Evaluation of fluoride release and mechanical properties of different glass ionomers

OBJECTIVE: To assess the fluoride release and mechanical properties of four restorative glass ionomer cements (GIC) and to determine the correlation between the mechanical properties and fluoride release. MATERIALS AND METHODS: Four restorative glass ionomers were studied: ChemFil ROCK (DENSPLY), Fuji IX (GC), Riva self cure (SDI), and Ketac Nano (3M ESPE). Fluoride release in deionized water from the tested specimens was measured using a fluoride-selective ion electrode for 9 days. The compressive strengths and diametral tensile strengths after storing in distilled water (room temperature, 24) were tested. Glass ionomer surface wear by dental ceramic (Vita Mark II cylinders) was evaluated by a depth micro analyzer. Data were analyzed using ANOVA followed by Tukey’s test or Bonferroni method (p= 0.05). RESULTS: The fluoride release exhibited high concentration, following by a significant drop on the second day. Fuji IX had the highest fluoride release followed by “Ketac”,” Riva”, and “ChemFil”. Compressive strength results ranked that ChemFil as the highest value, followed by Fuji IX, Ketac, and Riva. The diametral tensile strength test ranked ChemFil and Ketac as the highest values. Surface ear against dental ceramic (Vita Mark II cylinders) revealed that Fuji IX had the lowest material loss, followed by Ketac, ChemFil, and Riva. Data showed significant differences between all of them. After coating the glass ionomer, the surface wear loss was reduced significantly in Riva and ChemFil. CONCLUSIONS: The tested restorative glass ionomers showed differences in fluoride release and the differences decreased over time, with Fuji IX releasing the highest amount of fluoride ion. ChemFil Rock showed the highest mechanical properties but the lowest fluoride release. Riva self cure had the highest material loss value in wear test. There was a weak inverse correlation between fluoride release and compressive strength (r = - 0.32); fluoride release and diametral tensile strength (r = - 0.60), and fluoride release and surface wear against dental ceramic (Vita Mark II cylinders) (r = - 0.55)

Metabolic, Endocrine, and Immune Consequences of Sleep Deprivation

Over the last three to four decades, it has been observed that the average total hours of sleep have decreased to less than seven hours per person per night. Concomitantly, global figures relating to obesity and diabetes mellitus have increased in an alarming fashion in adults and children, and it has been hypothesized that neuro-hormonal changes accompanying this behavioral sleep deprivation may lead to insulin resistance and, subsequently, to diabetes mellitus. Sleep deprivation has been associated with multiple physiological changes, including increased cortisol and ghrelin levels, decreased leptin levels and impaired glucose metabolism. Experimental studies have also shown an increase in inflammatory and pro-inflammatory markers, which are indicators of body stress, under sleep deprivation. This review elaborates further on this hypothesis, exploring the molecular basis for the link between both entities and the underlying pathophysiology that results in insulin resistance and diabetes mellitus. We review the results of experimental and epidemiological studies, specifically examining the relationship between sleep duration and the immune and endocrine systems

Sleep-related breathing disorders in obese patients presenting with acute respiratory failure

SummaryIntroduction: The study was conducted to assess the clinical and polysomnographic characteristics of patients with sleep-related breathing disorders who presented to the intensive care unit (ICU) with acute respiratory failure and the practicability of performing polysomnography for such patients.Material and methods: We analyzed clinical presentation, cause of admission to the ICU, ICU course and outcome of 11 subjects with acute respiratory failure who were diagnosed to have sleep disordered breathing based on polysomnography between October 1999 and January 2003. Subjects were compared to 11 patients with obstructive sleep apnea syndrome matched to each subject using body mass index, age and apnea hypopnea index measured at the time of diagnosis (matched comparison group). Repeated arterial blood gases and polysomnography were done for 8 subjects compliant to treatment 6–8 months after discharge from ICU.Results: The reason for ICU admission for all subjects was hypercapnic respiratory failure. pH and daytime PaO2 were significantly lower in studied subjects compared to the matched comparison group while awake daytime PaCO2 was significantly higher. Subjects had frequent episodes of hypoventilation. Follow up arterial blood gases and polysomnography 6–8 months after treatment (non-invasive ventilation) in compliant subjects showed significant improvement in all blood gases parameters.Conclusions: Early polysomnography (or portable cardio-respiratory monitoring) allows accurate diagnosis and institution of the appropriate ventilation method Further studies should assess the evolution of respiratory drive in patients with sleep disordered breathing and hypercapnia under therapy (non-invasive ventilation)

Current clinical practice for the use of hypnotics to manage primary insomnia in adults in a tertiary hospital in Saudi Arabia: an audit study

