Objectives: To evaluate perceived quality, clarity, and accuracy of self-developing films compared to conventional D- and E-speed manually processed films, and to evaluate their ease of use and satisfaction amongst pre-clinical dental students. Methodology: Mesiobuccal root canals of 30 extracted mandibular molar teeth were instrumented and size 10 K-files were glued into the canals at 3 different levels. Each tooth was exposed thrice with the same angulation using conventional E-speed, D-speed, and self-developing films. Conventional films were processed manually and self-developing films according to the manufacturer’s instructions, which required 50 seconds of contact time with the solution. Radiographs were evaluated by 4 examiners for quality, clarity, and apical position of the file. A questionnaire-based survey was conducted to evaluate the ease of use, quality, and satisfaction of undergraduate students. Data were analyzed using one-way ANOVA and Tukey–Kramer multiple comparison test, significant at p < 0.05. Results: The quality and clarity of conventional E-speed films was perceived as significantly better than that of D-speed and self-developing films (p < 0.05). There was no statistically significant difference amongst the 3 film types for recorded file positions (p > 0.05). The results of the student survey corroborated the examiners’ views that the self-developing radiographic films were of poor quality. Conclusion: Manually processed E-speed films provided significantly superior quality and clarity of images, but for apical file position, no significant differences were found amongst the 3 film types. Conventional E-speed, D-speed, and self-developing films are all adequate for measuring endodontic working lengths.

Objectives: To create awareness to the radiologist and clinicians for the magnetic resonance imaging (MRI) appearance of Pterygopalatine fossa (PTF) tumours and to evaluate the role of MRI in the diagnostic of PTF lesions. Methodology: Retrospective evaluation of MRI features of 29 patients with pathologically proved pterygopalatine fossa (PTF) lesions was performed. The study included 18 males and 11 females with ages ranging between 15 and 68 years. All patients were examined on 1.5 Tesla magnets before and after injection of Gadolinium Meglumine. TI WI   5mm section sagittal scout views, followed by axial T1 5mm sections for the skull base and same sliced thickness during PD and T2 WI in axial and coronal planes. Results: MRI features of various masses in pterygopalatine fossa were reviewed and correlated with those demonstrated in the literatures. Out of 29 PF masses, 7 masses were proved to be angiofibroma and 6 were nasopharyngeal carcinoma, entering the PTF. Conclusion:   MRI is a useful imaging test which helps in the differential diagnosis of pterygopalatine fossa lesions with precise evaluation of their extensions and nature of lesion and helping to reach the correct diagnosis. However, MRI has limitation for evaluation of associated bony erosion, for which adjuvant CT scan is needed.

Background: In Saudi Arabia where there is lack of dermatologists in primary health care centers, patients with simple or minor skin conditions have to attend to hospitals to be treated. We analyzed the data of patients with cutaneous disorders attending the tertiary referral hospital in Qassim region of Saudi Arabia, with the aim to identify the most common conditions that patients complain of, in order to define the areas where the education of General Practitioners in Dermatology must focus. Methodology: All patients seen at the Dermatology ambulatory office in the Emergency Department of Qassim University affiliated hospital from January 2011 to December 2011 were included in this retrospective analysis. The medical records of the patients (history, physical examination and laboratory investigations) were analyzed to ascertain the diagnosis and the management of cases. All patients were evaluated by qualified dermatologists. Results: A total of 1147 patients attended the Dermatology ambulatory office. Most patients were young adults in the age group 21–30 years (34.4%). Allergic skin diseases (65.2%), mostly dermatitis (48.8%) and urticaria (10.5%) were the most common for attendance, followed by infectious diseases (25.8%) and inflammatory and autoimmune disorders (5.3%). The management of the vast majority of cases (94.1%) consisted of systemic treatment and 58.2% patients required topical treatment. A re-evaluation plan as outpatients was planned in 9.0% patients while only 0.3% of patients required admission in the hospital. Conclusion: Allergic and infectious skin diseases were the most common cutaneous diseases in patients attending this tertiary University hospital, while the management of most patients did not require specialized care. On the basis of the present data, the training of primary health care providers in Dermatology should emphasize these common conditions, with the aim of improving primary care and alleviating the burden on hospital care. Key words: Dermatology, ambulatory office, Saudi Arabia  

