fixed-effects model showed a highly significant decrease in mean MDP in follow up assessment (p<0.001). The random-effects model of the meta-analysis study showed a non-significant difference in mean dLPP in follow up assessment (p>0.05). To conclude, Botulinum toxin A injection proved its efficacy through reducing mean PVR, MDP, and MUP in the follow-up assessment, but we didn't find a significant change in mean dLPP in the follow-up assessment.
Frenum is considered as a normal anatomic structure in the oral cavity. However, it may exist intraorally as a thick broad fibrous attachment and/or become located near the crest of the residual ridge, thus interfering with proper denture border extension resulting in inferior denture stability, retention and overall patient satisfaction. The aim of this study was to assess the prevalence of high frenal attachment in edentulous patients. The present retrospective study was conducted among 355 edentulous patients reported to Saveetha Dental College and Hospitals, Chennai from June 2019 to March 2020. Data regarding the type of frenal attachment of the study participants was collected and the incidence was assessed. Frequency distribution and percentage and chi-square test were calculated. Among 355 edentulous patients, only 2 patients had high frenal attachment. The association between gender and high frenal attachment was not statistically significant. The present study showed that the prevalence of high frenal attachment in edentulous patients in the given population was less.
Background: The 'Aarogya Setu' mobile phone application (app) is designed to inform people regarding the potential risk of COVID-19.Alimited amount of information is available about awareness and usage of the app. Objective: To assess awareness, opinions, and usage of the 'Aarogya Setu' app amongst out patients of three clinics in Mulshi taluka of Pune district. Methods: Convenient sampling technique was used. A total of 234 patients were interviewed who visited the clinics over five months. The interviews were conducted on phone using a pre-tested questionnaire. Additionally, 15 indepth interviews were conducted with the participants who had previously used the app. on the telephone using an interview schedule. Quantitative data were analyzed by calculating frequencies and associations. An inductive approach was used to analyze qualitative information. Results: Around one-third of the participants (33.8%) were aware that the 'Government of India' (Gol) has developed an app named 'Aarogya Setu' to fight against the pandemic. A significantly higher percentage of awareness was observed in the participants less than 35 years of age. The app was mostly known and used for 'obtaining the number of nearby COVID-19 patients'. Overall, the participants believed in the purpose of the app. Concerns were raised about the reliability of the data gained from the app. Conclusion: Awareness of the 'Aarogya Setu' app needs to be enhanced amongst all age groups. Trust building in the app must be strengthened simultaneously.
Objective: This study aims to create statistical and analytical data describing different orthodontic brackets debonding techniques used in the Arab region, stating the most commonly used methods, instruments and the outcome of each method to provide sufficient information for future guidelines to improve its performance. Materials and Methods: An online survey was sent to members of four orthodontic societies in the Arab region (Saudi, Jordanian, Egyptian and, Lebanese), the survey included five demographic data questions: (sex, age, nationality, years of experience and job description) and six epidemiological questions about bracket debonding techniques and instruments used. Results: A total of 252 responses were received,39% of the participants did not report any enamel changes after the debonding procedure, while 61% found some enamel damage. The majority of bracket type used was metal (86%), and the bracket remover plier was the most commonly used plier to remove the brackets (74.6%), followed by a light wire cutter (9.5%). Rotary instruments were the method of choice for eliminating residual adhesive from enamel (90.1%); tungsten carbide burs were the most common (24.6%) specifically with low-speed hand piece (24.2%) while prophylaxis paste is the most used method for polishing. The respondents (61%) found enamel esthetic changes between treated and untreated teeth while 39% did not see any changes. Conclusion: This study results showed the similarity between Arab orthodontists with their approach and used armamentarium of debonding and polishing. This study has also drawn a picture of the current debonding, finishing and polishing techniques used in the Arab region in comparison with the Italian study from which this study survey was adopted.
