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Background/Aims Roxadustat, an oral medication for treating renal anemia, is a hypoxia-inducible factor prolyl hydroxylase inhibitor used for regulating iron metabolism and promoting erythropoiesis. To investigate the efficacy and safety of roxadustat in patients undergoing peritoneal dialysis (PD) with erythropoietin hyporesponsiveness. Methods Single-center, retrospective study, 81 PD patients (with erythropoietin hyporesponsiveness) were divided into the roxadustat group (n = 61) and erythropoiesis-stimulating agents (ESAs) group (n = 20). Hemoglobin (Hb), total cholesterol, intact parathyroid hormone (iPTH), brain natriuretic peptide (BNP), related indicators of cardiac function and high-sensitivity C-reactive protein (hs-CRP) were collected. Additionally, adverse events were also recorded. The follow-up period was 16 weeks. Results The two groups exhibited similar baseline demographic and clinical characteristics. At baseline, the roxadustat group had a mean Hb level of 89.8 ± 18.9 g/L, while the ESAs group had a mean Hb level of 95.2 ± 16.0 g/L. By week 16, the Hb levels had increased to 118 ± 19.8 g/L (p < 0.05) in the roxadustat group and 101 ± 19.3 g/L (p > 0.05) in the ESAs group. The efficacy of roxadustat in improving anemia was not influenced by baseline levels of hs-CRP and iPTH. Cholesterol was decreased in the roxadustat group without statin use. An increase in left ventricular ejection fraction and stabilization of BNP were observed in the roxadustat group. Conclusions For PD patients with erythropoietin hyporesponsiveness, roxadustat can significantly improve renal anemia. The efficacy of roxadustat in improving renal anemia was not affected by baseline levels of hs-CRP0 and iPTH.

The incidence of chronic kidney disease (CKD) is increasing worldwide and the current prevalence rate is 13.4%. There are > 120 million CKD patients in China and this number is expected to increase. One of the main abnormalities in patients with CKD and kidney impairment is decreased synthesis of erythropoietin (EPO), which causes anemia and affects iron metabolism. The probability of developing is higher in anemia patients with CKD than in the general population, and the incidence increases as kidney function decreases. Deficient EPO production by the kidney is the most important cause of renal anemia. Notably, anemia in patients with CKD has multiple causes, such as bleeding caused by platelet dysfunction, iron deficiency due to digestive and absorption disorders of the gastrointestinal tract, and shorter red blood cell life. Anemia is also a leading cause of hospitalization in patients with CKD. A new oral medication to treat renal anemia, the hypoxia-inducible factor prolyl hydroxylase inhibitor called roxadustat (FG-4592), regulates iron metabolism and promotes erythropoiesis. This drug has a therapeutic effect on patients with CKD. Roxadustat showed advantages over EPO in clinical experiments. This review summarizes the mechanisms of action, clinical applications, effectiveness, and safety of roxadustat.

ZnO nanoparticles (ZnO-NPs) can be synthesized by chemical, physical and biological methods; many studies have indicated that biologically synthesized ZnO-NPs have ecofriendly benefits over physically and chemically synthesized ZnO-NPs. This study was carried out to evaluate the differences in characteristics and effects on pathogenic bacteria between ZnO-NPs synthesized by a chemical method and a biological method using the marine green alga Ulva fasciata. Additionally, the synergistic or antagonistic effects of loading ZnO-NPs synthesized by chemical and biological methods on antibiotics are investigated. The results show that there are differences in the characteristics of ZnO-NPs synthesized by the various methods, as determined by Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS) and transmission electron microscopy (TEM). ZnO-NPs had antibacterial activity against Staphylococcus aureus, Salmonella enterica subsp. salamae (Em.1-EGY015), Aeromonas hydrophila, Escherichia coli O157 (KY797670) and Bacillus cereus SH06; moreover, green-synthesized ZnO-NPs were more effective against pathogenic bacteria than chemically synthesized ZnO-NPs. The minimum inhibitory concentration (MIC) of ZnO-NPs synthesized by the green method was less than that of ZnO-NPs synthesized by the chemical method. The results demonstrated that the synergistic or antagonistic effects of ZnO-NP loading on antibiotics (ampicillin/sulbactam, tobramycin, flucloxacillin, chloramphenicol, amoxicillin, cephalexin, of loxacin, and neomycin) varied according to the type of pathogenic bacteria, antibiotic, and method of synthesis of ZnO-NPs. [ABSTRACT FROM AUTHOR]

