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AlHanouf AlHabdan,1 Fatemah AlAhmari2 1Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia; 2Department of Periodontics and Community Sciences, College of Dentistry, King Saud University, Riyadh, Saudi ArabiaCorrespondence: AlHanouf AlHabdan, Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia, Tel +966 556693242, Email alhabdan@ksu.edu.saPurpose: To assess the efficacy of Er,Cr:YSGG lasers in reducing dentine hypersensitivity (DH).Methods: Electronic literature were searched through various databases (MEDLINE, SCOPUS, ProQuest, LILACS and EBSCO) up to March 2022 for articles addressing the following focused question: “In patients with dentine hypersensitivity, does an Er,Cr:YSGG laser provide a better outcome in terms of pain reduction than other dentine desensitizer agents?”. The literature was searched using combinations of the following medical subject heading (MeSH) terms and keywords: (laser OR phototherapy OR Er,Cr:YSGG laser) AND (dentine hypersensitivity OR dentine sensitivity OR dental sensitivity).Results: A total of 486 studies were found, of which 7 randomized controlled trials were included in the review. The Er,Cr:YSGG laser wavelengths, power density and duration of irradiation used in the studies were 2780 nanometers, 0.25– 0.5 watts and 20– 60 seconds, respectively. The follow-up assessments were conducted ranging from immediately to 3 months after treatment. All studies showed that the Er,Cr:YSGG laser was effective in alleviating DH.Conclusion: This systematic review suggests that the application of an Er,Cr:YSSG laser is effective in alleviating DH and may have limited adverse effects if adequate parameters are followed.Keywords: phototherapy, dentine hypersensitivity, dentine sensitivity, Er,Cr:YSGG laser

Fatemah Mohammed AlAhmari,1 Hind Saleh Albahouth,2 Hadeel Ali Almalky,2 Ebtihal Saad Almutairi,2 Muzun Hamoud Alatyan,2 Lama Ali Alotaibi2 1Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia; 2College of Dentistry, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Fatemah Mohammed AlAhmari, King Saud University, Riyadh, Saudi Arabia, Email falahmari@ksu.edu.saObjective: Periodontal diseases are chronic inflammatory disorders influenced by systemic health of the individual. This study aimed to investigate the association between hypothyroidism and periodontal disease in a cohort of adult Saudi population.Methods: This case–control study included 201 adults with hypothyroidism on hormone replacement therapy and 188 healthy controls. The medical files of patients were reviewed to check thyroid stimulation hormone (TSH) and free thyroxine (FT4) levels. Participants completed a questionnaire on demographic and health information, followed by a comprehensive periodontal examination. Pearson chi-square and binary logistic regression analyses determined associations, with a significance set at p ≤ 0.05.Results: Gingivitis was found in 20.9% of cases and 58% of controls. Periodontitis stages I, II, III and IV were in general higher in cases compared to controls (23.4%, 27.9%, 21.9%, 6% in cases versus 13.8%, 17%, 9.6%, 1.6% in controls, respectively). Mean PPD and CAL values were higher in cases (5.54 ± 2.5 and 3.88 ± 3.1) than in controls (4.03 ± 1.6 and 1.72 ± 2.4). Significant associations between periodontal status and hypothyroidism were found (p < 0.0001). The periodontal status in hypothyroid cases correlated significantly with hormone replacement therapy dose and duration (p < 0.0001).Conclusion: The findings of the current study showed that, in a cohort of adult Saudi subjects, patients with hypothyroidism have higher prevalence and more severe periodontal disease symptoms compared to controls, suggesting significant association.Keywords: hypothyroidism, periodontal diseases, hormone replacement therapy, association, case–control study

