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Aafreen Aafreen,1 Abdur Raheem Khan,1 Ashfaque Khan,1 Ausaf Ahmad,2 Abdullah Hussain Alzahrani,3 Abdullah Ibrahim Alhusayni,3 Abdulaziz H Alameer,4 Ramzi Abdu Alajam,4 Bhuvanesh Babu Mondey Ganesan,4 Mohammad Abu Shaphe4 1Department of Physiotherapy, Integral University, Lucknow, India; 2Department of Community Medicine, Integral University, Lucknow, India; 3Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia; 4Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan, Saudi ArabiaCorrespondence: Abdur Raheem Khan, Department of Physiotherapy, Integral University, Lucknow, India, Tel +9616739965, Email abdul.fortis@gmail.comPurpose: Neck pain is a prevalent musculoskeletal issue among bike drivers, often resulting from extended static postures, repetitive head movements, and exposure to vibrations. This study aims to assess the connection between cervical ROM, neck proprioception, CVA, and QOL in bike drivers with neck pain compared to those without neck pain so that the targeted interventions can be developed to enhance their well-being.Methods: A cross-sectional study involving 100 bike drivers aged 20– 50 years was conducted, split into two groups: those with neck pain (n=50) and those without neck pain (n=50). Cervical ROM was measured using a smartphone, neck proprioception was assessed through a head repositioning test, and CVA was determined using lateral-view photographs with a plumb line. The Short Form-36 (SF-36) questionnaire was employed to evaluate QOL. Data analysis was conducted using independent t-tests and Pearson’s correlation coefficient.Results: Bike drivers with neck pain exhibited significantly reduced cervical ROM (p-value=< 0.001), impaired neck proprioception (p-value=< 0.001), and decreased CVA (p-value=< 0.001) compared to their counterparts without neck pain. A strong negative correlation was found between neck pain and QOL, with lower scores in all eight domains of the SF-36. Cervical ROM, neck proprioception, and CVA showed moderate correlations with various QOL domains (p-value=< 0.05).Conclusion: Neck pain in bike drivers is linked to decrease cervical ROM, compromised neck proprioception, and reduced CVA. These factors correlate with a lower quality of life, both physical and mental domains. Interventions addressing these aspects may enhance the quality of life for bike drivers experiencing neck pain.Keywords: cervical range of motion, neck proprioception, craniovertebral angle, quality of life, neck pain, bike drivers

Purpose: The aim of this study was to evaluate the existence of different esthetic smile criteria as determined on the smiles of celebrities, which were considered by lay people to be beautiful. Materials and Methods: An Internet search for 'best smile' and 'female celebrities' in the years 2007 and 2008 identified 50 celebrities who were voted to have beautiful smiles. Another search was made for images of these celebrities that showed the entire face with an open smile. The images were analyzed using Digimizer image analysis software for different esthetic smile criteria. Results: Eighty percent of the sample was classified as having an average upper lip position, 62% showed upward upper lip curvature, and 78% had a parallel smile line. Forty-two percent of the images showed the maxillary anterior teeth not touching the lower lip, while 34% were touching, and 24% slightly covered it. Sixty percent displayed up to the second premolar, and 32% displayed up to the first molar when smiling. Midline deviation was detected in 36% of the sample. Diastema and golden proportion were not seen in any of the subjects. Conclusion: Female celebrities voted to have the best smile by lay people showed most of the esthetic smile criteria with slight variations, except for the golden proportion. The opinions and perceptions of lay people about beauty should be studied and evaluated. Int J Prosthodont 2011;24:64-70. [ABSTRACT FROM AUTHOR]

The primary objective of this study was to conduct a bibliometric analysis of the most influential papers on ST-Elevation Myocardial Infarction (STEMI). Using the Scopus database (October 2024), a targeted search was performed to identify relevant publications. Three retrieval options were considered based on the appearance of search terms. Precisely those documents were analyzed where the search terms appeared only in the title, allowing for a focused analysis of the most directly relevant studies. Next, from this search, the top 100 most cited papers, spanning from 1981 to 2018, were selected for detailed examination. Data analysis was conducted using VOSviewer and R Studio to provide insights into publication trends, author productivity, and the thematic focus of STEMI research. Author performance was evaluated through various bibliometric indicators, including total publications (TP), total citations (TC), h-index, g-index, m-index, HG composite, and Q2 index. Key metrics such as mean total citations per article (MeanTCperArt) and mean annual citation rate (MeanTCperYear) were also calculated. Thematic analysis of research topics was conducted using unigrams, bigrams, and trigrams, highlighting primary areas of focus across the most impactful STEMI studies. The results underscore significant trends in STEMI research, with highly cited papers shaping the field's evolution. This bibliometric approach provides valuable insights into research patterns, major contributors, and prevalent themes within STEMI literature., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Inc. All rights reserved.)

BACKGROUND This study examined the effects of khat extract on the proinflammatory cytokines, liver, and kidneys of rats. Unlike previous research that focused on broad immune markers and general effects, this study investigated specific proinflammatory cytokines (IL-1ß, IL-2, IL-4, IL-6, and TNF-alpha) and considered gender differences in the immune response. Fresh khat plants and nontoxic doses were used to obtain clear observations relevant to human health. MATERIAL AND METHODS Extracts were prepared from young shoots of khat plants and fresh leaves. 150-gram male and female rats were randomly divided into 8 groups (5 rats per group). Six groups received the extract orally for 8 weeks at doses of 100, 300, and 500 mg/kg/day. Blood samples were collected after 56 days and assayed for cytokines using ELISA, while liver enzymes and kidney markers were assayed using kinetics and colorimetric methods. RESULTS Khat extract increased the levels of most cytokines, with higher doses causing greater increase. This effect was consistent across sexes for some cytokines (IL-1ß, IL-2), but not others (IL-4, IL-6, TNF-alpha), where sex played a role at specific doses. Various doses of the extract influenced glucose levels in both male and female rats. In addition, liver enzyme markers showed some variations. CONCLUSIONS This study, with its intriguing findings, illuminates the complex effects of khat on various systems. Variations in AST and ALT levels in the liver support earlier hepatotoxicity research and suggest possible khat-induced damage. This study revealed consistently increased levels of all cytokines as the dose of khat extract increased.

Background: Two validated and effective extraction techniques have been developed to ascertain the presence of polycyclic aromatic hydrocarbons (PAHs) in traditional cigarettes and E-cigarettes. PAHs are a class of chemicals that occur naturally, and these contaminants may cause cancer and other harmful effects in human beings. Traditional cigarettes and E-cigarettes contain many PAHs., Method: In terms of linearity, limit of detection, limit of quantification, accuracy (%), and precision (%), the two in-house lab setups for 7PAHs extraction from traditional cigarettes and E-cigarette were validated using high-performance liquid chromatography-fluorescence detection., Results: The concentration of Σ7PAHs for traditional cigarettes and E-cigarettes ranged from 6.23 ± 0.04 ng/cig to 75.61 ± 0.02 ng/cig, and non-detectable to 3.56 ± 2.71 ng/puff. The PAHs recovery in traditional cigarettes and E-cigarettes ranged from 92.74-110.45%, and 97.20-111.74%. The toxicity of equivalent (TEQs) of carcinogens revealed that traditional cigarettes brands have higher TEQs than E-cigarettes., Conclusion: This study highlights the detection of 7PAHs levels and its risk assessment in product brands for traditional cigarettes and E-cigarettes marketed in Saudi Arabia. The results suggested that the developed methods are a precise and versatile approach for measuring 7PAHs in traditional cigarettes and E-cigarettes., (© 2024. The Author(s).)

Objective: Frankincense ( Boswellia ) and Myrrh ( Commiphora ) are natural substances that have a long history of traditional use and potential therapeutic applications. This study aimed to provide comprehensive insights into the literature on Frankincense and Myrrh research (FMR) by examining patterns, perspectives, and research trends within the research landscape., Methods: This bibliometric study utilized MeSH-generated terms, followed the PRISMA guidelines, and analyzed English-based bibliographic data from original studies retrieved from the Scopus database. The VOSviewer and Bibliometrix applications were employed to analyze the CVS and BibTex data consisting of 955 records. This study focuses on publication trends, research topics, citation counts, research impacts, and collaboration dynamics., Results: The analysis revealed a steady increase in FMR, indicating growing interest in these substances. Egypt, the United States, and Saudi Arabia are the most prolific countries in terms of research output. FMR primarily focuses on chemical composition, pharmacological properties, and medicinal applications. Key research topics include identification and analysis of bioactive compounds, optimization of extraction techniques, and evaluation of their therapeutic potential. Surprisingly, the thematic map was overwhelmed by the niche, motor, basic, and emerging themes. Trending topics in FMR include "Myrrh oil", "sesquiterpene", "tapping", "triterpenoids", and "allergic contact dermatitis". Collaboration networks highlight the involvement of diverse stakeholders, indicating the importance of multidisciplinary and international collaboration in advancing the field., Conclusions: These insights contribute to a better understanding of the research landscape of FMR, guiding future studies and facilitating the utilization of these natural substances for the benefit of society., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

