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Purpose. The purpose was to investigate the effect of a psycholinguistic training to improve expressive language among children with ASD. Methods. Data were collected from children during the academic year 2021-2022. The participants were 20 children with ASD, aged 7 to 10 years, who were enrolled in a school for children with ID. All children attended the same semester inside the school. Parent consent forms were sent home by the principal and school psychologist to the parents of the prospective participants to inform them about the study and ask them to give permission for their children to participate. Demographic information was obtained from school records and as reported by families. Children were divided randomly into two groups: one experimental (n=10) and other was the control group (n=10). These children were matched as a group with cases on the basis of age, IQ, social class and general level of language ability. A 24 items, six-dimensional Questionnaire was developed in particular for this study. The intention was to identify expressive language skills for children with ASD. The six dimensions are: speaking and questioning skills in correct language (4 items), the ability to verbally express things, needs, and desires (4 items), the skill of pronouncing and imitating words, letters and sounds (4 items), repetition and arranging skill (4 items), the ability to verbally express feelings (4 items), the ability to respond to the speech and questions of others. Results. Results indicated increased speaking and questioning skills in correct language, the ability to verbally express things, needs, and desires, the skill of pronouncing and imitating words, letters and sounds, repetition and arranging skill, the ability to verbally express feelings and the ability to respond to the speech and questions of others. Conclusions. Overall, results from this study contribute to the growing literature on the effect of a psycholinguistic training to improve expressive language among children with ASD. The present study lends empirical support to the notion that expressive language of children with ASD can be improved through a psycholinguistic training.

The unanticipated outbreak of the COVID-19 pandemic has shocked the world in terms of both lives and livelihood. SARS-CoV-2 virus primarily affects the respiratory system, although other organ systems are also involved. Early diagnosis followed up by a retrospective analysis and tracking of a few markers relevant to the immunological status of the individual may aid in determining the state of the patient's disease prognosis. The aim of the present study was to evaluate immunological parameters such as neutrophil to lymphocyte ratio (NLR), C-reactive protein (CRP), and D-dimer, taking into account the patient's age and oxygen saturation level. Our retrospective analysis of clinical data revealed that such parameters as CRP, D-dimer, and NLR should be taken into consideration to predict severe COVID-19-related complications. The data obtained indicate that patients over age 60 are especially vulnerable to severe COVID-19.

Purpose. The aim of this study was to investigate the contribution of rapid automatized naming skills (RAN) and phonological awareness (PA) to Arabic language reading fluency(RF). Methods. A quantitative, cross-sectional and descriptive method was employed, with the main focus on the contribution of rapid automatized naming skills and phonological awareness to Arabic language reading fluency. A cross-sectional study was performed for all children in six prim art schools located in Makka. A convenience sampling method was used to recruit children. For children to be included in this study, there were some criteria: (a) to have no academic or developmental disabilities; (b) Both gender (males and females). Questionnaires were distributed to the children with the help of classroom teachers. All questions must be answered and responded to. A total of 360 participants aged 6–10 years took part in this study: 280 males (77.7%, age mean = 8.9, SD = 3.27), and 80 females (22.3%, age mean = 9.2, SD = 2.44). Results. The first main finding of the current research is that the correlations between RAN, PA and reading fluency were significant. In the final model, PA was directly and positively predictive of RAN (β = 0.664, p = 0.000) and RAN was directly and strongly related to RF (β = 0.623, p = 0.000). PA explained 52.3% of variance of RF. RAN explained 51.8% of variance of RF. PA and RAN together explained 69.9% of variance of RF. Conclusions. The findings of this study add to our knowledge of the contribution of PA and RAN to RF, as well as the complex intralingual relationship between PA and RAN.

