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The widespread misconception that tonsillectomy leads to a decrease in immunity may lead to fear and avoidance of the operation. This can result in a deterioration of the situation, such as sleep-related breathing issues, frequent infections, and an increase in complications. The current research was conducted to assess the awareness and perception with respect to the impact of tonsillectomy on the immune system and to assess the awareness and perception of the relationship between autoimmune diseases and tonsillectomy. This 6-month descriptive cross-sectional online questionnaire survey was conducted among individuals who were 18 years and above living in Abha city, Saudi Arabia. Out of the 800 study subjects, 104 (13%) had undergone tonsillectomy. Statistically significant associations were found between age group, education, income, and occupation among those who had undergone tonsillectomy. Multivariate logistic regression analysis showed that ages 18–30 years and 31–40 years (OR: 2.36, 95% CI: 1.18–4.71, and OR: 1.46, 95% CI: 0.53–3.97) and education levels of high school, bachelors, and above (OR: 8.30, 95% CI: 3.05–22.58 and OR: 10.89, 95% CI: 4.23–28.05) were found to be associated with tonsillectomy status of the subjects. On the contrary, income levels of 5000–9000 and >9000 (OR: 0.65, 95% CI: 0.36–1.17 and OR: 0.78, 95%CI: 0.42–1.42) and male gender (OR: 0.79, 95% CI: 0.52–1.19) were found to be associated with non-tonsillectomy status of subjects. Almost 36% of study subjects thought that tonsillectomy affects immunity. Only 18% of study subjects thought that there is a relationship between tonsillectomy and autoimmune diseases. About one-third of the respondents had received this information from community members and social media. A small number of study subjects relied on public awareness programs. Therefore, social media can play a vital role in the community to remove misconceptions regarding tonsillectomy and its effect on immunity and autoimmune disease. Further educational interventional studies are required to see the correction to the public perception of tonsillectomy and its effect on immunity and autoimmune diseases.

This study was designed to investigate the ameliorating effect of methanolic extract of green walnut husk (GWH) in hypercholesterolemic rats. A total of thirty male Albino Wistar rats (Rattus norvegicus domestica) were divided randomly into six equal groups. Group 1, negative control, fed on a standard rat diet whereas groups 2–6, hypercholesterolemic rats, fed a high-fat diet (1% cholesterol in a standard diet). Group 2, positive control, was left untreated, whereas the groups 3–5 treated orally with methanolic extract of GWH at 200, 400, and 800 mg/kg/day BW, respectively. Group 6, treatment control, received atorvastatin intraperitoneally at a dosage rate of 0.8 mg/kg/day. The treatment lasted for 84 days. Lipid profiles, biomarkers for liver and kidney functions, some hematological parameters, and liver histopathological assessment were performed. No significant variation was observed on lipid profile values after 42 days of GWH intake; while after 84 days, there was significant reduction (P

Digital‐to‐analogue converters (DACs) are essential blocks for interfacing the digital environment with the real world. A novel architecture, using a digital‐to‐time converter (DTC) and a time‐to‐voltage converter (TVC), is employed to form a low‐power time‐based DAC (T‐DAC) that fits low‐power low‐speed applications. This novel conversion mixes the digital input code into a digital pulse width modulated (D‐PWM) signal through the DTC circuit, then converts this D‐PWM signal into an analogue voltage through the TVC circuit. This new T‐DAC is not only an energy‐efficient design but also an area‐efficient implementation. Power optimization is achieved by controlling the supply voltage of the TVC circuit with a discontinuous waveform using a low bias current. Moreover, the implementation area is optimized by proposing a new DAC architecture with a coarse‐fine DTC circuit. Post‐layout simulations of the proposed T‐DAC is conducted using industrial hardware‐calibrated 0.13 μm. Complementary metal oxide semiconductor technology with a 1 V supply voltage, 1 MS/s conversion rate, and 0.9 μW power dissipation.