Despite the risks associated with hypnotics and their recent increased use in Saudi Arabia, there are no specific national guidelines for using these medicines to treat insomnia nor are there any data on how these medicines are currently prescribed. There is the potential, however, that some physicians might be adhering to the US guidelines. The current audit study was aimed to assess the current practice in treating insomnia with hypnotics in Saudi Arabia, and to evaluate its agreement with the US guidelines. The audit was conducted using data collected between April 2012 and March 2017 at King Fahad Central Hospital (KFCH; Jazan), of patients who were either prescribed benzodiazepines (BZDs) or Z-drugs or diagnosed with insomnia. The audit criteria followed two US guidelines for the management of insomnia in adults. Data included documented diagnosis, use of CBT-I (Cognitive Behavioral Therapy for Insomnia), use of BZDs and Z-drugs including treatment regimen, and whether physicians prescribed anti-histamines for insomnia. The data were analyzed using STATA 14 after transcription to a MS XL file. Of the 504 records reviewed, 379 patients (75%) were prescribed BZDs or Z-drugs; only 182 (48%) of them had clearly documented indications for their use. Three hundred and seven patients (60%) were diagnosed with insomnia; none of them received CBT-I as initial treatment. No patients on long-term use of hypnotics were reviewed by their physicians after they began using the medication. More than 43% of patients were prescribed anti-histamines for insomnia. No records met all (or even six) of the seven criteria. KFCH physicians do not follow US guidelines. Therefore, the Ministry of Health (MOH) should improve its administrative systems including documentation, and instead of using international guidelines that are seldom followed, physicians should be trained in prescribing hypnotics and national guidelines need to be developed

Using benzodiazepines and Z-Drugs for managing primary insomnia in adults in Saudi Arabia: an e-Delphi study to aid the development of clinical guidelines

Purpose: To obtain consensus statements required for the development of clinical guidelines for the use of benzodiazepines (BZDs) and Z-drugs for the management of primary insomnia in adults in Saudi Arabia. Methods: Three rounds of the e-Delphi technique using a Bristol Online Survey (BOS) were conducted between May and August 2018. The Director of the Saudi Sleep Medicine Group helped recruit the country’s sleep medicine experts. Snowballing was used to forward invitation emails, information sheets and the survey to known sleep medicine experts and physicians deemed to be interested in the field. All participants’ details were anonymized except to the researcher. Results: Fifteen experts from four different regions and specialities in Saudi Arabia participated in Round 1. Twenty-one statements originated from participants’ responses. In Round 2, there were 17 respondents and 16 of the statements obtained the required consensus of 70% or higher. Eleven experts participated in Round 3 and eight statements received 100% agreement, two received 91%, and six received 82%. Having obtained the required consensus of 80% or higher in Round 3, these 16 statements fulfilled the criteria to be included in future guidelines. The five statements that failed to attain the required consensus were rejected as inappropriate for inclusion in Saudi Arabian clinical guidelines. Conclusions: The items that achieved the required consensus can be included in future guidelines for the use of BZDs and Z-drugs in the treatment of primary insomnia in adults to standardize best practices in sleep medicine in Saudi Arabia

The Saudi Households’ Requirements of Dwelling Unit’s Components: A Case Study of Riyadh

Abstract Due to the large number of dwelling’s components and their big sizes, the size of a single-family dwelling in Saudi Arabia is big, which leads it to high costs. Such phenomenon has been shaped by the society during the period of economic ease, when easy access to free grants of residential plot and affordable Real Estate Development Fund loans were available, which later has been continued through the regulations of land division and building. The study aims to determine the real needs (of the dwelling’s components, their number, and their areas), of the Saudi households who are wishing to own a dwelling in the city of Riyadh, within the limits of their financial ability. An easy-to-use mobile interactive tool was used for data collection, enabling participants to define their preferences for dwellings’ components, and easily modify them, to reach their exact needs within their financial ability. The finding showed that the average area of residential plot needed to build a prototype dwelling that achieve the participants’ needs is (55%) of the required plot area required for small single-family dwelling in the city of Riyadh, and that the average built-up area needed to provide all dwelling’s components is (59%) of the built-up area of small single-family dwelling at the housing market, while the average cost of the prototype dwelling that meets the household’s needs is equal (5 years) of the household income from salaries, while the average cost of a small single-family dwelling in the housing market is equal (10 years) of the household income