Anthroponotic cutaneous leishmaniais (ACL) and zoonotic cutaneous leishmaniasis (ZCL) caused by

The eradication rates for Helicobacter pylori globally are decreasing with a dramatic increase in the prevalence of antibiotic resistant bacteria all over the world, including Saudi Arabia. There is no current consensus on the management of H. pylori in Saudi Arabia. The Saudi Gastroenterology Association developed these practice guidelines after reviewing the local and regional studies on the management of H. pylori. The aim was to establish recommendations to guide healthcare providers in managing H. pylori in Saudi Arabia. Experts in the areas of H. pylori management and microbiology were invited to write these guidelines. A literature search was performed, and all authors participated in writing and reviewing the guidelines. In addition, international guidelines and consensus reports were reviewed to bridge the gap in knowledge when local and regional data were unavailable. There is limited local data on treatment of H. pylori. The rate of clarithromycin and metronidazole resistance is high; therefore, standard triple therapy for 10-14 days is no longer recommended in the treatment of H. pylori unless antimicrobial susceptibility testing was performed. Based on the available data, bismuth quadruple therapy for 10-14 days is considered the best first-line and second-line therapy. Culture and antimicrobial susceptibility testing should be considered following two treatment failures. These recommendations are intended to provide the most relevant evidence-based guidelines for the management of H. pylori infection in Saudi Arabia. The working group recommends further studies to explore more therapeutic options to eradicate H. pylori.

Coronavirus disease 2019 (COVID-19), a mystified cryptic virus has challenged the mankind that has brought life to a standstill. Catastrophic loss of life, perplexed healthcare system and the downfall of global economy are some of the outcomes of this pandemic. Humans are raging a war with an unknown enemy. Infections, irrespective of age and gender, and more so in comorbidities are escalating at an alarming rate. Cardiovascular diseases, are the leading cause of death globally with an estimate of 31% of deaths worldwide out of which nearly 85% are due to heart attacks and stroke. Theoretically and practically, researchers have observed that persons with pre-existing cardiovascular conditions are comparatively more vulnerable to the COVID-19 infection. Moreover, they have studied the data between less severe and more severe cases, survivors and non survivors, intensive care unit (ICU) patients and non ICU patients, to analyse the relationship and the influence of COVID-19 on cardiovascular health of an individual, further the risk of susceptibility to submit to the virus. This review aims to provide a comprehensive particular on the possible effects, either direct or indirect, of COVID-19 on the cardiovascular heath of an individual.

A framing analysis of eight US media with different political bias was done to identify how they positioned themselves regarding the role of China in Covid-19 in the USA. The number of articles in the media varied much with Los Angeles Times leading with 32 articles discovered in the search. About 76% of all articles in the media were negative to China and 24% were sympathetic and only one article (American Conservative) saw the benefit of economic contribution of China to the USA. Both maximum negative and positive articles were seen in Los Angeles Times. All of the articles in the Star Tribune were negative and close to 95% in US today, also. However, the total numbers of articles in these two were only 15 and 19 respectively. Majority of articles in both right-centered and left-centered media were negative with obvious sympathetic stand of left-centered media towards China. On this basis, no definite association between political bias and positive or negative reporting on the role of China in Covid-19 spread in the USA exists for the eight US media studied. The results have been discussed with the aid of other works. Some limitations of this study are also discussed at the end.

Background Pneumocystis pneumonia (PCP) is a fatal infectious disease caused by Pneumocystis jirovecii (PJP). The major factor relevant to morbidity and mortality seems to be the host inflammatory reaction. The objective of this study was to evaluate the role of IL-2, IL-4, IL-10, and IL-13 cytokine mRNA expression among suspected P. jirovecii infection. Methods This was a cross-sectional analytical study undertaken in Aseer region, Saudi Arabia. One hundred suspected PCP cases and 100 healthy controls were included in the study. Basic clinical manifestations, radiological findings, microbiological and immunological findings were extracted from the hospital records from January 2019 to August 2019, Pneumocystis detection was done by immune-fluorescent staining (IFAT, Gomorimethanamine silver staining (GMSS), Giemsa staining, Toluidine blue O (TBO), and Pneumocystis RT-PCR. Results Increased more than 5 fold, 3 fold, 4 fold, and 7 fold of IL-2, IL-4, IL-10, and IL-13 mRNA expression were observed in PCP cases compared to controls. Higher expression of IL-2 mRNA was connected with crept, wheezing and chest X-ray findings like central perihilar infiltrate, patchy infiltrate, consolidation, hilar lymphadenopathy, pneumothorax, pleural effusion which showed higher expression compared to counterpart (pp=0.002), dyspnea (p=0.003), crept (p=0.01), and chest X-ray findings (p Conclusion Confirmed cases of P. jirovecii showed higher IL-2, IL-4, IL-10, and IL-13 mRNA expression comparatively to negative cases. Increased expression of cytokines may be indicative of infection severity and could help in patients’ management.