Background and Aim: This study was conducted in the Kingdom of Saudi Arabia to investigate the effects of the COVID-19 virus and the vaccine on menstrual periods. The data from this study would increase people's awareness of the impacts of the virus and its vaccines on menstrual periods and serve as a reference for further studies., Materials and Methods: The data was collected through a web link where standardized close-ended questionnaires were distributed via several social media platforms in Saudi Arabia., Results: The study included 691 respondents, with 411 women meeting the inclusion criteria. The majority of participants fell within the age range of 35-45, and 64% held at least a bachelor's degree. The Eastern region of Saudi Arabia had the highest percentage of participants, while the Northern region had the lowest. More than half of the participants were married, and 57% reported having been infected with COVID-19. The vast majority (99%) had received the COVID-19 vaccine, primarily the Pfizer/BioNTech vaccine. The study assessed the association between menstruation experience and symptoms in three situations: before infection or vaccination, after COVID-19 infection, and after vaccination. Differences were observed in the length of the menstrual cycle and flow, but no statistically significant differences were found for pelvic and back pain., Conclusions: The result of this current study suggests that COVID-19 infection and/or vaccination has several effects on the menstrual cycle which changes in menses are minimal and transient., (© Wael Nazzal et al., 2024; Published by Mary Ann Liebert, Inc.)

In this study, we investigated Cu-Co ferrite nanofibers (NFs) that were synthesized for the first time employing the electrospinning technique. The structure, phase purity and crystallite size of all the prepared NFs were revealed by powder X-ray diffraction (PXRD) analysis. The NFs crystallized in the Fd 3̄ m (no. 227) space group and the cation distribution arrangement over distinct sites in their structure was analyzed. Scanning electron microscopy (SEM) together with energy-dispersive X-ray (EDX) spectroscopy analysis showed the microstructure of the NFs and verified their expected chemical compositions. High-resolution transmission electron microscopy (TEM) images confirmed the fibrous nature and the construction of the NFs. The band gap energies derived from the UV-vis reflectance spectra showed a blue shift with an increase in the amount of Cu in the sample from 1.42 eV to 1.86 eV. Magnetization ( M ) as a function of magnetic field ( H ) measurements performed at ambient and low temperatures showed the ferrimagnetic behavior of all the NFs. The magnetic parameters including coercivity ( H c ), saturation magnetization ( M s ), remanent magnetization ( M r ), and squareness ratio were determined from the recorded magnetization curves. At 300 K, M s was reduced from 78.8 to 42.4 emu g -1 , M r reduced from 22.8 to 7.6 emu g -1 and the Bohr magneton reduced from 3.3 to 1.8 μ B with an increase in the content of Cu in the samples. The same trend was observed at 10 K, where M s was reduced from 93.7 to 50.9 emu g -1 , M r reduced from 60.9 to 35.9 emu g -1 and the Bohr magneton reduced from 3.94 to 2.16 μ B . Alternatively, H c has the highest values for x = 0 (850 Oe at 300 K and 5220 Oe at 10 K) and x = 0.6 (800 Oe at 300 K and 5400 Oe at 10 K). The anti-cancer activity of the NFs was evaluated using the MTT cell viability assay, showing a reduction in the viability of both HCT-116 and HeLa cancer cells compared to non-cancerous HEK-293 cells after treatment with the NFs. Apoptotic activity was examined by DAPI staining, where treatment with the NFs induced chromatin condensation and nuclear disintegration in HCT-116 cells., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Introduction: Nuclear Magnetic Resonance (NMR) spectroscopy stands as a preeminent analytical tool in the field of metabolomics. Nevertheless, when it comes to identifying metabolites present in scant amounts within various types of complex mixtures such as plants, honey, milk, and biological fluids and tissues, NMR-based metabolomics presents a formidable challenge. This predicament arises primarily from the fact that the signals emanating from metabolites existing in low concentrations tend to be overshadowed by the signals of highly concentrated metabolites within NMR spectra., Objectives: The aim of this study is to tackle the issue of intense sugar signals overshadowing the desired metabolite signals, an optimal pulse sequence with band-selective excitation has been proposed for the suppression of sugar's moiety signals (SSMS). This sequence serves the crucial purpose of suppressing unwanted signals, with a particular emphasis on mitigating the interference caused by sugar moieties' signals., Methods: We have implemented this comprehensive approach to various NMR techniques, including 1D 1 H presaturation (presat), 2D J-resolved (RES), 2D 1 H- 1 H Total Correlation Spectroscopy (TOCSY), and 2D 1 H- 13 C Heteronuclear Single Quantum Coherence (HSQC) for the samples of dates-flesh, honey, a standard stock solution of glucose, and nine amino acids, and commercial fetal bovine serum (FBS)., Results: The outcomes of this approach were significant. The suppression of the high-intensity sugar signals has considerably enhanced the visibility and sensitivity of the signals emanating from the desired metabolites., Conclusion: This, in turn, enables the identification of a greater number of metabolites. Additionally, it streamlines the experimental process, reducing the time required for the comparative quantification of metabolites in statistical studies in the field of metabolomics., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background Intracranial Atherosclerotic Stenosis (ICAS) represents a noteworthy cerebrovascular pathology linked to ischemic stroke, contributing to a considerable burden of morbidity and mortality on a global scale. The present study was undertaken with the primary objective of investigating the frequency, risk factors, and outcomes of ICAS in stroke patients within the Southern Region of Saudi Arabia. Methods This was a descriptive cross-sectional study conducted at a tertiary care hospital located in the southern region of Saudi Arabia, from June 2022 to December 2022. The study population consisted of patients aged 18 years and above who were diagnosed with acute ischemic stroke during the designated research period. Patients with hemorrhagic stroke, transient ischemic attack (TIA), or incomplete medical records were excluded from the analysis. Data pertaining to the patients were retrieved from their respective medical records. Results Out of 201 patients admitted with stroke, 92 (45.77%) were found to have intracranial stenosis. The majority of patients were female (52.2%) and aged over 55 years (60.9%). The presence of hypertension exhibited a statistically significant correlation with varying degrees of stenosis (p=0.02), as did ischemic heart disease and obesity (p=0.04) and active smoking (p=0.01). Hypertension displayed a marginal association with intracranial stenosis, with an odds ratio of 1.01 (95% CI: 0.25, 4.11) and a p-value of 0.02. Similarly, dyslipidemia showed a potential correlation, with an odds ratio of 1.16 (95% CI: 0.44, 3.03) and a p-value of 0.014. On the other hand, obesity showed a stronger association, with an odds ratio of 4.53 (95% CI: 1.05, 19.51) and a p-value of 0.04. Among the patients, 25 (27.17%) underwent revascularization procedures, while 44 (47.83%) were not eligible for such intervention. During the three-month follow-up, 4 (16%) experienced an ipsilateral stroke, and 3 (12%) suffered from a contralateral transient ischemic attack (TIA). Encouragingly, 18 (72%) of the treated patients showed no recurrence during the follow-up period. Conclusion This study concludes that approximately half (45.77%) of stroke patients had intracranial stenosis, and significant associations were found between varying degrees of stenosis and hypertension, ischemic heart disease, obesity, and active smoking. Hypertension demonstrated a marginal correlation, while obesity exhibited a stronger association with intracranial stenosis., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Alqahtani et al.)