Background and Objectives : To assess the knowledge, attitude and practices among Gynecologists’ regarding oral health of expectant mothers of Vadodara city, by using self designed, structured, pre-tested close ended questionnaire. Methodology : Total of 130 gynaecologists are included in the study. Ethical approval was obtained by the Ethics committee, Sumandeep Vidyapeeth, Vadodara. Prior to study, questionnaire was pre-tested and validated. Those individuals who participated in the pilot study were not considered for the main study to prevent possible bias. The informed consent was obtained and information sheet was given. The questionnaire was administered on first day of visit and on the next day it was collected back. For statistical analysis SPSS package version 17 and Pearson’s Chi Square test was used. Results :  The study revealed that majority of gynecologists had good knowledge, attitude and practices regarding oral health of expectant mothers and there is no significant difference in relation with age, sex and years in practice. Conclusion : Majority of gynecologists had good knowledge, attitude and practices but still there is a need for more active participation and involvement of medical specialists like gynecologists and pediatricians, in continuing education programs and forums on dentistry.   Keywords:  Gynecologists, Expectant mother, Oral health

Objective: The aim of this study was to assess the level of importance, adequacy and need of biostatistics and biostatistics education regarding health sciences in Turkey. Methodology: Within the scope of the study a survey (questionnaire) was applied to a total of 237 academicians (academicians holding various titles employed by different departments) officiating at medical, veterinary medicine and health sciences faculties of six universities (Afyon Kocatepe, Gazi, Ankara, Hacettepe, Marmara ve Düzce) in Turkey. With this survey were taken views of academics on the status of the training they had received regarding biostatistics, their need for biostatistics education, the importance of biostatistics education and its level of adequacy, the source and adequacy of current information on biostatistics, the solutions to meet biostatistics needs and the statistical techniques which were required.   Results: According to the results, 27.8% of the participants have not received biostatistics education. It was determined that the importance of biostatistics education was emphasized as “very and exactly important†by 88.19% of the participants. 14.35% of the participants reported that biostatistics education was far from adequate for post graduate. They needed biostatistics knowledge mainly in the analysis of researches data (=4.01). On the other hand, they met biostatistics knowledge needs mostly by “help from friendsâ€. Conclusions: The study revealed that most of the academicians found biostatistics education important but claimed it had been inadequate. They emphasized the need for the organization of courses, seminars, etc. regarding biostatistics at sufficient intervals. As a consequence of that, this study reveals the importance of biostatistics and biostatistics education once again in the data analysis process in health sciences.   Key Words: Biostatistics, Biostatistics education, Health sciences

Background: Educational environment hugely impacts the learning process. An assessment of perceptions of students about the educational environment at Qassim University College of Medicine (QUCOM) would assist educators and college administration in gauging the quality of the learning in this venue. The aim of this study is to see the educational environment of an innovative undergraduate medical program through the eyes of students. Methods: During the academic year 2011/2012, a survey was performed at QUCOM using the Dundee Ready Education Environment Measure (DREEM) questionnaire. All undergraduate students participated in the survey. Comparisons between, students’ responses according to their study years in the college and gender were taken into consideration. Data were entered and analyzed using SPSS version 17.0. The scores assigned by the students to questionnaire items were converted into and continuous variables and summarized as means. Results: Out of 467 students enrolled at QUCOM 454 students (61% males and 39% females)participated in the study (response rate of 97%).The mean age of the participants was 21.4 (standard deviation: 2.2). The mean total score was 112, out of a possible maximum of 200. The mean total score for Perception of Learning was 26/48; for Perceptions of Teaching 25/44; for Academic Self perceptions 20/32; for Perceptions of Atmosphere 26/48 and for Social Self Perceptions 15/28. The mean score of 1.13 for Item 3 “There is a good support system for students who get stressed†was the lowest and is indicative of the pressures felt by the students. While the mean score of 3.24 for Item 15 “I have good friends in this school†was the highest showing good relationship between students. There were no significant differences of perceptions between genders and between basic sciences and clinical phases. Conclusion: Students perceive the educational environment at QUCOM as having more positives than negatives. Certain areas need further exploration and improvements, which should serve as a decision support mechanism for educationists at QUCOM in rationalizing their priorities for reforms. Key words: Educational climate, Educational environment, Medical culture, Medical education

