Background: Subscription-based models are increasingly being explored as a potential solution to enhance patient access to preventive dental care, reduce reliance on traditional insurance and offer a more predictable financial framework for both patients and dental practices. These models aim to foster regular dental visits, encourage better oral health and reduce overall treatment costs by emphasizing preventive care. This study investigates the knowledge, attitudes and practices (KAP) of dental professionals concerning subscription-based membership plans and their potential impact on patient care. Methods: A cross-sectional survey was conducted with 230 participants, including dental students, private practitioners and academic faculty. The survey aimed to evaluate the participants' knowledge of subscription models, their attitudes toward these models and their experiences with recommending or implementing these plans in their practices. Descriptive statistics were used to summarize and analyze the data and Chi-square tests were applied to explore potential correlations between professional groups and their KAP. Results: The results reveal that 60% of participants were familiar with subscription-based models for preventive dental care. Among those, 72% recognized the potential benefits of these models in reducing reliance on traditional insurance and improving access to care. In terms of practices, 45% of participants had recommended subscription plans to patients and 62% expressed an interest in incorporating these plans into their future practices. Interestingly, a significant proportion (38%) rated themselves as “moderately proficient” in recommending these plans. Additionally, the study found that participants who were more familiar with subscription models were significantly more likely to recommend them (p<0.05). Numerical data analysis showed that 60% of participants had some level of familiarity with subscription models, with 72% acknowledging the models' benefits. Despite the favorable attitude, only 45% had actively recommended these plans. The correlation between familiarity with the subscription model and the likelihood of recommending it was statistically significant (p<0.05). Furthermore, 62% of the respondents showed interest in incorporating such models into their practices in the future. Conclusion: The study highlights that while dental professionals generally recognize the advantages of subscription-based models in improving preventive care, there are challenges that hinder their wider adoption. These challenges include limited familiarity and self-reported moderate proficiency in implementing or recommending these models. The findings indicate that further education, training and exposure to subscription-based care models are essential to overcome barriers and increase their successful integration into routine dental practice. Addressing these gaps will not only promote better oral health but also enable dental practices to offer more sustainable and patient-friendly options for preventive care.One of the study's limitations is the reliance on self-reported data, which may be subject to response bias. Additionally, the sample size of 230 participants, while varied, may not fully represent the broader dental community. Future studies could include a larger sample across more regions to generalize the findings.

Introduction: The construction industry is among the most hazardous sectors, with high rates of musculoskeletal disorders (MSDs) and orofacial trauma due to physically demanding tasks, awkward postures and poor ergonomics. These injuries contribute to long-term disability risks and productivity loss. This study evaluates the prevalence of MSDs, ergonomic risks and orofacial trauma among construction workers in Chennai, India, while proposing preventive strategies. Methods: A cross-sectional survey was conducted among 297 male construction workers in Chennai using a pre-validated questionnaire based on the Nordic Musculoskeletal Questionnaire. Data were collected through in-person camps and Google Forms. The analysis was performed using SPSS (Version 20), with statistical significance set at p<0.05. Subgroup analyses were conducted to identify injury patterns by age, job role and experience level, enhancing the study's insights into risk factors. Results: Workers aged 25-34 reported the highest prevalence of MSDs, particularly in the neck (28.5%) and back (22.5%) within the past 7 days, resulting in significant activity restrictions. The study also identified repetitive tasks, prolonged standing and awkward postures as major contributors to MSDs. Additionally, cases of orofacial trauma were noted, highlighting the need for enhanced protective equipment use. The findings underscore the role of environmental and organizational factors in injury prevalence. Conclusion: The significant prevalence of MSDs, ergonomic risks and orofacial trauma underscores the urgent need for targeted interventions. Recommendations include comprehensive ergonomic training, improved use of Personal Protective Equipment (PPE) and enhanced workplace design. Introducing education campaigns, implementing injury prevention strategies and adopting emerging technologies such as wearable devices can further mitigate risks. Future research should explore gender disparities, rural construction settings and long-term intervention outcomes to enhance worker safety and productivity.

Objectives: Forensic scientists now recognize lip print research known as cheiloscopy as a valuable method for identifying people which supplements fingerprints and DNA examination. Although lip prints are unique and permanent features they receive limited use in forensic analysis of certain population groups. Aim: The study analyzes how gender and age influence lip prints among residents of Qassim Saudi Arabia according to Suzuki and Tsuchihashi’s classification system. Methods: The study's design involved 100 participants selected by age from 18 to 45 among 50 males and equal female participants. Eye examination revealed lip print classifications that researchers collected using non-invasive method involving a lipstick and transparent film. Investigators used the Chi-square test to evaluate whether demographic variables showed an association with lip print distribution types. Results: The majority of participants showed Type I lip print patterns which accounted for 44% of all participants. The results showed that female participants displayed Type I patterns in 70% of cases but male participants mostly had Type IV patterns at 42%. A measurement analysis showed that lips print distribution across genders differed significantly in lip print frequencies (χ² = 15.72, p < 0.01). Lip print type demonstrated no statistical connection with the participants' age divisions (p > 0.05). Limitations: The research contained a restricted participant number alongside a bias toward younger individuals which potentially reduced the study's ability to generalize its findings. The assessment process by manual methods along with missing power analysis measurements warrant attention because they could lead to classification bias. Conclusion: Interpretation of lip prints showed important distinctions based on gender thus strengthening cheiloscopy as an investigative aid during forensic investigations. Additional research of large size using artificial intelligence should be supported to study multiple population groups

Background: Migrant construction labourers often face challenging working conditions, low income and inadequate access to healthcare, including dental services. These factors contribute to significant oral health issues that impair daily activities such as eating, speaking and social interactions. This study aims to assess the Oral Impact on Daily Performance (OIDP) among migrant construction workers in Chennai, identify associated covariates and recommend targeted interventions. Methodology: A cross-sectional study was conducted among 108 migrant construction labourers in Chennai using a structured questionnaire to assess oral health status and OIDP. The questionnaire collected demographic data, oral hygiene practices and self-reported oral health issues. The OIDP scale evaluated the impact of oral problems on daily tasks like eating, speaking and sleeping. ANOVA and Student’s T-test were used to examine associations between OIDP and covariates such as age, gender, education and occupation. Special focus was placed on socioeconomic factors and healthcare access. Results: The study found no significant correlation between the Oral Hygiene Index-Simplified (OHI-S) and OIDP scores (p = 0.237). However, higher Decayed, Missing and Filled Teeth (DMFT) scores, tooth loss and periodontitis significantly correlated with increased OIDP scores. Workers without dental decay had a mean OIDP score of 0.907, while those with severe decay (DMFT >9) scored 8.355 (p = 0.000). Workers with 7-9 missing teeth had the highest mean OIDP score of 18.389 (p = 0.000). Periodontitis also showed a significant association (p = 0.009). Conclusion: Migrant construction workers in Chennai face serious oral health issues that impact their daily performance. Socioeconomic barriers and limited healthcare access play a key role. Policymakers must address these challenges by introducing affordable dental care programs, awareness campaigns and integrating oral healthcare into primary healthcare services to improve their quality of life.

Objectives: This study aimed to assess the bonding effectiveness of bioactive restorative materials when used for orthodontic bracket placement. Specifically, it evaluated whether these materials could provide shear bond strength (SBS) comparable to that of conventional resin-based adhesives, while also minimizing residual adhesive and preserving enamel integrity after bracket debonding. Methods: Forty-five extracted, caries-free premolars were randomly assigned into three main groups (n=15) based on the restorative material used: ACTIVA Bioactive-Restorative (AB), Beautifil II (BF), and Transbond XT (TB XT) — with TB XT serving as the control. Each group was further subdivided into three adhesive primer subgroups (n=5): FL-Bond II, BeautiBond Xtreme, and Transbond XT Primer. After standardized enamel cleaning and etching procedures, orthodontic metal brackets were bonded to the tooth surfaces and light-cured as per manufacturer guidelines. Specimens were stored in distilled water at 37°C for 24 hours before being subjected to shear bond strength testing using a universal testing machine. Following debonding, residual adhesive was evaluated under a stereomicroscope and scored using the modified Adhesive Remnant Index (ARI). Results: Two-way ANOVA revealed a statistically significant interaction between the type of adhesive and restorative material on SBS values (p<0.001). Among all combinations, the group using FL-Bond II with Transbond XT exhibited the highest mean SBS (19.44±3.90 MPa), while the Beautifil II group paired with BeautiBond Xtreme showed the lowest bond strength. ARI score analysis demonstrated significant differences across groups, with FL-Bond II generally resulting in minimal adhesive remnants on the enamel surface. Conclusion: The combination of FL-Bond II adhesive with conventional Transbond XT composite resin exhibited superior shear bond strength and favorable ARI scores, making it an optimal choice for orthodontic bracket bonding. ACTIVA Bioactive, when used with suitable primers, demonstrated promising results in terms of bond strength and enamel preservation, indicating its potential as an alternative to conventional systems. However, further in vivo and long-term clinical studies are warranted to validate these findings under dynamic oral conditions.

