Knowledge and Attitude of Oral Health Professionals in the Management of Avulsed Teeth

Objectives: The purpose of this study is to assess the knowledge and to compare the attitude and management of tooth avulsion between the general dentist and the specialist all with dental interns.  Materials and Methods:16-point questionnaires have been developed to a similar study and have been validated by a group of specialist.  The first part of the survey contained demographic data. The second part consisted of eight questions checking dentists’ knowledge on the treatment of avulsed teeth. All in which took part in Saudi Arabia, Riyadh and covered 311 dentists. Data were analyzed with SPSS program version 21Results: 583 questionnaires have been distributed and a total of 311 were collected. Which consisted 53.34% of distributed surveys. Almost two-third (219) of the surveyed populations have never treated any patient with dental avulsion. Amongst those who had such experience, the majority treated at least one case (35.9%), there were also 22 (23.9%) dentist who treated more than 5 avulsed teeth. 25 of 311 dentist have never received education or training in the management of tooth avulsion. Conclusion: there is a need to familiarize oral health professions with the needed knowledge and management of avulsion through lectures and proper training. Keywords: Avulsion; knowledge; management; oral professional; denta

Enhanced protein-energy provision via the enteral route in critically ill patients: a single center feasibility trial of the PEP uP protocol

INTRODUCTION: The purpose of this pilot study is to assess the feasibility, acceptability, and safety of a new feeding protocol designed to enhance the delivery of enteral nutrition (EN). METHODS: In a prospective before and after study, we evaluated a new protocol compared to our standard feeding protocol. Innovative elements of the new protocol included setting daily volume based goals instead of hourly rate targets, initiating motility agents and protein supplements on Day 1, liberalizing the gastric residual volume threshold, and the option to use trophic feeds. Bedside nurses filled out questionnaires to assess the acceptability of the new approach and we assessed patients' nutritional and clinical outcomes. RESULTS: We enrolled 20 mechanically ventilated patients who stayed in the Intensive Care Unit for more than three days in the before group and 30 such patients in the after group. On a scale where 1 = totally unacceptable and 10 = totally acceptable, 30 nurses rated the new protocol as 7.1 (range 1 to 10) and no incidents compromising patient safety were observed. In the before group, on average, patients received 58.8% of their energy and 61.2% of their protein requirements by EN compared to 67.9% and 73.6% in the after group (P = 0.33 and 0.13). When the subgroup of patients prescribed to receive full volume feeds in the after group were evaluated (n = 18), they received 83.2% and 89.4% of their energy and protein requirements by EN respectively (P = 0.02 for energy and 0.002 for protein compared to the before group). The rates of vomiting, regurgitation, aspiration, and pneumonia were similar between the two groups. CONCLUSIONS: This new feeding protocol seems to be safe and acceptable to critical care nurses. The adoption of this protocol may be associated with enhanced delivery of EN but further trials are warranted to evaluate its effect on nutritional and clinical endpoints. TRIAL REGISTRATION: ClinicalTrials.gov NCT0110234

Pharmacological Inhibition of Caspase and Calpain Proteases: A Novel Strategy to Enhance the Homing Responses of Cord Blood HSPCs during Expansion

Background: Expansion of hematopoietic stem/progenitor cells (HSPCs) is a well-known strategy employed to facilitate the transplantation outcome. We have previously shown that the prevention of apoptosis by the inhibition of cysteine proteases, caspase and calpain played an important role in the expansion and engraftment of cord blood (CB) derived HSPCs. We hypothesize that these protease inhibitors might have maneuvered the adhesive and migratory properties of the cells rendering them to be retained in the bone marrow for sustained engraftment. The current study was aimed to investigate the mechanism of the homing responses of CB cells during expansion. Methodology/Principal Findings: CB derived CD34 + cells were expanded using a combination of growth factors with and without Caspase inhibitor-zVADfmk or Calpain 1 inhibitor- zLLYfmk. The cells were analyzed for the expression of homingrelated molecules. In vitro adhesive/migratory interactions and actin polymerization dynamics of HSPCs were assessed. In vivo homing assays were carried out in NOD/SCID mice to corroborate these observations. We observed that the presence of zVADfmk or zLLYfmk (inhibitors) caused the functional up regulation of CXCR4, integrins, and adhesion molecules, reflecting in a higher migration and adhesive interactions in vitro. The enhanced actin polymerization and the RhoGTPase protein expression complemented these observations. Furthermore, in vivo experiments showed a significantly enhanced homing to the bone marrow of NOD/SCID mice

Playerunknown\u27s battlegrounds: Yet another internet gaming addiction

The overarching goal of video games is to amuse the end-users by means of interactive systems that are now existent across numerous platforms such as personal computer, mobile phones, tablets and game consoles. Player Unknown\u27s Battlegrounds (PUBG) is a multiplayer online game. The addiction of PUBG is soaring worldwide and it has thick user-base. It is suggested that inhuman attitudes such as lack of empathy and war-related sentiments are likely to emerge among children who play aggressive and violent games like PUBG. In 2018, World Health Organisation (WHO) acknowledged online gaming compulsion as a grave mental health problem. Some of the well-known repercussions of playing PUBG video game are eyes strain, exhaustion, headache, obesity, poor quality of sleep, insomnia, withdrawal symptoms (rage and irritability) and even drug abuse owing to compulsive disorder. This game craze is unfortunately triggering world\u27s young population to invest their valuable time, money and effort in a no-return business, and therefore needs urgent measures

