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Rabia Latif,1 Nazish Rafique,1 Lubna Al Asoom,1 Ahmed A Alsunni,1 Ayad Mohammed Salem,1 Dinah Abdulhadi AlNoaimi,2 Wasan Mohammed AlHarbi,2 Ahad Yasir Shaikh,2 Shoug Abdullah AlRaddadi,2 Leena Abdulrahman AlMuhaish,2 Dana Almohazey,3 Sayed Abdulazeez,4 J Francis Borgio4 1Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 3Department of Stem Cell Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 4Department of Genetic Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Rabia LatifDepartment of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam, 31441, Saudi ArabiaTel +966 596212648Fax +966 38578048Email rlhussain@iau.edu.saBackground: A reliable, migraine-specific biomarker has not been identified so far. Calcitonin Gene-Related Peptide (CGRP) and Apolipoprotein E (ApoE) might serve as migraine biomarkers due to their roles in migraine pathophysiology. However, their diagnostic usefulness has not been explored yet. Present study explored the diagnostic accuracy of CGRP and ApoE in migraine.Methods: A cross-sectional, case–control study was conducted from November 2019 to April 2020 at Physiology department of our university. Fourteen female migraine patients, 18– 25 years old, with confirmed “Migraine” diagnosis by a neurologist, were recruited. Control group consisted of 14 age-matched healthy females with no personal/family history of migraine. Blood was drawn once from control subjects and twice from migraine patients (ictal and interictal phase). Serum CGRP and ApoE levels were assessed by ELISA. Statistical analysis involved paired t-test, one-way ANOVA, Receiver operating characteristic (ROC) curves and cross-tabs.Results: ApoE (mg/dl) was higher significantly in interictal (1.90± 0.50) and ictal (1.97± 0.65) phases of migraine compared to control (1.07± 0.26) (p ≤ 0.001). ROC curves for ApoE were significant in migraine ictal vs control (AUC= 0.91, AUC 95% CI: 0.78– 1.0) and migraine interictal vs control (AUC=0.92, AUC 95% CI: 0.8– 1.0) subjects. ROC curve for CGRP (pg/mL) was significant in migraine ictal vs control subjects only (AUC=0.79, AUC 95% CI: 0.6– 0.97).Conclusion: Serum ApoE has “excellent” accuracy to diagnose migraine patients whether in ictal or interictal phase, from healthy subjects. ApoE levels of patients in these two phases of migraine are raised significantly than healthy subjects. CGRP has “fair” diagnostic accuracy to discriminate between migraine ictal phase and healthy subjects. Its levels do not differ significantly among migraine ictal, interictal phase and healthy controls.Keywords: apolipoprotein E, calcitonin gene-related peptide, migraine, receiver operating curve, biomarkers

Objectives: To assess the effect of inter-proximal enamel reduction (IPR) on interradicular bone volume and incisal inclination in patients undergoing clear aligner therapy (CAT)., Materials and Methods: The study sample consisted of 60 cases which underwent orthodontic CAT, in a private clinic in Dammam, KSA. A total of 120 CBCT scans (60 pre-treatment and 60 post- treatment) were measured using the CS 3D Imaging software to examine bone volume (using height, width, and depth of the interproximal area) and incisal inclination. The corresponding ClinCheck models were collected to determine the amount and locations of interproximal reduction performed. Little's Irregularity Index values were measured using OrthoCAD software. Paired sample t-test was used to address the measurements of bone height, width, depth, bone volume, and inclination of upper and lower incisors before and after IPR., Results: IPR did not affect the upper or lower bone volume except at LR3-2 and UL 2 - 1 where a significant difference between the bone volume with and without IPR was detected (p = 0.02 and p = 0.04 respectively). Upper and lower incisor inclination showed a statistically significant decrease after IPR. There was no correlation between IPR and bone volume difference between upper and lower teeth except at LR3-2 and UL 2 - 1., Conclusions: IPR had no significant effect on inter-radicular bone volume except at areas of lower right canine-lateral and at areas of upper left central-lateral. There was a positive correlation between the amount of IPR and incisal inclination., Clinical Relevance: The current study findings suggest that while IPR has a minimal and localized effect on bone volume in certain areas, it plays a role in adjusting incisal inclination, highlighting its significance in the careful planning of orthodontic treatment using clear aligners., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: A fixed drug eruption (FDE) is an immunological cutaneous adverse reaction, classified as a cutaneous adverse drug reaction (CADR) and characterized by well-defined lichenoid lesions that occur at the same site each time. Ceftriaxone is a third-generation antibiotic of cephalosporin antibiotics of the beta-lactam antibiotic family, which has typical in vitro activity against many Gram-negative aerobic bacteria. This is the first clinical case from Saudi Arabia and the fifth in the world to document a woman's experience with recurrent FDE after repeated ceftriaxone use. Case Report . A 25-year-old Saudi woman with a known case of sickle cell anemia (SCA) with a history of avascular necrosis of the right hip after replacement was hospitalized with a pain crisis triggered by an upper respiratory tract infection. The patient denied having a history of allergy previously. Due to fever, leukocytosis, and active follicular tonsillitis, ceftriaxone was started. However, a few hours later she developed lip edema and a fixed drug eruption measuring 7 × 11 cm on the left side of her back. The lesion reformed over a hyperpigmented lesion (4 × 8 cm) that the patient did not report upon initial examination. It turned out that this was due to the intravenous administration of ceftriaxone, a year ago in another hospital. An allergy to ceftriaxone was considered, and steroids and antihistamines were started. The case was labeled as ceftriaxone induced FDE., Conclusion: Ceftriaxone induced FDE is an uncommon type of allergic reaction that has been reported infrequently. Understanding this condition and the mechanism by which FDE becomes recurrent with the same previous fixed lesion is of great importance for both academic and future research purposes., Competing Interests: The authors declare that they have no conflicts of interest or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Rehab Y. Al-Ansari et al.)

Introduction: Chemical testing showed that Zamzam water is completely safe to drink and has health benefits due to its high percentage of sodium, calcium, magnesium, and many other minerals. The purpose of this study was to evaluate the remineralization effect of Zamzam water on extracted premolars using the Vickers Microhardness test., Methods: Teeth samples (N=40) with artificially induced carious lesions were divided randomly into four groups: Study group (I) treated with agitated Zamzam water (n=10), study group (II) treated with non-agitated Zamzam water (n=10), control positive group (III) treated with sodium fluoride (n=10), and control negative group (IV) treated with deionized water (n=10). Teeth were subjected to microhardness testing before and after artificial demineralization and after remineralization treatment within the four groups., Results: Following treatment with different solutions in both study and control groups, there was an increase in microhardness after remineralization but with varying degrees. The highest increase in microhardness was shown after remineralization with sodium fluoride followed by agitated Zamzam water., Conclusion: Zamzam water with agitation causes an increase in the microhardness of the enamel surface after demineralization. Zamzam water is an effective remineralizing agent in initial carious lesions, and its efficacy is comparable to that of sodium fluoride., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Alkhalifah et al.)

Splenic artery aneurysm is a relatively rare, potentially life-threatening condition due to its high potential for rupture. We report a case of two incidentally found unruptured splenic artery aneurysms in a 39 year-old female victim of severe trauma resulting from a motor vehicle accident (MVA). Management by coiling of the splenic artery aneurysm and embolization to the entire segment distal to it was successfully performed for this patient., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Selim et al.)