The revolution of biomedical applications has opened new avenues for nanotechnology. Zinc Chromium vanadate nanoparticles (VCrZnO4 NPs) have emerged as an up-and-coming candidate, with their exceptional physical and chemical properties setting them apart. In this study, a one-pot solvothermal method was employed to synthesize VCrZnO4 NPs, followed by a comprehensive structural and morphological analysis using a variety of techniques, including X-Ray diffraction, scanning electron microscopy, high-resolution transmission electron microscopy, Energy-dispersive X-ray, and X-ray photoelectron spectroscopy. These techniques confirmed the crystallinity of the NPs. The VCrZnO4 NPs were tested for their antibacterial activity against primary contaminants such as Enterobacteriaceae, including Shigella flexneri , Salmonella cholerasis , and Escherichia coli , commonly found in hospital settings, using the broth dilution technique. The results indicated a stronger antibacterial activity of VCrZnO4 NPs against Shigella and Salmonella than E. coli. Electron microscopy showed that the NPs caused severe damage to the bacterial cell wall and membrane, leading to cell death. In addition, the study evaluated the anticancer activities of the metal complexes in vitro using colorectal cancer cells (HCT-116) and cervical cancer cells (HELA), along with non-cancer cells and human embryonic kidney cells (HEK-293). A vanadium complex demonstrated efficient anticancer effects with half-inhibitory concentrations (IC 50 ) of 38.50+3.50 g/mL for HCT-116 cells and 42.25+4.15 g/mL for HELA cells. This study highlights the potential of Zinc Chromium vanadate nanoparticles as promising candidates for antibacterial and anticancer applications. Various advanced characterization techniques were used to analyze the properties of nanomaterials, which may help develop more effective and safer antibacterial and anticancer agents in the future., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Rehman, Alahmari, Aldossary, Alhout, Aljameel, Ali, Sabir, Khan and Rather.)