Background: Tobacco use remains a major public health concern, contributing to approximately five million deaths annually, with projections rising to eight million by 2030. Family-based interventions have shown promise in reducing adolescent tobacco use by improving parental communication and setting household restrictions. Aim: This systematic review evaluates the effectiveness of family-based tobacco cessation interventions for children and adolescents, focusing on behavioral strategies and parental influence. Methodology: A systematic review was conducted using PubMed, Cochrane, Google Scholar, Lilac and Web of Science databases. Randomized controlled trials (RCTs) assessing the impact of family interventions on adolescent tobacco cessation were included. The RoB 2 and Robvis tools were used to assess the risk of bias. Results: Out of 984 identified studies, five RCTs met the inclusion criteria after duplicates and irrelevant articles were excluded. Family-based interventions were found to improve parent-child communication, enhance family bonding and reduce adolescent tobacco initiation rates. Interventions that involved active parental engagement, household smoking restrictions and behavioral counseling yielded better outcomes. While some interventions showed delayed effects, those tailored to individual family dynamics demonstrated greater long-term success. Studies indicated that cultural factors, family involvement intensity and parental smoking status influenced outcomes. The overall risk of bias across included studies was moderate. Conclusions: Family-based interventions are effective in promoting adolescent tobacco cessation by fostering communication, setting behavioral boundaries and strengthening family support. Future research should focus on developing culturally adaptable strategies and improving implementation frameworks for enhanced real-world impact.

Background: Acinetobacter baumannii has emerged as a significant nosocomial pathogen with a high rate of multidrug resistance (MDR). This review was conducted systematically to meta-analyze the antimicrobial susceptibility of A. baumannii isolates, especially focusing on resistance trends, mechanisms and geographic variability. Methods: A systematic search was conducted across seven databases: PubMed, Scopus, Web of Science, Embase, Cochrane Library, CINAHL and ScienceDirect. All of the databases were easily modified using appropriate Boolean operators and MeSH terms to further narrow down the specific outcome for the search strategy. All the studies for this systematic review were observational, retrospective, prospective, cross-sectional or in-vitro and involved an analysis of resistance of A. baumannii against antimicrobial therapy. Results: A total of 21 studies were included, representing diverse geographic regions. The meta-analysis demonstrated that carbapenem resistance persisted at alarmingly high levels across all geographic locations, with the highest rates observed in the Middle Eastern and Asian regions. Despite this, colistin remained largely effective, with susceptibility rates exceeding 90% in most studies. The presence of resistance genes, particularly blaOXA-23 and blaOXA-51, was frequently reported and associated with the widespread emergence of MDR and XDR strains. The overall heterogeneity was significantly high (I² = 99%), reflecting variability in study design, sample size and antimicrobial testing methodologies. Sensitivity analysis indicated that excluding smaller and in-vitro studies reduced heterogeneity and strengthened the association of carbapenem resistance trends. Due to substantial inter-study variability and asymmetric study distribution, a funnel plot analysis could not be conducted reliably. Conclusion: The findings highlight the global heterogeneity and severity of A. baumannii resistance, particularly to carbapenems, which presents ongoing challenges in infection management. While colistin remains a viable last-resort antibiotic, regional variations in resistance patterns emphasize the need for enhanced antimicrobial stewardship and continuous surveillance efforts to mitigate the spread of MDR A. baumannii.

Background: The potential health risks associated with synthetic and inorganic dyes have become a growing concern in recent years. As a safer, eco-friendly alternative, Punica granatum (pomegranate) has demonstrated promising antibacterial and antioxidant properties. This study aims to evaluate the effectiveness of Punica granatum as a natural dental plaque-disclosing agent compared to conventional synthetic dyes in staining Streptococcus mutans, Lactobacillus and Enterococcus  faecalis.  The  study  also  investigates  its  color  spreadability,  absorption  properties  and  cytotoxicity  levels. Methods: Cultures of Streptococcus mutans, Lactobacillus and E. faecalis were reactivated and maintained for testing. Samples were divided into three groups: Group I (Control-Eosin dye), Group II (Pomegranate extract) and Group III (Pomegranate extract with ethanol). Color spreadability, UV spectroscopy and cytotoxicity using nauplii fish were analyzed. Potential variables such as pH differences, extraction quality and solvent interactions were carefully monitored to ensure result accuracy. Results: UV spectroscopy revealed that Group I exhibited peak absorption at 550 nm (orange-red region), while Groups II and III peaked at 350 nm (UV region). Cytotoxicity assessment showed significantly reduced mortality rates in Groups II (10 deceased nauplii fish) and III (20 deceased nauplii fish) compared to Group I at 40 µg/mL. This suggests a notable reduction in cytotoxicity with the pomegranate-based formulations. Additionally, Group III (pomegranate extract with ethanol) achieved superior staining efficiency, comparable to the control group. Conclusion: Within the study's limitations, Punica granatum demonstrated significant potential as a natural and effective dental plaque-disclosing agent with reduced cytotoxicity. Its eco-friendly profile makes it a viable alternative to conventional dyes. Further clinical studies are recommended to explore its long-term stability, cost-effectiveness and practical application in dental hygiene practices.

Introduction: A nutritious diet is essential for sustaining good health and preventing illness. Globally, billions of people take dietary supplements like Multivitamin-Multimineral (MVMM) preparations to improve their health, prevent diseases, or fill vitamin and mineral shortages. This current study was carried out to determine the prevalence and characteristics of Multivitamin- Multimineral (MVMM) use among Saudi populations in Al-Majmaah, Saudi Arabia. Methods: A descriptive cross-sectional study as conducted in Majmah, Saudi Arabia, where all adults age above 18 years old were enrolled in this study, data was collected by using properly designed an online survey and collected data, was analyzed using Statistical Package for Social Sciences (SPSS 24). Results: The study included 347 participants, of whom about 55% were male and 45% were female adults. Most of participants did not follow any special diets behavior, 34% had vegetables and fruits regularly and only 20% had regular physical activity. About 47% of participants (Male 46.3% and Female 53.7%, p-value .001 significant statistical relationship between genders) used vitamins and minerals in their daily life, for those who using these products, about 51% used multiple vitamins and minerals, 42% used Vit D, 7% used Folic Acid, 7% used Ferrous, 5% used Vit B and 5% used other vitamins or minerals. About 47% of participants used it daily and 34% on weekly basis. Our study found a significant statistical relationship between, age group (18-28 years; 53.7%, 29-39; 16.5%, 40-50; 26.8% and more than 50; 3.0%; p-value .009 significant statistical relationship between age groups) marital status (Married; 45.7%, Single; 45.7%, Divorced; 2.4%, Widowed; 0.6%; p-value .000 highly significant statistical relationship between marital status groups), while there was no statistical relationship between educational level groups with p-value >0.05. Conclusion: The study revealed a high prevalence of MVMM use among the general population in Saudi Arabia, reporting a significant statistical relationship with gender, age group and marital status. Most participants (more than two-thirds) thought that MVMM supplements were used to enhance health. They obtained MVMM directly from the pharmacy without a prescription, as part of a hospital prescription. These findings show the need for greater awareness on the importance of balanced nutrition and physical exercise, in addition to supplement use, in improving general well-being in the Saudi population. The study’s findings are intriguing but have limitations. Its online survey approach and Al-Majmaah City restriction could have introduced bias. Therefore, a broad population and more comprehensive methodological approaches might be used in future research.