Previous research has investigated whether hyperuricemia serves as an independent risk factor for cardiovascular and renal diseases. Hyperuricemia is defined as an abnormally high level of uric acid (UA; i.e., serum urate level > 6.8 mg/dL). Hyperuricemia has been considered a complication of chronic kidney disease (CKD). However, it seems to play a pathogenic role in the progression of renal diseases. There has been increasing focus on the link between hyperuricemia and CKD. The results of randomized controlled trials have implied independent associations between hyperuricemia and the progression of cardiovascular and renal morbidities. These associations may be mediated by renin-angiotensin system activation, nitric oxide synthase inhibition, and macrovascular/microvascular disease development. There remains controversy regarding the use of serum UA level as an indirect index of renal vascular disease. This literature review focuses on the role of asymptomatic hyperuricemia in the progression of CKD, as well as the association between hyperuricemia and cardiovascular disease. It also provides a general overview of the physiological metabolism of UA.

Usama H Abo-Shama,1 Hanem El-Gendy,2 Walid S Mousa,3 Ragaa A Hamouda,4,5 Wesam E Yousuf,4 Helal F Hetta,6,7 Eman E Abdeen8 1Department of Microbiology and Immunology, Faculty of Veterinary Medicine, Sohag University, Sohag 82524, Egypt; 2Department of Pharmacology, Faculty of Veterinary Medicine, University of Sadat City, Sadat City, Egypt; 3Department of Animal Medicine and Infectious Diseases, Faculty of Veterinary Medicine, University of Sadat City, Sadat City, Egypt; 4Genetic Engineering and Biotechnology Research Institute, University of Sadat City, Sadat City, Egypt; 5Department of Biology, Faculty of Sciences and Arts Khulais, University of Jeddah, Jeddah, Kingdom of Saudi Arabia; 6Department of Medical Microbiology & Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt; 7Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA; 8Department of Bacteriology, Mycology and Immunology, Faculty of Veterinary Medicine, University of Sadat City, Sadat City, EgyptCorrespondence: Usama H Abo-Shama Email usama.shama@gmail.com; helalhetta@aun.edu.egBackground and Aim: Nanosized inorganic antibacterial materials have received increasing attention in recent years. The present study aimed to determine the antimicrobial activity of silver (Ag) and zinc oxide (ZnO) nanoparticles alone and in combination with antibiotics against reference strains of pathogenic microorganisms as Staphylococcus aureus (Staph. aureus), Salmonella enterica subsp. Bukuru, Escherichia coli (E.coli) and Candida albicans ( C. albicans).Methods: The antimicrobial effect of metal-nanoparticles (AgNPs and ZnONPS) and in combination with antibiotics was studied using the normal disc-diffusion method.Results: Both AgNPs and ZnONPs had increased antibacterial activity with an increase in their concentration against Gram-positive bacterium (Staph. aureus), Gram-negative bacteria (E. coli and Salmonella spp) and no effect on C. albicans. The synergistic effect of antibiotics (azithromycin, cefotaxime, cefuroxime, fosfomycin and chloramphenicol) against E. coli was significantly increased in the presence of AgNPs compared to antibiotic only. However, all antibiotics had a synergistic effect in the presence of AgNps against Salmonella spp. On the other hand, the antibacterial action of AgNPs with oxacillin and neomycin antibiotics against Staph. aureus was significantly decreased in comparison with antibiotics only. The synergistic effect of antibiotics (azithromycin, oxacillin, cefotaxime, cefuroxime, fosfomycin and oxytetracycline) against E. coli was significantly increased in presence of ZnONPs compared to antibiotic only and also the synergistic effect of antibiotics (azithromycin, cefotaxime, cefuroxime, fosfomycin, chloramphenicol and oxytetracycline) against Staph. aureus was significantly increased in the presence of ZnONPs compared to antibiotics only. On the other hand, most antibiotics had an antagonistic effect in presence of ZnONps against Salmonella spp.Conclusion: AgNPs and ZnONPs demonstrate a good synergistic effect with antibiotics and this may open the door for a future combination therapy against pathogenic bacteria.Keywords: AgNPs, ZnONPs, antimicrobial activity E. coli Staph. aureus, Salmonella spp, Candida albicans