Background: Chronic obstructive pulmonary disease (COPD) is a common but preventable disease and has a prevalence of 5%-14% in the general population. It is characterized by airflow limitation and persistent respiratory symptoms. In this survey, we aimed to assess the awareness of COPD among the general population in the Aseer Region of the Kingdom of Saudi Arabia (KSA)., Method: This was an observational, cross-sectional study in which predesigned electronic questionnaires were distributed to 504 randomly selected community personnel utilizing phone services. The collected data were analyzed using the IBM SPSS Statistics software, version 24 for Windows (IBM Corp., Armonk, NY)., Results: Participants were asked 11 questions with yes-or-no answers based on awareness and symptoms of COPD: 35.5% of participants had heard about the COPD as a term and 72% had no detailed information about COPD. Only 3.5% of participants had relatives with COPD. During the survey on COPD symptoms, 31% of participants chose shortness of breath and the rest chose cough (20%), sputum production (15%), wheezing (14%), and chest pain (19%). Almost two-third of the participants had no idea about COPD symptoms. For the most disease knowledge, majority of the study participants had very poor knowledge about the disease that was evident in the 22 questions intended to assess this domain. Social media sites ranked as the most popular source of information on COPD among the study participants., Conclusion: Awareness about COPD among the general population in the Aseer Region in KSA is poor. It is advisable to carry out programs to increase their level of awareness., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Family Medicine and Primary Care.)

Objective: The aim of this research was to evaluate peri-implant health status in patients infected with COVID-19 and control patients (individuals without COVID-19)., Methods: This observational investigation was performed in adults with (test group) and without (control group) COVID-19 infection having at least 1 functional dental implant. Self-reported education status and daily frequency of toothbrushing and flossing was determined. A questionnaire was administered to record demographic data, brushing/flossing frequency, and education status. Periodontal examination comprised full-mouth assessment of clinical attachment loss (CAL), plaque index (PI), probing depth (PD), and gingival index (GI). Peri-implant PD, modified PI, and modified gingival index were recorded. Loss of marginal and crestal bone around teeth and implants was also measured. Significance level was established for P < .05., Results: Seventy-three (41 males) and 71 (44 males) individuals were included in the test and control groups, respectively. Average ages of patients and controls were 44.6 ± 5.2 and 40.1 ± 3.1 years, respectively. University-level education was attained by 52 (75.3%) and 50 (70.4%) individuals in the test and control groups, respectively. Seventy (95.9%) and 68 (95.7%) patients and controls were brushing twice a day. Once-daily interproximal flossing was reported by 44 (60.3%) and 48 (67.6%) individuals in test and control groups. All participants had healthy periodontal and peri-implant tissues., Conclusions: The study indicated that there are no short-term adverse effects on the peri-implant tissues due to acute COVID-19 infection, and further well-controlled longitudinal studies are needed to evaluate the long-term effect of the infection on these tissues., Competing Interests: Conflict of interest None disclosed., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Background Stroke is a substantial cause of disability and mortality worldwide and is characterized by the sudden onset of acute neurological deficit. During acute ischemia, cerebral collateral circulations are crucial in preserving blood supply to the ischemic region. Recombinant tissue plasminogen activator (r-tPA) and endovascular mechanical thrombectomy (MT) are the primary standards of care for acute recanalization therapy. Methodology From August 2019 through December 2021, we enrolled patients treated in our local primary stroke center with anterior circulation acute ischemic stroke (AIS) treated with intravenous thrombolysis (IVT) with or without MT. Only patients diagnosed with mild to moderate anterior ischemic stroke, as measured by the National Institutes of Health Stroke Scale (NIHSS), were included in the study. The candidate patients underwent non-contrast CT scanning (NCCT) and CT angiography (CTA) at admission. The modified Rankin scale (mRS) was used to assess the functional outcome of the stroke. The modified Tan scale, graded on a scale of 0-3, was used to determine the collateral status. Results This study comprised a total of 38 patients who had anterior circulation ischemic strokes. The mean age was 34. 8±13. All patients received IVT; eight patients (21.1%) underwent MT following r-tPA. In 26.3% of cases, hemorrhagic transformation (HT), both symptomatic and asymptomatic, was evident. Thirty-three participants (86.8%) had a moderate stroke, whereas five participants (13.2%) had a minor stroke. With a P-value of 0.003, a poor collateral status on the modified Tan score is substantially associated with a short, poor functional outcome. Conclusion In our study, patients with mild to moderate AIS with good collateral scores at admission had better short-term outcomes. Patients with poor collaterals tend to present with a disturbed level of consciousness more than patients with good collaterals., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Alqahtani et al.)