Background: Hydroxyethyl Methacrylate (HEMA) has shown potential as a restorative material due to its biocompatibility, chemical stability and adhesive properties. However, challenges such as polymerization shrinkage and limited mechanical strength have prompted efforts to improve its performance. Acetylated Hydroxyethyl Methacrylate (Ac-HEMA) has been developed with the aim of enhancing mechanical strength, marginal integrity and resistance to microleakage. This study investigates the performance of Ac-HEMA as a restorative material in comparison with conventional Glass Ionomer Cement (GIC) and composite resins. Materials and Methods: Ac-HEMA was synthesized through an acetylation process confirmed via Fourier Transform Infrared Spectroscopy (FTIR). The material’s microleakage and fracture resistance were evaluated using thermocycling and Scanning Electron Microscopy (SEM) analysis. Dye penetration methods were used to assess microleakage and compressive strength testing was conducted to determine mechanical performance. Comparative analysis with GIC and composite resins was performed under identical conditions and statistical analysis was applied to validate the findings. Results: Ac-HEMA demonstrated a maximum force of 474.24 N and a compressive stress of 8.98 MPa. The compressive displacement and strain were recorded at 3.84 mm and 3.84%, with a compressive strain value of 1.37%. The GIC exhibited a maximum force of 1130.59 N and a compressive stress of 11.64 MPa, while composite resins recorded superior results with a maximum force of 2198.49 N and compressive stress of 21.85 MPa. Microleakage assessment revealed increased dye penetration in Ac-HEMA compared to GIC and composite resins, indicating higher microleakage levels. Conclusion: Although Ac-HEMA demonstrated moderate mechanical strength and promising adhesive properties, its increased microleakage presents a significant limitation in its current formulation. Further refinement of Ac-HEMA’s chemical composition and bonding characteristics is recommended to improve its sealing ability and clinical performance. Future research should focus on enhancing Ac-HEMA’s hydrophilic balance, improving structural durability and conducting long-term clinical trials to assess its viability for minimally invasive dental treatments. Ac-HEMA holds potential as a restorative material with continued development.

Objectives: No other treatment works as effectively as guided tissue regeneration (GTR) membranes in periodontal therapy because they facilitate selective cell growth. The addition of bioactive glass (BG) to periodontal membranes enhances their antibacterial features along with the ability to be compatible with biological tissues. The current study examines both antibacterial effectiveness and cytotoxic characteristics of new bioactive glass-treated periodontal membrane constructions. Methods: New periodontal membranes were created by adding bioactive glass particles into a polymer substance that breaks down naturally over time. The antibacterial activity measurement for Streptococcus mutans and Porphyromonas gingivalis involved agar diffusion with zone of inhibition determination. The tests were carried out for cytotoxicity using MTT assays and human gingival fibroblasts (HGF) during 24 and 48 hours of incubation time. Statistical evaluation used one-way ANOVA as the analysis method. Results: The biological activity of bioactive glass-containing membranes effectively inhibited bacterial growth producing zones of inhibition that measured 15.2±1.3 mm for S. mutans and 14.8±1.5 mm for P. gingivalis. The MTT assay results showed that cell viability exceeded 85% at 24 hours and reached 80% at 48 hours which proved the low level of cytotoxicity in the samples. Conclusion: The periodontal membranes with incorporated bioactive glass displayed strong antimicrobial effects together with favorable biocompatible behavior. Bioactive glass shows indications to become an effective material for guided tissue regeneration applications in periodontal treatment. Limitations: The current research only examines laboratory results testing two bacterial strains while conducting brief tests for toxicity. Clinical Implications: Additional testing with live human subjects must validate the membranes for their intended use in guided tissue regeneration.

Background: Over the past two decades, increasing emphasis has been placed on improving oral healthcare through social perspectives that prioritize subjective well-being and oral health-related quality of life (OHRQoL). Children are particularly vulnerable to dental issues, making targeted interventions crucial. This study aimed to assess the effectiveness of oral health initiatives in improving pediatric OHRQoL, emphasizing practical applications, cultural diversity and global relevance. Materials and Methods: A comprehensive literature search was conducted across Cochrane, PubMed, Scopus and Web of Science using MeSH terms. The review followed PRISMA guidelines, ensuring rigorous data collection and analysis. Risk of Bias was assessed using the ROBINS-I tool for non-randomized trials and the Cochrane Collaboration tool for randomized trials. The study incorporated subgroup analysis to evaluate cultural and demographic diversity, enhancing the broader applicability of findings. Visual aids such as PRISMA flowcharts were utilized to improve clarity. Results: Out of 277 initial articles, 85 were excluded as duplicates. After reviewing titles and abstracts, eight studies met the eligibility criteria. Included studies utilized validated tools such as the Child Perception Questionnaire (CPQ) and Early Childhood Oral Health Impact Scale (ECOHIS). Results highlighted that school-based interventions, preventive treatments and oral awareness programs significantly improved children's OHRQoL. Improvements were seen in social well-being, self-confidence and academic performance, emphasizing the broader psychosocial benefits of these interventions. Consistent follow-up and sustained education programs proved essential for maintaining long-term benefits. Conclusion: Oral health initiatives are effective in enhancing pediatric OHRQoL. The study underscores the importance of culturally adaptive strategies, cost-effective approaches and interdisciplinary collaboration to ensure wider impact. Further longitudinal research is encouraged to evaluate the sustained impact of these interventions across diverse populations.

Objectives: Bacterial biofilms cause most cases of periodontal diseases requiring effective therapeutic approaches. Local drug delivery systems (LDDS) serve as complementary treatment to standard mechanical methods through precise antibacterial activity. The research investigates how different Local DDS fare at controlling periodontal pathogens through an in vitro biofilm testing protocol. Methods: The biofilm creation process involved Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans cultivating on hydroxyapatite discs within an in vitro environment. A research using three different LDDS involved chitosan-based gel as Group A plus doxycycline-loaded microspheres in Group B together with chlorhexidine-based varnish as Group C. During a seven-day period the treated biofilms underwent bacterial viability analysis which included colony-forming unit (CFU) counts accompanied by confocal laser scanning microscopy evaluation. Group A (chitosan gel) reduced CFU by 60.5%, Group B (doxycycline microspheres) by 75.3%, and Group C (chlorhexidine varnish) by 55.8%. Analysis of variance based statistical tests resulted in p values less than 0.05 to determine significance. Results: The CFU counts reduced by 60% in Group A and both Group B and Group C showed CFU count reductions of 75% and 55% respectively. Biofilm disruption reached its most effective level in Group B according to confocal microscopy results that were statistically significant compared to the other groups (p<0.05). Conclusion: The antibacterial performance of periodontal biofilms against tested LDDS reached its maximum with microspheres containing doxycycline. The discovered potential indicates doxycycline-loaded microspheres could function as additional treatment for periodontal diseases. The study’s in vitro design limits clinical generalizability. Further in vivo and clinical studies are recommended to confirm these findings.

 Introduction: Stress is a significant contributor to various health disorders, often linked to elevated cortisol levels mediated by the hypothalamic-pituitary-adrenal (HPA) axis. Salivary cortisol measurement is a reliable, non-invasive biomarker for assessing stress. This study aimed to compare salivary cortisol levels between the Malayali tribal population in Thiruvannamalai, Tamil Nadu and a non-tribal urban control group to evaluate stress differences and explore potential socio-environmental influences on cortisol levels. Methods: An in-vitro study was conducted between July and August 2024, involving 44 participants divided into two groups: Malayali tribes (n = 22) and non-tribal individuals (n = 22). Saliva samples were collected using the passive drool technique and analyzed using the Abbkine Human Cortisol ELISA Kit. Environmental and lifestyle factors, including dietary habits and occupational stress, were recorded to assess potential confounders. The Mann-Whitney U test was used for statistical analysis, with significance set at p<0.05. Results: The Malayali tribal group exhibited significantly higher mean salivary cortisol levels (13.44±2.15 µg/L) compared to the non-tribal group (8.73±1.85 µg/L) (p<0.05). Optical density values were also notably higher in the tribal group, reinforcing the elevated cortisol concentration. The ELISA assay demonstrated a non-linear relationship between optical density and cortisol concentration. The findings suggest that socio-economic challenges, environmental hardships and limited healthcare access may contribute to heightened stress levels in the tribal population. Conclusion: The study revealed significantly higher stress levels in the Malayali tribal population than in their non-tribal counterparts, likely driven by socio-environmental stressors. These results emphasize the urgent need for targeted interventions such as culturally adapted stress management programs, improved healthcare access and educational initiatives to mitigate chronic stress in tribal communities. Future research should explore broader sample sizes, longitudinal stress assessments and the role of cultural practices in influencing stress responses.