Given that teaching Arabic, as a second language has become increasingly significant in the present context, it follows that there is an urgent and pressing need to develop efficient learning tools as well as adequate measuring tools for testing the learner’s development. There are numerous problems associated with measuring a learner’s proficiency in Arabic in the context of Western cultures. These problems are related to the non-adaptability of measuring tools from one setting into another without taking cultural factors into account. The difficulties faced by scholars in adapting Teaching English to Speakers of Other Languages (TESOL) tools to the Saudi context is an example. However, the problems associated with such an adaptation indicate the need for context-specific language acquisition measuring tools. Either currently existing tools such as TESOL need to be radically altered to fit Saudi contexts and requirements, or entirely new tools must be created in order to test the efficacy of language learning in Saudi Arabia. This study aims at a close examination of ways in which existing tests such as TESOL may be adapted or modified to suit the requirements of teachers and learners in the Saudi context. A survey and evaluation of existing tools was followed by developing new tools specifically for Arabic language. It concludes by giving recommendations for proposed modification of existing strategies for Arabic learners that associates the language more directly with functional workplace contexts.

Monogenic diseases that result in early pregnancy loss or neonatal death are genetically and phenotypically highly variable. This often poses significant challenges in arriving at a molecular diagnosis for reproductive planning. Molecular autopsy by proxy (MABP) refers to the genetic testing of relatives of deceased individuals to deduce the cause of death. Here, we specifically tested couples who lost one or more children/pregnancies with no available DNA. We developed our testing strategy using whole exome sequencing data from 83 consanguineous Saudi couples. We detected the shared carrier state of 50 pathogenic variants/likely pathogenic variants in 43 families and of 28 variants of uncertain significance in 24 families. Negative results were seen in 16 couples after variant reclassification. In 10 families, the risk of more than one genetic disease was documented. Secondary findings were seen in 10 families: either genetic variants with potential clinical consequences for the tested individual or a female carrier for X-linked conditions. This couple-based approach has enabled molecularly informed genetic counseling for 52% (43/83 families). Given the predominance of autosomal recessive causes of pregnancy and child death in consanguineous populations, MABP can be a helpful approach to consanguineous couples who seek counseling but lack molecular data on their deceased offspring.

The proliferation of technology has re-defined the traditional learning environment. The classical classroom model of teacher to student delivery is changing as technology becomes more pervasive in educational environments. In addition, the availability of technology and the breadth of different device categories and platforms is a stark contrast to the traditional classroom, and the pervasiveness of low-cost devices provides opportunities to significantly re-define the learning environment. In this paper, we have developed a real-time feedback mechanism supported by technology to allow students and educators to assess comprehension in the teaching environment. Real-time feedback is input that is acquired whilst a teaching practice is ongoing, and the outcomes derived from the feedback mechanism have provided a strong pedagogical value to the learning environment. These benefits have been clearly elicited by the academic staff who trialled the system.

