CT SCAN IMAGES ANALYSIS OF MAXILLARY SINUS DIMENSIONS AS A FORENSIC TOOL FOR SEXUAL AND RACIAL DETECTION IN A SAMPLE OF KURDISH POPULATION

Despite the fact that the skull and other bones may be badly disfigured in victims who are incinerated, it became an urgent necessity to gender determination using maxillary sinuses as a useful tool of human skeletons in forensic medicine. The aim of the study: to determine the reliability and accuracy of maxillary sinus dimension measurement as a method for gender and racial identification through the use of reconstructed helical CT images. Material and Methods: This prospective study included cranial computerized tomography images (CT) of 119 (M: 57 and F: 62) of the Kurdish population of Sulaimani city of Iraq with an age range (20 - 75) years. All patients were examined on Spiral Computed Tomography Scanner from October 2014 to March 2015.The greatest measurements were taken from the width, length, and height of the maxillary sinuses. The descriptive and discriminate analyzes were performed by using the SPSS package program. Results The mean of the length, the width, and the height of maxillary sinus in males on both right and left sides were (35.90± 4.71, 36.63 ± 5.34) (25.74 ± 5.69 , 25.36 ± 6.03) and (32.86 ± 7.00 , 33.13± 6.87) mm, respectively but in females were (34.58 ± 4.21, 35.60 ± 3.94 ), (22.54 ± 4.74 and 21.53 ± 4.47) and (29.16 ± 7.20,29.25 ± 6.17 )mm respectively. The present study showed that the left maxillary sinus width was the best discrimination parameter, that could be used to study sex dimorphism with Prediction of 69.4% for female and 52.6% for male (overall accuracy = 61. 3%). The discriminative analysis showed that the accuracy of maxillary sinus measurements-i.e the ability of the maxillary sinus size to identify gender-was 71% in females and 56.1% of males (overall accuracy = 63.9%). Conclusion The study showed that the diameters of the maxillary sinus can be used as a guide and a useful tool for racial and sex determination

CT SCAN IMAGES ANALYSIS OF MAXILLARY SINUS DIMENSIONS AS A FORENSIC TOOL FOR SEXUAL AND RACIAL DETECTION IN A SAMPLE OF KURDISH POPULATION

Despite the fact that the skull and other bones may be badly disfigured in victims who are incinerated, it became an urgent necessity to gender determination using maxillary sinuses as a useful tool of human skeletons in forensic medicine. The aim of the study: to determine the reliability and accuracy of maxillary sinus dimension measurement as a method for gender and racial identification through the use of reconstructed helical CT images. Material and Methods: This prospective study included cranial computerized tomography images (CT) of 119 (M: 57 and F: 62) of the Kurdish population of Sulaimani city of Iraq with an age range (20 - 75) years. All patients were examined on Spiral Computed Tomography Scanner from October 2014 to March 2015.The greatest measurements were taken from the width, length, and height of the maxillary sinuses. The descriptive and discriminate analyzes were performed by using the SPSS package program. Results The mean of the length, the width, and the height of maxillary sinus in males on both right and left sides were (35.90± 4.71, 36.63 ± 5.34) (25.74 ± 5.69 , 25.36 ± 6.03) and (32.86 ± 7.00 , 33.13± 6.87) mm, respectively but in females were (34.58 ± 4.21, 35.60 ± 3.94 ), (22.54 ± 4.74 and 21.53 ± 4.47) and (29.16 ± 7.20,29.25 ± 6.17 )mm respectively. The present study showed that the left maxillary sinus width was the best discrimination parameter, that could be used to study sex dimorphism with Prediction of 69.4% for female and 52.6% for male (overall accuracy = 61. 3%). The discriminative analysis showed that the accuracy of maxillary sinus measurements-i.e the ability of the maxillary sinus size to identify gender-was 71% in females and 56.1% of males (overall accuracy = 63.9%). Conclusion The study showed that the diameters of the maxillary sinus can be used as a guide and a useful tool for racial and sex determination

Traditional knowledge of wild edible plants used in Palestine (Northern West Bank): A comparative study