Objective: This systematic review aimed to assess childhood vaccine hesitancy among parents in Saudi Arabia and explore the perceptions of pediatric healthcare professionals regarding vaccine-hesitant parents (VHPs). Methods: Following PRISMA guidelines, a search was conducted in Scopus, PubMed and Web of Science for studies published between January 2015 and December 2024. Studies were selected using the PEO framework. Data were extracted independently by two reviewers and quality was assessed using the AXIS tool. Results: From 823 initial records, 26 studies were included in the final analysis. Vaccine hesitancy rates varied from 7.1% to 72.2%. Factors influencing hesitancy included parental education, fear of side effects, lack of reliable information, social media misinformation and limited trust in healthcare providers. Conclusion: Demographic, social and healthcare-related factors contribute significantly to vaccine hesitancy among Saudi parents. Targeted public health interventions, improved health literacy and effective physician-parent communication are essential to address this growing concern.

Background: The growing resistance of oral pathogens to conventional antimicrobial agents has created a demand for innovative, natural alternatives in dental care. Ocimum tenuiflorum and Ocimum gratissimum are widely recognized for their medicinal properties, particularly their antimicrobial potential. This study investigates the green synthesis of silver nanoparticles (AgNPs) using these herbal extracts and their incorporation into a dental varnish. The varnish underwent comprehensive characterization using Fluorescent analysis, NMR analysis, Zeta potential studies and UV-Vis spectroscopy to evaluate its structural and physicochemical properties. Methods: Silver nanoparticles were synthesized using Ocimum tenuiflorum and Ocimum gratissimum herbal extracts via a green synthesis approach. The synthesized AgNPs were incorporated into a dental varnish and their antibacterial efficacy was tested against Staphylococcus aureus, Streptococcus mutans, Lactobacillus sp., Enterococcus faecalis and Escherichia coli. The antibacterial activity was evaluated using the agar well diffusion method and time-kill curve assay. Inhibition zones were measured at concentrations of 25 µg/mL, 50 µg/mL and 100 µg/mL and results were compared with a commercially available dental varnish. Results: The AgNP-based dental varnish demonstrated superior antibacterial activity across all tested concentrations. The inhibition zones for S. aureus were 10 mm, 14 mm and 26 mm at 25 µg/mL, 50 µg/mL and 100 µg/mL, respectively, outperforming the commercial varnish's 9 mm inhibition zone. For S. mutans, the Ocimum-based varnish showed inhibition zones of 24 mm, 27 mm and 34 mm, which significantly exceeded the standard varnish's 9 mm. Lactobacillus sp. exhibited inhibition zones of 20 mm, 22 mm and 31 mm, while E. faecalis showed 9 mm, 11 mm and 14 mm. E. coli displayed the highest inhibition zones of 27 mm, 30 mm and 35 mm, compared to the 9 mm zone produced by the commercial varnish. The time-kill curve assay demonstrated that the Ocimum-based varnish at 100 µg/mL effectively reduced bacterial counts of E. coli and S. mutans to 10 CFU/mL within 5 hours. Similar reductions were observed for S. aureus, Lactobacillus sp. and E. faecalis, indicating potent bactericidal activity with increasing concentrations. Conclusion: The Ocimum-mediated AgNP dental varnish exhibited superior antibacterial efficacy compared to the commercial dental varnish, particularly at 100 µg/mL. The enhanced antibacterial activity, combined with the eco-friendly green synthesis process, suggests that Ocimum tenuiflorum and Ocimum gratissimum-based AgNPs hold promising potential as effective and safe alternatives in dental care for combating oral pathogens. Further in vivo studies are recommended to evaluate the varnish’s clinical performance and long-term safety.

Background: Traumatic Dental Injuries (TDIs) occur in approximately 37% of children globally, with nearly 16% involving permanent tooth avulsion, primarily in children aged 7-11 years. Objective: To examine Saudi parents’ awareness regarding the identification and management of TDIs in children. Methods: A total of 552 parents in Hail, Saudi Arabia completed a structured and validated questionnaire on managing tooth fractures and avulsions. Pearson’s chi-squared and Fisher’s exact tests were used to evaluate associations between demographic variables and TDI awareness. Results: 87.7% of parents had witnessed a TDI; however, only 16.5% had attended a TDI education course. 28.1% had received prior information on TDIs, mainly from dentists (55.5%). While 84.4% recognized the need for urgent dental care, only 33.2% chose correct preservation methods for avulsed teeth. Government-employed and college-educated parents were more likely to feel confident managing TDIs (p<0.05). However, no demographic factor showed significant association with overall TDI knowledge scores. Conclusion: Despite frequent exposure to TDIs, parents in Hail exhibit gaps in effective TDI management knowledge. Educational programs tailored to various demographic groups are essential to improve outcomes in emergency dental care.

Introduction: Oral health is a crucial component of overall well-being, extending beyond healthy teeth to impact systemic health and quality of life. The Narikuravar community, an indigenous tribal group predominantly involved in hunting as their primary occupation, faces numerous challenges in accessing healthcare services. This study aims to assess the oral health status and barriers to dental care utilization among the Narikuravar tribal gypsies living in Chennai. Methods: This cross-sectional study was conducted among the Narikuravar tribal gypsies residing in Thirumullaivoyal, Chennai. All available individuals aged 18 years and above who were permanent residents of the area were included. Oral health status was evaluated using the WHO Oral Health Assessment Proforma (2013), which assesses dental caries, gingivitis, periodontitis, dental trauma and treatment needs. The OHI-S index was employed to measure oral hygiene status. To identify perceived barriers to dental care, a pretested questionnaire was administered. Data analysis was performed using SPSS Software version 23.0 and descriptive statistics along with Pearson’s correlation test were used to assess associations, with p<0.005 considered statistically significant. Results: A total of 460 participants were included in the study, with 55% (n = 253) being male and 45% (n = 197) female. The mean DMFT score was 13.1±5.56, indicating a high prevalence of dental caries in the population. Regarding oral hygiene, 65.1% (n = 280) of participants had a fair OHI-S score, while 41.5% (n = 238) required comprehensive dental evaluation and treatment. The most commonly reported barrier to dental care utilization was a lack of awareness about the importance of oral hygiene, followed by financial constraints and limited access to dental services. Conclusion: The findings reveal that the Narikuravar community faces significant barriers in accessing dental care, contributing to poor oral health outcomes. The study highlights the urgent need for targeted educational programs, community-based dental outreach services and improved access to affordable dental care. Public health strategies should focus on enhancing awareness, promoting preventive dental care practices and implementing mobile dental clinics to reduce these barriers and improve oral health outcomes in this marginalized population.

Objectives: Non-communicable diseases which include hypertension along with diabetes mellitus and hypercholesterolemia represent major and expanding health problems across Saudi Arabia. These healthcare conditions generate extensive mortality and morbidity together with high healthcare expenditure in the nation. Knowledge about age group distribution together with gender identity and nationality background helps develop purposive evidence-based treatment approaches and healthcare initiatives. Methods: 5,000 adult participants underwent a cross-sectional secondary data analysis based on National Health Research and Studies Portal (NHRSP) data gathered throughout an 11-month time period. Self-reported information about chronic disease diagnoses together with related risk factors appeared in the available dataset. A demographic breakdown together with the prevalence numbers of each NCD were presented through descriptive statistics. The connection between demographic factors and disease occurrences was evaluated through Chi-square methods but multivariate logistic models determined key NCD prediction variables. Different tests were used throughout this study at a significance level of p<0.05. Results: Statistics showed that hypertension affected 16.3% of male participants while 15.2% of female participants faced the same condition (p = 0.021). Results showed diabetes prevalence rates at 14.6% for males and 13.2% for females but this difference proved not statistically significant (p = 0.169). The occurrence of high cholesterol varied between 17.0% in males and 16.3% in females yet these numbers had equal statistical significance (p = 0.569). All groups demonstrated a significant increase in measured conditions at each age stage according to statistical analysis (p<0.001). The smoking prevalence rate showed highly significant differences between male (26.9%) and female patients (4.8%) (p<0.001). Hypertension prevalence rates among Saudi nationals exceeded non-Saudi residents by 5.6 percent points (17.8 percent and 12.2 percent respectively) and diabetes prevalence by 6.9 percentage points (16.5 percent and 9.6 percent) along with high cholesterol risk (19.0 percent and 12.5 percent) (p<0.001 for all conditions). Logistic regression statistics showed age, gender and nationality served as important predictors to define NCD risk throughout the population. Conclusion: Research findings demonstrate significant differences in NCD distribution that exist across sociodemographic groups of Saudi Arabian citizens. The disease burden involving hypertension and diabetes is greatest among elderly adults and high cholesterol rates are predominant in both genders but smoking occurs mainly among males. All studied Non-Communicable Diseases show higher risks among Saudi nationals when compared to the non-Saudi population. Public health initiatives need to become target-oriented through age-specific screening tools and gender-related smoking cessation programs and culturally appropriate health education approaches for Saudi nationals. The primary healthcare system should receive additional support because this enhanced approach will decrease the national NCD burden while improving long-term health results.