Efficient content caching for 5G assisted vehicular networks

Abstract Traffic congestion is one of the major challenges faced by daily commuters in smart cities. An autonomous transportation system with a 5 G-based Cellular Vehicle-to-Everything (C-V2X) communication system is the solution to meet the traffic challenges faced in smart cities. Vehicular networks provide wireless connectivity to enable a large number of connected vehicle applications. Vehicular networks allow vehicles to share their emergency and infotainment traffic by following vehicle-to-vehicle (V2V) or by using vehicle-to-infrastructure (V2I) communication. The infrastructure of vehicular networks mainly comprises multiple Road Side Units (RSUs). Fog computing nodes are placed adjacent to these RSUs to provide quick access to vehicles. For infotainment traffic, vehicles intend to download their required content from the content provider. Caching the same contents from the nearby fog computing node significantly reduces delay with improved quality of service. As there are millions of contents with varying sizes, caching all demanded contents on these fog nodes is not possible due to their limited caching capacity. In this work, we propose an improved content caching scheme for fog nodes to satisfy vehicles and content providers for fair content placement. The proposed algorithm is based on a modified Gale–Shapley technique that considers factors such as content popularity, vehicle connectivity, and quality of the communication channel to optimize the content caching process. Simulation results show that the proposed technique caches a higher number of popular contents with lower downloading time

Beliefs, awareness, use, and factors associated with herbal supplements usage among patients with chronic diseases-A cross-sectional insight from Alkharj, Saudi Arabia.

BackgroundHerbal supplements (HSs) are used to treat a variety of diseases and ailments. Individuals with chronic diseases are at a higher risk of having adverse events and drug interactions from the use of HSs.AimThis study determined the beliefs, awareness, use, and factors associated with HSs usage among patients with chronic diseases in Alkharj, Saudi Arabia.MethodA cross-sectional study was conducted among patients with chronic diseases between February and June 2019. Face-to-face interviews were conducted at various out-patient clinics in different hospitals. Patients diagnosed with chronic diseases were included in the study. Data were analyzed by descriptive, comparative, and inferential statistics using SAS ver. 9.4.ResultsThe study participants were consisted of 533 patients, with mean age 53.6 ±12.9 years. The most prevalent chronic diseases were diabetes mellitus (67.7%), followed by hypertension (54.8%), and hyperlipidemia (53.8%). Among the studied participants, 336 (63%) had used at least one HS, whereby the most commonly used HSs were ginger (74.7%), mint (72%), and cumin (66.7%). Almost 78% of HSs users did not consult any healthcare provider about their use. HSs use varied significantly between female and male participants (pConclusionThe results of this study showed that HSs usage was high among patients with chronic diseases in Saudi Arabia. Concurrent usage of HSs with drugs should be well-discussed with healthcare providers to avoid potential adverse events or drug interactions especially among patients with chronic diseases

Influence of lip position on esthetics perception with respect to profile divergence using silhouette images

Abstract Background The aim of the study was to determine the facial divergence and lip position combinations that are most and least preferred, and to investigate whether age or gender has an impact on these preferences. Methods The current investigation was carried out on a sample of 1077 individuals who were not experts in the field (253 men and 824 females). The research employed black silhouette photographs of profiles featuring different lip locations and profile divergences. The recruitment of participants was conducted in order to assess the attractiveness of the profiles, employing a Likert scale. The various positions of the lips and variations in facial profiles were thoroughly categorized. Results were analyzed using the Chi-square test. Results The findings of the research demonstrated that aesthetic perceptions displayed diversity when considering different lip locations and profile divergences. It was shown that neutral lip positions were predominantly favored, accounting for approximately 40.2% of the total frequencies in the anterior diverging group. It is noteworthy to highlight the aesthetically pleasing features exhibited by those with the most prominent lip position, occurring at a frequency of 10.9% in straight-diverging group. In the posterior divergent group, the most protruded lip position, showed very attractive aesthetics with frequency (7.1%). Gender, age, region, and level of education had significant influence on aesthetic perception. Conclusions The variety of aesthetic preferences is influenced by the location of the lips and the divergence of the facial profile, resulting in different outcomes within the categories of anterior, straight, and posterior divergence. Clinicians are advised to customize the treatment regimen in order to correspond with the unique desires and preferences of the patient

Resistance Patterns of Gram-Negative Bacteria Recovered from Clinical Specimens of Intensive Care Patients

Intensive care units are complex environments favoring high resistance in microorganisms. This study evaluated the resistance and the distribution dynamics of resistant Gram-negative bacteria (GNB) in patients admitted to intensive care units. This retrospective, record-based, cross-sectional study analyzed all of the antibiograms of patients admitted to the ICUs. The BD Phoenix system (BD Diagnostics, Sparks, MD, USA) was used for bacterial identification and antimicrobial testing. Clinical and Laboratory Standard Institute recommendations were used for antimicrobial testing. Frequencies and percentages of multidrug and pan-drug resistance were calculated. A total of 570 bacterial growths were observed, out of which 437 (76.7%) were of GNB. K. pneumoniae (21.0%), P. aeruginosa (11.8%), and Staphylococcus aureus (13.2%) were the most frequent disease-causing bacteria in intensive care patients. Resistance rates of 73.2% and 70.1% were observed for third- and fourth-generation cephalosporins, respectively, while 48.2% carbapenem and > 65% fluoroquinolones resistance rates were observed. Amikacin was the most effective antibiotic, with a sensitivity rate of 69.5%. A total of 372 (85.1%) of GNB were multidrug resistant. The majority of infections in intensive care patients are caused by multidrug-resistant (MDR) Gram-negative bacteria. Female gender and advancing age are factors favoring MDR. Enhanced surveillance and strengthening of the antimicrobial stewardship program are warranted