The project aimed to conduct an up-to-date and comprehensive bibliometric analysis of robotic surgery to provide a detailed and holistic understanding of the field. Three strategies were employed in the data analysis i.e. search terms were explored in (A) the title, abstract, and keywords and (B) only in the title of the documents. In 3rd part we analyzed the top 100 most cited papers. Vosviewer and R Studio were utilized for detailed bibliometric and network analyses. Strategy one identified 38,469 publications, and strategy two identified 6451 publications from 2001 to 2023. The top authors, universities, countries, sponsors, and sources based on the number of publications were identified for both strategies. The top 100 most cited papers were analyzed, providing the annual number of publications and various citation metrics. Top authors (by number of publications, total citations, h-index, g-index, and m-index), universities, and countries within these highly cited papers, along with their co-authorship networks and dynamics, were examined. Co-words analysis of the top 100 most cited papers revealed the primary focus of these documents across 25 categories. This comprehensive bibliometric analysis of robotic surgery highlighted significant contributions and collaborations in the field, emphasizing the importance of global and collaborative efforts in advancing robotic surgery research., (© 2024. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)

Background: Over the past 15 years, WORLD NEUROSURGERY (WN) has emerged as a pivotal source in the neurosurgery field, reflecting remarkable growth and development. Originally published as Surgical Neurology from 1973 to 2009, the journal transitioned to its current title in 2010, significantly expanding its reach and influence., Methods: A comprehensive bibliometric analysis of WN's publications from 1973 to 2023 was performed. The analysis focused on identifying the top authors, universities, countries, and sponsors in 2 periods: 1973-2009 and 2010-2023. Additionally, the study included a detailed examination of the top 1000 most cited papers, and summary of top 10 most cited papers., Results: The analysis revealed that during the Surgical Neurology period, 6567 research documents were published, including 6503 articles and 64 reviews. Since rebranding as WN, the journal has published an additional 17,663 documents, comprising 15,366 articles and 2297 reviews up to 2023. The top contributors (authors, universities, and sponsors) were identified, and the study found that WN has successfully increased its foothold across various continents. The co-word analysis provided insights into the thematic focus of the top 1000 most cited papers, categorizing them into 15 distinct areas., Conclusions: This study underscores WN's significant role in advancing neurosurgical research over the past 5 null decades. The findings highlight the journal's evolution, its expanding global influence, and the key contributors to its success., (Copyright © 2024 Elsevier Inc. All rights reserved.)

This laboratory research aimed to assess the Flexural strength, fracture toughness, Volumetric wear and optical properties of various recent 3D-printed denture tooth materials and compare them to CAD/CAM milled materials. Four 3D-printed denture tooth materials (Lucitone Tooth, OnX, Flexcera Ultra +, and VarseoSmile Crown Plus) and one CAD/CAM milled denture teeth material (Ivotion Dent) were used to fabricate fifteen specimens for each material (with total no. of 300 specimens). Tests were conducted according to ISO standards to assess flexural strength, fracture toughness, color staining, and volumetric wear. All materials were printed, washed, cured, or milled following the manufacturer's instructions. Flexural strength and fracture toughness values were obtained by a universal testing machine. Volumetric wear was evaluated using a non-contact optical profilometer. Color stability outcomes were obtained via a spectrophotometer for determining L*a*b* values, with color change (ΔE2000) based on the CIEDE2000 formula. Data were analyzed using one-way ANOVA and Tukey post-hoc analysis (α = 0.05). All 3D-printed materials exhibited higher flexural strength values than the milled material (p < 0.05). For fracture toughness, two of the 3D-printed materials showed higher values than the milled material, while the other two had lower values. Insignificant variances in volumetric wear were detected between the materials (p > 0.05). Color staining results varied, with milled materials generally demonstrating better-staining resistance compared to the 3D-printed materials. 3D-printed denture tooth materials exhibit good mechanical and optical properties, presenting a cost-effective and efficient alternative to CAD/CAM milled materials for denture tooth fabrication., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 THE AUTHORS.)

This study analyzed the growth, collaboration, citation trends, and emerging topics in nanoparticle-based vaccine and adjuvant research (NVAR) from 1977 to 2023, using data from the Scopus database. The field showed a steady growth rate of 7.53% per year. Leading researchers Jaafari, M.R. and Alving, C.R. contributed significantly to the field, with 24.22% of publications and 38.92% of total citations coming from the United States. International collaboration was very strong, particularly between the US, UK, Germany, China, and France. Key research topics include nanoparticles, immunotherapy, COVID-19, and vaccines with a focus on SARS-CoV-2 and malaria. Emerging topics include vaccine adjuvants, mRNA, and neutralizing antibodies. This study emphasizes the importance of ongoing collaboration and interdisciplinary efforts to advance the field of NVAR.

Background: Research on Coffea arabica focuses on various aspects, including genetics, breeding, climate change resilience, pest and disease management, agronomy, sensory analysis, and sustainability. This study aims to analyze the hotspots, conceptual map and dynamicity, global landscape, and emerging trends in Coffea arabica research (CA-R)., Methods: A comprehensive dataset comprising data-driven articles (N = 3967) from 1932 to 2023 was extracted from Scopus using predefined search terms. VOSviewer and Bibliometrix applications were utilized to analyze the data. Thematic evolution was examined by identifying shifts in research focus over time. The global landscape was assessed by examining comparative productivity and collaborative dynamics. Highly-cited CA-R was identified to highlight key findings in specific research areas., Results: The analysis revealed a steady growth of CA-R (annual growth rate = 6.53 %), with strong international collaboration (international co-authorships = 29.35 %) and significant contributions from various countries. Brazil leads the way with 1601 publications, accounting for 28.55 % of the total. Recognizable CA-R focused on important areas such as pollination, shade management, nanotechnology applications, roasting effects, disease management, and environmental impacts. Thematic analysis identified five distinct clusters representing different CA-R themes: "coffee", "coffea," "fermentation," " Coffea arabica ," and "climate change." Emerging themes such as " in vitro culture," "sustainable agriculture," "climate change," and "coffee berry borer" were also identified., Conclusion: The current findings enhance our understanding of CA-R and lay the groundwork for future studies in the coffee industry., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier Ltd.)

BACKGROUND We used the 14-item Oral Health Impact Profile-14 (OHIP-14) questionnaire to evaluate the association between sociodemographic variables and oral health-related quality of life in 241 wearers of removable partial or complete dentures attending a single center in Yemen. MATERIAL AND METHODS A total of 241 partial dentures (PD) and complete dentures (CD) wearers were enrolled from the Department of Prosthodontics at the Faculty of Dentistry, Sana'a University, and the University of Science and Technology. Data were collected before the commencement of denture wearing and after 3-6 months of denture use. The questionnaire consisted of sociodemographic information and denture type, and another for the OHIP to assess oral health-related quality of life (OHRQoL), oral health impact profile scale comprises 7 subscales, each evaluating different aspects of oral health and functionality. Descriptive statistics were calculated for participants. Independent t tests were performed to compare different patient groups, focusing on PD and CD wearers. Paired-sample t tests were used to examine changes within patient groups before and after removable denture use. RESULTS Among all participants, 67.6% were male, wearers of CDs were 74.6% male, PDs were 58.3%, and was consistent for CD (71.0%) and PD (72.8%) wearers. The wearing prostheses significantly impacted the OHRQoL of patients using both PDs and CDs (P<0.01). Among CD wearers, 4 of these subscales (3-6) were statistically significant, but the handicaps subscale showed evident reductions in physical pain after treatment among PD wearers. CONCLUSIONS Wearing dentures positively affects the OHRQoL of patients, influencing various aspects of their health, including functional, physical, psychological, and social well-being.

Introduction Ear, nose, and throat (ENT), often known as otorhinolaryngology (ORL), is a subspecialty within medicine that specializes in diagnosing and treating conditions affecting the head, neck, and ears. Understanding ORL is essential for treating common ENT issues, avoiding complications, and preserving quality of life. These diseases can affect numerous physiological processes, including taste, smell, speaking, breathing, swallowing, hearing, and secretion clearance. In order to guide interventions for improved ENT health, our study sought to evaluate university students' degree of ORL-related knowledge. Methodology It is a cross-sectional study conducted among students at King Khalid University in Saudi Arabia. Validated surveys are used to collect data via the Internet, including online and email-based data collecting. Data are cleaned in Excel and analyzed by IBM SPSS (IBM Corp., Armonk, NY). Results Our study included 131 Saudi university students in Abha City, revealing significant knowledge gaps and misconceptions regarding ENT issues. Despite high awareness of certain topics like flu vaccination (87.8%) and the association between hearing loss and social life (95.4%), misconceptions persisted, such as the belief in vitamin C's efficacy against influenza (51.9%). Notably, 47.3% displayed good knowledge, 26.7% showed moderate knowledge, and 26% demonstrated poor knowledge about ENT issues. Significant associations were found between knowledge levels and age (p<0.001), academic level (p<0.001), and previous surgery related to ENT issues (p=0.014). Conclusion Our study revealed that 47.3% of participants have good levels of knowledge regarding ENT problems, with significant associations found with age, academic level, previous ENT surgery, and diagnoses of throat issues. Education campaigns should target specific demographics to improve the overall understanding of ENT health., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Research Board of King Khalid University, Abha, Saudi Arabia issued approval ECM#2024-1405. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Al Sulaiman et al.)