Background: The increasing resistance of oral pathogens to conventional antimicrobial agents has prompted the exploration of innovative solutions such as nanocomposite-based formulations. Silver-zinc oxide nanocomposites (Ag-ZnONCs) have demonstrated potent antimicrobial properties, making them promising candidates for oral care products. However, their potential cytotoxic effects necessitate thorough evaluation before clinical application. Materials and Methods: The antimicrobial activity of an Ag-ZnONC-based oral rinse was evaluated using the agar well diffusion method against common oral pathogens, including Staphylococcus aureus, Streptococcus mutans, Lactobacillus sp., Enterococcus faecalis and Candida albicans. The antimicrobial efficacy was tested at concentrations of 25 µg/mL, 50 µg/mL and 100 µg/mL. Cytotoxicity was assessed using a brine shrimp lethality assay by exposing nauplii to varying concentrations of the oral rinses. A commercial herbal oral rinse was used as a comparative control. Results: The Ag-ZnONC-based oral rinse demonstrated superior antimicrobial activity across all tested pathogens. At 100 µg/mL, the Ag-ZnONC rinse achieved inhibition zones of 16 mm for S. mutans, 15 mm for S. aureus, 14 mm for Lactobacillus sp. and 13 mm for E. faecalis and C. albicans. The commercial herbal rinse exhibited lower antimicrobial activity, with inhibition zones ranging from 9 mm to 12 mm. In the cytotoxicity study, both rinses showed a concentration-dependent reduction in brine shrimp survival. At 100 µg/mL, the Ag-ZnONC rinse resulted in 40% survival, while the commercial rinse showed 48% survival, indicating slightly lower cytotoxicity in the commercial formulation. Conclusion: The Ag-ZnONC-based oral rinse demonstrated enhanced antimicrobial efficacy against oral pathogens compared to the commercial herbal rinse. However, its cytotoxic effects at higher concentrations highlight the need for careful dose optimization. Further in vivo studies are recommended to evaluate its safety, stability and long-term clinical effectiveness in oral healthcare applications.

Objectives: A common 12% of shoulder injuries are acromioclavicular (AC) joint injuries, particularly in young athletes and manual laborers. It's still debatable how to handle grade III injuries. Surgical procedures restore anatomy but increase the risk of complications, while non-surgical techniques offer less complications but run the risk of persistent insatiability. With an emphasis on patient safety and functional outcomes, this systemic review evaluates the clinical outcomes of surgical versus non-surgical treatments. Research hypothesis: Surgical treatment leads to superior long-term functional outcomes compared to non-surgical management in Grade III AC joint dislocations. Tightrope fixation provides better joint stability and fewer complications compared to other surgical techniques. Methods: Following PRISMA guidelines, a systematic search for randomized controlled trials (RCTs) was carried out in the Cochrane, Web of Science, and PubMed databases. The inclusion criteria were satisfied by six RCTs with 345 patients that compared surgical and non-surgical management, as well as Tightrope fixation versus other surgical techniques. We extracted and examined data based on demographics, joint stability, functional outcomes, interventions, and complication rates. Results: A meta-analysis showed no discernible difference between non-surgical and surgical methods in terms of functional outcomes [MD=-0.24 [-4.49, 4.00] 95% CI, P= 0.11]. However, when compared to different types of surgical procedures, tightrope fixation showed better functional outcomes with fewer problems [MD=8.34 [5.67, 11.02] 95% CI, P= 0.48]. The rates of postoperative complications [RD= 0 [-0.11, 0.11] 95% CI, P= 0.22] and joint displacement [MD=-2.15 [-5.89, 1.59] 95% CI, P= 0.35] did not significantly differ between surgical techniques. Conclusion: For grade III AC joint dislocations, the functional results of surgical and non-surgical approaches are similar. Among surgical options, tightrope fixation yields the best outcomes. Patients’ activity levels and cosmetic preferences should be taken into account while making a personalized treatment decision. Given the study limitations of the small sample size, which restricts the generalizability of findings, future large-scale RCTs with longer follow-up periods are necessary to establish more definitive treatment guidelines and further evaluate the clinical significance of Tightrope fixation over other surgical techniques.

This case report details the management of a three-rooted maxillary first premolar presenting with symptomatic apical periodontitis after root canal has been done. An 18-year-old male patient experienced persistent pain localized around the treated tooth, despite a previous intervention six months ago. Clinical and radiographic evaluations revealed a complex three-canal system with a extruded material. Given the persistent symptoms and anatomical complexities, a combined approach of apicoectomy, surgical debridement and guided tissue regeneration were employed. No postoperative complications were observed and the 10-month follow-up confirmed satisfactory periapical healing and restoration of function. The treatment included the use of biocompatible materials and microsurgery techniques to enhance healing and structural integrity. This report highlights the importance of recognizing anatomical variations and discusses the effective integration of advanced surgical approaches and materials in managing complex endodontic cases. This case underscores the significance of recognizing rare anatomical variations and highlights the effective use of guided tissue regeneration and microsurgical techniques for successful endodontic outcomes. The follow-up demonstrated significant symptomatic relief and radiographic signs of healing, highlighting the effectiveness of the chosen management strategy.

Background: Silver nanoparticles (AgNPs) are widely recognized for their potent antimicrobial properties, making them promising candidates for dental applications. However, concerns regarding their potential cytotoxicity and embryotoxicity remain significant. This study evaluates the safety profile of a green-synthesized AgNPs-based dental varnish using Ocimum tenuiflorum and Ocimum gratissimum extracts as reducing and stabilizing agents. The study aims to compare its toxicity profile with a commercial dental varnish to assess its potential as a safer alternative in dental care. Methods: AgNPs were synthesized using Ocimum tenuiflorum and Ocimum gratissimum extracts, confirmed by visual color change and UV-Visible spectroscopy. Zebrafish embryos were selected as a model to evaluate toxicity. Embryos were exposed to different concentrations of the AgNPs-based dental varnish (5, 10, 20, 40 and 80 µg/mL), with their viability, hatching rates and morphological changes recorded. The commercial dental varnish was tested under identical conditions to serve as a comparison. Results: The AgNPs-based varnish displayed concentration-dependent toxicity. At lower concentrations (5 and 10 µg/mL), 100% viability and 100% hatching rates were observed, similar to the control. At 40 µg/mL, slight toxicity was evident, with viability decreasing to 85% and hatching rates reducing to 80%. At 80 µg/mL, the AgNPs varnish showed reduced viability (60%) and hatching rates (60%). In comparison, the commercial varnish exhibited greater toxicity, with only 50% hatching rates observed at 80 µg/mL and higher instances of morphological abnormalities in zebrafish embryos. Conclusion: The green-synthesized AgNPs-based dental varnish demonstrated reduced toxicity compared to the commercial dental varnish at higher concentrations. The antioxidant properties of phytochemicals present in Ocimum extracts, such as eugenol and rosmarinic acid, may have contributed to stabilizing the nanoparticles, thus minimizing oxidative stress. These findings suggest that the AgNPs-based varnish holds promise as a safer and eco-friendly dental care alternative. Further in vivo studies are recommended to assess its long-term safety and clinical efficacy.