Ghada H Naguib,1,2 Gamal S Abd El-Aziz,3 Hisham A Mously,4 Wafaa A Alhazmi,5 Abeer M Alnowaiser,6 Ali H Hassan,7 Mohamed T Hamed4,8 1Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; 2Department of Oral Biology, Faculty of Dentistry, Cairo University, Cairo, Egypt; 3Department of Anatomy, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 4Department of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; 5Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia; 6Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; 7Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; 8Department of Fixed Prosthodontics, Faculty of Dentistry, Cairo University, Cairo, EgyptCorrespondence: Mohamed T HamedDepartment of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, P.O.Box 80209, Jeddah, 21589, Saudi ArabiaEmail mthamed@kau.edu.saPurpose: This in vitro study was undertaken to investigate the antimicrobial effect of distinctive oral mouth washes after the addition of zein-coated (Magnesium oxide) MgO nanoparticles on exemplary of some oral microorganisms.Materials and Methods: Three hundred and twelve samples were used in this study. A set of five concentrations of MgO nanoparticles with zein and without zein-coating were incorporated into three oral mouth washes: Listerine zero, Listerine total control and Oral B in the mass percentages of 0.3%, 0.5%, 1%, 2%, 5% and 10%, in addition to controls with no MgO nanoparticles. The antimicrobial effect of three mouth washes with variable concentrations of MgO was tested against the following organisms: Staphylococcus aureus, Streptococcus mutans, Enterococcus faecalis and Candida albicans using the disc diffusion test (DDT) and direct contact test (DCT). Data were analyzed using one-way ANOVA statistical test.Results: The tested mouthwashes with zein-coated MgO nanoparticles showed significant differences of antimicrobial activity on S. mutans, S. aureus, E. faecalis, and C. albicans in the disc diffusion test. While in the DCT, all tested mouthwashes with MgO nanoparticles with and without zein coating showed antimicrobial activity on all tested microorganisms.Conclusion: Zein-coated MgO nanoparticles may be considered as a potential antimicrobial agent when added to oral mouthwashes. Future analysis, including in vivo studies, is required in order to incorporate zein/MgO nanoparticles into oral mouthwashes that may improve its antibacterial property.Keywords: MgO, nanoparticles, zein polymer, antibacterial, mouthwash

Objective To systemically review all clinical trials that evaluate the effectiveness of orthodontic intrusion using bone anchorage devices versus using other orthodontic techniques in adult patients. Material and methods All randomized, controlled clinical trials and prospective studies that compare the use of TADs in intrusion versus alternative devices from the year 2000 to 2019 were searched using various electronic databases. Databases used include Pubmed, Cochrane, Scopus, Lilacs, and ScienceDirect. Selection was initially made by reading the titles and abstracts of potential suitable studies. The final selection was made after reading the full retrieved articles. A methodological score developed by Lagravere was used to assess the quality of evidence. The selection process was illustrated using a PRISMA flow chart. Results A total of 3942 articles were retrieved, from which only two randomized clinical trials met the inclusion criteria. This presented a low to medium level of evidence to support the hypothesis that TADs are more effective than other orthodontic intrusion techniques for intruding upper incisors and improving upper incisor to lip relation while eliminating the adverse effect of compromising vertical posterior anchorage. Shorter treatment times and less root resorption were found in the TAD group. Conclusion There is insufficient evidence to state that TADs can be used as orthodontic anchorage to effectively intrude the incisors without the need for patient cooperation. Future high quality prospective randomized clinical trials are required.

This case report presents the treatment of a 12-year-old female with a severely crowded upper arch, severely palatally displaced upper premolars and lateral incisors, large midline diastema, lower midline deviation to the right, class III dental and skeletal relationships due to mild maxillary deficiency, retroclined lower incisors, straight profile, and retrusive lips. A nonextraction treatment approach is described, in which the upper and lower arches were expanded to their original three dimensions using a trihelix expander, a lip bumper appliance, and a fixed orthodontic appliance. Retention was also planned in accordance with the original malocclusion, which inclued a full-time-wear upper wraparound retainer, upper and lower anterior fixed lingual retainers, upper frenectomy, and fibrotomy for rotated teeth. Conclusion. Severe malalignment of teeth does not necessarily require extraction treatment. Gaining space is an art that requires a proper assessment of the anteroposterior and transverse dimensions of alveolar arches, lip prominence, and postorthodontic stability.