Objectives: To discuss and summarize the scholarly published literature on the difference in obesity rate in treated and untreated attention deficit hyperactivity disorder (ADHD) patients to evaluate the influence of ADHD medication on weight status in these individuals., Methods: PubMed, Cochrane Library, and Google Scholar databases were searched for eligible articles from January to December 2020 using the following medical subject headings (MeSH) terms: "attention deficit hyperactivity disorder and other hyperactivity disorders", "obesity and overweight", "obesity treatment"., Results: A total of 19,449 study participants included in selected 8 studies were assessed with respect to the prevalence of obesity in medicated and unmedicated subgroups of ADHD patients. The total number of ADHD patients with the prescribed medication was 10,279, while the number of unmedicated ADHD patients was 9,170. The odds ratio was 0.65 with a 95% confidence interval of 0.50 to 0.84 favoring regular medical treatment for management of obesity in case of patients with ADHD., Conclusion: The prevalence of obesity observed in treated ADHD patients was significantly lower compared to that in unmedicated patients. This result suggests that the treatment is not only important for controlling ADHD manifestations but is also associated with lower body mass index. Therefore, further prospective studies with large sample size are required for controlling the confounding factors such as comorbidities and medication status., (Copyright: © Saudi Medical Journal.)

Background: The aim was to assess the association between levels of advanced glycation endproducts (AGEs) in the gingival crevicular fluid (GCF) and periodontal parameters among cigarette-smokers and waterpipe-users., Methods: Self-reported cigarette-smokers; waterpipe-users and never-smokers were included. Demographic data was recorded using a questionnaire. Periodontal parameters (plaque index [PI], gingival index [GI], clinical attachment loss [AL], probing depth [PD], and marginal bone loss [MBL]) were assessed in all groups. The GCF samples were collected using standard techniques and assessed for AGEs levels using enzyme-linked immunosorbent assay. Sample-size estimation was done and group-comparisons were done. Correlation between levels of GCF AGEs levels and periodontal parameters was assessed using a logistic regression model. Level of significance was set at P < 0.01., Results: Eighty-two individuals (28 cigarette-smokers, 28 waterpipe-users and 26 never-smokers) were included. There was no difference in mean ages of all patients. Cigarette-smokers had a smoking history of 5.1 ± 0.2 pack years and waterpipe-users were using waterpipe for 4.4 ± 0.6 years. There was no statistically significant difference in PI, GI, clinical AL, PD and MBL in all groups. Levels of AGEs were significantly higher among cigarette-smokers (P < 0.001) and waterpipe-users (P < 0.001) than never-smokers. There was no significant correlation between levels of GCF AGEs levels and periodontal parameters in all groups., Conclusion: Clinical periodontal status of individuals with a short history of cigarette-smoking and waterpipe-usage may appear similar to never-smokers. On a molecular level, cigarette-smoking and waterpipe-users express raised levels of AGEs than never-smokers that sirens about the ongoing yet latent periodontal inflammatory process., (© 2022. The Author(s).)

Here we report the electrospinning synthesis of Cd-substituted Ni-Co ferrite Ni 0.5 Co 0.5-x Cd x Fe 1.78 Nd 0.02 O 4 ( x  ≤ 0.25) nanofiber (NFs) with a very low concentration of Nd as a dopant. The structure and surface morphology of the Ni 0.5 Co 0.5-x Cd x Fe 1.78 Nd 0.02 O 4 (x ≤ 0.25) NFs were analyzed by X-ray powder pattern (XRD), transmission and scanning electron microscopes (TEM) along with Energy-dispersive X-ray (EDX). We have examined the biological applications of the Ni 0.5 Co 0.5-x Cd x Fe 1.78 Nd 0.02 O 4 (x ≤ 0.25) NFs on both cancerous cells and bacterial cells. We have found that Ni 0.5 Co 0.5-x Cd x Fe 1.78 Nd 0.02 O 4 (x ≤ 0.25) NFs produced inhibitory action on the human colorectal carcinoma cells (HEK-293) and also showed inhibitory action on the bacterial strains ( S. aureus and E. coli ) respectively. Finally, this is the first report on the synthesis of Cd- substituted Co-Ni ferrite nanofibers using electrospinning technique exhibiting anti-cancer and anti-bacterial activities.Communicated by Ramaswamy H. Sarma.