Objectives: Durability of dental restorations is influenced by their wear resistance and surface roughness. CAD-CAM ceramics and 3D-printed resin-based crowns are widely used in prosthodontics; however, comparative data on their wear behavior is limited. Materials and Methods: This in vitro study evaluated 40 crowns, equally divided into Group A (CAD-CAM lithium disilicate ceramic crowns) and Group B (3D-printed photopolymer resin crowns). All crowns underwent wear simulation using a dual-axis chewing simulator (50 N, 100,000 cycles). Surface roughness (Ra) was assessed pre- and post-wear using a non-contact profilometer. Statistical analysis included independent t-tests (p<0.05), effect size (Cohen’s d), and 95% confidence intervals. Results: CAD-CAM ceramics exhibited significantly less wear (25±2 µm) compared to 3D-printed resin crowns (58±3 µm; p<0.001, d = 11.0). Initial surface roughness was lower for ceramics (0.21±0.03 µm) versus resin (0.35±0.05 µm). After simulation, roughness increased to 0.28±0.04 µm (ceramics) and 0.62±0.06 µm (resins) (p<0.001). Conclusion: CAD-CAM ceramic crowns demonstrated superior wear resistance and smoother surface characteristics compared to 3D-printed resin crowns. While 3D-printed crowns offer cost and customization benefits, their clinical use may be best suited for provisional or low-load applications. Further in vivo studies are warranted.

Background: Orofacial dysfunctions, both static and dynamic, are known to influence dental development and contribute to malocclusion. Early identification of these dysfunctions in primary dentition can play a crucial role in preventing future orthodontic complications. This study aimed to evaluate the correlation between orofacial myofunctional dysfunctions and occlusal characteristics in primary dentition to identify key predictors of future orthodontic issues. Methods: A cross-sectional study was conducted involving 50 children in the primary dentition phase. Each participant underwent a comprehensive evaluation of their myofunctional status and occlusal characteristics. Static and dynamic orofacial dysfunctions were assessed using standardized functional examinations. Additionally, oral habits such as thumb-sucking, mouth breathing and tongue thrusting were recorded to evaluate their impact on occlusion. Data were analyzed to determine the correlation between myofunctional dysfunctions and occlusal abnormalities such as distoclusion, lateral crossbite, increased overjet and primary frontal open bite. Results: The results showed that orofacial dysfunctions were not significantly correlated with functional problems or the presence of distoclusion in 11.2% of the children assessed. However, children with orofacial dysfunctions had notably higher rates of lateral crossbite, increased overjet and primary frontal open bite. Static dysfunctions were significantly more prevalent among children presenting with frontal open bite and lateral crossbite. Children displaying a combination of one static dysfunction and two dynamic dysfunctions were found to have an increased risk of developing future orthodontic problems. Conclusion: The findings suggest that children with specific orofacial dysfunction patterns are at greater risk of developing orthodontic issues. Identifying and addressing these dysfunctions early in primary dentition may help prevent future malocclusion and improve long-term dental outcomes. Early screening for both static and dynamic dysfunctions should be integrated into pediatric dental care to support timely intervention strategies.

Introduction: The endocrine condition called polycystic ovarian syndrome (PCOS) consists of three distinctive features including hyperandrogenism combined with ovulatory malfunction and polycystic ovarian appearance. The endocrine and metabolic and reproductive complications of PCOS affect approximately ten percent of women within their childbearing years. Objective: PCOS patients require evaluation of their clinical features along with hormonal imbalance and metabolic abnormalities and reproductive system problems. Methods: The study involved assessing 350 women who received Rotterdam criteria diagnosis. The research analyzed hormonal results along with reproductive histories and lipid examination data through SPSS 25. Results: About three-fourths (75%) of females exhibited high testosterone while 70% revealed HOMA-IR higher than 2.5 and 80% presented abnormal menstrual rhythms. Forty percent of patients mentioned infertility as their condition while twenty percent encountered recurrent miscarriages. Research showed that metabolic syndrome affected 45% of the patient group under study. Conclusion: Women with PCOS need early recognition followed by combined medical treatments from various health professionals because this condition creates multiple medical issues.

Introduction: Oral health significantly influences overall well-being, particularly in elderly populations where poor dental health can affect nutrition and quality of life. Marginalized groups such as the Particularly Vulnerable Tribal Groups (PVTGs) in India face increased risks due to limited healthcare access. This study focused on the Beta Kurumbas and Mullu Kurumbas tribes of the Nilgiris Biosphere Reserve, aiming to assess the dental caries experience, nutritional status and oral health-related quality of life among geriatric individuals in these communities. Materials and Methods: A cross-sectional study was conducted among 575 participants aged 65-74 years using snowball sampling. The Decayed, Missing, Filled Teeth (DMFT) Index measured dental caries experience, the Mini Nutritional Assessment (MNA) evaluated nutritional status and the Geriatric Oral Health Assessment Index (GOHAI) assessed oral health-related quality of life. Statistical analyses, including Kendall tau correlation, were used to explore relationships among these variables. Results: The mean DMFT score was 18.32±8.12, indicating a high prevalence of tooth loss and untreated dental caries. Nutritional assessment revealed that 62.95% of participants were malnourished, 23.3% were at risk of malnutrition and only 13.73% were classified as normally nourished. GOHAI scores indicated significant psychosocial and functional impacts, with over half of the participants reporting discomfort during eating and difficulty chewing. A strong positive correlation was found between poor oral health (DMFT), malnutrition (MNA) and diminished quality of life (GOHAI). Conclusion: The findings underscore the urgent need for targeted interventions to improve oral health, enhance nutritional support and provide accessible dental care services for these vulnerable tribal populations. Integrating oral healthcare initiatives within primary healthcare frameworks and implementing culturally appropriate awareness programs is essential to addressing these disparities.

Objectives: By emphasizing the regeneration of compromised or diseased pulp tissue rather than relying solely on conventional root canal treatments, regenerative endodontics marks a significant advancement in dental care. Primarily relying on stem cell-based treatments, this method aims to restore normal tooth function, repair pulp tissue, and preserve the native tooth structure. With their remarkable capacity to differentiate into multiple cell types, stem cells hold great potential for regenerating pulp and periapical tissues. Stem cell-based regenerative endodontics has excellent potential, but its practical use is hampered in several ways. Methods: The efficacy, challenges, and prospects of stem cell-based therapies in regenerative endodontics were evaluated through a systematic literature review. With an eye toward peer-reviewed preclinical and clinical research from 2013 to 2023, a thorough search was conducted across critical databases including PubMed, Web of Science, and the Cochrane Library. Studies were selected based on their relevance to regenerative endodontic treatments, pulp regeneration, and stem cell-based tissue engineering. Emphasizing stem cell types, techniques, results, and obstacles found, data from qualified studies were gathered, analyzed, and synthesized. Results: Particularly with dental pulp stem cells (DPSCs), stem cells from the apical papilla (SCAP), and induced pluripotent stem cells (iPSCs), stem cell-based therapies for regenerative endodontics have shown promise in regenerating pulp and restoring tooth vitality. Because they can differentiate into odontoblast-like cells and encourage dentin development, DPSCs are known for their particular properties. Particularly in young teeth, SCAPs have shown outstanding regeneration potential; iPSCs offer an alternative but still require further development. Improvements in growth factors and scaffold materials have further enhanced the regenerative capabilities of stem cell treatments. Challenges such as immunological response, stem cell differentiation, and long-term safety still exist, despite favorable preclinical and clinical data. Discussion: Although stem cells from various sources show great promise for regenerative endodontics, their clinical applications are still in their early stages, and further study is required to optimize techniques and enhance results. Effective pulp regeneration depends critically on biomaterial scaffolds, growth factors, and the regulation of stem cell differentiation. Despite significant advancements, the sector still struggles with the long-term viability of regeneration treatments and the standardization of treatment strategies. Conclusion: Mainly stem cell-based treatments, regenerative endodontics has significant promise to transform dental care by repairing damaged pulp tissue and preserving tooth health. Although DPSCs, SCAPs, and iPSCs have made tremendous progress, further study and development are necessary to address clinical issues and enhance the long-term effectiveness of these treatments. The future of regenerative endodontics will be shaped by ongoing research into stem cell technologies and biomaterials, resulting in more biologically oriented and successful therapies for pulp and periapical diseases.

