Potential of wild plant Artemisia judaica L. as sustainable source of antioxidant and antimicrobial compounds

Artemisia judaica L. (Shih Balady, family Asteraceae), is a medicinal plant that grows in the desert, commonly used as tea by population in Egypt Sinai and of Saudi Arabia. The present study aims to evaluate antimicrobial and antioxidant activities of aerial parts of A. judaica collected from the inland desert (Wadi Hagoul) of Egypt. Total phenolics, tannins, alkaloids, flavonoids, and saponins were measured in the plant of interest. According to the reduction of DPPH the anti-oxidant activity was measured. Different extracts of A. judaica were screened for their antimicrobial activity against nine pathogenic microorganisms using filter paper disc assay. The secondary metabolites of A. judaica were examined and proved that it was rich in tannins and phenolics (13.29 and 7.62 mg/g dw). The IC50 values of A. judaica extract was 1.78 mg.ml-1 compared to standard catechol (0.15 mg.ml-1). In the present study, the extracts of A.  judaica showed unusual activity depending on the type of bacteria and fungi. Also, ethyl acetate and methyl alcohol extracts showed considerable broad spectrum (77.78%, each) against both bacteria and fungi, followed by acetone, then methylene chloride and petroleum ether extracts. This study showed that A. judaica extracts could be used as antimicrobial substances in pharmaceutical and food preservation systems

Management of neuropathic bladder secondary to spina bifida: Twenty years' experience with a conservative approach

IntroductionTreatment of neuropathic bladder secondary to spina bifida is an ongoing challenge. Although different management strategies and protocols are available in the literature, reliance on expert opinion remains fundamental. A conservative approach can be utilized, but patients must be closely monitored throughout the management process. The objective of this study was to review the management and outcomes of neuropathic bladder in spina bifida by appraising long-term bladder and renal function in patients treated at a medical center utilizing a conservative management style.MethodsThis is a single-center retrospective review of urology care for all spina bifida patients 5–19 years of age with a neuropathic bladder who attended follow-ups between April 2000 and April 2020. Only patients with more than 5 years of follow-up were included. Renal functions, continence and results of invasive video urodynamics (IUD) and any surgical interventions were recorded.ResultsSeventy-one patients (mean age = 10.5 years) were identified after exclusions. Bladder compliance between first and last IUDs increased significantly (p = 0.0056). Anticholinergic treatment was started at the first outpatient appointment. Intravesical botulinum toxin injection was the second line treatment in ten patients. 94% of patients had an end fill pressure below 40 cm H2O in their last IUD. 82% were socially continent (dry or occasional damp patches) with or without catheterisations at the age of 11.5 years. One patient in the cohort had bladder augmentation.ConclusionThe optimal management of neuropathic bladder secondary to spina bifida remains controversial. Bladder and renal functional outcomes can be improved with close monitoring and less invasive management

Patch repair of congenital diaphragmatic hernia is not at risk of poor outcomes

Purpose: Recurrence of congenital diaphragmatic hernia (CDH) was retrospectively evaluated after correction with or without a patch in an institution where tension-free repair is advocated. // Methods: Demographics and outcomes of patients with a postero-lateral CDH repaired (2000-2016) were analysed (univariate tests and binary logistic regression adjusting for time since start of study, gender, defect side, liver herniation, patch, surgical approach, absence of postero-lateral rim and length of follow-up). // Results: Of 203 patients, 107 received a patch (P), and 96 were not patched (NP). Groups were not different for gestational age birthweight, gender, defect side and minimally-invasive approach rate. Preoperative ECMO incidence (P:29.9% vs. NP:2.1%, p<0.01), liver herniation (P:57.0% vs. NP:22.9%, p<0.01) and absence of a postero-lateral rim (P:61.7% vs. NP:8.3%, p<0.01) were higher in the P group. The mortality rate was 10.8% (P:15.0% vs. NP:6.2%, p=0.07). Recurrence was not different (P:9.3% vs. NP:4.2%, p=0.15). Multivariate analysis showed that recurrence was higher after thoracoscopy compared to open (OR=12.2 [2.2-68], p<0.01); neither the use of patch (OR=2.3, [0.5-10.4], p=0.28) nor any other factors were associated with recurrence. // Conclusion: In this single centre series where tension-free repair was advocated, patch repair of CDH was not associated with higher recurrence, though access route was

Do the clinical practice guidelines for paediatric dentistry meet the quality standards? A meta‐research and quality appraisal using the AGREE II tool