[Ni 0.4 Cu 0.2 Zn 0.4 ](Fe 2- x Dy x )O 4 spinel ferrite nanoparticles with different Dy 3+ concentrations (0.00 ≤ x ≤ 0.04) were prepared by a citrate sol-gel auto-combustion technique. A strong correlation among Dy concentration, structural parameters, and magnetic, electrical, and microwave properties was established. An increase in the Dy 3+ concentration is the reason for a rise in the crystal structure parameters (due to different ionic radii of Fe and Dy ions) and a slight increase in the average particle size with a minor reduction in the specific surface area. It was observed that Dy 3+ ions prefer to occupy the octahedral B site due to their large ionic radius (0.91 Å). The explanation of the electrical and magnetic properties was given in terms of the features of Dy 3+ -O 2- -Fe 3+ dysprosium-oxygen-iron indirect exchange. The occurrence of the intensive changes in amplitude-frequency characteristics was observed from 1.6 to 2.7 GHz. The explanation of electromagnetic absorption was given in terms of the peculiarities of the microstructure (resonance of domain boundaries). The results open perspectives in the utilization of [Ni 0.4 Cu 0.2 Zn 0.4 ](Fe 2- x Dy x )O 4 spinel ferrite nanoparticles as functional materials for targeted drug delivery and hyperthermia applications., Competing Interests: The authors declare no competing financial interest., (© 2021 The Authors. Published by American Chemical Society.)

Background: This study discusses the summary, investigation and root causes of the top four sentinel events (SEs) in Saudi Arabia (SA) that occurred between January 2016 and December 2019, as reported by the Ministry of Health (MOH) and private hospitals through the MOH SE reporting system (SERS). It is intended for use by legislators, health-care facilities and the public to shed light on areas that still need improvement to preserve patient safety., Objectives: The purpose of this study is to review the most common SEs reported by the MOH and private hospitals between the years 2016 and 2019 to assess the patterns and identify risk areas and the common root causes of these events in order to promote country-wide learning and support services that can improve patient safety., Methods: In this retrospective descriptive study, the data were retrieved from the SERS, which routinely collects records from both MOH and private hospitals in SA. SEs were analyzed by type of event, location, time, patient demographics, outcome and root causes., Results: There were 727 SEs during this period, 38.4% of which were under the category of unexpected patient death, 19.4% under maternal death, 11.7% under unexpected loss of limb or function and 9.9% under retained instruments or sponge. Common root causes were related to policies and procedures, guidelines, miscommunication between health-care facilities, shortage of staff and lack of competencies., Conclusion: Given these results, efforts should focus on improving the care of deteriorating patients in general wards, ICU (Intensive Care Units) admission/discharge criteria and maternal, child and surgical safety. The results also highlighted the problem of underreporting of SEs, which needs to be addressed and improved. Linking data sources such as claims and patient complaints databases and electronic medical records to the national reporting system must also be considered to ensure an optimal estimation of the number of events., (© The Author(s) 2021. Published by Oxford University Press on behalf of International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Studying disease models at the molecular level is vital for drug development in order to improve treatment and prevent a wide range of human pathologies. Microbial infections are still a major challenge because pathogens rapidly and continually evolve developing drug resistance. Cancer cells also change genetically, and current therapeutic techniques may be (or may become) ineffective in many cases. The pathology of many neurological diseases remains an enigma, and the exact etiology and underlying mechanisms are still largely unknown. Viral infections spread and develop much more quickly than does the corresponding research needed to prevent and combat these infections; the present and most relevant outbreak of SARS-CoV-2, which originated in Wuhan, China, illustrates the critical and immediate need to improve drug design and development techniques. Modern day drug discovery is a time-consuming, expensive process. Each new drug takes in excess of 10 years to develop and costs on average more than a billion US dollars. This demonstrates the need of a complete redesign or novel strategies. Nuclear Magnetic Resonance (NMR) has played a critical role in drug discovery ever since its introduction several decades ago. In just three decades, NMR has become a "gold standard" platform technology in medical and pharmacology studies. In this review, we present the major applications of NMR spectroscopy in medical drug discovery and development. The basic concepts, theories, and applications of the most commonly used NMR techniques are presented. We also summarize the advantages and limitations of the primary NMR methods in drug development.