Background: This study investigates the complex relationship between Body Mass Index (BMI), tobacco consumption and oral health status among construction workers in Chennai, India. Using a neural network model, the study aims to identify significant predictors of oral health outcomes. Methods: A cross-sectional study was conducted among 812 construction workers in Chennai. Data on BMI, tobacco usage patterns and oral health indicators such as the Oral Hygiene Index-Simplified (OHI-S), Decayed, Missing and Filled Teeth (DMFT) index, Gingival Index and loss of attachment (LOA) were collected. A pretested, interviewer-administered questionnaire was used to gather demographic and behavioral information. BMI was calculated using participants' height and weight. Data were analyzed using SPSS software, with a neural network model employed to identify complex interactions among variables. Results: The neural network analysis revealed significant positive correlations between BMI and oral health indicators such as DMFT, Gingival Index and missing teeth. Additionally, a negative correlation was identified between BMI and tooth brushing frequency. Notably, education emerged as the most influential predictor, followed by age, gender, BMI and tobacco consumption. The neural network model demonstrated superior predictive accuracy of 87%, outperforming traditional statistical methods in identifying complex, non-linear relationships. Conclusion: The study highlights the intricate interplay between BMI, tobacco use and oral health outcomes, underscoring the need for targeted interventions. Emphasis should be placed on improving nutrition, promoting tobacco cessation and enhancing oral health awareness among construction workers. The findings demonstrate the value of machine learning in public health research and emphasize the need for future longitudinal studies to establish causal links and explore additional factors such as occupational stress, dietary patterns and healthcare access.

Introduction: The EGFR receptor tyrosine kinase is revealed to be the critical biomarker involved in cancer metastasis and proliferation. The FDA approved drugs have shown an outstanding result in cancer treatment but these drugs suffer a lot of side effects, so there is a need to identify the novel phytochemicals that may have anti-EGFR activity. Methodology: The protein EGFR was retrieved from the PDB along with the hetero atoms attached with the crystal structure. The chosen 86 ginger compounds were downloaded from TIP database in 3D sdf format. Using the PyRx virtual screeing tool the target protein and ligand set were docked and then the Dockthor server was used to find docking score of the potential compounds. The docking score of all the compounds along with the standard compound, Erlotinib was obtained and analysed after the execution of docking program. Moreover, the Pharmacokinetic study was performed for the potential compounds. Results: The molecular docking study of our selected top compounds, TIP012988, TIP009544 and TIP013002 with higher binding affinity score than standard compound and good pharmacokinetic profile reveal that the selected ginger compounds are potent in obstructing the EGFR activity. Conclusion: The EGFR tyrosine kinase is found to be critical in the proliferation and metastasis of cancer. The identified top three ginger compounds through computational approaches exhibit higher potential in targeting EGFR activity in comparison to standard, Erlotinb, as the binding energy of the standard is less than the identified potential top three compounds. Moreover, the identified potential compounds possess good pharmacokinetic features indicating their characteristic of being safe for human consumption. The results obtained can be further validated through in-vitro approaches. The in-vitro validation is important as it will ensure that our findings are fruitful and synergetic for the cancer patients who possess EGFR lead cancer progression. Enhancing synergy with EGFR inhibitors and optimizing drug delivery could improve efficacy, leading to potential preclinical and clinical development of plant-derived EGFR-targeted cancer therapies.

Objectives: Head and neck squamous cell carcinoma (HNSCC) is among the most prevalent malignancies globally, often associated with tobacco, alcohol use, and human papillomavirus (HPV) infection. Recent studies have highlighted the importance of genetic alterations in the development and progression of HNSCC. The COL28A1 gene, a member of the collagen family, has not been extensively studied in the context of HNSCC pathogenesis. This study aimed to investigate the genomic and transcriptomic alterations of the COL28A1 gene in HNSCC and assess its potential role in disease progression, prognosis, and interaction with molecular pathways. Methods: Publicly available datasets from The Cancer Genome Atlas (TCGA) and Firehose Legacy were analyzed using bioinformatics platforms including cBioPortal, UALCAN, PolyPhen-2, I-Mutant, and STRING. Genomic alterations such as mutations, amplifications, and deletions were assessed, along with differential gene expression between tumor and normal tissues. Survival analysis was performed using Kaplan-Meier curves, and protein-protein interaction networks were constructed to explore functional associations. Results: COL28A1 alterations were identified in a subset of HNSCC and LUSC cases, primarily in the form of amplifications and missense mutations. Expression analysis revealed significantly elevated COL28A1 expression in HNSCC tumor tissues compared to adjacent normal tissues (p < 0.05). Survival analysis indicated that patients with higher COL28A1 expression had poorer overall survival. Pathogenicity predictions classified several mutations as "probably damaging," while protein stability analysis indicated reduced stability due to specific variants. Protein interaction analysis highlighted potential associations with extracellular matrix remodeling and cellular adhesion pathways. Conclusion: Genomic and transcriptomic alterations in COL28A1 may contribute to the pathogenesis and progression of HNSCC. Its elevated expression is associated with poorer prognosis, suggesting a potential role as a prognostic biomarker. Further functional studies are warranted to validate these findings and explore COL28A1 as a therapeutic target in HNSCC.

Background: Obesity in children in today’s world is becoming a critical global health problem, with very serious long-term consequences. In Saudi Arabia growing urbanization, changing eating habits, sedentary lifestyle are some of the common contributing factors to the growing prevalence of childhood obesity. This study seeks to assess the prevalence of paediatric obesity, explore associated risk factors and examine parents perception regarding their child's weight status. Methods: A cross-sectional epidemiological survey was carried out in 5 regions of Saudi Arabia (Riyadh, Jeddah, Abha, Qassim and Al Jouf). This survey included 600 participants (aged 0 to 18 years) and their parents. Information about respondents was collected through structured questionnaires that examined sociodemographic characteristics, lifestyle behaviours, parental weight status and attitudes. Data analysis was carried out using SPSS with a chi-square test being performed to find significant associations. Results: The study discovered that before the age of 5 years 58.6% children will become obese. Parents misunderstanding was prevalent among 60.7% of parents, considering their obese child as normal weight. Childhood obesity is significantly associated (p<0.001) with lifestyle factors such as, screen time exceeding 3 hours (38.3% overweight); eating fast foods, (62.5% overweight); and low physical activity of less than 15 minutes of daily exercise, (55.6% overweight). Furhermore, parents weight status and smoking status in the household conferred on a child a risk for being overweight, meaning smoking households had an overweight prevalence rate of 37.7% (p = 0.004). Conclusion: This work highlights the interaction of lifestyle, socio-economic and parental variables dictating the fate of paediatric obesity. Findings from this study underlines the need of the rigorous assessment of modalities of public intervention, from parental education to community initiatives and policy-driven health work. Future longitudinal studies should devote their lenses towards causation and the impact of obesity prevention input grounded in socio-economic variants.

Background: The surge in e-cigarette use among young adults has raised significant concerns about nicotine dependence and associated health risks. Traditional cessation methods often fall short in addressing the unique behavioral and psychological dimensions of vaping. Emerging strategies-amely digital interventions such as text message-based and mobile app support, alongside pharmacotherapy using varenicline and cytisinicline-resent new opportunities. This systematic review evaluates the effectiveness and clinical relevance of these interventions in supporting vaping cessation among young adults. Materials and Methods: A systematic search of PubMed, Scopus, Web of Science and Cochrane Library was conducted for randomized controlled trials (RCTs) assessing digital interventions and pharmacotherapy (varenicline, cytisinicline) for vaping cessation in young adults aged 18-30. Studies with follow-up durations exceeding 3 months were included. Outcomes evaluated included quit rates, reduction in vaping frequency, changes in nicotine dependence, adherence and long-term abstinence. Dual independent review and data extraction were performed using standardized forms. Study quality was assessed using the Cochrane Risk of Bias tool (RoB2). Results: Three eligible RCTs were included. Digital interventions, particularly personalized and interactive text messaging, achieved significantly higher quit rates (up to 24.1%) compared to controls (18.6%). Mobile-based behavioral tools integrating gamification, CBT and peer support showed improved user engagement and adherence. Varenicline increased abstinence rates up to 40% at 12 weeks but was associated with side effects including nausea and vivid dreams. Cytisinicline showed comparable efficacy (31.8% abstinence at 12 weeks) with a better safety profile and shorter treatment duration. Combined approaches (digital+pharmacological) demonstrated enhanced outcomes compared to single-modality interventions. Conclusion: Digital and pharmacological interventions are effective tools for vaping cessation among young adults. While text-based and mobile health solutions offer accessible behavioral support, pharmacotherapies provide critical aid for highly dependent users. A personalized, multimodal approach may maximize cessation success. Clinicians and public health providers should consider integrating these strategies into routine cessation programs. Further large-scale studies are needed to explore long-term effectiveness, adherence factors and cost-efficiency.