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Plants often experience variations in light intensity, referred to as light stress, that negatively impact important aspects of plant growth and development, including photosynthesis and antioxidant system. The photosynthetic machinery is susceptible to these disturbances, especially photosystem II and its reaction centers. We aimed to evaluate the role of brassinosteriod in plants under both high and low light conditions by examining various physiological parameters such as photosynthetic efficiency, pigment levels, and enzymatic activity of various antioxidant enzymes in one month old tomato plants. We investigated various chlorophyll fluorescence parameters under low light (LL) and high light (HL) conditions and the associated gene expression related to photosynthesis, including plastocyanin, ferredoxin, and photosystem II oxygen-evolving enhancer protein 3 (PsbQ). Our results indicate that exogenous brassinosteroid application considerably increased tolerance to both high and low light stress in 4-week-old tomato as treated plants displayed enhanced photosynthesis, reduced oxidative damage, and increased antioxidant enzyme activity in comparison to control plants. Furthermore, brassinosteroid treatment enhanced the expression of genes associated with antioxidant pathways, which significantly contributed to the recovery of chlorophyll fluorescence parameters crucial for plant growth and development. Our results provide valuable insights into how brassinosteroid reduces light-induced stress in tomato plants.

Objective: We aimed to investigate the association between university students' dietary patterns, their demographics and lifestyle in a cross-sectional study in Qatar. Participants: 370 students in eight universities in Qatar enrolled between February 2017 and February 2018. Methods: Based on a structured questionnaire, dietary patterns were identified using principal component analysis, and their associations with student characteristics were assessed using logistic regression. Results: Four dietary patterns were identified. The 'fast food' pattern was associated with being younger and male ( p -values ≤ 0.1). The 'traditional diet' pattern was associated with not skipping meals or eating when bored ( p -values = 0.1). The 'healthy diet' pattern was associated with regular exercise and having time to eat healthy foods ( p -values ≤ 0.01). The 'protein shake' pattern was associated with being male and engaging in more vigorous physical activity ( p -values ≤ 0.01). Conclusions: Our findings provide a roadmap for the prioritization of population-specific interventions in university students within Qatar and the region.

Background: Lower gut bleeding is an alarming sign among caregivers. Determining the etiology is of utmost importance for further management. This is the first study conducted in northernmost India. Methods: This cross-sectional study was conducted at the Department of Pediatrics, Government Medical College, Srinagar. This study aimed to describe the etiology of lower gastrointestinal bleeding in the age group of 1-18 years over the past 5 years from June 2017 to June 2022. Results: A total of 310 children presented with hematochezia (53.5%), blood mixed with loose stools for > 2 weeks (39.3%), melena (1.9%), and occult blood in stools (0.3%). The mean age was 5.12 years. The age group of 1-6 years was 73.5 %. The most common findings were rectosigmoid polyps n=104 (33.5%), anal fissure n=47 (15.1%), lymphoid nodular hyperplasia (LNH) n=38 (12.2%), trichuris dysentery syndrome n=30(9.7%), cow's milk protein allergy n=27(8.7%), non-specific colitis n=18(5.8%), solitary rectal ulcer syndrome n=14(4.5%), inflammatory bowel disease n=6 (1.9%),intestinal tuberculosis n=3(0.9%), duodenal dieulafoy lesion 1(0.3%), and blue bleb nevus rubber syndrome n=1(0.3%). 21 patients had a normal colonoscopy. The colonoscopy yield was 93.3 %. Among the colonoscopy-negative patients, 6(1.6%) had Meckel's diverticulum, and 1(0.3%) had a duodenal dieulafoy lesion. Conclusion: Lower GI bleeding most commonly presents as hematochezia, and the most common cause is a rectosigmoid polyp. Colonoscopy is the procedure of choice to evaluate the etiology of lower GI bleeding. Anal fissures, LNH, Trichuris trichiura , and cow's milk protein allergy are other common causes of lower gut bleeding in Kashmir, northernmost India., Competing Interests: Competing Interests The authors declare no conflict of interest related to this work., (© 2023 Middle East Journal of Digestive Diseases.)