Background: Brucellosis is a bacterial zoonotic infection that is endemic in Saudi Arabia and associated with clinical and economic impacts. Several studies from countries endemic for brucellosis evaluated the knowledge and attitude of livestock farmers regarding brucellosis. However, no such study was conducted in Saudi Arabia. This study aimed to evaluate the knowledge, attitude, and practice of livestock farmers and meat handlers in Saudi Arabia., Methods: This was a cross-sectional questionnaire-based study, where participants were interviewed in-person in Arabic in livestock markets between September-December 2023. Convenient sampling was utilized. The questionnaire included basic demographics and questions to assess the knowledge, attitude, and practice toward personal protection and protection of the animals from brucellosis. The questionnaire was adapted from a previously validated survey and included 59 questions. Providing at least one correct answer to a certain question indicated a good knowledge about this item or a safe practice. The participants were divided into: farmers (shepherds working for the animal owners), commercial animal owners (those who rent a stockyard in the livestock market and employ farmers to sell their animals), and private animal owners (owners of private farms from which they sell their animals)., Results: 545 participants were interviewed ( n  = 291 farmers, n  = 118 commercial animal owners, n  = 113 private animal owners, and n  = 23 animal slaughterhouse workers). >90% have heard of brucellosis. Lack of education and short experience (<5 years) of working with livestock were negatively associated with good knowledge of brucellosis symptoms and transmission (OR, 0.30; 95%CI, 0.10-0.94; p  = 0.038 and OR, 0.23; 95%CI, 0.08-0.62; p  = 0.004, respectively). Taking sick animals to the veterinarian was reported by 61.2%, whereas 36.4% follow safe practices when disposing of aborted fetuses. While 34% consume raw milk, only 10% consume rare/medium-rare meat. 51.2% acknowledged the need for more information on brucellosis., Conclusion: This study revealed the need to augment the knowledge of people working with animals, particularly those with no school education and those with short work experience, via providing educational visits or materials or through veterinarians. This should help them identify human and animal brucellosis symptoms and increase the knowledge on how to protect oneself and animals from this disease., 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 © 2024 Alghafeer, Aldhukair, Alzahrani, Alsaedi, Almutairi, Aloliky, Almutairi and Thabit.)

BACKGROUND The nasopalatine canal (NPC), or incisive canal, is located in the midline of the palate, posterior to the maxillary central incisors. Its anatomy is important in prosthetic dentistry procedures. This study aimed to assess the anatomical morphology of the NPC according to age, sex, and dental status using cone-beam computed tomography (CBCT) in 335 patients. MATERIAL AND METHODS In this retrospective cross-sectional study, a total of 335 patients were recruited and categorized according to sex, age, and dental status. Individual CBCT images were analyzed in the sagittal, coronal, and axial planes. Also, we recorded the dimensions and morphological shape of the NPC and adjacent buccal bone plate (BBP) under standardized conditions. The associations between sex, age group, NPC shapes and types, and presence of central incisors were assessed. A significance level was set at P<0.05. RESULTS Mean labio-palatal and mediolateral measurements of the incisive foramen were 5.13±1.45 mm and 3.21±0.96 mm, whereas the mean diameter of Stenson foramen was 2.57±1.25 mm, and the total length of the NPC was 11.79±2.50 mm. Funnel, Y, and round-shaped canals were the most prevalent shapes of the NPC in sagittal, coronal, and axial planes. BBP was greater in men, with P=0.011, P=0.000, and P=0.001 at BBP1, BBP2, and BBP3, respectively. CONCLUSIONS NPC and BBP parameter values were slightly higher among male patients. NPC parameters increased with older age. The crest width of BBP decreased with older age and after missing maxillary central incisor teeth.

Objectives: Autism spectrum disorder (ASD) is a neurological condition that affects social communication and causes repetitive behavior. Autistic children often have comorbidities such as epilepsy. Although the co-occurrence of epilepsy and ASD is frequent, the genetic basis for this association is not fully understood. Many cases of ASD and epilepsy remain unresolved without a molecular diagnosis. The purpose of this study was to determine the molecular diagnostic yield in two Saudi families with a single affected offspring with both ASD and epilepsy using whole-exome sequencing (WES)., Methods: Pediatric patients were diagnosed by a pediatric psychiatrist and neurologist, and diagnosed according to the diagnostic and statistical manual of mental disorders (DSM-V) criteria. WES was used to analyze the coding region of DNA from the two trios. Enrichment analysis was performed on the final list of genes., Results: De novo variations were detected in eleven genes (two in ZBTB17 and FRG, and one each in CAD, CTNNA3, GILGA8J, CCZ1, CASKIN1, growth differentiation factor (GDF7), NBPF10, DUX4L4, and ZNF681). Variations in CTNNA3, GOLGA8J, CASKIN1, CCZ1, and NBPF10 genes were correlated to autism. In addition, similar studies found that CAD, CASKIN1, and GOLGA8J were candidate genes for epilepsy. FRG1 and DUX4 variations were associated with facioscapulohumeral muscular dystrophy. The expression of ZBTB17 and GDF was high in nervous system, and variations in these genes might be correlated to autism and epilepsy., Conclusion: Not all the genes presumed to cause ASD and epilepsy in this study were previously identified, suggesting that more genes were suspected of being involved in ASD and epilepsy co-occurrence., (Copyright: © International Journal of Health Sciences.)

Objective: Limited comparative data guide the decision between coronary artery bypass grafting and percutaneous coronary intervention for multivessel revascularization in ischemic cardiomyopathy. The study objective was to compare the long-term outcomes of coronary artery bypass grafting and percutaneous coronary intervention for ischemic cardiomyopathy., Methods: Clinical registries from the New Jersey Department of Health linked to administrative databases were used to compare all-cause mortality, repeat revascularization, heart failure readmissions, myocardial infarction, and stroke using Cox proportional hazards and propensity matching with competing risk analysis in 5988 patients with ejection fraction 35% or less who underwent coronary artery bypass grafting (3673, 61.3%) or percutaneous coronary intervention (2315, 38.6%) for multivessel coronary disease between 2007 and 2018. Median follow-up time was 5.2 years (range, 0-13 years); the last follow-up date was December 31, 2020., Results: After controlling for completeness of revascularization, at 13 years, mortality was 57% (95% CI, 51-63) after percutaneous coronary intervention and 60% (95% CI, 53-66) after coronary artery bypass grafting (hazard ratio [HR], 1.10; 95% CI, 0.93-1.31; P = .28); risk of repeat revascularization was 18% for percutaneous coronary intervention versus 14% for coronary artery bypass grafting (HR, 1.62; 95% CI, 1.17-2.25; P = .003); risk of readmission for heart failure was 16% after percutaneous coronary intervention and coronary artery bypass grafting (HR, 1.13,95% CI, 0.84-1.51, weighted P = .10); risk of myocardial infarction was 10% versus 6%, respectively (HR, 1.91; 95% CI, 1.18-3.09; P = .007); and stroke risk was 3% versus 4%, respectively (HR, 0.79; 95% CI, 0.41-1.53; P = .52). Rate of complete revascularization was lower after percutaneous coronary intervention than after coronary artery bypass grafting and associated with higher mortality after percutaneous coronary intervention (HR, 1.35; 95% CI, 1.20-1.52; P < .001)., Conclusions: Coronary bypass was associated with similar mortality, stroke, and heart failure readmissions, and reduced repeat revascularization compared with percutaneous coronary intervention in patients with ischemic cardiomyopathy if similar rates of complete revascularization were achieved. These findings support consensus recommendations for coronary artery bypass grafting and medical therapy in patients with multivessel coronary disease and left ventricular dysfunction., Competing Interests: Conflict of Interest Statement The authors reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest., (Copyright © 2024 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)

BACKGROUND Modification of the glass fiber post (GFP) with titanium dioxide or silver particles can improve the durability and reliability of dental treatments for ensuring long-term success. This research assessed the tensile bond strength (TBS) of an adhesive system used for cementing GFPs into root dentin following the incorporation of nanoparticles of titanium dioxide (NTiO2) and silver (NAg). MATERIAL AND METHODS Sixty human maxillary canines were prepared to create a 10-mm intra-radicular space for post placement from the cementoenamel junction. The specimens were randomly allocated into 2 groups (a non-thermocycling group and a thermocycling group). Each group was divided into 3 subgroups (10 samples each) according to the adhesive system used (adhesive system devoid of any addition, adhesive system including 1% NAg, and adhesive system infused with 1% NTiO2). TBS tests were conducted and recorded in MPa using a Universal Testing Machine, with an axial load applied at a rate of 0.5 mm/min until failure. The TBS for both groups (non-thermocycling and thermocycling) was measured in megapascals (MPa), and the failure type was recorded. The data were statistically analyzed using one-way analysis of variance (ANOVA) and Tukey's test with P.