The aim of this paper was to evaluate the contentions and evidence supporting two divergent views about the existence of advantages offered by bilingualism. It also considered whether a definite conclusion was possible. A qualitative research methodology using the published evidence was adopted. The published evidence supporting or rejecting the advantages of bilingualism was collected using search terms in the Google Scholar search engine. A total number of 64 papers were collected, among which only five challenged the claimed advantages enjoyed by bilingual individuals. The papers were classified by their orientation and discussed. Based on the points derived from the evaluation of evidence, some conclusions were drawn. The overwhelming research support in favour of the existence of supposed bilingual advantage tends to suggest a conclusion in favour of that hypothesis. However, the points raised by critics, such as small sample sizes, inadequate matching of other variables, as well as defective measurements and analysis cannot be ignored as they question the very validity of the studies which support bilingual advantage. Future research needs to pay more attention to these aspects.

The current status of research on working memory (WM) and its components in second language acquisition (SLA) was examined in this review. Literature search was done on four aspects using search terms in Google Scholar. Hence, the review results are given and introduced. 1. In the definition of WM, some confusion exists on whether short term memory (STM) or recent memory is the same as WM or different. 2. In this review, three main models have been discussed elaborately, as they are the only ones discussed in literature. They are: multicomponent model of Baddeley (2000), embedded process model of Cowan (2005) and attention control model of Engle and Kane (2003). 3. The phonological and executive components of WM were examined in more detail, as these determine the two basic aspects of language acquisition: language characteristics and acquisition methods (Wen, 2012). Overall, the variables related to phonological and executive working memories are evident from published research, but their interactive relationships and affecting factors are not entirely clear. 4. Admittedly, several diverse internal and external factors affect WM in relation to SLA. Some practically useful interventions are indicated by certain findings.

The aim of this review was to critically evaluate the research works done on power distance and individualism-collectivism in English as a foreign language (EFL) and other types of English language learning. There is a more or less agreement on what happens to teaching and learning processes in high and low power distance (PD) classrooms. However, there are some findings suggesting thesimultaneous existence of both individualism and collectivism (e.g. North Vietnam). In that case, individualism and collectivism have separate identities, rather than being mutually exclusive parts of a single dimension. There are some works in which Hofstede’s(1983, 1986) cultural dimensions could not explain observed differences in thelearning environment. There are possibilities of learning-specific new sets of cultural dimensions in classrooms due to the attitudinal changes of students compared to the average culture of the general population. In many works, a variety of approaches has been suggested for the teacher either to adapt to the culture of the classroom or to use methods of low PD and individualistic methods in high PD-collectivist classrooms in a cautious manner. Communicative Language Teaching (CLT) seems an effective alternative to Grammar-Translation Method (GTM). Contradictory findings have been reported on Japanese classrooms. In one, the students desire to study independently, which the high PD and the collectivist culture of Japan does not allow. Two, for the Japanese learners, group working is more effective due to the collectivist culture. The contradictions involved in the two contentions need to be resolved through more research.

The aim of this review was to evaluate certain methodological issues related to the measurement of cultural dimensions and their effects with special reference to educational contexts. Using Google Scholar with the exact topics as search terms, 50 research reports were obtained. The results obtained from the critical analysis of the methodologies used in these reports are discussed in this review. Most studies were on power distance and individualism/collectivism dimensions of culture. A large number of conceptual frameworks and as many as 121 measurement instruments have been proposed by different workers. Research approach in any particular study is determined by the framework and the instrument chosen or self-developed instruments. Surveys and interviews are more commonly used. Not estimating internal consistency or reliability tests in some works makes it difficult to judge the validity of the method of data analysis. Generally the sample size is in the range of 200-500 participants in surveys. Small sample sizes used in a few works may affect the validity and applicability of their findings. It is concluded that large groups of scientists doing a common research programme across several countries is better than individual researches. Meta-analyses are also superior to individual researches. Such methods ensure validity and replicability of the findings. Although none of the research used scenario analysis, it is also a promising method.

Additional file 1. Raw data used to determine the MIC and MBIC of cinnamon water extract on S. mutans biofilm and the Combined effect of cinnamon water extract (2.5 mg/ml) and nicotine on S. mutans total growth absorbance, planktonic growth and biofilm formation.