Maize (Zea mays L.), a major multipurpose crop for food, feed and energy is extremely susceptible to environmental perturbations and setting off the major factors for limiting maize yield. Generally, plant yields are reduced and significantly lost to adverse environments and biotic strains. To ensure the safety of living cells under unfavourable circumstances, polyamines (PAs) play an important role in regulating the response under both abiotic and biotic stresses. It is the relative abundance of higher PAs (spermidine, Spd; spermine, Spm) vis-à-vis the diamine putrescine (Put) and PA catabolism that determines the stress tolerance in plants. Climate changes and increasing demands for production of maize have made it pressing to improve the stress tolerance strategies in this plant and it is imperative to understand the role of PAs in response to various environmental perturbations. Here, we critically review and summarise the recent literature on role of PAs in conferring stress tolerance in the golden crop. The responses in terms of PA accumulation, their mechanism of action and all the recent genetic manipulation studies carried out in PA metabolism pathway, ameliorating range of abiotic and biotic stresses have been discussed. As PA metabolism under stress conditions does not operate singly within cells and is always linked to other metabolic pathways in maize, its complex connections and role as a signalling molecule have also been discussed in this review.

Objective: University students face high levels of stress-related factors, such as an unfamiliar environment, challenging workload, and uncertainty about their ability to succeed. Participants: A total of 370 students in Qatar who consented to participate between February 2017 and February 2018. Methods: This cross-sectional study assessed perceived stress [using a validated 4-point perceived stress scale (PSS-4)], as well as diet, exercise, body mass index, sleep, and life satisfaction. Results: Among students aged 18-39 (mean = 20.1 ± 3.0 years), PSS-4 scores varied between 0 and 16 (mean = 7.4 ± 3.4). Elevated stress was significantly associated with female sex, country of origin, residing off-campus, eating when bored, lack of self-discipline, disturbed sleep, and low levels of life satisfaction. Furthermore, students with PSS-4 scores above the median level were 2.3 times likelier to report difficulty concentrating on academic work. Conclusion: Elevated stress levels are present in university students in Qatar. Strengthening coping skills may improve health and academic performance.

Type-1 Diabetes Mellitus (T1DM) is regarded as a multifunctional, immune-related disease which causes massive destruction of islet β-cells in pancreas resulting in hyperglycemic, hypoinsulinemia and hyperlipidimic conditions. The aim of the present study, was to investigate the hypothesis that streptozotocin (STZ)-induced T1DM in Balb/c mice when treated with crude polysaccharide from seaweed, Dictyopteris divaricata (CDDP) depicts improvement in diabetes-related symptoms. Treatment with CDDP resulted in decreased body weight loss, improved food consumption and water intake disbalances. The CDDP effectively improved fasting blood glucose, oral glucose tolerance (OGTT), serum insulin, insulin secretion, rejuvenation of β-cells mass, serum lipid profile and pro-inflammatory cytokines levels. Additionally, treatment with CDDP increased the population of beneficial bacteria such as Firmicutes, Bacteroidetes and Lactobacillus at phylum, family and genus levels by 16S rRNA sequencing. Furthermore, immunohistological examination confirmed that CDDP reduces the inflammation and restored the structural morphology of colon and upraised the levels of insulin receptor substrate-1 (IRS-1), Mucin-2 (MUC-2) and tight-junction proteins (TJs) whereby maintaining the gut structures and barrier permeability. Thus, the above presented data, highlights the safe and therapeutic effects of crude polysaccharide (CDDP) from D. divaricata in the treatment and restoration of T1DM disorders and can be used as a food supplement alternative to diabetes medicine., (© 2022. The Author(s).)