Background: Current guidelines recommend revascularization in patients with ischemic cardiomyopathy (ICM). However, there is limited information about the trends and outcomes of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in ischemic cardiomyopathy patients with multivessel coronary artery disease., Methods and Results: Using New Jersey state mandatory registries, 8083 patients with ischemic cardiomyopathy with CABG or PCI revascularization for multivessel coronary artery disease from 2007 to 2018 were included in the analysis. Joinpoint regression and multivariable logistic regression analyses were performed to assess the annual percentage change in trends and predictors of the 30-day mortality rate, respectively. A decline in CABG procedures was observed from 2007 to 2011 (annual percentage change, -11.5%; P =0.003), followed by stabilization. The PCI trend remained unchanged from 2007 to 2010 and then increased significantly (annual percentage change, 3.2%; P =0.02). In the subsample of patients with proximal left anterior descending artery plus circumflex and right coronary artery, CABG was a predominant procedure until 2011, and the proportion of both procedures did not differ thereafter. In the subsample of patients with left anterior descending artery and any other artery stenosis, PCI remained dominant from 2007 to 2018, while in patients with left main and any other artery stenosis, CABG remained dominant from 2007 to 2018 ( P <0.001). The 30-day risk-adjusted mortality rate was higher after PCI versus CABG for each year, but after adjustment for completeness of revascularization, there was no difference between groups., Conclusions: The patterns of revascularization procedures for patients with ischemic cardiomyopathy with multivessel coronary artery disease have changed over the years, as evidenced by the changes in CABG and PCI trends. CABG and PCI had comparable 30-day risk-adjusted mortality risks.

Aim: To develop and characterize doxorubicin-loaded sodium selenite nanoparticles (SSNP-DOX) and their surface attachment with cetuximab (mAb-SSNP-DOX). Methods: SSNP-DOX was formulated by gelation and then conjugated with cetuximab to form mAb-SSNP-DOX. Characterization included DLS, SEM, TEM, DSC, Raman spectroscopy and XRD. In vitro , the kinetics of doxorubicin release and cytotoxicity in MCF-7 breast cancer cells were investigated. Results: The zeta potential for SSNP-DOX and mAb-SSNP-DOX was -14.4 ± 10.1 mV and -27.5 ± 7.28 mV, with particle sizes of 181.3 nm and 227.5 nm, respectively. The formulation intensity was 89.7% for SSNP-DOX and 100% for mAb-SSNP-DOX, with PDI values of 0.419 and 0.251, respectively. SEM and TEM showed that mAb-SSNP-DOX was smooth and spherical. The DSC analysis revealed exothermic peaks at 102.44°C for SSNP-DOX and 144.21°C for mAb-SSNP-DOX, along with endothermic peaks at 269.19°C and 241.6°C, respectively. Raman spectroscopy showed a higher intensity for mAb-SSNP-DOX. The XRD study showed different peaks for each formulation. Both followed zero order kinetics for doxorubicin release. Cytotoxicity studies showed significant effects and high apoptosis in MCF-7 cells for both formulations. Conclusion: The mAb-SSNP-DOX showed promising properties, more effective doxorubicin release and higher cytotoxicity against breast cancer cells compared with SSNP-DOX.

Background/purpose Periodontal pathologies which are considered odontogenic in origin can be a major cause of maxillary sinusitis, along with other dental and non-dental causes. The aim of this study is to define and assess the relationship between periodontitis and maxillary sinusitis. Material and methods A total of 415 CBCT datasets of periodontitis patients were cross-sectionally evaluated. Alveolar bone loss and maxillary sinus mucosal thickening were measured in coronal and sagittal sections, these two variables represent the severity of periodontitis and maxillary sinusitis, respectively. Results This study found that mucosal thickening was significantly higher in patients with increased alveolar bone loss severity (P=0.03). Mucosal thickening was significantly higher among males (83.5%) than among females (69.8%) (P=0.001). moderate or severe alveolar bone loss had a significantly higher risk of mucosal thickening with an odds ratio of 1.8 when compared to those with mild alveolar bone loss (95% CI: 1.04-3.2). Males had an increased risk of mucosal thickening compared to females with an odds ratio of 2.2 (95% C.I.: 1.4-3.6). Conclusion In conclusion, periodontal structure can affect maxillary sinus and its health. Therefore, after confirming a diagnosis of maxillary sinusitis, a detailed examination of periodontal health is needed. These results can be used to increase the awareness of dental students and practitioners in clinical and diagnostical judgement., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, AlRowis et al.)

Background and Objectives : This review focuses on reviewing studies from the literature regarding the effects of deep margin elevation on the surrounding periodontium. Materials and Methods : A review of the literature was carried out using the following online databases: Embase, The Cochrane Library, MEDLINE-PubMed and Google Scholar. Our search was limited to articles from 2010 to 2023. The search terms consisted of keywords and MeSH terms, which were 'deep margin elevation', 'coronal margin relocation', 'periodontium' and 'periodontal tissues'. The literature was searched thoroughly by two reviewers. Initially, the titles of the articles were extracted. After removing irrelevant and duplicate articles, abstracts were assessed for relevant articles. Finally, the reviewers analyzed full-text articles. Results: A total of twelve articles, including one randomized clinical trial, three systematic reviews, two prospective cohort, three case series, one a clinical study, one pilot study and one a retrospective study, were selected and analyzed. Conclusions: The review suggests potential benefits of Deep Margin Elevation (DME) over surgical crown lengthening due to reduced invasiveness, yet conclusive effects on periodontal tissue remain unclear, warranting further studies on clinical parameters and inflammatory biomarkers.

Background and objective Shoulder pain stands out as the most prevalent musculoskeletal issue that office workers face. This type of pain has been observed to be linked to various aspects of one's job. To address this concern, the current research endeavors to examine the impact of digital device use on the intensity of shoulder pain and the extent of disability experienced by office employees in Saudi Arabia. This study is driven by two principal objectives. Firstly, it aims to assess the overall occurrence of shoulder discomfort and functional limitations among the Saudi office worker population. Secondly, it seeks to draw comparisons between the parameters of the shoulder pain and disability scale and the amount of time spent using electronic screens. Methodology This cross-sectional descriptive study was conducted in Riyadh, Saudi Arabia. We recruited 150 participants to measure shoulder pain and disability among office workers. The study was carried out to determine the general frequency of shoulder discomfort and impairment by using the Shoulder Pain and Disability Index (SPADI). The survey was conducted online in June 2022 via Google Forms. The survey questions included data regarding age, sex, year of study, exercise, and duration of computer time per day (hours).  Results This study recruited 150 participants to measure shoulder pain and disability among office workers. The mean age of the cohort was 42.56 ± 2.56 years. Among the total participants, 90 (60%) were male, and 60 (40%) were female. We observed that pain parameters had a negative correlation of -0.008 with screen time. The participants who had high shoulder pain and disability scores were older in age and spent less than two hours on screens, which affects the correlation results, and hence we recommend performing a study involving the younger population working on screen for more than four hours to find the better correlation. At the same time, the shoulder disability score reported a correlation of 0.05, and the overall correlation between SPADI and screen time was observed to be 0.04. Based on these findings, the present study observed a weak correlation between SPADI and screen time. Conclusion These results suggest that while there may be some association between screen time and shoulder pain and disability, it is not substantial. Therefore, it is unlikely that screen time alone significantly contributes to the occurrence or severity of shoulder pain and disability among office workers. Additional factors and variables may need to be explored in future research to gain a more comprehensive understanding of this issue., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Alzahrani et al.)

Introduction Recent cases of human monkeypox virus (MPXV) infections have raised global health concerns, as sporadic instances have occurred in various regions, prompting investigations into the potential for increased transmission. This underscores the importance of effective communication strategies in addressing the emerging challenges associated with this viral ailment. The study was conducted to understand public anxiety and knowledge related to MPXV infection, particularly in the context of emerging infectious diseases. Our aims included assessing anxiety levels and knowledge about monkeypox infection among the Saudi population, as well as their willingness to receive vaccinations if available. Methods A cross-sectional cohort study among the adult Saudi population was conducted. A questionnaire with four sections, including demographic data and disease knowledge, comprised optimized questions of the standard generalized anxiety disorder assessment (GAD-7) as well as questions related to acceptance of getting the vaccine if it could be afforded. Results Out of a total of 5298 participants, 927 (17.5%) showed different degrees of GAD-7 anxiety. Females showed a significantly higher rate of anxiety (487/2189, 22.2%) than males (440/3109, 14.2%). People aged 46 to 55 and >55 years old showed significantly higher rates of anxiety (30.7% and 27.2%). There is an overall decrease in knowledge and awareness about the MPXV. Interestingly, 59% of the participants admitted that they would get the MPXV vaccine if it were made available. There was a positive correlation between the anxiety level and the response of people toward the MPXV vaccine if it were available. Conclusion Our study underscores a significant level of anxiety and a notable lack of awareness concerning MPXV infection. Although a substantial number of participants expressed their willingness to receive an MPXV vaccine, our findings emphasize the pressing need for improved public education and awareness campaigns to alleviate anxiety levels and enhance understanding of this infectious disease. This effort is crucial for mitigating health concerns and facilitating well-informed decision-making among the Saudi population., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Alqthami et al.)