<p>Abstract</p> <p>Background</p> <p>A comparative food ethnobotanical study was carried out in fifteen local communities distributed in five districts in the Palestinian Authority, PA (northern West Bank), six of which were located in Nablus, two in Jenin, two in Salfit, three in Qalqilia, and two in Tulkarm. These are among the areas in the PA whose rural inhabitants primarily subsisted on agriculture and therefore still preserve the traditional knowledge on wild edible plants.</p> <p>Methods</p> <p>Data on the use of wild edible plants were collected for one-year period, through informed consent semi-structured interviews with 190 local informants. A semi-quantitative approach was used to document use diversity, and relative importance of each species.</p> <p>Results and discussion</p> <p>The study recorded 100 wild edible plant species, seventy six of which were mentioned by three informants and above and were distributed across 70 genera and 26 families. The most significant species include <it>Majorana syriaca, Foeniculum vulgare, Malvasylvestris</it>, <it>Salvia fruticosa, Cyclamen persicum, Micromeria fruticosa, Arum palaestinum, Trigonella foenum-graecum</it>, <it>Gundelia tournefortii</it>, and <it>Matricaria aurea</it>. All the ten species with the highest mean cultural importance values (mCI), were cited in all five areas. Moreover, most were important in every region. A common cultural background may explain these similarities. One taxon (<it>Majoranasyriaca</it>) in particular was found to be among the most quoted species in almost all areas surveyed. CI values, as a measure of traditional botanical knowledge, for edible species in relatively remote and isolated areas (Qalqilia, and Salfit) were generally higher than for the same species in other areas. This can be attributed to the fact that local knowledge of wild edible plants and plant gathering are more spread in remote or isolated areas.</p> <p>Conclusion</p> <p>Gathering, processing and consuming wild edible plants are still practiced in all the studied Palestinian areas. About 26 % (26/100) of the recorded wild botanicals including the most quoted and with highest mCI values, are currently gathered and utilized in all the areas, demonstrating that there are ethnobotanical contact points among the various Palestinian regions. The habit of using wild edible plants is still alive in the PA, but is disappearing. Therefore, the recording, preserving, and infusing of this knowledge to future generations is pressing and fundamental.</p

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Vitamin D Status and Its Association with Multiple Intelligence among Arab Adolescents

Studies investigating the association of vitamin D on intelligence is limited. The present study therefore aims to determine the association of vitamin D status with the different domains of intelligence among Saudi Arabian adolescents. This study used relational survey method among 1864 Saudi adolescent, including 549 boys and 1315 girls (mean age 14.7 &plusmn; 1.7 years) recruited using a multistage, stratified cluster randomization of 47 public and private schools in Riyadh in Saudi Arabia. A general questionnaire was used to collect demographic information. Intelligence was assessed using multiple intelligence inventory. Anthropometrics were measured and fasting blood samples collected for assessment of glucose and lipid profile. Vitamin D deficiency (25(OH)D &lt;50 nmol/L) was observed in 84.2% of boys and 93.5% of girls. Girls had higher levels of verbal, kinesthetic, musical, naturalist and existential intelligence than boys, while boys have higher logical intelligence than girls (p-values &lt; 0.05). Mixed regression analysis controlled for age, BMI and sex revealed that kinesthetic intelligence was significantly associated with 25(OH)D in boys (&beta; 5.6 (2.8&ndash;8.5; p &lt; 0.001)) and inversely associated with musical intelligence (&beta; &minus;1.2 (&minus;2.3&ndash;0.1; p = 0.03)) and positively with naturalist (&beta; 2.3 (0.5&ndash;4.2; p = 0.01)) in girls. Vitamin D status is associated with several domains of intelligence in adolescents and is sex-specific. Development a specific domain of intelligence may indirectly affect vitamin D status among adolescents, but needs to be proven prospectively

Effectiveness of mobile phone applications in improving oral hygiene care and outcomes in orthodontic patients