The purpose of this study was to evaluate the effect of simulated gastric acid solution on surface topography and bending properties of esthetic coated nickel-titanium (NiTi) archwires. Three brands of as-received white-coated superelastic NiTi upper archwires were used in this study: Dany, Perfect, and Nitanium. Uncoated metallic areas for each white-coated NiTi archwire were used for comparison with the coated areas. The specimens for each archwire were divided into two groups according to coating as follows: Group A, uncoated, and group B, coated. Then, each group was further subdivided into two subgroups according to the immersion medium as follows: Subgroup 1, immersed in artificial saliva, and subgroup 2, immersed in simulated gastric acid. Surface roughness, surface morphology, and three-point bending test were performed. The data were analyzed statistically using ANOVA and Tukey test. The archwires immersed in simulated gastric acid solution showed significantly higher surface roughness and lower forces on loading and unloading than the archwires immersed in artificial saliva (P

Sequestering CO2 in the form of carbon-based liquid fuels would provide both a convenient and sustainable form of energy for practical use as well as mitigate the effects of global warming and climate change. Ocean wave energy is an abundant and relatively stable source of renewable energy, which would be highly desirable for the conversion of CO2 to conveniently stored and transported liquid fuels. In this work, we demonstrate a wave-energy-driven electrochemical CO2 reduction system, consisting of triboelectric nanogenerators, a supercapacitor and a CO2 reduction reactor, that converts ocean wave energy to chemical energy in the form of formic acid, a liquid fuel. We optimize the energy storage component of the system and operation voltage of the electrochemical cell to achieve efficient energy storage and maximize the production of formic acid. Under simulated waves, the system can produce 2.798 μmol of formic acid per day via the wave energy harvested from a water surface area of 0.04 m2. Moreover, we have performed field tests in the Red Sea to demonstrate the practicality of such an electrochemical CO2 reduction system. Finally, we present design guidelines for achieving a cost-effective, efficient, and large-scale wave-energy-driven CO2 reduction system for liquid fuel production.

AIM The aim of this study is to assess the impact of dental visits on oral health awareness among the Saudi population. MATERIALS AND METHODS A cross-sectional survey was conducted in Saudi Arabia. An online self-administered questionnaire was distributed from January 2011 to June 2013. The questionnaire consisted of 21 multiple choice questions which was categorized into four: demographic data, dental care status, oral hygiene behavior, and oral health knowledge (OHK). Responses to the questions in the OHK category were grouped and scored according to their percentage of correct answers: 1 = very poor (0 to

Background To evaluate the effect of surface treatments on the push-out bond strength of Biodentine (BD) and white mineral trioxide aggregate (WMTA) to fiber posts. Methods Two brands of fiber posts were used: Reblida post; RP and RelyX post; RX. Each type of post (n = 80/group) was divided into four groups (n = 20/group) and exposed to surface treatment as follows: Control (no treatment), sandblasting (SB), hydrofluoric acid (HF), and TiF4 4 wt/v%. Each group was further subdivided into two subgroups (n = 10/subgroup) based on the type of CSCs used as follows: Subgroup A: BD and Subgroup B: WMTA. Push-out bond strength of BD and WMTA to glass fiber posts was assessed. Data were statistically analyzed using three-way ANOVA and Tukey’s test. A Weibull analysis was performed on the push-out bond strength data. Results BD showed higher bond strength than WMTA (P P 4 4 wt/v% showed the greater characteristic bond strength (σ0) (15.93) compared with the other groups. Surface treatments modified the surface topography of glass fiber posts. Conclusions The BD/RP-TiF4 4 wt/v% showed greater bond strength compared with the other groups. The TiF4 4 wt/v% surface treatment enhanced the bond strength of BD and WMTA to glass fiber posts than the other treatments. Surface treatment of fiber post with TiF4 4 wt/v% could be used to improve the bond strength with calcium silicate-based cements.

45S5 Bioglass is a bioactive glass capable of releasing ions that can interact with dental hard tissues. The current study aimed at examining the effectiveness of 45S5 Bioglass in remineralizing enamel white spot lesion (WSL) as well as its effect on the bond strength of orthodontic brackets bonded to demineralized enamel.WSLs were induced in the buccal surfaces of 135 human extracted teeth by storage in acid solution pH 4.5 for four days. The specimens were then equally divided into three groups; Demineralized group, Bioglass group (BG), and control group (intact enamel). The groups were chemically analyzed using (FTIR/ATR) Fourier-transform infrared spectroscopy/attenuated total reflectance, (XRD) X-ray diffraction, and (SEM/EDS) scanning electron microscope equipped with electron-dispersive-spectroscopy. Moreover, 10 specimens from each group were tested using Transverse Micro Radiography (TMR) technique, and 15 specimens from each group were bonded with metal orthodontic brackets and tested for shear bond strength test (SBS). The data were analyzed statistically using One way ANOVA p0.05.TMR study showed that bioglass group samples recorded lesion depth of 70.19 ± 29.21 μm and Δ Z (mineral loss) 732.15 ± 210.16 vol% μm which was significantly lower than the demineralized specimens having lesion depth of 115.75 ± 19.98 μm and Δ Z (mineral loss) 3472.69 ± 738.38 vol%μm, moreover, bioglass specimens recorded 14.15 ± 2.35 Mpa which was significantly higher than demineralized specimens 6.82+1.83 Mpa but less than the control specimens 20.5 + 6.1 MPa (p0.05). FTIR/ATR, XRD, and SEM/EDS tests showed that bioglass paste formed a layer of brushite crystals onto the treated enamel surface.45S5 bioglass paste may serve as an effective remineralizing agent for demineralized enamel.