Among the social media, Twitter is widely used by political leaders and the public to express opinions about various political issues. These tweets may influence the course of major political events like elections, Brexit and popularity of certain politicians. This common observation led to the research question of this paper: What are the political implications of Twitter postings? To answer this research question, an exploratory qualitative review of tweets was undertaken. Google Scholar was searched using the topic itself as the search term twice with two different time frames till 2019. The search yielded 41 papers. The papers were listed with brief description. A table categorising the methods used in the papers was useful to derive some conclusions. Generally, Twitter can be used for both positive and negative purposes and it can impact either or both the leader and the people who read them. Certain factors are involved in determining the nature of post and its outcomes. Many theories and methods had been used in the papers. Manual, machine learning and automatic analytical tools have been tested and used widely. None of the methods is perfectly suitable for all types of Twitter analysis. General content textual descriptions, characteristics of the texts, symbols, hidden meanings and presentation methods have been used in the tweets examined by the authors. The potential of negative tweets and hate speeches is quite clear. Absence of internal standard definition of these types of posts stands in the way of effective prevention. Some recommendations have been listed based on the findings of this review. A few limitations of this review have also been listed.

The present studies were undertaken to develop solvent-free solid dispersions (SDs) for poorly soluble anti-inflammatory drugs mefenamic acid (MA) and flufenamic acid (FFA) in order to enhance their in vitro dissolution rate and in vivo anti-inflammatory effects. The SDs of MA and FFA were prepared using microwaves irradiation (MW) technique. Different carriers such as Pluronic F127® (PL), Eudragit EPO® (EPO), polyethylene glycol 4000 (PEG 4000) and Gelucire 50/13 (GLU) were used for the preparation of SDs. Prepared MW irradiated SDs were characterized physicochemically using differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), Fourier transform infra-red (FT-IR) spectroscopy, powder X-ray diffraction (PXRD) and scanning electron microscopy (SEM). The physicochemical characteristics and drug release profile of SDs were compared with pure drugs. The results of DSC, TGA, FT-IR, PXRD and SEM showed that SDs were successfully prepared. In vitro dissolution rate of MA and FFA was remarkably enhanced by SDs in comparison with pure MA and FFA. The SDs of MA and FFA prepared using PEG 400 showed higher drug release profile in comparison with those prepared using PL, EPO or GLU. The dissolution efficiency for MA-PEG SD and FFA-PEG SD was obtained as 61.40 and 59.18%, respectively. Optimized SDs were also evaluated for in vivo anti-inflammatory effects in male Wistar rats. The results showed significant % inhibition by MA-PEG (87.74% after 4 h) and FFA-PEG SDs (81.76% after 4 h) in comparison with pure MA (68.09% after 4 h) and pure FFA (55.27% after 4 h) (P

The proliferation of technology has re-defined the traditional learning environment. The classical classroom model of teacher to student delivery is changing as technology becomes more pervasive in educational environments. In addition, the availability of technology and the breadth of different device categories and platforms is a stark contrast to the traditional classroom, and the pervasiveness of low-cost devices provides opportunities to significantly re-define the learning environment. In this paper, we have developed a real-time feedback mechanism supported by technology to allow students and educators to assess comprehension in the teaching environment. Real-time feedback is input that is acquired whilst a teaching practice is ongoing, and the outcomes derived from the feedback mechanism have provided a strong pedagogical value to the learning environment. These benefits have been clearly elicited by the academic staff who trialled the system.