Background: Diabetes self-management education (DSME) is a critical part of diabetes care. Guidelines for the treatment of diabetes recommend that all diabetes patients must take part in DSME to enhance clinical outcomes and quality of life. Aim: This work aims to assess the impact of educational interventions in type 2 Diabetes Mellitus (DM) patients in primary health care. Materials and Methods: A systematic search was performed over different medical databases to identify Family Medicine studies, which studied the outcome of the Interventional group versus the Control group of primary health care DM patients. Using the meta-analysis process, either with fixed or random-effects models, we conducted a meta-analysis on HbA1C difference as the main outcome measure. Results: Ten studies were identified involving 3335 patients, with 1635 patients in the Interventional group, and 1700 patients in the Control group. The meta-analysis process revealed a highly significant decrease in mean HbA1C in the Interventional group compared to the Control group (p=0.001). Conclusion: To conclude, educational interventions in primary care addressing T2DM could be effective for metabolic control, but the low quality of the evidence and the lack of measurement of critical results generate uncertainty and highlight the need for high-quality trials.
Since it started in late December 2019, the impact of the COVID-19 pandemic is now widespread with over 1,300,000 cases and more than 7,000 deaths globally. Preliminary data tend to suggest that the burden of COVID-19 on children is relatively low. In one Chinese study only 1% of the 44,672 COVID-19 cases were below 10 years while another study reported that children just like adult get infected. Also, a recent analysis has suggested that community transmission of COVID-19 may be link to pediatric COVID-19 cases. Pediatric COVID-19 infection rates tend to differ by underlying infections. In one viral surveillance pediatric study in China, there were more COVID-19 cases among children with ARDS than those with human metapneumovirus while 10% of the pediatric hospitalized children with respiratory tract infections in Norway were diagnosed with COVID-19.
Background and Aim: Several studies have shown elevated C-Reactive Protein (CRP) levels in patients with chronic periodontitis. In addition to periodontitis, CRP being a marker of systemic inflammation, is also used in studies predicting CVD such as myocardial infarction, stroke, acute coronary syndromes and peripheral arterial disease. Therefore, the aim of this study was to evaluate the levels of CRP in patients with CVD only, CVD and periodontitis and periodontitis only. Materials & Methods: The study involved 45 patients aged between 35 years-65 years. Periodontal disease status was determined using parameters like Gingival Index, Plaque Index, Probing Pocket Depth (PPD) and Clinical Attachment Level (CAL). A blood sample was obtained from the patient for evaluating CRP levels. For statistical analysis of assessment between the association of several parameters with patient characteristics, Pearson's correlation coefficient (r) was practiced and its significance was verified with t-test. Results: The present study did not show any significant association between CRP levels of the three study groups. Conclusion: This study indicated that periodontal disease may add an inflammatory burden of the individual thus increasing the risk of future CVD, the results however were not statistically significant. Randomized controlled clinical trials with large sample size and control of confounding factors are needed to evaluate this relationship between periodontal disease, CRP and CVD.
Background: Electronic cigarette is becoming more popular worldwide recently. However, there is limited evidence on e-cigarette consumption in an environment conducive to smoking as the United Arab Emirates (UAE). The current study aimed to assess the prevalence, risk factors and awareness associated with e-cigarette use among a convenient sample of Inhabitants in the northern emirate of United Arab Emirates. Methods: A cross-sectional descriptive study was conducted in was conducted in the emirate of Ras Al khaimah from November 2019 to January 2020. An anonymous structured self-administrative questionnaire was used to collect data from the selected participants. The objective of the study was adequately explained to participants and their consent was obtained with assured confidentiality. Results: Almost two thirds of the participants (66.3%; 302/455) showed low level of e- cigarettes awareness with a mean score of 6.23(2.1) out of 13. The prevalence of usage was significantly higher among males (75%), Arab nationality (70.5%), occupation not health related (68.9%), higher monthly income (85.8%) and smokers (60.7%). Significant difference in the mean score of awareness toward e-cigarettes among users and non- users (p<0.001, 4.30(1.33) and 9.14(2.69)) respectively. Multivariable logistic regression revealed that current smokers, male group and those showing a low score of awareness associated with e-cigarettes were likely to be users of e-cigarettes. Conclusion: Instituting laws that are more stringent and holding nationwide awareness campaigns regarding safe usage of e-cigarettes targeting those group identified in this study are necessary to control the increasing e-cigarette use in the near future.