Objective:   Delayed wound healing is one of the complications of diabetes mellitus, exhibited by profound inflammation and decreased granulation tissues. The current study was carried out to evaluate wound healing in both normal and diabetic rats. In addition, it evaluated the potential protective effect of transforming growth factor β1 (TGF β1), that  has the broadest spectrum of actions, affecting all cell types that are involved in all stages of wound healing to accelerate wound healing in normal & diabetic rats. Methods : The present study was performed on 40 male albino rats. Each 10 rats were designed as a group. Group I saved as control. They received incisional wound in their tongues 1 cm length and 1/2 cm depth. Group II received 500 ng/kg of TGF β1 5 minutes before wounding. Group III diabetes was induced then rats were treated as second group.  At the 14 th day post wounding, sections of tongues were taken for hematoxylin and eosin and Masson's trichome staining to examine the histological changes. The intracellular actions of TGF β1 were studied by TEM. Results: A higher cell proliferation rate and a denser and more organized new extracellular matrix and complete wound closure was detected at the 14 th days in the TGF β1 treated wound in comparison with the 14 th days for the untreated, control groups. There were delayed wound healing in diabetic rats, decreased re-epithelialization, granulation tissue thickness, matrix density, number of infiltrated cells, and number of capillaries. In TGF β1 treated diabetic rats, showed significant healing improvement was obvious as compared with diabetic rats. Conclusions: A single intravenous injection of TGF β1 was sufficient to enhance wound healing in rat's tongue. This approach represents a new strategy that may be applied to the treatment of incisional wounds in human diabetic patients. Key words:   Transforming growth factor β1, wound healing, diabetes mellitus, tongue mucosa.

Objectives: The purpose of this study was to investigate the prevalence of occupational exposure incidents among undergraduate dental students and the factors associated with it in the educational dental clinics at Pharos University in Alexandria – Egypt, and to measure the commitment with applying infection control policy in the form of compliance with post-exposure management protocol and reporting exposure incidents. Materials and Methods: An anonymous self-administered questionnaire consisting of thirteen multiple-choice questions was distributed among 350 undergraduate dental students in mid-senior and senior levels during lec­tures at the end of the second semester of 2011, with a response rate of 90.00%. Results: About 62.00% of the senior students reported that exposures occurred outside the patient’s mouth. A high percentage of both the mid-senior and senior students (74.70% and 70.70%, respectively) reported that they were exposed to multiple sources of incidents. The vast majority of studied groups stated that they didn’t follow Infection Control Protocol after Incident Exposure.  Conclusion: The findings of this study confirm that dental students experience exposure incidents but are not likely to report them, thus it is important that the principles of infection control training and reporting of all exposure incidents continue to be emphasized throughout undergraduate dental education. Key words: exposure incident, bloodborne exposure, risk factors, infection control protocol

Background : Lead toxicity has been subjected to intensive research work, but some aspects of its mechanism needs to be elucidated. Objectives: In the current study we aim to investigate the impact of lead toxicity on some different intermediates of apoptotic signaling pathway in experimental rats. Design and methods : We measured caspase-8 and caspase-9 [by chemilumenescence], Bax and Bcl-2 [by ELISA] in Experimental rats, injected intraperitoneally with lead acetate for 7days at the dosage of 25, 50 and l00 mg/kg body weight and compared to control rats injected with deionized distilled water instead. Results:  Lead acetate significantly increased the levels of caspase 8, caspase 9 and Bax in liver, kidney and brain of experimental animals especially those with high doses. Meanwhile, caspase 8 and Bax significantly increased in brain tissue at low dose of lead, while Bcl-2 significantly increased only with advanced toxicity. Furthermore, Bax/ bcl2 ratio was significantly high in kidney (p<0.05), liver (p<0.01) and brain (p<0.01) at higher doses of lead toxicity. However, brain tissues showed significant Bax/Bcl2 ratio (p<0.05) at low lead dose. A significant positive correlation was noticed between the blood level of lead and enzymatic level of caspase 8, caspase 9 and Bax in different tissues. Conclusion : we concluded that lead might have toxic effect through intrinsic and extrinsic induction of apoptotic pathway with prominent effect on brain tissue even at low dose. Keywords: Lead toxicity, Rats, Apoptosis, Bcl-2, Bax, Caspase 8 and Caspase 9.