Background: Tobacco use remains a leading cause of premature death. To combat tobacco use, the Ministry of Health (MOH) improved access to smoking cessation clinics (SCCs) by developing fixed SCCs and mobile SCCs, which move based on demand across locations. The goal of this study was to investigate awareness and utilization of SCCs among tobacco users in Saudi Arabia and the factors that influence their awareness and utilization., Method: This cross-sectional study used the 2019 Global Adult Tobacco Survey. Three outcome variables were employed, including tobacco users' awareness of fixed SCCs, mobile SCCs, and utilization of fixed SCCs. Several independent variables were examined, including sociodemographic characteristics and tobacco use. Multivariable logistic regression analyses were performed., Results: One thousand six hundred sixty-seven tobacco users were included in this study. There were 60%, 26%, and 9% of tobacco users who were aware of fixed SCCs, aware of mobile SCCs, and visited fixed SCCs, respectively. The likelihood of being aware of SCCs increased among users residing in urban areas (fixed SCCs: OR = 1.88; 95% CI = 1.31-2.68; mobile SCCs: OR = 2.09; CI = 1.37-3.17) while it decreased among those reported self-employed (fixed SCCs: OR = 0.31; CI = 0.17-0.56; mobile SCCs: OR = 0.42; CI = 0.20-0.89). The likelihood of visiting fixed SCCs increased among educated tobacco users aged 25-34 (OR = 5.61; CI = 1.73-18.21) and 35-44 (OR = 4.22; CI = 1.07-16.64) while the odds of visiting SCCs decreased among those who were working in the private sector (OR = 0.26; CI = 0.09-0.73)., Conclusion: The decision to quit smoking must be supported by an effective healthcare system that provides accessible and affordable smoking cessation services. Knowing the factors that influence the awareness and utilization of SCCs would help policymakers dedicate efforts targeting those who desire to quit smoking yet face limitations in using SCCs., (© 2023. The Author(s).)

Background: Polyether ether ketone (PEEK) has emerged as a new thermoplastic material with potential applications as a restorative material. Aim: This study aimed to evaluate the marginal adaptation of PEEK copings compared to zirconia copings using field emission scanning electron microscopy., Materials and Methods: A freshly extracted maxillary central incisor was prepared for a full-coverage restoration following standard principles of tooth preparation. The tooth was sent to a laboratory for fabrication of samples using computer-aided design and manufacturing (CAD/CAM). Twenty samples of polyether ether ketone (PEEK) copings (group A) and 20 of zirconia copings were fabricated (group B). The copings were scanned under a field emission scanning electron microscope and measurements were taken at four distinct points. The marginal adaptation over the buccal, lingual, mesial, and distal margins for both groups was evaluated. One-way analysis of variance (ANOVA) and independent t test were applied., Results: Our findings indicate that PEEK showed better marginal adaptation than zirconia at all measurement points. The mean marginal gap value of the PEEK group was 33.99 ± 8.81 μm and of the zirconia group was 56.21 ± 15.07 μm. On comparing marginal adaptation among the mesial, distal, buccal, and lingual aspects, PEEK showed better adaptation on all four margins, with the best adaptation on the buccal margin that had the lowest mean gap value of 29.27 ± 6.07 μm. The zirconia group adapted best at the distal margin, with a lowest mean gap value of 53.58 ± 15.25 μm (P ≤ 0.05)., Conclusion: PEEK copings had better marginal adaptation and fit compared to zirconia copings. It may have applications as a restorative material in fixed prostheses., Competing Interests: None

Introduction: Saudi Arabia is expected to witness a slight reduction in tobacco use. The Saudi government offers free-of-charge smoking cessation services. Yet, factors influencing the desire to quit smoking are not comprehensively investigated in Saudi Arabia. This study examines the factors influencing the desire to quit among smoking adults in Saudi Arabia and investigates whether using alternative tobacco products, such as e-cigarettes, is associated with the desire to quit smoking., Methods: Data from the 2019 nationally representative Global Adults Tobacco Survey (GATS) was used. GATS utilized a face-to-face household cross-sectional survey that collected data from adults aged ≥15 years. Several factors including, sociodemographic characteristics, use of alternative tobacco products, attitude toward tobacco control, and awareness of smoking cessation clinics (SCCs), were examined to predict the desire to quit. Logistic regression analysis was conducted., Results: A total of 11381 individuals completed the survey. Of the total sample, 1667 participants were tobacco smokers. The majority of the tobacco smokers were interested in quitting smoking (82.4%); 58% of cigarette smokers and 17.1% of waterpipe smokers were interested in quitting smoking. The desire to quit smoking was positively associated with the awareness of SCCs (AOR=3; 95% CI: 1.8-5), attitude toward raising tobacco taxes (AOR=2.3; 95% CI: 1.4-3.8), and a strict rule of smoking inside the home (AOR=2; 95% CI: 1.1-3.9). No statistical association was found between the desire to quit smoking and the use of e-cigarettes., Conclusions: The desire to quit tobacco smoking among Saudi smokers increased with awareness of SCCs, favoring taxes on tobacco products, and implementing strict rules of smoking inside the home. The study reveals valuable insights into the main factors that could inform the development of more effective policy interventions targeting smokers in Saudi Arabia., Competing Interests: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported., (© 2023 Monshi S.S. et al.)

Background: Several modalities are available for the diagnosis of rectal cancer, including conventional gold standard rigid endoscopy and recent flexible endoscopy and magnetic resonance imaging (MRI). Each modality affects the management of these patients., Aim: To compare the accuracy of flexible endoscopy and MRI in the measurement of tumor height in patients with rectal cancer., Methods and Results: This study included 174 patients with rectal cancer who underwent flexible endoscopy and MRI for the measurement of tumor height. Data on patient demographics, comorbidities, treatment, and histopathology were identified and collected. We evaluate intraclass correlation coefficient (ICC) and Bland-Altman plot to test the agreement between the measurements. ICC were excellent with an ICC of 89% (95%CI 48%-99%). The mean ± standard deviation of the distance from the anal verge to the distal part of the tumor was 7.73 ± .47 for flexible endoscopy and 6.21 ± 0.39 for MRI, with mean difference of 1.52 (p ˂ .001). The accordance between the two modalities was not affected by sex, age, body mass index, histopathology, or metastasis., Conclusion: Excellent agreement between flexible endoscopy and MRI was noted, and no factor was found to affect such concordance., (© 2022 The Authors. Cancer Reports published by Wiley Periodicals LLC.)

Context: The COVID-19 pandemic has changed the structure of the healthcare system. As a response to the pandemic, the ministry of health applied many changes to the primary healthcare system. These changes created new challenges for healthcare workers (HCWs)., Aims: To identify the roles and challenges of practitioners in primary healthcare (PHC) centers during COVID-19 in Al-Baha city, Saudi Arabia, in 2022., Methods and Materials: An analytical cross-sectional study was carried out in 2022 in Al-Baha city, Saudi Arabia. An electronic online questionnaire was distributed formally to HCWs in PHC centers. All primary HCWs during the COVID-19 pandemic in Al-Baha city, Saudi Arabia, were included., Results: A total of 424 responses were analyzed. Half (50.7%) of the participants had fieldwork roles during the pandemic. The two most commonly agreed-upon challenges were stress (78.7%) and worry about getting infected (79.8%). The majority (74.4%) of the participants' roles involved direct contact with suspected COVID-19 cases, whereas 50.9% involved direct contact with confirmed COVID-19 cases. Direct contact with confirmed cases showed a significant association with worrying about getting infected ( P = 0.019)., Conclusions: Workload, overtime, conflict ambiguity, fear of getting and transmitting the infection, stress, and lack of personal protective equipment were challenges faced by the primary HCWs, which negatively impacted the quality of delivered services and mental health. We recommend facilitating access of primary HCWs to psychiatric clinics to improve stress and help cope with new roles during the pandemics and changes in the healthcare system., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Family Medicine and Primary Care.)

BACKGROUND The aim of this study was to assess and compare the effect of surface type (glazed or polished) with coffee immersion and aging on surface topography (Ra), optical properties (TP, OP), and mechanical properties (fracture forces and modes) of zirconia-reinforced lithium silicate (Vita Suprinity), hybrid polymer-infiltrated-feldspathic ceramic network material (Vita Enamic), and leucite-containing feldspathic glass (Vitablocs® Mark II) made by computer-aided design and computer-aided manufactured (CAD/CAM) ceramic materials. MATERIAL AND METHODS Fifty-four specimens were assembled out of the above 3 CAD/CAMs ceramic materials. Each group was divided into glazed or polished surfaces, having 9 specimens of every type and stained in coffee for 15 days. Ra and color of specimens in the form of TP and OP were recorded before and after immersion in staining material. Fracture forces and modes were analyzed after the 90-day aging. Data were analyzed using ANOVA, then post hoc analysis and Bonferroni tests. RESULTS Our study found significant differences in Ra, TP, and Op before and after coffee immersion between glazed and polished specimens, with higher values in the polished surfaces among the 3 ceramic materials. The highest values of fracture resistance were noted in Vita Suprinity, and Vita Enamic had the lowest values, without significant differences among groups. CONCLUSIONS Most of the TP and OP values were in acceptable clinical range, and Vita Suprinity had superior TP than the other groups. Reparable fracture types were observed in Vita Suprinity, whereas semi-reparable and non-reparable were predominant in other groups.