Background: The parent-adolescent relationship plays a key role in adolescent development, including behaviour, physical health, and mental health outcomes. Studies on the parental factors that contribute to an adolescent's dietary habits, exercise, mental health, physical harm and substance use are limited in the Middle East and North Africa region, with none in Oman. This study aims to investigate the association between parental involvement and adolescent well-being in Oman., Methods: Cross-sectional data from the 2015 Global School Health Survey for Oman was analysed. The dataset consisted of 3468 adolescents. Adolescents reported on their parental involvement (checking to see if they did their homework, understanding their problems, knowing what they are doing in their free time and not going through their things without permission). Parental involvement was scored on a 20-point scale. Associations with the following dependent variables: nutrition, exercise, hygiene, physical harm, bullying, substance use, tobacco use and mental health well-being were done using Spearman's correlations, linear and logistic regressions., Results: The surveyed population was 48% male, 65% aged 15 to 17 years old and 5% reported that they "most of the time or always" went hungry. Parental involvement was positively correlated with each of the dependent variables. Adolescents with higher parental involvement had significantly higher odds of good nutrition (1.391), hygiene (1.823) and exercise (1.531) and lower odds of physical harm (0.648), being bullied (0.628), poor mental health (0.415), tobacco use (0.496) and substance use (0.229)., Conclusions: Parental involvement plays a positive role in all aspects of adolescents' well-being in Oman. Awareness campaigns and interventions aimed to help improve the well-being of adolescents should incorporate such positive role in their designs., (© 2021. The Author(s).)

Objective: Pivotal clinical trials revealed good clinical efficiency of ocrelizumab while having a good safety profile in the management of multiple sclerosis (MS). However, real-world data of ocrelizumab in daily clinical practice remain scarce. The aim of this study was to evaluate the preliminary safety profile and effectiveness of ocrelizumab treatment for MS in an Arab population in a real-world clinical setting., Methods: In this retrospective single-center observational study in Qatar, we reviewed the medical records and analyzed the clinical and MRI data of all patients with relapsing-remitting MS (RRMS) and active secondary progressive MS (aSPMS)-between October 2017 through December 2020-who had received at least one infusion of ocrelizumab (Q-OCRE)., Results: A total of 60 MS patients were included (57 with RRMS, three SPMS). The Median follow-up period was 19 months (range, 1-32). The most common reason for switching to ocrelizumab was increased disease activity and three-quarters of the patients were on a previous disease-modifying drug (DMD). No evidence of disease activity (NEDA) status at year 1 was achieved in 73% of the cohort. Mild infusion-related reactions (IRR) and infections were reported (mainly upper respiratory tract infections followed by urinary tract infection) with a declining percentage over the follow-up applications. No severe side effects were observed., Conclusion: Our real-world experience confirms good efficacy, tolerability, and safety of ocrelizumab in our Arab population., (© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Apigenin is an edible flavonoid widely distributed in natural plants, including most vegetables and fruits. Previous studies have revealed that apigenin possesses multiple biological functions by demonstrating antiinflammatory, anti-oxidative, anti-bacterial, anti-viral, anti-tumor and cardiovascular protective effects. Furthermore, recent progressions have disclosed a novel perspective of the anti-cancer roles of apigenin through its immunoregulatory functions. With the rapid progression of the groundbreaking strategies being developed for cancer immunotherapy, its immunoregulatory roles are being recognized as intriguing features of the multifaceted apigenin. However, the current understanding of this emerging role of apigenin still remains limited. Therefore, in the present review, recent advances on the immunoregulatory properties of apigenin in various diseases with a special focus on neoplasm, are summarized. Clinical strategies of cancer immunotherapy are briefly introduced and findings on apigenin linked to immunoregulatory roles in immunotherapy-associated aspects are brought together. The bioactivity, bioavailability, toxicity and potential of apigenin, to be considered as a therapeutic agent in anti-tumor immunotherapy, is discussed. Disclosed molecular mechanisms underlying the immunoregulatory roles of apigenin in cancer immunotherapy are also summarized. Based on findings from the literature, apigenin has the potential to serve as a prospective adjuvant for anti-cancer immunotherapy and warrants further investigations., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