AIMTo evaluate and compare the effectiveness of nanocrystalline hydroxyapatite (NcHA) with advanced platelet-rich fibrin (A-PRF) and hydroxyapatite-reinforced beta tricalcium phosphate (HA + β-TCP) with A-PRF in the treatment of human infrabony defects clinically and radiographically using cone-beam computed tomography (CBCT).MATERIALS AND METHODSThere were a total of 28 defects, with 14 defects in the test and control groups, respectively. There were total 28 patients were involved in the study. The test group (group A) was treated with NHA and A-PRF, while the control group (group B) was treated with HA + β-TCP and A-PRF. Bone defect fill was the primary result of the investigation. Periodontal pocket depth (PPD), R-CAL, papillary bleeding index (PBI), and PI were the secondary outcome. Clinical and radiographic measurements were recorded at baseline and 6 months postoperatively.RESULTSNo significant difference was observed between the two groups in terms of PPD reduction (4.64 ± 0.74 mm vs 4.07 ± 0.99 mm), clinical attachment loss (CAL) gain (4.64 ± 0.74 mm vs 3.92 ± 0.99 mm) and radiographic defect depth reduction (2.41 ± 0.32 mm vs 2.40 ± 0.27 mm) for test and control groups, respectively.CONCLUSIONAt 6-month post-surgery, both treatment modalities demonstrated statistically significant improvements with regard to CAL gains, PPD reduction, and reduction in radiographic defect depth.CLINICAL RELEVANCEThe NcHA and HA + β-TCP with A-PRF is a novel material used in the treatment of infrabony defect for periodontal regeneration. The NcHA and HA + β-TCP with A-PRF need to consider biomaterials for bone defect fill.
Background: Computer Vision Syndrome (CVS) described by the American Optometric Association (AOA) as "The complex of eye and vision problems related to near work experience during computer use." The current study aims to evaluate the prevalence of CVS and the association between CVS symptoms with age and behavior's, among college students and employees in Jeddah, Saudi Arabia. Subjects & Methods: This was a cross-sectional analytic study conducted in Jeddah, Saudi Arabia from July to August 2020. The study targets college students and employees living in Jeddah, Saudi Arabia, from July 2020. The target sample size was a minimum of 377 that was calculated using raosoft. Data entry was performed by Microsoft Excel 2019, and analysis was done using Statistical Package for the Social Sciences (SPSS) software, version 25. Frequency, descriptive analysis, Chi-square, and One-way ANOVA was performed. P-value of <0.05 was considered statistically significant. Results: Overall, 786 responses were received, only 459 met the criteria of which 277 (60.3%) were college students and 182 (39.7%) were employees. Pain in and around the eyes 288 (66.5%) and sore eyes 247 (57%) were the most commonly reported ocular symptoms among participant and in terms of extra-ocular symptoms; headache 355 (82%) and neck and shoulder pain 237 (55%) recorded highest. The highest number of symptoms was reported by IbnSina National College (ISNC) students with approximately a mean number of symptoms 7 +/- 3.443. Conclusion: Computer Vision Syndrome is a common syndrome among college students and employees.
Background: Alcohol holds an important role in social engagement in southeast Nigeria. It is considered pleasurable by many who drink it in mild or moderate quantities. Studies show an increasing trend in alcohol consumption, including among adolescents. Aim: The aim of the study is to determine the prevalence and pattern of alcohol use among adolescents living in urban settlements in Enugu Urban, Southeast Nigeria. Materials & Methods: A cross sectional descriptive study was conducted, using purposive sampling method. Using semi-structured questionnaires, we obtained information on their biodata, medical history, alcohol consumption profiles and a few other lifestyle behaviors. Statistical analysis was carried out using SPSS version 23. Results: A total of 473 youngsters aged 10 yeras-19 years were recruited from the two settlements. Females (mean age 15.4 years) were also older than males (mean age 14.8 years) p=0.02. The prevalence of current alcohol use within the preceding 4 weeks was 23.7% (112/473). Males drank alcohol more frequently than females (31.8% vs. 17.8%). p<0.01) and local brew (palm wine) was the commonest alcoholic consumed 40 (35.7%). The amount of alcohol consumed (in grams) rose sharply after the age of 15 years with a steeper gradient being observed among the males. Conclusion: This study shows that there was a moderate rate of alcohol use among adolescents in the study population which increased sharply after 15 years of age. There is therefore a need for public health enlightenment targeted at adolescents both in school and in the community, to highlight the dangers of excessive alcohol use thereby preventing future alcoholism and consequent heart, vascular, brain and liver diseases that may ensue.