Background: We hypothesized that crestal bone loss (CBL) and peri-implant soft tissue inflammation are increased when conventionally-loaded dental implants are placed in cigarette and waterpipe smokers compared to nonsmokers., Purpose: The present 8-years' follow-up retrospective clinical study evaluated the stability of the conventionally-loaded dental implants placed in cigarette- and waterpipe (narghile) smoking and nonsmoking population group., Materials and Methods: Self-reported cigarette-smokers, waterpipe users along with never-smokers have been included. Data pertaining to gender, age, duration and frequency of cigarette-smoking, and usage of waterpipe were collected using a preformed questionnaire. Probing depth (PD), bleeding on probing (BOP), and peri-implant plaque index (PI) were recorded measuring mesial and distal CBL on digital bitewing radiographs. Study power estimated with group comparisons performed using the Kruskal-Wallis and Bonferroni post-hoc adjustment tests. Statistically significant P-values of less than 0.05 were considered., Results: Forty-one cigarette-smokers, forty waterpipe-users, and forty-two never-smokers with mean ages of 44.5 ± 4.3, 41.2 ± 4.7, 43.3 ± 2.8 years, respectively, were included. The mean duration of smoking habit and duration of each session of cigarette-smoking was 5.5 ± 0.3 years and 7.7 ± 1.2 minutes, respectively. The mean period of waterpipe use and time of each session of was 10.6 ± 0.8 years and 20.2 ± 3.1 minutes, respectively. Among cigarette-smokers, waterpipe-users and never-smokers, the implants had been in function for 8.5 ± 0.3, 8.6 ± 0.3, and 8.5 ± 0.5 years, respectively. PD, CBL, and peri-implant PI were positively more among cigarette and waterpipe smoking users (P < 0.05) than with never-smokers. Peri-implant bleeding on probing was significant among never-smokers (P < 0.05) compared to waterpipe-users and cigarette-smokers. There was no difference in Peri-implant PI, PD, and CBL in cigarette-smokers and waterpipe-users., Conclusions: Cigarette-smokers and waterpipe users are vulnerable to peri-implant soft tissue inflammation and CBL than never-smokers. There is no variation in the severity of peri-implant soft tissue inflammation and CBL in waterpipe and cigarette users., (© 2019 Wiley Periodicals, Inc.)

Over the past two decades, nuclear magnetic resonance (NMR) has emerged as one of the three principal analytical techniques used in metabolomics (the other two being gas chromatography coupled to mass spectrometry (GC-MS) and liquid chromatography coupled with single-stage mass spectrometry (LC-MS)). The relative ease of sample preparation, the ability to quantify metabolite levels, the high level of experimental reproducibility, and the inherently nondestructive nature of NMR spectroscopy have made it the preferred platform for long-term or large-scale clinical metabolomic studies. These advantages, however, are often outweighed by the fact that most other analytical techniques, including both LC-MS and GC-MS, are inherently more sensitive than NMR, with lower limits of detection typically being 10 to 100 times better. This review is intended to introduce readers to the field of NMR-based metabolomics and to highlight both the advantages and disadvantages of NMR spectroscopy for metabolomic studies. It will also explore some of the unique strengths of NMR-based metabolomics, particularly with regard to isotope selection/detection, mixture deconvolution via 2D spectroscopy, automation, and the ability to noninvasively analyze native tissue specimens. Finally, this review will highlight a number of emerging NMR techniques and technologies that are being used to strengthen its utility and overcome its inherent limitations in metabolomic applications.