Objectives: To assess the effectiveness of mobile phone applications in improving oral hygiene care and oral health outcomes in patients undergoing fixed orthodontic treatment. Materials and methods: PUBMED/MEDLINE, CINAHL, EMBASE, COCHRANE, PROQUEST, Google Scholar, and Web of Science were systematically searched for original studies published between January 2000 and March 2020. The eligibility criteria being: (i) observational study [cross-sectional, case-control, cohort study, or RCTs] that reported mobile phone application as an intervention or exposure for oral hygiene care. Standard Protocol Items Recommendations for Interventional Trials (SPIRIT) statement was used for quality assessment of interventional studies. The comprehensive search strategy yielded 154 studies after the removal of duplicates. Based on eligibility criteria only 5 studies were included in the data extraction phase. Results: This review finds that smartphone applications have a significant short term effect in the improvement of oral hygiene when measured using plaque index and gingival index scores. The mean plaque index and gingival index reduced significantly in three out of five studies. The intervention groups [62%] had a lower level of plaque at a 12-week interval as compared to the control group [72%]. Short term follow-ups showed greater improvement in oral hygiene following smartphone application administration. Conclusion: Within the available evidence, a recommendation can be made for the use of mobile applications in the orthodontic process [oral hygiene] care. Clinical relevance: Further research for the development of patient-centered applications for patient safety, clinical decision making, and increasing their effectiveness in the treatment of orthodontic patients are required

Effects of a 12-Month Hybrid (In-Person + Virtual) Education Program in the Glycemic Status of Arab Youth

This 12-month school-based intervention study investigated the effects of hybrid educational lifestyle modifications on glycemic control among Saudi youth with different glycemic statuses. A total of 2600 Arab adolescents aged 12&ndash;18 years were recruited from 60 randomly selected schools. Anthropometrics, blood glucose, and HbA1c were measured pre- and post-intervention. Participants were grouped according to baseline HbA1c into normal, prediabetes, and diabetes groups. All participants received lifestyle education at base line and at every 3-month interval to improve diet and exercise behavior. Diabetic and prediabetic participants received a tailored lifestyle intervention. Post-intervention, 643 participants were analyzed as follows: 20 participants from the diabetes group, 39 from prediabetes, and 584 from the normal group. A modest but significant improvement in the glycemic status of diabetic and prediabetic participants was observed, but not in the normal group. In the diabetes group, 11 (55%) participants achieved normal HbA1c levels, 5 had prediabetes levels, and only 4 remained within diabetes HbA1c levels. In the prediabetes group, 34 (87.2%) participants achieved normal HbA1c levels, while 2 (5.1%) participants remained prediabetic and 3 (7.7%) had diabetes HbA1c levels (p &lt; 0.001). This hybrid lifestyle intervention program modestly reduces the risk of T2DM among youth with elevated HbA1c levels. The challenge of sustaining interest in adopting lifestyle changes for a longer duration should be addressed in further studies in this population

Drug shortages in Saudi Arabia: Root causes and recommendations

Drug shortages are a multifaceted problem that has been recurring in Saudi Arabia over the past decade with its significant negative impact on patient care. However, there is a dearth of evidence about possible domestic reasons, if any, behind this recurring problem. Recently, the Pharmacy Education Unit at King Saud University College of Pharmacy has called for a meeting with multiple stakeholders from academia, pharmaceutical care, pharmaceutical industry, purchasing and planning, and regulatory bodies to unveil the root domestic causes of the drug shortages in the Kingdom. Four major topics were used to guide the discussion in this meeting, including: current situation of drug shortages in Saudi Arabia, major factors contributing to drug shortages, challenges and obstacles to improve drug supply, and stakeholders’ recommendations to manage drug shortages. The meeting was audio-recorded and transcribed into verbatim by five authors. The text was then reviewed and analyzed to identify different themes by the first and third authors. Multiple causes were identified and several recommendations were proposed. The main domestic causes of drug shortages that were explored in this study included poor medication supply chain management, lack of government regulation that mandates early notification of drug shortages, a government procurement policy that does not keep pace with the changes in the pharmaceutical market, low profit margins of some essential drugs, weak and ineffective law-violation penalties against pharmaceutical companies and licensed drug importers and distributors, and overdependence on drug imports. The participants have also proposed multiple recommendations to address drug shortages. Policy makers should consider these factors that contribute to drug shortages in Saudi Arabia as well as the recommendations when designing future initiatives and interventions to prevent drug shortages. Keywords: Shortage, Drugs, Patient safet