Background: Clinical practice guidelines (CPGs) enhance health care and aid clinicians' decisions. Aim: To evaluate the quality of clinical guidelines in paediatric dentistry using the AGREE II tool. Design: PubMed, EMBASE, Scopus, LIVIVO, Lilacs, international guidelines websites, scientific societies, and gray literature were searched until September 2021. We included paediatric dental clinical guidelines and excluded drafts or guidelines for patients with special needs. Two independent reviewers performed quality assessment using the APPRAISAL OF GUIDELINES FOR RESEARCH & EVALUATION II (AGREE II) instrument. We calculated the mean overall domain scores (95% confidence interval) for each guideline. We used regression analysis to correlate the score of overall assessment and the six domains of AGREE II with guideline characteristics. Results: Forty‐four guidelines were included in this study. Highest mean score was for Domain 4 (Clarity of Presentation; 58%, 95% CI: 50.8–64.9), whereas the lowest was for Domain 5 (Applicability; 16%, 95% CI: 10.8–21.4). The reporting quality was improved in Domains 1–5 with reporting checklists (p < .001), whereas that of Domain 6 was improved by decreasing years since publication (p = .047). Conclusion: Paediatric dental guidelines do not comply with the methodological quality standard, especially in Domain 5 (Applicability). The AGREE reporting checklist should be implemented with a system to evaluate the certainty of evidence for future guidelines

Frequency and risk factors of bronchopulmonary dysplasia in low-birth-weight infants in Saudi Arabia: a 5-year experience

Background: Due to improved survival of extremely low-birth-weight (ELBW) infants, the frequency of bronchopulmonary dysplasia (BPD) has remained unchanged or even increased.  Objective: To study the frequency as well as the perinatal and neonatal risk factors of moderate-to-severe BPD and its related mortality in low-birth-weight (LBW) infants in a single-center study over 5 years in the Kingdom of Saudi Arabia (KSA).  Methods: A total of 461 LBW infants’ files with gestational age (GA) ≤ 32 weeks that met the inclusion criteria were retrospectively reviewed. Maternal and neonatal characteristics were evaluated. Furthermore, the hospital course of management of LBW infants and outcomes of mortality and morbidity were recorded.  Results: The overall mortality rate in LBW and ELBW infants was 19.52% and 38.62%, respectively. At 36 weeks’ corrected GA, the total BPD frequency in LBW and ELBW infants was 9.87% and 32%, respectively. BPD(+) cases had a lower mean GA and birth weight than BPD(-) cases, 26 ± 2.68 weeks, 830 ± 340 grams and 29 ± 2.56 weeks, 1,395 ± 470 grams, respectively (p < 0.0001). The BPD(+) group had a significantly higher maternal chorioamnionitis infection rate, 8/39 (20.51%), than the BPD(-) group, 25/356 (7.02%) (p = 0.004), higher late-onset sepsis (11 [28.21%] and 54 [15.17%], p = 0.04). BPD(+) cases had a significantly higher risk of intubation in the delivery room, more frequently more than one dose of pulmonary surfactant, more invasive ventilation on day 1 and day 7, more days on oxygen therapy, more days on invasive and non-invasive ventilatory support, more days of hospitalization (115.41 ± 92.14 days compared to 43.72 ± 27.98 days in BPD[-]; all p < 0.0001).  Conclusion: ELBW infants had a 2-fold higher rate of mortality and a 3-fold higher rate of BPD, compared with LBW infants. The frequency of BPD increased with low GA/birth weight and BPD(+) cases had a higher risk for intubation in the delivery room, received more frequently more than one dose of pulmonary surfactant, remained for more days on either invasive or non-invasive ventilatory support, and had longer hospital stays

Do the clinical practice guidelines for paediatric dentistry meet the quality standards? A meta-research and quality appraisal using AGREE II tool

Clinical Practice Guidelines (CPGs) are recommendations for health care providers and a method to close the know-do gap, transferring the knowledge from academic research to the clinician. The proposal of this meta-research is to assess the quality of published clinical practice guidelines in Pediatric Dentistry using AGREE II instrument

Selective outcome reporting (SOR) in pediatric dentistry restorative treatment randomized clinical trials - a meta-research

ackground Selective outcome reporting (SOR) is a bias that occurs when the primary outcome of a randomised clinical trial (RCT) is omitted or changed. Aim We evaluated the prevalence of SOR in RCTs on restorative treatment in primary teeth. Design We conducted an electronic search on ClinicalTrials.gov and the World Health Organisation platform (International Clinical Trials Registry Platform) on 1st April/2021 with no time or language restrictions. We included RCT protocols that evaluated restorative treatments in primary teeth and excluded trials that did not have a complete publication in a scientific journal. The Chi-square test was used to identify the association between SOR and variables as a discrepancy in the follow-up period, timing of registration, type of sponsorship, and study design (α=5%). Results Of the 294 identified protocols, 30 were included in the study. 83.3% of trials were registered retrospectively. SOR was observed in 53.3% (n=16) of the published trials and was significantly associated with a discrepancy in the follow-up period (p=0.017). Conclusion The high prevalence of SOR in restorative treatment RCTs proves that this is a prominent threat. A proper pre-registered protocol, declaration of any protocol deviation, and allowing stakeholders to compare the protocol with the submitted papers will achieve transparency