Background: One of the popular ancient plants used to treat various diseases such as hyperglycemia, hepatitis, jaundice, bronchitis, and pneumonia has been Juniperus procera (JP). JP is abundantly seen in the region of Al-Baha, Saudi Arabia, and is being used as a medicinal plant traditionally by local healers. Objectives: The objective was to evaluate the anticancer properties of JP from Al-Baha region on SCC-9 cells. Materials and Methods: Colorimetric assays such as 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay, sulforhodamine B assay, and lactate dehydrogenase (LDH) assay were performed to check the cytotoxicity induced and cell viability. Assays evaluating cellular events such as apoptosis and cell cycle were also performed. Results: MTT assay revealed IC50value of 201.6 μg/ml. The cancer cells primed with increasing concentrations of JP displayed an enhanced emission of LDH at elevated concentrations contrasted to cells which were not treated. The samples of JP pooled fraction (PF) (6–9) treated at 160 μg/ml and 320 μg/ml concentration showed 8.39% and 23.37% and 17.35% and 20.89% in early and late phases of apoptosis, respectively. Sample P (PF 6-9) at 160 μg/ml and 320 μg/ml has induced a G2M phase arrest of up to 21.06% and 26.94%. Deoxyribose nucleic acid damage was compared in tested concentrations of sample JP with untreated control cells in SCC9 cells. SCC9 cells that were treated with sample JP PF 6–9 showed the olive moments 23.22 and 37.30 at concentrations 160 μg/ml and 320 μg/ml, respectively. Studies of gene expression showed that increased concentrations of JP triggered the development of caspases and p53. Conclusion: The bioactive compounds found in JP were effective and potent against the SCC-9 cancer cells.

Background/Purpose: Tooth size discrepancy is one of the causative factors of malocclusion. This study aimed to establish the TDS among various malocclusion classes and normal occlusion subjects in a Southern Saudi population. Materials and Methods: The study casts of orthodontic patients from Southern Saudi Arabia (mean age: 19.6 years ± 2.45; n = 120) were randomly selected and grouped into eight equal classes based on Angle's classification and gender. An additional 30 study casts, devoid of malocclusion, having excellent intercuspation and class I occlusion, were grouped into two controls (n = 15) based on gender. The study casts were three-dimensional scanned to measure mesiodistal widths of all the teeth. The calculated anterior ratios (AR) and overall ratio (OR) were statistically analyzed with analysis of variance and t-tests. Results: There were no significant differences in “OR” and “AR” between the genders (P > 0.05) and among the malocclusion and control subgroups (P > 0.05). The mean “OR” (92.01 ± 0.18) and “AR” (78.60 ± 0.27) of the malocclusion group were significantly higher than that of Bolton's ratios (P > 0.05). The “AR” of the control group was significantly higher than Bolton's standards (P = 0.048). However, “OR” was no different (P = 0.105). Malocclusion patients displayed a discrepancy (±2 standard deviation) in “AR” of 22.5% and 'OR' of 6.7% from Bolton's mean (BM). Similarly, the control group displayed a discrepancy in “AR” of 20% and “OR” of 10% from BM. Conclusion: The mean “OR” and “AR” of the Southern Saudi population showed no sexual dimorphism and no significant difference among various malocclusion and control subgroups. The “AR” of the malocclusion and control subgroups did not comply with Bolton's standards.

In recent years there have been a growing number of studies on written corrective feedback (WCF), particularly in terms of the efficacy of different types of WCF. However, few of these studies have investigated what shapes teachers’ WCF practices and how they align with students’ preferences. This study, conducted with staff and students in a large Saudi university that has strict guidelines on WCF provision, examined the teachers’ WCF practices in relation to the institutional guidelines, their own beliefs about the most effective forms of WCF as well as their students’ preferences. Data collected included the feedback given by three teachers on their students’ writing (15 students per teacher), follow-up interviews with the teachers, and questionnaires completed by the students. The study found that although the teachers followed the strict guidelines and provided comprehensive indirect feedback, these practices did not always accord with their beliefs. Most of the WCF given tended to be on mechanics, and the teachers seemed unaware that this was the main focus of their feedback. They were also largely unaware that their students preferred direct feedback and mainly on grammar. We conclude our paper with some policy recommendations.