Objectives: This experimental study aimed to evaluate the effects of central catalase inhibition on cardiovascular responses in rats exposed to sidestream cigarette smoke (SSCS) for 3 weeks. Methodology: A total of 20 males Wistar rats (320-370g) were implanted with a stainless steel guide cannula into the fourth cerebral ventricle (4 th V). Femoral artery and vein were cannulated for mean arterial pressure (MAP) and heart rate (HR) measurement and drug infusion, respectively. Rats were exposed to SSCS for three weeks, 180 minutes per day, 5 days/week [carbon monoxide (CO): 100-300 ppm)]. Baroreflex was tested with one pressor dose of phenylephrine (PHE, 8 μg/kg, bolus) and one depressor dose of sodium nitroprusside (SNP, 50 μg/kg, bolus). Cardiovascular responses were evaluated before and 15 minutes after 3-amino-1, 2, 4-triazole (ATZ, catalase inhibitor, 0.001g/100μL) injection into the 4 th V. Results: Vehicle treatment into the 4 th V did not change cardiovascular responses. Central catalase inhibition increased tachycardic peak, attenuated bradycardic peak and reduced HR range at 15 minutes, increased MAP at 5, 15 and 30 min and increased HR at 5 and 15 min. In rats exposed to SSCS, central ATZ increased basal MAP after 5 min and increased HR at 5, 15 and 30 minutes, respectively, and attenuated bradycardic peak at 15 minutes. Conclusion: This study suggests that brain oxidative stress caused by SSCS influences autonomic regulation of the cardiovascular system. Keywords: Baroreflex; Oxidative Stress; Catalase inhibition; Medulla Oblongata; sidestream cigarette smoking.

     Hypertension exhibits a winter peak and summer trough in countries both north and south of the equator. A variety of explanations have been proposed to account for the seasonal nature of hypertension. It is likely that this reflects seasonal variations in risk factors. Seasonal variations have been demonstrated in a number of risk factors may play essential roles for seasonality of hypertension such as noradrenalin, catecholamine and vasopressin, vitamin D, and serum cholesterol. However, a number of studies have also suggested a direct effect of environmental temperature and physical activity on blood pressure. This paper was design to review the available evidence on seasonal variations in hypertension and possible explanations for them.

     Mycosis fungoides (MF) and Sézary Syndrome (SS) are the most common subtypes of cutaneous T-cell lymphomas. Most of patients have indolent and incurable course of disease. Therefore, treatment should be reaching the optimal benefit with minimizing the toxicity as much as possible. To achieve this aim, the management should follow a -stage-based- approach.      Treatment of early-stage MF (IA-IIA) involves skin-directed therapy (SDT) including topical corticosteroids, phototherapy, topical chemotherapy, topical retinoids and radiotherapy.      For aggressive/recalcitrant early-stage MF or advanced-stage MF, systemic therapy should be considered including interferone-alpha, oral retinoids including bexarotine and more recently acitretin, histone deacetylase inhibitors (HDACi), fusion toxin denileukin diftitox and chemotherapy drugs. Combined drug regimens can be considered in some situations to get the synergistic effect while lowering the individual drug's doses on the other hand. By exception of aggressive stages, chemotherapy should always come after other systemic drugs have been tried or contraindicated. Novel drugs should be considered in situations when all systemic drugs have failed.   Key words:   Ctaneous T-cell lymphoma, Mycosis fungoides, Sézary Syndrome

Odontomas are odontogenic lesions with occurrence rate of 22% in the oral Cavity. They generally appear as small, solitary ormultiple radio-opaque lesions on routine radiographic examinations and are subdivided into complex or compound odontomas morphologicaly.Compound odontomas occur commonly in the incisor-canine region of the maxilla and complex odontomas are located frequently in the premolar and molar region of both jaws. This paper describes a case of compound odontoma in anterior maxilla blocking the eruption of upper incisors and canine in a eight years old child. The surgical excision of the lesion was performed to allow the eruption of permanent teeth. In present case three years follow up indicate no sign of recurrence. Early detection of odontomas allows the adoption of a less complex expensive treatment, eruption of permanent teeth and ensures better prognosis. Keywords: Odontomas, Compound Odontoma, Complex Odontoma, Odontogenic Lesions.