This paper introduces a 9-bit time-based capacitance-to-digital converter (T-CDC). This T-CDC adopts a new design methodology for parasitic cancellation with a simple calibration technique. In T-CDCs, the input sensor capacitance is first converted into a delay pulse using a capacitance-to-time converter (CTC) circuit; then this delay signal is converted into a digital code through a time-to-digital converter (TDC) circuit. A prototype of the proposed T-CDC is implemented in UMC 0.13 μm CMOS technology. This T-CDC consumes 8.42 μW and achieves a maximum SNR of 45.14 dB with a conversion time of 1 μs that corresponds to a figure of merit (FoM) of 16.4 fJ/Conv.

This paper proposes a new optimization methodology for RF-to-DC converters. The proposed methodology optimizes the power conversion efficiency (PCE) at low RF input power. In addition, it improves the sensitivity and extends the dynamic range. An LC-circuit is embedded with any RF-to-DC converter circuit architecture. Since it reduces the matching constraints at different frequency bands and boosts up the low RF input power. The proposed methodology is applied to four different circuit topologies where the performance results are improved significantly compared to the original architectures. All designs are simulated and verified at dual frequency bands (1.9GHz and 2.4 GHz) with fixed load impedance $50K\Omega$ . Finally, a prototype is implemented using two different CMOS technology nodes (130nm and 65nm) to emphasize the technology process effect on the circuit nerformance.

Objectives: To determine the dental arch dimensions and arch forms in a sample of Saudi orthodontic patients, to investigate the prevalence of Bolton anterior and overall tooth size discrepancies, and to compare the effect of gender on the measured parameters. Methods : This study is a biometric analysis of dental casts of 149 young adults recruited from different orthodontic centers in Jeddah, Saudi Arabia. The dental arch dimensions were measured. The measured parameters were arch length, arch width, Bolton’s ratio, and arch form. The data were analyzed using IBM SPSS software version 22.0 (IBM Corporation, New York, USA); this cross-sectional study was conducted between April 2015 and May 2016. Results : Dental arch measurements, including inter-canine and inter-molar distance, were found to be significantly greater in males than females ( p less than 0.05). The most prevalent dental arch forms were narrow tapered (50.3%) and narrow ovoid (34.2%), respectively. The prevalence of tooth size discrepancy in all cases was 43.6% for anterior ratio and 24.8% for overall ratio. The mean Bolton’s anterior ratio in all malocclusion classes was 79.81%, whereas the mean Bolton’s overall ratio was 92.21%. There was no significant difference between males and females regarding Bolton’s ratio. Conclusion : The most prevalent arch form was narrow tapered, followed by narrow ovoid. Males generally had larger dental arch measurements than females, and the prevalence of tooth size discrepancy was more in Bolton’s anterior teeth ratio than in overall ratio. Saudi Med J 2018; Vol. 39 (1): 86-91 doi: 10.15537/smj.2018.1.21035 How to cite this article: Omar H, Alhajrasi M, Felemban N, Hassan A. Dental arch dimensions, form and tooth size ratio among a Saudi sample. Saudi Med J . 2018 Jan;39(1):86-91. doi: 10.15537/smj.2018.1.21035.