Background: Biologic therapies have all demonstrated efficacy inside the treatment of AS. however, some patients do not reply to remedy (i.e., number one treatment failure) or enjoy diminished efficacy over the years (i.e., secondary treatment failure), while others experience side effects necessitating treatment discontinuation e.g. (incidence of malignancies). Aim: This work aims to assess the incidence of malignancies in spondyloarthritis (SpA) patients treated with biologics. Materials and Methods: A systematic search was performed over different medical databases to identify Internal Medicine studies, which studied the outcome of the Biologics group versus the Nonbiologics group of spondyloarthritis (SpA) patients. Using the meta-analysis process, either with fixed or random-effects models, we conducted a meta-analysis on the overall incidence of malignancy as a primary outcome, and on the incidence of malignancy in TNF-A and IL-17 therapies (as secondary outcomes). Results: Eleven studies were identified involving 4395 patients, with 2878 patients in the Biologics group, and 1517 patients in the Non-biologics group. The meta-analysis process revealed a non-significant difference in the overall incidence of malignancy in the Biologics group compared to the Non-biologics group (p>0.05), with also a non-significant difference in the incidence of malignancy in TNF-A and IL-17 users (p>0.05). Conclusion: To conclude, we found no evidence for elevated risk of malignancy with the use of biologics in SpA. We were also unable to assess the long-term risk of biologics in SpA, which requires longer follow-up durations, and further investigatory studies.
Background: The severity of lung involvement associated with SARS-CoV-2 infection levels from lack of symptoms or slight pneumonia (in 81%) to excessive disease-associated hypoxia (seen in 14%), a critical disease associated with shock, respiration failure, and multi-organ failure (in 5%) or death (2.3%). Aim: This work aims to determine the prevalence of clinical and radiological manifestations among children and adolescents COVID-19 patients. Materials and Methods: A systematic search was performed over different medical databases to identify Pediatrics studies, which studied the outcome of COVID-19 infection in children and adolescents. Using the meta-analysis process, either with fixed or random-effects models, we conducted a meta-analysis on the prevalence of clinical manifestations (e.g., fever, nasal congestion, cough, dyspnea, abdominal pain, diarrhea, and critical cases), as primary outcomes, and on radiological manifestations (e.g., CT involvement - ground-glass opacities), as a secondary outcome. Pooled prevalence of abdominal pain=9.6%, pooled prevalence of critical cases=7.7%. Results: Eight studies were identified involving 682 patients. The meta-analysis process revealed a pooled prevalence of fever=61.1%, a pooled prevalence of nasal congestion=8%, pooled prevalence of cough=49.7%, pooled prevalence of dyspnea=21.4%, pooled prevalence of diarrhea=13.3%, pooled prevalence of critical cases=7.7%. Concerning the secondary outcome measures, the pooled prevalence of CT involvement=41.6%. Conclusion: To conclude, COVID-19 disease cause different manifestations in children such as fever and respiratory symptoms such as cough and dyspnea, organizing pneumonia and decreased pulmonary function.
Objectives: Objectives of the study were to determine the level of knowledge and practices regarding Nosocomial infection among nurses working in public and private hospitals of Islamabad and to determine the factors associated with knowledge and practices among these nurses. Design: A cross sectional study based on self-administered questionnaire was ducted. Setting: Study was carried out in public and private tertiary teaching hospitals in Islamabad. Study Participants: A sample of 356 nurses including 185 from public hospital and 171 from private hospital through stratified random sampling proportion to size for collecting information regarding knowledge and practices about Nosocomial infection was selected. Main outcome measures of the study were good and bad knowledge and practices regarding Nosocomial infection. Results: A total sample size was 356 participants was studied where 185(51%) nurses from public hospital and 171(48%) from private hospitals were included. Most of the participants, 212 (59.6%) were of age between 20-29 years. Among the participants 221(62.1%) were females and 135 (37.9%) were male staff. Regarding knowledge level, 194(54.5%) participants had good knowledge about Nosocomial infection and as far as practice is concerned, 204(45.5%) of the participants had good practices regarding Nosocomial infection. Conclusion: Overall, the knowledge and practices of the nursing staff was good. Based on facility, knowledge of the private hospital was better as compare to knowledge of the participants of public hospital however, practice of the participants from public hospital was better as compare to the practice of the participants from private hospital.