ErbB2 overexpression identifies a subclass of breast cancer as ErbB2-positive that is frequently associated with poor prognosis. Current ErbB2-targeted therapies have profoundly improved patient outcomes, but mutations occurring in ErbB2 have been shown to confer drug resistance. Induction of ErbB2 degradation was proposed as an intriguing strategy to battle with ErbB2-positive breast cancer and reduced mutation-incurred drug resistance. Although multiple HSP90 inhibitors have been demonstrated to effectively trigger ErbB2 degradation, none succeeded in the clinical evaluations. To develop novel ErbB2-targeting strategies, we investigated the endocytic degradation and reversible ubiquitylation of ErbB2 in breast cancer. In this study, we reveal that HSP90 inhibition leads to efficient ubiquitylation and endocytic degradation of ErbB2 through the canonical endo-lysosomal route. USP2 associates with internalized ErbB2 and prevents its lysosomal sorting and degradation via exerting deubiquitylase activity. Accordingly, the USP2 inhibitor ML364 is capable of inducing ErbB2 ubiquitylation and accelerating its turnover. ML364 potentiates the pro-degradation effects of HSP90 inhibitors on ErbB2 and hence sensitizes ErbB2-positive breast cancer cells to HSP90 inhibition. The combination of USP2 and HSP90 inhibitors effectively restrains ErbB2-positive breast cancer xenograft growth in vivo. Based on these observations, we conclude that USP2 safeguards ErbB2 surface levels by antagonizing its ubiquitylation-mediated endocytic degradation, which can be exploited to design novel therapeutic strategies against ErbB2-driven malignancies as combinatorial treatment with HSP90 inhibitors.

Objective: To describe the epidemiology of herpes simplex virus type 1 (HSV-1) in Europe., Methods: We systematically reviewed HSV-1 related publications, conducted various meta-analyses and meta-regressions, assessed pooled mean seroprevalence, and estimated pooled mean proportions of HSV-1 viral detection in clinically diagnosed genital ulcer disease (GUD) and in genital herpes., Results: We extracted, from 142 relevant records, 179 overall (622 stratified) seroprevalence measures, 4 overall proportions of HSV-1 in GUD and 64 overall (162 stratified) proportions of HSV-1 in genital herpes. Pooled mean seroprevalence was 67.4% (95% CI 65.5% to 69.3%) with 32.5% (95% CI 29.4% to 35.7%) of children and 74.4% (95% CI 72.8% to 76.0%) of adults infected. Pooled seroprevalence increased steadily with age, being lowest in those aged <20 years (39.3%, 95% CI 35.9% to 42.7%) and highest in those aged >50 years (82.9%, 95% CI 78.8% to 86.6%). Pooled seroprevalence decreased yearly by 0.99-fold (95% CI 0.99 to 1.00). Pooled mean proportion of HSV-1 detection was 13.6% (95% CI 4.1% to 27.1%) in GUD, 34.1% (95% CI 31.7% to 36.5%) in genital herpes and 49.3% (95% CI 42.2% to 56.4%) in first episode genital herpes. Pooled proportion of HSV-1 detection in genital herpes increased yearly by 1.01-fold (95% CI 1.00 to 1.02), with higher detection in women (42.0%, 95% CI 37.4% to 46.7%) than men (24.1%, 95% CI 19.8% to 28.6%)., Conclusions: HSV-1 epidemiology is transitioning away from its historical pattern of oral acquisition in childhood. Every year, seroprevalence is declining by 1% and the proportion of HSV-1 in genital herpes is increasing by 1%. As many as two-thirds of children are reaching sexual debut unexposed, and at risk of HSV-1 genital acquisition in adulthood., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Primary healthcare in Qatar uses electronic prescribing to reduce the risk of medication errors. Electronic prescribing is supported by computerized Physician Order Entry systems through Cerner (electronic medical record system). There are still prescription errors, despite electronic prescribing being in place for one year at West Bay Health Center. West Bay Health Center is a famous primary healthcare center in Qatar. It is a training center for the family medicine residency program, which is accredited by the accreditation council of general medical education international (ACGME-I). It serves a population of about 98,000 in Qatar with 35 physicians and 12 pharmacists. The aim of this project was to decrease medication errors by 30% from baseline measurement (according to type of error) from October 2015 to March 2016. It was found that there was a discrepancy between the pharmacy medication list and the list within Cerner. A master drug index was created to eliminate the discrepancy. Training on the use of this index was provided through lectures and one to one education, with material also sent through email. We found that there was some resistance from the physician side and therefore introduced a second intervention. We sent out a survey to find out more about these difficulties and provided more training and education. Our results showed an decrease in the proportion of wrong dose errors from 11.8% to 10.6%, wrong name from 6.9% to 6.2%, wrong duration from 11.7% to 10.3%, and non-formulary drug errors from 2.6% to 1.6%.