Cardiovascular diseases (CVD) are the leading causes of death worldwide. Dyslipidemia is a cardiometabolic risk factor of CVD, yet it can be modifiable. Walnuts have been suggested as a dietary intervention to improve the lipid profile. Therefore, we reviewed the literature to assess the evidence linking walnut intake to the improvement of blood lipids, including total cholesterol (TC), low-density lipoprotein (LDL-C) cholesterol, high-density lipoprotein (HDL-C) cholesterol, and triglycerides (TG). PubMed and Embase databases were searched from 2010 up to March 2022. We limited our search to randomized controlled trials conducted on humans and published in English during the specified period. Cochrane's risk of bias tool for interventional studies was used. A random-effects model was used for the meta-analysis, and weighted mean differences were obtained (WMD) Thirteen trials from the U.S., Europe, and Asia were included. Walnut intake was associated with significant reductions in TC (WMD: -8.58 mg/dL), LDL-C (WMD: -5.68 mg/dL), and TG (WMD: -10.94 mg/dL). Walnut consumption was not associated with HDL-C. Subgroup analysis showed that overweight/obese and those with comorbidities had more lipid improvement. A longer trial duration did result in further improvements. However, our results may be prone to bias due to extraneous confounding factors. Additionally, levels of heterogeneity were considerable for some outcomes of interest. Results from this meta-analysis provide evidence for the health benefits of walnuts on blood lipids. Walnuts possibly reduce the risk of CVD; thus, they can be successfully added to a dietary pattern to enhance health benefits.

Fluconazole (FLZ) is the most widely used antifungal agent for treating cutaneous candidiasis. Although oral FLZ has been proved to be effective, the incidence of side effects necessitates the development of an effective formulation that could surpass the pitfalls associated with systemic availability. Accordingly, this research aimed at developing a self-assembled mixed micelles topical delivery system to enhance the topical delivery of the drug. Self-assembled mixed micelles were developed using D-α-tocopheryl polyethylene glycol 1000 succinate and phospholipids and optimized using Box-Behnken design. The optimized formulation with minimized size was then tested in vivo for the antifungal activity against C. albicans in immunocompromised mice. Treatment with the optimized formulation led to decreased peripheral erythema as well as lesions due to fungal infection in comparison to raw FLZ loaded gel. Therefore, the developed formulation was found to be a promising vehicle for the treatment of cutaneous candidiasis., (© 2022 Shaimaa M. Badr-Eldin et al., published by Sciendo.)

Resin-bonded fixed dental prostheses (RBFDP) are minimally invasive alternatives to traditional full-coverage fixed partial dentures as they rely on resin cements for retention. This study compared and evaluated the tensile bond strength of three different resin-bonded bridge designs, namely, three-unit fixed-fixed, two-unit cantilever single abutment, and three-unit cantilever double-abutted resin-bonded bridge. Furthermore, the study attempted to compare the tensile bond strengths of the Maryland and Rochette types of resin-bonded bridges. Based on the inclusion and exclusion criteria, a total of seventy-five extracted maxillary incisors were collected and later were mounted on the acrylic blocks. Three distinct resin-bonded metal frameworks were designed: three-unit fixed-fixed (n = 30), two-unit cantilever single abutment (n = 30), and a three-unit cantilever double abutment (n = 30). The main groups were further divided into two subgroups based on the retainer design such as Rochette and Maryland. The different prosthesis designs were cemented to the prepared teeth. Later, abutment preparations were made on all specimens keeping the preparation as minimally invasive and esthetic oriented. Impression of the preparations were made using polyvinyl siloxane impression material, followed by pouring cast using die stone. A U-shaped handle of 1.5 mm diameter sprue wax with a 3 mm hole in between was attached to the occlusal surface of each pattern. The wax patterns were sprued and cast in a cobalt-chromium alloy. The castings were cleaned by sandblasting, followed by finishing and polishing. Lastly, based on the study group, specimens for Rochette bridge were perforated to provide mechanical retention between resin cement and metal, whereas the remaining 15 specimens were sandblasted on the palatal side to provide mechanical retention (Maryland bridge). In order to evaluate the tensile bond strength, the specimens were subjected to tensile forces on a universal testing machine with a uniform crosshead speed. The fixed-fixed partial prosthesis proved superior to both cantilever designs, whereas the single abutment cantilever design showed the lowest tensile bond strength. Maryland bridges uniformly showed higher bond strengths across all framework designs. Within the limitations of this study, the three-unit fixed-fixed design and Maryland bridges had greater bond strengths, implying that they may demonstrate lower clinical failure than cantilever designs and Rochette bridges.

BACKGROUND Miswak is a form of chewing stick used to clean teeth in different parts of the world, including Saudi Arabia. We present a description of the effects of miswak derivatives, namely toothpaste, mouthwash, and brushing sticks, on the mean color changes (DE00), compressive fracture resistance values, and fracture modes of polymer-based computer-aided design (CAD) and computer-aided manufactured (CAM) prosthetic materials. MATERIAL AND METHODS Eighty-one rectangular-shaped samples were prepared from lithium disilicate glass-ceramic (IPS e.max CAD), zirconia-reinforced lithium silicate (Vita Suprinity), and monochromatic tooth-colored feldspar (Vitablocs Mark II) CAD/CAM ceramics. The color parameters were recorded using spectrophotometer before and after exposing the specimens to the different miswak oral hygiene derivatives for 15 days. Compressive fracture resistance values and fracture types were also assessed, and statistical analysis was performed. RESULTS Vita Suprinity and Vitablocs Mark II miswak sticks had the highest ΔE₀₀ values. Moreover, miswak mouthwash had the lowest ΔE₀₀ values, with significant differences among groups. IPS e.max CAD miswak sticks had the highest mean values of compressive fracture. Vitablocs Mark II had the lowest values for mouthwash and toothpaste. Significant differences were found within the IPS e.max CAD group. Reparable fractures were found in IPS e.max CAD, while semi-reparable fractures were seen in other groups. CONCLUSIONS Most ΔE₀₀ values were within the acceptable clinical range, with IPS e.max CAD showing superior color stability. The mouthwash group showed minimal ΔE₀₀. IPS e.max CAD had the highest mean compressive fracture resistance values with reparable fracture types.

CAD/CAM technology is gaining popularity and replacing archaic conventional procedures for fabricating dentures. CAD/CAM supports using a digital workflow reduce the number of visits, chair time, and laboratory time, making it attractive to patients. This study aimed to provide a comparative review of complete dentures manufactured using CAD/CAM and conventional methods. The PubMed/Medline, Science Direct, Cochrane, and Google Scholar databases were searched for studies published in English within the last 11 years (from 2011 to 2021). The keywords used were "computer-engineered complete dentures", "CAD/CAM complete dentures", "computer-aided engineering complete dentures", and "digital complete dentures". The search yielded 102 articles. Eighteen relevant articles were included in this review. Overall, computer-engineered complete dentures have several advantages over conventional dentures. Patients reported greater satisfaction with computer-engineered complete dentures (CECDs) due to better fit, reduced chair time, shorter appointments, and fewer post-insertion visits. CAD/CAM allows for precision and reproducibility with fewer procedures compared to conventional dentures. Polymethyl methacrylate is used as the denture base material for conventional dentures. For CECDs, the resin can be modified and cross-linked to improve its mechanical properties. The advantages of CECDs include a reduced number of appointments, saving chairside time, a digital workflow allowing easy reproducibility and greater patient satisfaction with a better fit.

Purpose: We previously reported beneficial glucoregulatory effects of a fully provided carbohydrate-reduced, high-protein (CRHP) diet in patients with type 2 diabetes mellitus (T2DM) in a crossover 2 × 6-week trial, in which patients maintained their body weight. Here, we investigated physiological changes during an additional 6-month period on a self-selected and self-prepared CRHP diet., Methods: Twenty-eight patients with T2DM were instructed to consume a CRHP diet (30% of energy from carbohydrate and 30% from protein) for 24 weeks, after an initial 2 × 6-week trial when all food was prepared and provided to them. Patients received dietary advice every 2 weeks. At weeks 0, 6, 12 and 36, they underwent a 3-h intravenous glucose tolerance test, a 4-h mixed meal test, and a 48-h continuous glucose monitoring. Liver, muscle, pancreas, and visceral fat contents were measured by magnetic resonance imaging., Results: During the 24-week self-selected diet period (weeks 12-36), body weight, visceral fat, liver fat, and glycated haemoglobin were maintained at the same levels achieved at the end of the fully provided diet period, and were still lower than at baseline (P < 0.05). Postprandial insulinaemia and insulin secretion were significantly greater (P < 0.05). At week 36, fasting insulin and C-peptide levels increased (P < 0.01) and daily glycaemia decreased further (P < 0.05) when compared with the end of the fully provided diet period., Conclusion: Substituting dietary carbohydrate for protein and fat has metabolic benefits in patients with T2DM. These beneficial effects are maintained or augmented over the next 6 months when patients self-select and self-prepare this diet in a dietitian-supported setting., Trial Registration: ClinicalTrials.gov NCT02764021., (© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: Assessment of the effect of aging and bonding on the reparability of different temporary crown and bridge materials using a flowable resin composite., Methods: The materials used included two bis-acryl and two polymethylmethacrylate materials. The materials were aged either dry, in distilled water, or in a 75% ethanol/water solution. Each group was divided into three subgroups (n = 6) according to the bonding method: application of a universal adhesive, application of a universal primer followed by a universal adhesive, or no bonding. Materials were repaired with a light-cure flowable resin composite; then, they were subjected to thermocycling and tested by shear bond strength. The data were analysed using three-way ANOVA, one-way ANOVA, and Tukey post hoc tests (α = 0.05)., Results: The shear bond strength was significantly higher for bis-acryl compared to polymethylmethacrylate materials (p < 0.001). In terms of aging conditions, shear bond strength was in the order of 75% ethanol/water solution < dry < water. The application of bonding agents significantly increased the shear bond strength of polymethylmethacrylate-based materials (p < 0.001). The difference between water and dry storage was insignificant (p = 0.558); however, storage in a 75% ethanol/water solution showed significantly lower values compared to both dry and water storage in most of experimental groups (p < 0.001). Polymethylmethacrylate-based materials mainly demonstrated adhesive failure, while bis-acryl materials predominantly showed cohesive failure., Conclusion: The bond strength of a light-cure flowable resin composite is significantly higher with bis-acryl compared to that with polymethylmethacrylate-based substrates. Aging in water does not have a significant effect; however, the 75% ethanol/water solution tends to negatively affect repairability. The application of different bonding agents positively affects the repair strength, especially for polymethylmethacrylate-based substrates., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2020 The Authors.)