Introduction: This study was done with the objective of determining the frequency and distribution of teeth requiring endodontic treatment in Saudi Arabia subpopulation. Materials & Methods:A retrospective, cross-sectional study was done in the Department of Clinical Sciences, Dental Program, Batterjee Medical College, Jeddah, Saudi Arabia. Patient's data (age, gender, arch and type of tooth involved) that underwent root canal treatment from 1st January 2018 to 31st December 2018 was collected and analyzed. Results: Out of 3731 patients, 538 teeth required endodontic treatment. More male patients undergone root canal treatment as compared to females, and most root canal treatments were done in young adult patients. Most of the teeth that required root canal treatment were posteriors. Conclusion: This study showed that root canal treatment was done more in males, in mandibular posteriors and in young adult patients.
Coronary artery disease (CAD) is one of the major causes of death worldwide. CAD is narrowing of coronary arteries that prevents adequate blood supply to the heart muscle and results in acute coronary syndrome which includes unstable angina and myocardial infarction. The only remedy for it is to restore the perfusion through percutaneous intervention and grafting which may sometime cause reperfusion injury and other complications. Coronary collaterals are small inter-arterial connections that act as natural bypass which provide blood flow to the vascular territory, when the artery supplying to it gets obstructed. Acute collateral recruitment can occurs as a remedy for these adverse cardiac events. Various methods of therapies considered for the promotion and sustenance of functional coronary collaterals. The determinants of human coronary collaterals give clear evidence for prognosis in CAD and a new insight for further therapeutic promotion of coronary collaterals. This review mainly focuses on various studies done on coronary collaterals and the effect of various demographic, morphological and cardiovascular risk factors on the formation of coronary collaterals during obstructive CAD. Many studies have proven that various independent variables such as morphology of coronary artery, location of the lesion, duration of the occlusion, coronary dominance, biochemical factors, and cardiac risk factors, such as diabetes, hypertension, also affect collateral formation. The current update review gives a holistic view on coronary collaterals and findings of various authors on the effect of these independent variables on collateral formation.
We aim to observe the inflammatory status in patients with hepatitis C associated cryoglobulinemia after COVID-19 infection. We evaluated 3 patients with hepatitis C associated cryoglobulinemia, 6 patients with hepatitis C and 16 patients without comorbidities with COVID-19 infection. In lammatory markers were signi icantly increased in 2 patients with cryoglobulinemia, as opposed to patients without the associated condition, with or without hepatitis C. In the third patient the levels of C reactive protein and erythrocyte sedimentation rate were similar to HCV positive patients.
Attention Deficit Hyperactivity Disorder (ADHD) is today one of the most relevant disorders in the clinical setting, not only because of its prevalence but also because of its high comorbidity with other diseases. Its peculiar characteristics undoubtedly represent a risk factor, which explains the connection with the use of addictive substances. This report aims to show the link between ADHD and substance use since both pathologies show significant interactions. This was possible to observe thanks to the neuropsychological deficits of the subjects with ADHD, such as impulsivity, lack of inhibitory control and emotional regulation difficulties, which interfere in aspects as significant as social behavior. Both evaluation and treatment represent a considerable challenge that requires exhaustive information as part of a differential diagnosis. The combination of adequate therapeutic strategies linked to correct pharmacological treatment represents an essential target in today's clinic.
Most of the studies on the COVID-19 pandemic produced by the SARS-CoV-2 reported neuropsychiatric symptoms only as part of the manifestations of the disease in its terminal phase. However, there are neuropsychiatric symptoms since the beginning of the disease. Several investigations have indicated a direct relationship between chronic diseases such as human immunodeficiency virus (HIV), tuberculosis, SARS, MERS, Ebola and SARS 2003 with mental disorders such as depression. Neuropsychiatric disorders can occur due to different mechanisms, such as cerebral hypoxia, cytokine storm due to exaggerated immune response and encephalitis due to direct brain infection. Nervous system involvement leads to poor prognosis of COVID-19.