Introduction. The aim of our study is to assess the need for postoperative antibiotics following simple exodontia and determine its role in minimizing patient discomfort and postoperative complications. Material and Methods. All the patients undergoing simple extractions were grouped into two categories: Group 1, patients receiving antibiotics, and Group 2, patients receiving no antibiotics. Patients were recalled on the sixth day to assess postoperative complications. On recall, patients were evaluated for signs of persistent inflammation and signs of dry socket. Presence of persistent inflammation and/or suppuration on the 6th day was considered as wound infection. Results. A total of 146 patients were included in this study. Out of the total sample, 134 (91.8%) presented with no postoperative complications and 12 (8.2%) had postoperative complications, out of which 11 (7.5%) patients presented with dry socket (alveolar osteitis), 5 (3.4%) in the antibiotic group and 6 (4.1%) in the nonantibiotic group. Only 1 patient (0.7%) was reported with infection of the extraction socket in the nonantibiotic group, whereas no case of infection was found in the antibiotic group. Conclusion. Antibiotics are not required after simple extractions in patients who are not medically comprised nor do they have any role in preventing postoperative complications.

Background: Traditionally, poor obturation has been considered the primary cause of root canal treatment failures. The purpose of this study was to assess the success rate of overfilled root canal treatment cases in order to decide whether a definitive restoration can be placed immediately following treatment in an overfilled case or whether the patient needs to be kept on a follow up prior to the placement of a definitive restoration., Methods: A total of 1242 patient's periapical radiographs (1748 teeth) were assessed, out of which 397 teeth (in 285 patients) were found to be overfilled. Out of these 285 patients, 111 (128 cases) agreed to participate in this cross sectional study and were recalled for clinical and radiographic examination. Success was evaluated clinically by absence of symptoms (pain, swelling, tenderness to percussion and sinus tract) and radiograhically by the decrease in size of periapical lesion or no change in size. Increase in size of periapical lesion was deemed to be a failure., Results: Our findings revealed that despite overfill, the treatment was successful in 115 cases and failure was noted in 13 cases showing an overall success rate of 89.8% and failure rate of 10.2%. Out of 13 cases of failure, all 13 showed an increase in periapical lesion size, out of which 10 were accompanied with pain., Conclusion: We have determined that there is no need to delay placement of a permanent restoration on overfilled teeth (ruling out the presence of other procedural errors) nor is there any need to pursue any further surgical or non-surgical endodontic treatment. However we would suggest that patients should be kept on follow-up after placement of permanent restoration.

Introduction. The aim of this study is to determine the most common endodontically treated tooth and the most common error produced during treatment and to note the association of particular errors with particular teeth. Material and Methods. Periapical radiographs were taken of all the included teeth and were stored and assessed using DIGORA Optime. Teeth in each group were evaluated for presence or absence of procedural errors (i.e., overfill, underfill, ledge formation, perforations, apical transportation, and/or instrument separation) and the most frequent tooth to undergo endodontic treatment was also noted. Results. A total of 1748 root canal treated teeth were assessed, out of which 574 (32.8%) contained a procedural error. Out of these 397 (22.7%) were overfilled, 155 (8.9%) were underfilled, 16 (0.9%) had instrument separation, and 7 (0.4%) had apical transportation. The most frequently treated tooth was right permanent mandibular first molar (11.3%). The least commonly treated teeth were the permanent mandibular third molars (0.1%). Conclusion. Practitioners should show greater care to maintain accuracy of the working length throughout the procedure, as errors in length accounted for the vast majority of errors and special care should be taken when working on molars.