Background: Multidisciplinary tumor board meetings (MDTs) have shown a positive effect on patient care and play a role in the planning of care. However, there is limited evidence of the association between MDTs and patient mortality and in-hospital morbidity for mixed cases of gastrointestinal (GI) cancer., Aim: To evaluate the influence of optional MDTs on care of patients with cancer to determine potential associations between MDTs and patient mortality and morbidity., Methods and Results: This was a retrospective observational study at the referral center of King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia. Among all adult patients diagnosed with GI cancer from January 2017 to June 2019, 130 patients were included. We categorized patients into two groups: 66 in the control group (non-MDT) and 64 in the MDT group. The main outcome measure was overall mortality, measured by survival analysis. The follow-up was 100% complete. Four patients in the MDT group and 13 in the non-MDT group died (P = .04). The median follow-up duration was 294 days (interquartile range [IQR], 140-434) in the non-MDT group compared with 176 days (IQR, 103-466) in the MDT group (P = .20). There were no differences in intensive care unit or hospital length-of-stay or admission rates. The overall mortality at 2 years was 13% (95% confidence interval [CI], 0.06-0.66) in the MDT group and 38% (95% CI, 0.10-0.39) in the non-MDT group (P = .08). The MDT group showed a 72% (adjusted hazard ratio [HR], 0.28; 95% CI, 0.08-0.90; P = .03) decrease in mortality over time compared with the non-MDT group., Conclusions: MDTs were associated with decreased mortality over time. Thus, MDTs have a positive influence on patient care by improving survival and should be incorporated into care., (© 2021 The Authors. Cancer Reports published by Wiley Periodicals LLC.)

We previously observed beneficial effects of a carbohydrate-reduced, high-protein (CRHP) diet on cardiovascular risk markers in patients with type 2 diabetes mellitus (T2DM) in a crossover 2 × 6-week trial, when all food was provided to subjects as ready-to-eat meals. Here, we report the results from a 6-month open label extension: 28 patients with T2DM were instructed to self-prepare the CRHP diet with dietetic guidance. At weeks 0, 6, 12, and 36, fasting and postprandial (4-h meal test) blood samples were collected for measurements of total, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, triacylglycerol (TG), apolipoproteins A1 and B, non-esterified fatty acids (NEFA), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin-6. Diurnal blood pressure and heart rate were also assessed. At the end of the study (week 36), concentrations of fasting total and LDL-cholesterol, fasting and postprandial NEFA and TG, and fasting apolipoprotein-B, CRP and TNF-α concentrations were significantly lower compared with week 0 ( p < 0.05). A significant decrease in diurnal heart rate was also observed. From week 12 to 36, an increase in HDL-cholesterol and apolipoprotein-A1 concentrations and a further reduction in fasting and postprandial NEFA ( p < 0.05) were found. These changes were independent of minor fluctuations in body weight. We conclude that the substitution of dietary carbohydrate for protein and fat has beneficial effects on several cardiovascular risk markers in patients with T2DM, which are maintained or augmented over the next 6 months when patients select and prepare the CRHP diet on their own in a dietitian-supported setting.

Background: Sleep disorders are a common medical problem and can affect health and quality of life. There are multiple types of sleep disorders such as obstructive sleep apnea, insomnia, narcolepsy, restless legs/periodic limb movement disorder, circadian rhythm disorders, sleepwalking and nightmares. Medical students appear to be more liable to develop sleep disorders due to their high academic load. Design and Methods: This study seeks to estimate the prevalence of sleep disorders among Umm Al-Qura University medical students and associated risk factors. This cross-sectional study was conducted at the Faculty of Medicine of Umm Al-Qura University in Makkah, Saudi Arabia. A self administrated questionnaire was used to collect the data including socio-demographic data and sleep-50 questionnaire. Four hundred and thirty-eight (438) medical students from the second year to the sixth year were recruited to the study Results: Three hundred and twenty-three participants (73.8%) complained of at least one sleep disorder. The most prevalent sleep disorder among students was narcolepsy at 226 (51.6%). Female students, second year students and students spending significant time watching television or on smartphones were more affected than others with p values of 0.001, 0.005, and 0.004 respectively. Conclusions: Sleep disorders are common among medical students. It is essential to detect and address them before their condition deteriorates., (©Copyright: the Author(s).)

Objective: Quantitative documentation of the effects of outbreaks, including the coronavirus disease 2019 (COVID-19) pandemic, is limited in neurosurgery. Our study aimed to evaluate the effects of the COVID-19 pandemic on neurosurgical practice and to determine whether surgical procedures are associated with increased morbidity and mortality., Methods: A multicenter case-control study was conducted, involving patients who underwent neurosurgical intervention in the Kingdom of Saudi Arabia during 2 periods: pre-COVID-19 and during the COVID-19 pandemic. The surgical intervention data evaluated included diagnostic category, case priority, complications, length of hospital stay, and 30-day mortality., Results: A total of 850 procedures were included, 36% during COVID-19. The median number of procedures per day was significantly lower during the COVID-19 period (5.5 cases) than during the pre-COVID-19 period (12 cases; P < 0.0001). Complications, length of hospital stay, and 30-day mortality did not differ during the pandemic. In a multivariate analysis comparing both periods, case priority levels 1 (immediate) (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.24-2.67), 1 (1-24 h) (OR, 1.63; 95% CI, 1.10-2.41), and 4 (OR, 0.28; 95% CI, 0.19-0.42) showed significant differences., Conclusions: During the early phase of the COVID-19 pandemic, the overall number of neurosurgical procedures declined, but the load of emergency procedures remained the same, thus highlighting the need to allocate sufficient resources for emergencies. More importantly, performing neurosurgical procedures during the pandemic in regions with limited effects of the outbreak on the health care system was safe. Our findings may aid in developing guidelines for acute and long-term care during pandemics in surgical subspecialties., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objective: This observational cross-sectional multicenter study aimed to evaluate the longitudinal impact of the coronavirus disease 2019 (COVID-19) pandemic on neurosurgical practice., Methods: We included 29 participating neurosurgeons in centers from all geographical regions in the Kingdom of Saudi Arabia. The study period, which was between March 5, 2020 and May 20, 2020, was divided into three equal periods to determine the longitudinal effect of COVID-19 measures on neurosurgical practice over time., Results: During the 11-week study period, 474 neurosurgical interventions were performed. The median number of neurosurgical procedures per day was 5.5 (interquartile range [IQR]: 3.5-8). The number of cases declined from 72 in the first week and plateaued at the 30's range in subsequent weeks. The most and least number of performed procedures were oncology (129 [27.2 %]) and functional procedures (6 [1.3 %]), respectively. Emergency (Priority 1) cases were more frequent than non-urgent (Priority 4) cases (178 [37.6 %] vs. 74 [15.6 %], respectively). In our series, there were three positive COVID-19 cases. There was a significant among-period difference in the length of hospital stay, which dropped from a median stay of 7 days (IQR: 4-18) to 6 (IQR: 3-13) to 5 days (IQR: 2-8). There was no significant among-period difference with respect to institution type, complications, or mortality., Conclusion: Our study demonstrated that the COVID-19 pandemic decreased the number of procedures performed in neurosurgery practice. The load of emergency neurosurgery procedures did not change throughout the three periods, which reflects the need to designate ample resources to cover emergencies. Notably, with strict screening for COVID -19 infections, neurosurgical procedures could be safely performed during the early pandemic phase. We recommend to restart performing neurosurgical procedures once the pandemic gets stabilized to avoid possible post pandemic health-care system intolerable overload., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: Rb-82 positron emission tomography (PET) myocardial perfusion imaging (MPI) is a robust tool for the evaluation of coronary artery disease (CAD). However, gastric uptake and spillover can be seen in 10% of Rb-82 PET MPI studies, commonly affecting the inferior wall, and can preclude the accurate identification of myocardial ischemia. We sought to understand the relationship between Rb-82 gastric uptake and the use of proton pump inhibitors (PPI)., Methods: 600 consecutive patients who presented for a clinically indicated Rb-82 PET MPI study were prospectively enrolled. In addition to the clinical history, PPI use was ascertained (medication, dose, frequency and duration of use, and time of last dose). Patients were categorized as PPI and non-PPI users. Rb-82 uptake in the gastrium, myocardium, and liver were measured at rest. Absolute uptake values and gastric:hepatic ratios were compared in PPI and non-PPI users., Result: Of 600 enrolled patients, 181 (30.2%) patients were using PPI. The gastric Rb-82 uptake in PPI users was 23% higher than non-PPI users (146 ± 52 kBq/cc vs 119 ± 40 kBq/cc, respectively; P < 0.001). The resting gastric:hepatic Rb-82 uptake ratio was also 23% higher in PPI vs non-PPI users (2.7 ± 1.0 vs 2.2 ± 0.8, respectively; P < 0.001)., Conclusion: The gastric uptake of Rb-82 appears to be greater in patients actively using PPI and may identify a group who might be at greater risk of non-diagnostic Rb-82 PET MPI.