Objectives: To evaluate the effectiveness of pre-surgical nasoalveolar molding (PNAM) in patients with unilateral cleft lip nasal deformities. Methods: This was a retrospective study involving 29 patients with unilateral cleft lip and palate defects, of whom 13 were treated with palatal devices with nasal stents (PNAM group) and 16 were treated with palatal devices without nasal stents or surgical tapes (control group). Submental oblique photographs and orthodontic models were longitudinally obtained at the initial visit (T1) and immediately before (T2) and after cheiloplasty (T3). Asymmetry of the external nose, degree of columellar shifting, nasal tip/ala nose ratio, nasal base angle, interalveolar gap, and the sagittal difference in the alveolar gap were measured. The study was conducted in the Orthodontic Clinic at Tokushima University Hospital, Tokushima, Japan between 1997 and 2012. Results: At T1, there were no significant intergroup differences in the first 4 asymmetry parameters. At T2, the PNAM group showed a significant improvement in all values compared to the control group. At T3, the PNAM group showed significant improvement in nasal asymmetry and columellar shifting. Model analysis showed significantly greater changes in the inter-alveolar gap and the sagittal difference of the alveolar cleft gap from T1 to T2 in the PNAM group. Conclusion: The use of PNAM is indispensable for pre-surgical orthodontic treatment at the early postnatal age. Saudi Med J 2018; Vol. 39 (2): 169-178 doi: 10.15537/smj.2018.2.21020 How to cite this article: Kinouchi N, Horiuchi S, Yasue A, Kuroda Y, Kawai N, Watanabe K,et al .Effectiveness of presurgical nasoalveolar molding therapy on unilateral cleft lip nasal deformity. Saudi Med J . 2018 Feb;39(2):169-178. doi: 10.15537/smj.2018.2.21020.

Analog-to-digital converter (ADC) is one of the crucial blocks for the software defined radio applications that require higher resolution, and less power consumption; accordingly, time-based analog to digital converters (T-ADC) are introduced to make use of the technology scaling, achieving low-power consumption and high-speed compared to traditional ADCs. T-ADC is composed of two parts voltage-to-time converter and time-to-digital converter; the proposed design is based on converting the voltage to frequency instead of time using the voltage-to-frequency converter. The new methodology increases the circuit sensitivity, and reduces the linearity error. Furthermore, the new methodology enhances the maximum input frequency, effective number of bits (ENOB), and signal to noise and distortion ratio (SNDR). In the proposed study, the maximum input frequency increases up to 74.8 MHz with linearity error of 3%, sensitivity of 43.24 GHz/V, ENOB of 2.79 bits and SNDR of 18.54 dB using TSMC 65 nm CMOS technology with a supply voltage of 1.2 V.

The present work compared the effects of 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride (EDC-HCl) and ultraviolet (UV)- or blue light-activated riboflavin cross-linking agents on resin–dentin micro-tensile bond strength and nanoleakage in bonds produced using a two-step, etch-and-rinse adhesive after three storage intervals (24 h, 6 months, and 12 months). Forty eight extracted human third molars were used to investigate micro-tensile bond strength and interfacial nanoleakage in resin–dentin bonds created using Adper Single Bond 2, with or without pretreatment of acid-etched dentin surfaces. Either 0.5 M EDC-HCl or 1% riboflavin-5-phosphate activated by blue or UV light were used as cross-linking agents. Samples were evaluated after storage for 24 h, 6 months, or 12 months in distilled water at 37 °C. Statistical analyses revealed that 12 months of storage resulted in significant decreases in the bond strength of the controls (p 0.05). Dental collagen cross-linking induced by UV- or blue light-activated 1% riboflavin or EDC-HCl enhanced the durability and strength of the resin–dentin bond.

Piezocision (corticotomy) is a minimally invasive approach that involves micro-incisions, piezoelectric incisions, and selective tunnelling for soft or hard tissue grafting. Piezocision has many uses in orthodontics, but its uses in cross-bite cases are limited. This case report illustrates the outcomes of a 19-year-old female patient with unilateral cross-bite that was treated with a minimally invasive piezocision with bone grafting in the affected side. In addition, she also had a functional shift, severe crowding, and mid-line shift. Therefore, the shift was eliminated using a quad helix expansion, she was treated with a fixed appliance, and a bimaxillary extraction of the first premolars was performed. The patient followed-up at 18 months, and the occlusion was stable with a pleasant profile. Piezocision can be used as an adjunct to the orthodontic treatment of adults to facilitate the treatment of complicated cases. Saudi Med J 2017; Vol. 38 (4): 425-430 doi:10.15537/smj.2017.4.16390 How to cite this article: Bakathir MA, Hassan AH, Bahammam MA. Piezocision as an adjunct to orthodontic treatment of unilateral posterior crossbite. Saudi Med J. 2017 Apr;38(4):425-430. doi: 10.15537/smj.2017.4.16390.