Langerhans cell histiocytosis (LCH) is a rare disease that usually affects children and young adults. Sclerosing cholangitis (SC) can occur in 10-15% of patients with disseminated form of the disease. Central diabetes insipidus (CDI) is a rare disorder that may be caused by a variety of diseases mainly LCH and germinoma especially in children. In this case report, a- 4-year-old girl who is a known case of CDI and a single bone lesion in the left humerus, presented with jaundice, abdominal distention and itching. The diagnosis of SC was made by histopathology on liver biopsy. In this case, we found a link between CDI and SC through LCH, the diagnosis of which was made by histopathology of the explanted liver. The combination of CDI, liver involvement with SC and a single bone lesion is remarkable, since the histological diagnosis of LCH was made outside the biliary tract in the liver parenchyma.

   Hepatocellular carcinoma (HCC) is rare in children. Progressive familial intrahepatic cholestasis type II (PFIC2 and also called BSEP ((Bile Salt Export Pump)) deficiency) is an inherited disease that initiates end-stage liver cirrhosis which can predispose to HCC.  HCC can occur in 15% of patients with PFIC2. In this case report, an 11-month-old boy with PFIC 2 was admittedfor liver transplant work up. The finding of HCC was made incidentally by histopathology on the explanted liver after suspiciously gross examination.  In this article, we found that the radiology (US) alone is not enough to exclude HCC.  Finally, we conclude that any case of PFIC 2 (male or female) needs routine screening of serum AFP concentration, advanced radiological examination (CT, MRI) as well as careful macroscopic examination of their explanted liver (triple assessment) to exclude HCC.

     World Health Organization (WHO) defines adolescents as young people aged 10-19 years. (1) Globally there are 1.2 billion adolescents, one fifth of world population.  Due to present demographic trends their number is increasing. Estimates suggest that approximately 25% of the populations in Kingdom of Saudi Arabia are adolescents. (2)      Adolescence is a journey from childhood to the world of an adult, a time of physical, psychological and emotional change. Adolescents are no longer children, but not yet adults. They can put themselves at risk without thinking of the consequences. They get fascinated by many rowdy and thrilling adventures and actions and start living in world of dreams imagining them to be an unbeatable personality.      A study in Riyadh city among adolescents found that overall prevalence of cigarette smoking 12.7% (n=187) among the study sample, the habit is more common in males (19.0%) than females (4.0%). Finding of same study indicate that adolescents males who drive car 45% of them had a car accident. The prevalence of drug use in this survey was 6.4% (10.6% in males and 0.8% in female study subjects), volatile substance was commonly abused among adolescents. (3)      Mental health problems frequently start at this age group. A study carried out in Tiaf Governorate,    Saudi Arabia, revealed that most important problems were anxiety (13.5%), somatic disorders (12.2%) obsession (10.8%), aggression (8.1%), delinquency and depression (4.1%). (4)      Recent evidence indicates that emotional and behavioral disorders frequently lead to poor school performance and dropping –out of school. This wastes education resources and seriously impairs the economic and social potential of such children. (5)      Saudi society is different from western societies in many respects. It is conservative society with strong Islamic values. The pattern of adolescent’s problems is expected to be different from that in the west. For example illegitimate teenage pregnancies are common in western world, but do not exist in KSA.      Most causes of mortality and morbidity in adolescents, such as road side accidents cigarette/ shisha smoking and drug abuse can be prevented by simple measures including health education and counseling. If adolescents are properly cared for and groomed, physically and emotionally at homes and schools, they will enjoy good physical & mental health. School environment and behavior of teachers play a critical role in character building and personality development of adolescents. Importance of school health clinics for health education & counseling has important role.       Antismoking program should be established, including prohibition of the sale and use of cigarettes in public places, along with application of firm traffic laws forbidding adolescents aged less than 18 years from driving.