Introduction Perforated peptic ulcer disease (PPUD) is associated with a high postoperative mortality and morbidity rates especially within the first 90 days. The size and site of the ulcer may contribute to the prognosis of PPUD. In this study, we will describe the association of size and site of PPUD with the overall mortality and in-hospital morbidities in a tertiary care university hospital. Methods A retrospective observational cohort study was conducted at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. A total of 50 patients who had PPUD and underwent open exploratory laparotomy with surgical treatment were analyzed. Patients were divided into two groups: a small ulcer group when the ulcer diameter was less than equal to 1 cm and a large ulcer group when it was more than 1 cm. For the subgroup analysis, patients were categorized according to site into small duodenum, large duodenum, small stomach, and large stomach PPUD. The primary outcome was overall mortality that was measured by survival analysis and Cox regression. Secondary outcomes were intensive care unit (ICU) admission, ICU and hospital length of stay, and in-hospital mortality, which were assessed by stepwise logistics and linear regression. Results Overall mortality at 10, 30, and 90 days was 14% (95% CI: 0.06-0.27), 24% (95% CI: 0.14-0.39), and 34% (95% CI: 0.23-0.49), respectively. Saudi patients had a 72% decreased risk of overall mortality compared to non-Saudi patients (P=0.03) over the follow-up period. Overall, patients who had stomach PPUD had a 2.23-fold increased risk of overall mortality over time compared to those who had duodenum PPUD (P=0.10). Large PPUD, >1 cm, had a 3.20-fold increased risk of overall mortality over time compared to small PPUD (P=0.04). Large stomach PPUD had a 4.22-fold increased risk of overall mortality over time compared to other ulcers (P=0.01). Conclusions Large stomach PPUD is associated with increased overall mortality and morbidity. These findings indicate that patients who have a large stomach PPUD might need careful perioperative and postoperative personalized surgical plans as these patients may eventually undergo complicated surgical procedures., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Aljiffry et al.)

Background: Sudden cardiac arrest (SCA) is a major cause of mortality, yet its epidemiological and outcome data in hospitals from Saudi Arabia are limited., Objectives: This study aimed to evaluate the prevalence, risk factors and outcomes of SCA in a teaching hospital in Jeddah, Saudi Arabia., Methods: This retrospective study included all patients aged ≥18 years with SCA who were resuscitated at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between January 1 and December 31, 2016. Data were retrieved from the hospital medical records as flow sheets designed in accordance with the Utstein-style recommendations. Factors relating to mortality were analyzed using descriptive analyses and chi-square test., Results: A total of 429 cases of SCA met the inclusion criteria, and its prevalence was 7.76 cases/1000 adult hospital admission. Of these, 61.3% were male, and the mean age was 58.4 years, with 36.6% aged >65 years. Only 3.5% were outside-hospital cardiac arrests. The most common initial rhythm was pulseless electrical activity/asystole (93.2%), while ventricular tachycardia/ventricular fibrillation was documented in only 29 cases (6.8%). The overall rate of return to spontaneous circulation (ROSC) was 56.2%, and 56.8% in cases of in-hospital cardiac arrest (IHCA). Patients with SCA due to sepsis had significantly increased mortality ( P < 0.000; odds ratio [OR] = 0.24 [0.12-0.47 95% confidence interval [CI]]), while those with SCA due to respiratory causes had significantly better survival outcomes ( P = 0.001; OR = 2.3 [1.5-3.8 95% CI]). No significant differences in outcomes were found between other risk factors, including cardiac causes., Conclusion: In this population, the prevalence of SCA in adults was higher than reported in many similar studies. Further, sepsis was found to affect the survival rate. Although the rate of ROSC for IHCA patients was favorable compared with other studies, it is relatively poor. This finding signifies the need to identify and control risk factors for SCA to improve survival., Competing Interests: There are no conflicts of interest.

Background: Colorectal cancer (CRC) is one of the most prevalent cancers in Saudi Arabia that is highly characterized with poor survival rate and advanced metastasis. Many studies contribute this poor outcome to the expression of ABC transporters on the surface of cancer cells., Objectives: In this study, two ABCB1 variants, C3435T and T129C, were examined to evaluate their contribution to CRC risk., Methods: 125 subjects (62 CRC patients and 63 healthy controls) were involved. The DNA was isolated and analyzed with PCR-RFLP to determine the different genotypes. The hardy-Weinberg equilibrium was performed to determine genotype distribution and allele frequencies. Fisher's exact test (two-tailed) was used to compare allele frequencies between patients and control subjects., Results: The study showed that for SNP C3435T, the population of both CRC patients and controls were out of Hardy-Weinberg equilibrium. Genotype distribution for CRC patients was (Goodness of fit χ2 = 20, df= 1, P≤0.05), whereas, for the controls the genotype distribution was (Goodness of fit χ2 = 21, df =1, P ≤0.05). For SNP T129C, all subjects showed normal (TT) genotype., Conclusion: There was no significant association between ABCB1 3435C>T and 129T>C polymorphisms with CRC risk., (© 2019 Qahtani et al.)

Background: Every minute, an accident occurs in Saudi Arabia, causing 39,000 injuries and 7,000 deaths annually. Facial trauma or maxillofacial trauma (MFT) is a frequent presentation of road traffic accidents (RTAs), ranging from simple nasal fractures to gross or severe maxillofacial injuries., Methods: A total number of 237 patients were included in this prospective study from May 2013 to January 2018. The following medical details were recorded for each case, gender, age, fracture location, the presence of scalp laceration, the presence of brain damage, type of brain damage, shock degree, Glasgow Coma Scale (GCS), number of units used for blood transfusions for documentation of patient survival rate. We followed up the patients in their first appointment after 21 days of patient discharge from the hospital., Results: Majority of the patients were young male adults. A total of 59.1% of patients had cerebral damage, 38% (n = 90) of patients had at least, one scalp laceration, 43.5% (n = 103) of patients had some degree of shock, whereas 27.8% of the recruited patients needed at least 1 unit of blood transfusion. A total of 14.3% of the patients died as a result of their injuries, and the survival rate was 85.7%., Conclusions: Kingdom of Saudi Arabia (KSA) is having a high incidence of RTAs leading to high mortality rate. Therefore, it requires a sound evaluation of the risk factors for RTAs and establishment of guidelines to decrease the incidence of road traffic injuries and reduce health-care burden. Road safety campaigns focused on young population can help reduce RTAs and subsequent mortalities. Prompt arrival at the hospital, early diagnosis, and timely management of maxillofacial fractures and brain damages by skilled physicians will lower mortality rate in KSA.., Competing Interests: There are no conflicts of interest.

Background: Obesity is a global health problem, increasing susceptibility to Type 2 Diabetes (T2DM) and Cardiovascular Disease (CVD). Varieties of products have been proposed for treatment with varying degrees of success. Recent studies, suggested Oligonol; an optimized phenolic product mixture from Lychee Fruit Polyphenols (LFP); as such treatment in Japanese population., Objectives: We aimed to investigate the effect of oligonol on weight, insulin resistance by (HOMA-IR), lipids profile, leptin, Adiponectin, and resistin in healthy overweight and obese Saudi females., Subjects and Methods: 60 Saudi healthy overweight and obese females were enrolled in a double blind case/control study to take either Oligonol or placebo for 12 weeks without dietary or lifestyle re-strictions. Weight, height, Waist Circumference (WC), hip circumference (HC), and blood pressure were measured, and fasting blood samples of participants were taken before, and at the end of study. Total cholesterol, HDL-cholesterol, triglycerides, glucose, insulin, leptin, adiponectin, and resistin were meas-ured. LDL- cholesterol, HOMA-IR were calculated by equation., Results: 47 subjects completed the study, 25 in placebo group, and 22 in Oligonol group. No ill effects were noted in any participant. Oligonol reduced means of serum triglycerides (P=0.008), and resistin (P=0.045) significantly. In addition, no weight gain was noted in oligonol group, unlike placebo group which exhibited significant increase in mean weight (P= 0.036), WC (P=0.027), HC (P= 0.047), and leptin (P <0.001)., Conclusion: Oligonol could be suggested as future hypolipidemic and weight controlling agent for overweight and obese Saudi females.