Access and utilisation of primary health care services comparing urban and rural areas of Riyadh Providence, Kingdom of Saudi Arabia

The Kingdom of Saudi Arabia (KSA) has seen an increase in chronic diseases. International evidence suggests that early intervention is the best approach to reduce the burden of chronic disease. However, the limited research available suggests that health care access remains unequal, with rural populations having the poorest access to and utilisation of primary health care centres and, consequently, the poorest health outcomes. This study aimed to examine the factors influencing the access to and utilisation of primary health care centres in urban and rural areas of Riyadh province of the KSA

Old World cutaneous leishmaniasis treatment response varies depending on parasite species, geographical location and development of secondary infection

Background: In the Kingdom of Saudi Arabia (KSA), Leishmania major and L. tropica are the main causative agents of Old World cutaneous leishmaniasis (CL). The national CL treatment regimen consists of topical 1% clotrimazole/2% fusidic acid cream followed by 1–2 courses of intralesional sodium stibogluconate (SSG); however, treatment efficacy is highly variable and the reasons for this are not well understood. In this study, we present a complete epidemiological map of CL and determined the efficacy of the standard CL treatment regime in several endemic regions of KSA. Results: Overall, three quarters of patients in all CL-endemic areas studied responded satisfactorily to the current treatment regime, with the remaining requiring only an extra course of SSG. The majority of unresponsive cases were infected with L. tropica. Furthermore, the development of secondary infections (SI) around or within the CL lesion significantly favoured the treatment response of L. major patients but had no effect on L. tropica cases. Conclusions: The response of CL patients to a national treatment protocol appears to depend on several factors, including Leishmania parasite species, geographical location and occurrences of SI. Our findings suggest there is a need to implement alternative CL treatment protocols based on these parameters

Evaluation of an experimental silane primer system in promoting adhesion between orthodontic bracket and ceramic

The aim of the study was to evaluate in vitro the effect of an experimental silane primer system on the adhesion strength of metallic orthodontic brackets bonded to a ceramic surface. For this purpose, a total of 180 glazed ceramic porcelain fused to metal (PFM) veneer were randomly assigned into 2 groups of 90 specimens, according to the primer used. Each group was further divided into 3 subgroups according to the surface treatment to be received, thus there were 6 study groups; three with 3-acryloxypropyltrimethoxysilane (ACPS) silane primer, namely 1a (pretreatment with hydrofluoric acid, HF), 1b (pretreatment with grit-blasting) and 1c (pretreatment with tribochemical silica-coating) and 3 with a novel silane system (ACPS+bis-1,2(triethoxysilyl) ethane (BTSE)) assigned as 2a (HF), 2b (grit-blast), and 2c (tribochemical silica coating). The samples were evaluated for surface roughness (Ra) before and after surface conditioning. Next, 15 samples from each subgroups were subjected to thermo-cycling and remaining 15 samples served as the baseline (n = 15). Adhesion strength (the shear bond strength, SBS) was recorded using a universal testing machine. Debonding failure types were classified according to the adhesive remnant index (ARI). Contact angles of the primers were measured. Data were analyzed by ANOVA and Tukey’s multiple comparison post hoc analysis. The highest SBS at baseline (26 8+1 7 MPa) and after thermocycling (24 6+1 7 MPa) was observed in group 2c, and the lowest (9 6+1 5 MPa and 4 5+1 1 MPa) was found in group 1a. Specimens pretreated with tribochemical silica-coating exhibited the highest Ra and the lowest Ra was observed in HF treated specimens. The application of experimental silane primer system on specimens pretreated with tribochemical silica-coating demonstrated increased adhesion of orthodontic brackets making it an excellent choice in orthodontic bonding for a relatively long term use

Feasibility Study of the Electrokinetic Remediation of a Mercury-Polluted Soil

This chapter is focused on the study of electroremediation of heavy metals from a real soil. Specifically, the case of the study was a soil from Almaden mining district, with a very high mercury concentration. The risk assessment of heavy metals depends on the mobility and bioavailability and not only on the total concentration. Therefore, this study evaluates the distribution of mercury into different fractions before and after the electrokinetic treatment. The electrokinetic experiments were performed in two operating scales that differ in more than two orders of magnitude. The results for both scales are consistent with the predictions of simple models, so it can be assumed that they are useful for the evaluation of a full-scale implementation. Two enhancing agents were studied in the application of electrokinetic process according to the mercury distribution in BCR fractions (Community Bureau of Reference). First, iodide was applied as complexing agent, and it was found that after treatment the most mobile fraction of mercury increased. Thus, to remove this mobile mercury fraction, electroremediation experiments were done with nitric acid as enhancing agent