Restless leg syndrome in multiple sclerosis: a case–control study

ObjectivesThis study assessed the prevalence of restless leg syndrome (RLS) among patients with multiple sclerosis (pwMS) and the association between RLS and MS disease duration, sleep disturbance, and daytime fatigue.MethodsIn this cross-sectional study, we interviewed 123 patients via phone calls using preset questionnaires containing the International Restless Legs Syndrome Study Group (IRLSSG) diagnostic criteria, Pittsburgh Sleep Quality Index (PSQI), and Fatigue Severity Scale (FSS) diagnostic criteria validated in both Arabic and English. The prevalence of RLS in MS was compared to a group of healthy controls.ResultsThe prevalence of RLS in pwMS, defined by meeting all four requirements included in the IRLSSG diagnostic criteria, was 30.3% compared to 8.3% in the control group. About 27.3% had mild RLS, 36.4% presented with moderate, and the remaining had severe or very severe symptoms. Patients with MS who experience RLS had a 2.8 times higher risk of fatigue compared to pwMS without RLS. pwMS with RLS had worse sleep quality, with a mean difference of 0.64 in the global PSQI score. Sleep disturbance and latency had the most significant impact on sleep quality.ConclusionThe prevalence of RLS among MS patients was significantly higher compared to the control group. We recommend educating neurologists and general physicians to increase their awareness of the increasing prevalence of RLS and its association with fatigue and sleep disturbance in patients with MS

Per3 length polymorphism in patients with type 2 diabetes mellitus

BACKGROUND: A number of observations support the involvement of circadian clock genes in the regulation of metabolic processes. One of these circadian genes, Per3, exhibits a variable number tandem repeat length polymorphism, consisting of two alleles, namely four and five repeat alleles, in its exon 18. The objective of this study was to examine the existence of Per3 variants in patients with type 2 diabetes mellitus (T2DM) as compared to a non T2DM control group. METHODS: Intravenous blood samples were collected to obtain white blood cells from 302 T2DM patients and 330 non-diabetic, age- and sex-matched, individuals. Per3 genotyping was performed on DNA by polymerase chain reaction. RESULTS: Frequency of five repeat allele was higher, and that of four repeat allele lower, in T2DM patients as compared to non-diabetic controls (χ2=6.977, p=0.0082) CONCLUSIONS: The results indicate an association of Per3 five repeat allele with T2DM occurrence and suggest that individuals with five repeat allele may be at a greater risk for T2DM as compared to those carrying the four repeat allele.Fil: Karthikeyan, Ramanujam. Madurai Kamaraj University. School of Biological Sciences. Department of Animal Behaviour and Physiology; IndiaFil: Marimuthu, Ganapathy. Madurai Kamaraj University. School of Biological Sciences. Department of Animal Behaviour and Physiology; IndiaFil: Sooriyakumar, Murugesan. Madurai Medical College. Department of Medicine; IndiaFil: BaHammam, Ahmed S.. King Saud University. College of Medicine; Arabia SauditaFil: Spence, David Warren.Fil: Pandi Perumal, Seithikurippu R.. Somnogen Canada; CanadáFil: Brown, Gregory M.. University of Toronto; CanadáFil: Cardinali, Daniel Pedro. Pontificia Universidad Católica Argentina "Santa María de los Buenos Aires". Facultad de Ciencias Médicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Melatonin and Human Cardiovascular Disease

The possible therapeutic role of melatonin in the pathophysiology of coronary artery disorder (CAD) is increasingly being recognized. In humans, exogenous melatonin has been shown to decrease nocturnal hypertension, improve systolic and diastolic blood pressure, reduce the pulsatility index in the internal carotid artery, decrease platelet aggregation, and reduce serum catecholamine levels. Low circulating levels of melatonin are reported in individuals with CAD, arterial hypertension, and congestive heart failure. This review assesses current literature on the cardiovascular effects of melatonin in humans. It can be concluded that melatonin deserves to be considered in clinical trials evaluating novel therapeutic interventions for cardiovascular disorders.Fil: Pandi Perumal, Seithikurippu R.. King Saud University; Arabia SauditaFil: BaHammam, Ahmed S.. King Saud University; Arabia SauditaFil: Ojike, Nwakile I.. King Saud University; Arabia SauditaFil: Akinseye, Oluwaseun A.. University of New York; Estados UnidosFil: Kendzerska, Tetyana. Sunnybrook Health Sciences Center; CanadáFil: Buttoo, Kenneth. Sleep Disorders Center; CanadáFil: Dhandapany, Perundurai S.. Oregon Health And Science University; Estados UnidosFil: Brown, Gregory M.. University of Toronto; CanadáFil: Cardinali, Daniel Pedro. Pontificia Universidad Católica Argentina ; Argentin