The pathological role of human herpesviruses (HHVs) (Epstein-Barr virus [EBV], Human cytomegalovirus [CMV], and Herpes simplex virus [HSV]) in peri-implant health needs clarification quantitatively. To determine the weight of evidence for HHVs in patients with peri-implantitis (PI) and substantiate the significance of HHVs in peri-implant inflammation, electronic databases including EMBASE, MEDLINE, Cochrane Oral Health Group Trials Register, and Cochrane Central Register of Controlled Trials were searched from 1964 up to and including November 2018. Meta-analyses were conducted for prevalence of HHVs in PI and healthy controls. Forest plots were generated that recorded risk difference (RD) of outcomes and 95% confidence intervals (CI). Five clinical studies were considered and included. Four clinical studies reported data on EBV while three clinical studies reported data on CMV. Considering the risk of these viruses in PI, significant heterogeneity for CMV (χ 2  = 53.37, p < 0.0001, I 2  = 96.25%) and EBV (χ 2  = 14.14, p = 0.002, I 2  = 78.79%) prevalence was noticed between PI and healthy control sites. The overall RD for only EBV (RD = 0.20, 95% CI, 0.01-0.40, p = 0.03) was statistically significant between both groups. Frequencies of the viruses were increased in patients with PI compared with healthy nondiseased sites. However, the findings of the present study should be interpreted with caution because of significant heterogeneity and small number of included studies., (© 2019 John Wiley & Sons, Ltd.)

Objective: The aim of the present short-term randomized clinical trial was to assess the efficacy of scaling and root planing (SRP) with and without adjunct antimicrobial photodynamic therapy (aPDT) in the treatment of chronic periodontitis (CP) among cigarette-smokers and never-smokers., Materials and Methods: Demographic information was collected using a questionnaire. Cigarette-smokers (group-1) and never-smokers (group-2) with CP were included. Treatment wise, these individuals were divided into two subgroups as follows: (a) SRP alone and (b) SRP with adjunct aPDT. Periodontal parameters (plaque index [PI], bleeding on probing [BOP], clinical attachment loss [AL] and probing pocket depth≥4 mm [PD] were measured at baseline and at 1 month and 3 months' follow-up. Group comparisons were done using the Kruskall-Wallis test., Results: Eighty-three male patients with CP (Group-1: 42 cigarette-smokers and; Group-2: 41 never-smokers) were included. In group-1, individuals that received SRP alone and SRP with adjunct aPDT had a mean history of cigarette smoking of 11.7 ± 0.3 and 12.5 ± 0.4 pack years. At baseline, PI, BOP, PD and clinical AL were comparable among all individuals in groups 1 and 2. At 1 month and 3 months' follow-up, PI (P < 0.05), PD (P < 0.05) and clinical AL (P < 0.05) were higher among all individuals in group-1 compared with group-2. In Group-2, PI, BOP, PD and clinical AL were comparable among all individuals at 1 month and 3 months' follow-up., Conclusion: Outcomes of SRP with or without aPDT for the treatment of CP are compromised in cigarette-smokers. Among never-smokers with CP, outcomes of SRP with or without aPDT are comparable. The significance of aPDT in this regard remains questionable., (Copyright © 2019 Elsevier B.V. All rights reserved.)

The new thioaluminogermanate Na(AlS 2 )(GeS 2 ) 4 (1) was successfully synthesized by a direct combination reaction. The compound crystallizes in the monoclinic space group P2 1 / n (no. 14) with unit cell parameters a = 6.803(3) Å, b = 38.207(2) Å, c = 6.947(4) Å, and β = 119.17(3)°. The crystal structure is composed of a [(AlS 2 )(GeS 2 ) 4 ] - 3D polyanionic network, in which Al and Ge atoms share the atomic positions and Na cations occupy the channels and voids formed by the connection of (Ge/Al)S 4 tetrahedra. The title compound shows a cation-exchange property with monovalent Ag + and Cu + ions at room temperature in solvent media, resulting in the formation of the isostructural compounds Ag(AlS 2 )(GeS 2 ) 4 (2) and Cu(AlS 2 )(GeS 2 ) 4 (3), respectively. The ion-exchange products Ag(AlS 2 )(GeS 2 ) 4 (2) and Cu(AlS 2 )(GeS 2 ) 4 (3) show higher air stability and narrower bandgap energies compared to those of the parent compound Na(AlS 2 )(GeS 2 ) 4 (1).