Aim: To evaluate the effect of varying cellulose casting ring liner length and its prewetting on the marginal adaptation and dimensional accuracy of full veneer metal castings. Materials and Methods: The master die was milled in stainless steel to fabricate the wax pattern. Sixty wax patterns were fabricated with a uniform thickness of 1.5 mm at an occlusal surface and 1 mm axial surface, cervical width at 13.5 mm, and 10 mm cuspal height. The samples were divided into six groups (n = 10). Groups I and II samples had the full-length cellulose prewet and dry ring liner, respectively. The groups III and IV had 2 mm short prewet and dry cellulose ring liner, respectively, whereas groups V and VI were invested in 6 mm short ring liner. The wax patterns were immediately invested in phosphate bonded investment, and casting procedure was completed with nickel-chrome alloy. The castings were cleaned and mean score of measurements at four reference points for marginal adaption, casting height, and cervical width was calculated. The marginal adaption was calculated with Imaje J software, whereas the casting height and cervical width was determined using a digital scale. The data was subjected to one-way analysis of varaince and Tukey post hoc statistical analysis with Statistical Package for the Social Sciences version 20 software. Results: The group II had the best marginal adaption with a gap of 63.786 μm followed by group I (65.185 μm), group IV (87.740 μm), and group III (101.455 μm). A large marginal gap was observed in group V at 188.871 μm. Cuspal height was more accurate with group V (10.428 mm), group VI (10.421 mm), and group II (10.488 mm). The cervical width was approximately similar in group I, group III, and group V. Statistically significant difference was observed in Tukey post hoc analysis between group V and group VI with all the other groups with regards to marginal adaptation. Conclusion: The dry cellulose ring liners provided better marginal adaptation in comparison to prewet cellulose ring liners. Accurate cuspal height was obtained with shorter ring liner in comparison to full-length cellulose ring liners.

This cross-sectional study was done to evaluate linear and angular measurement of lip morphology in Saudi adults and their comparison with the norms. After taking their history and physical examination, the patients were referred for a lateral Cephalograph using Dolphin Imaging Software. Linear and angular measurements related to lip morphology were recorded. Significant differences were found in the lower lip to E line, upper and lower lip protrusion, upper and lower lip to S line and upper and lower lip thickness, nasolabial angle, Z angle, with Saudi males having more prominent, thicker lips than the Saudi females. Comparison with the norms revealed that both lips are prominent among Saudi males, while in females there is an increased prominence of the lower lip. Value of the lower lip to H line is increased in both genders, males have prominent and thicker upper lips compared to the females and the lower lip in both genders is more prominent compared to the norms.

Aim: The aim of this study was to assess the oral health knowledge, behavior, and practices related to use of miswak (chewing stick) in population of Aseer Region, Saudi Arabia. Subjects and Methods: Of the 2023 participants, 1666 (83.3%) were females and 334 (16.7%) were males. The questionnaires having 10 online questions were used to assess the knowledge of oral hygiene methods, including frequency, reason, and methods for miswak use. Statistical Analysis Used: The survey data were collected and organized into Microsoft Excel spreadsheets (Microsoft Inc., USA) and were statistically analyzed utilizing the Statistical Package for the Social Sciences version 20.0 software (IBM Inc., USA). The statistical test used here was the Chi-square test, and P < 0.05 was considered to be statistically significant (P < 0.05). Results: Participants responded regarding the primary oral hygiene methods; 46.5% respondents used toothbrushes, 44.5% used both toothbrushing and miswak, and 8% used only miswak as their primary tooth cleaning method. 28.2% respondents cleaned their teeth with tooth brush or miswak at least once a day, 37.6% twice, 28.4% whenever required, and 5.9% infrequently. Majority of the participants, i.e. 70.2% were using miswak with taper and as a brush to clean all tooth surfaces. About 84.7% feel fresh, and teeth are whiter after the use of miswak. Nearly, 84.7% prefer to continue using miswak in combination with other teeth cleaning methods, which may have more benefits. Conclusions: In our study, most common type of oral hygiene method employed is toothbrush and in combination with miswak. Chewing stick use was common among participants with religious advice being the dominant reason for usage.