Background: The objective of this systematic review was to investigate the existing literature on the interconnections between Chronic Lower Back Pain (CLBP) and smoking. Past research has often alluded to a possible link between these factors, but the extent and nature of their relationship remained to be comprehensively synthesized. Methods: A methodical literature search was conducted across MEDLINE (via PubMed), EMBASE, PsycINFO, Scopus, Web of Science, CINAHL, Cochrane Library and Google Scholar for studies published from March 2014 up to March 2024. The inclusion criteria incorporated peer-reviewed articles that examined the relationship between smoking and CLBP. Studies were evaluated for quality and data were extracted on study design, participant demographics, smoking and pain measurements and outcomes. Results: The review included a diverse range of studies with varying methodologies. Across the studies, a significant association between smoking and the incidence, severity and persistence of CLBP was consistently observed. Quantitative analysis revealed a dose-response relationship, with higher smoking intensity and longer duration correlating with increased risk and severity of CLBP. The association persisted even when controlling for confounding factors. However, a subset of studies highlighted the predominance of psychosocial factors over smoking as predictors of CLBP chronicity. Conclusion: The systematic review substantiated the hypothesis that smoking is significantly associated with CLBP. The evidence suggested a potential causal relationship, whereby smoking could contribute to the development and exacerbation of CLBP. Nevertheless, the role of psychosocial factors in the manifestation of CLBP also emerged as a significant aspect, indicating the multifactorial nature of CLBP. These findings underscore the necessity for integrated treatment approaches that address both smoking cessation and psychological interventions for CLBP sufferers.

Background: The increasing prevalence of fungal infections like Candida albicans in the oral cavity has highlighted the need for alternative antifungal agents. Titanium oxide nanoparticles (TiO₂ NPs), synthesized through green methods using plant extracts, offer promising antimicrobial properties. This in vitro study investigates the antifungal potential of a dental varnish formulated with ginger and rosemary-mediated TiO₂ nanoparticles against C. albicans. Materials and Methods: Mueller Hinton agar plates were prepared and inoculated with Candida albicans. Using the agar well diffusion method, wells (9 mm) were filled with varying concentrations of the prepared dental varnish (25 µg/mL, 50 µg/mL, 100 µg/mL). A commercial dental varnish and fluconazole served as control groups. Plates were incubated at 37̊C for 24-48 hours. Zones of inhibition were measured in millimetres, and optical density was assessed using a spectrophotometer at various time intervals to evaluate fungal growth kinetics. Results: The antifungal activity of the nanoparticle-based varnish increased with concentration. At 25 µg/mL, 50 µg/mL, and 100 µg/mL, the zones of inhibition measured 18 mm, 22 mm, and 30 mm, respectively. The commercial dental varnish produced a 20 mm zone of inhibition. A notable reduction in optical density was observed with higher concentrations over 5 hours, confirming effective fungal suppression. Conclusion: The ginger and rosemary-mediated TiO₂ NP-based dental varnish demonstrated significant in vitro antifungal activity against Candida albicans. These findings suggest its potential use in preventive dental care, especially for patients susceptible to fungal colonization. Further studies involving biofilm models and clinical trials are recommended to validate its efficacy and safety in real-world conditions.

Abstract Childhood obesity remains one of the most significant health issues worldwide, affecting over 340 million individuals around the world. Research indicates that childhood obesity is prevalent in at least 1.8 per 1000 live births in Saudi Arabia. The genetic disposition greatly influences obesity in these nations as can be inferred from twin studies and identification of rare monogenic obesity types. Obesity is a multifaceted characteristic arising from an intricate interplay of contributing factors, including genetic and environmental influences, that collectively elevate the risk of disease. Inactive lifestyles and calorie-rich diets are significant environmental contributors to the obesity epidemic. The genetics of childhood obesity differs in particular ways from the genetics of adult obesity. Adult obesity and its associated disorders have been known to be correlated to childhood BMI. Among the childhood obesity syndromes, Prader Willi and Bardet Biedl syndromes are among the most well-known. Thus, this review discusses about the highlights of obesity related genetic syndromes and their prevalence in the population of Saudi Arabia.

Introduction: Pollutant accumulation in aquatic ecosystems has become a growing environmental concern, posing serious risks to aquatic organisms. While the toxic effects of individual chemicals are well-studied, limited research has explored their combined effects. This study investigates the synergistic and antagonistic toxicity of chlorhexidine (CHX) and dibutyl phthalate (DBP) on Daphnia magna, a commonly used ecotoxicological model. The objective was to assess toxicity levels of CHX and DBP at varying concentrations and evaluate their combined effects using the Bliss Independence Model through an immobilization assay. Methodology: Different concentrations of CHX and DBP were tested both individually and in combination (ratios of 2:1 and 3:1) over a 48-hour period. Immobilization rates were recorded at 24 and 48 hours. A total of 50 organisms per concentration were assessed. The Bliss Independence Model was applied to evaluate synergistic, additive, or antagonistic interactions. Results: The individual toxicity thresholds for CHX were IC30 = 22.85 mg/L, IC50 = 47.93 mg/L, and IC70 = 1.90 mg/L. For DBP, the respective values were IC30 = 8.31 mg/L, IC50 = 14.86 mg/L, and IC70 = 2.52 mg/L. At a 2:1 ratio, the combination demonstrated synergistic effects with combination indices (CI) of 0.718 (IC30), 0.734 (IC50), and 0.758 (IC70). The 3:1 ratio exhibited antagonism at IC30 (CI = 1.42) and IC50 (CI = 1.48), but showed synergism at IC70 (CI = 0.85). Conclusion: The findings demonstrate that chemical interactions vary with concentration and combination ratios. The observed synergistic effects at the 2:1 ratio highlight potential ecological risks, while the 3:1 ratio shows complex interaction patterns. These results underscore the need for comprehensive assessments of chemical mixtures to guide environmental risk management and improved water treatment strategies.

Purpose: The research examined the remineralization abilities between three ion-excluding dental restoratives under study: ACTIVA BioACTIVE, BEAUTIFIL Bulk Restorative and Fuji II LC on dentin weakened by demineralization through Raman spectroscopy and Knoop hardness testing (KHN). Methods: The investigators used artificially treated dentin specimens to apply test restorative materials as they conducted the study but omitted restorations from the control samples. The analysis through Raman spectroscopy and KHN tests occurred before storage and again at week eight when materials rested inside phosphate-buffered saline. Qualitative material penetration evaluation took place through the use of confocal laser scanning microscopy (CLSM). Results: The restorative materials contained in all groups produced an outstanding increase in phosphate Raman peak intensity and KHN measurement when compared to the control group at a significance level of p<0.001. ACTIVA BioACTIVE material demonstrated the most notable mean percentage increase of Raman peak intensity reaching 80.93% yet this metric was statistically equivalent to other evaluation groups (p>0.05). Conclusion: ACTIVA BioACTIVE proved superior to both other restorative materials when it came to dentin remineralization capability. The examined evidence confirms that treating dentin with ion-releasing materials represents a practical approach for minimally invasive dental procedures. Clinical Relevance: The materials help protect the tooth structure while simultaneously enabling caries-affected dentin to heal properly.

Background: Adolescent use of smokeless tobacco poses a serious public health concern due to its long-term effects on brain development and increased risk of nicotine dependence. Nicotine exposure during adolescence contributes to greater vulnerability to addiction and long-term behavioral and cognitive consequences. Assessing both biochemical and psychological markers of dependence is essential for developing targeted prevention and cessation strategies. Objective: To compare salivary cotinine levels with self-reported psychological nicotine dependence among adolescent smokeless tobacco users and evaluate their readiness to quit. Methods: This cross-sectional study was conducted among adolescents aged 13 to 18 years. Nicotine dependence was measured using the Fagerström Test for Nicotine Dependence (FTND) and the Contemplation Ladder. Salivary cotinine was assessed using a non-invasive saliva test kit. Participants were grouped into tobacco users and non-users. Statistical analysis was performed using the Mann-Whitney U test and Kruskal-Wallis test, with significance set at p<0.05. Results: The mean salivary cotinine level among tobacco users was 124.36 ng/mL, compared to 49.58 ng/mL in non-users. Among the 52 tobacco users, 36.5% showed very high dependence on the FTND scale. On the Contemplation Ladder, 86% had no intention of quitting, while only 0.3% indicated readiness to quit. Despite elevated cotinine levels in users, no statistically significant correlation was found between cotinine concentration and FTND scores (p = 0.620). Conclusion: Adolescents using smokeless tobacco exhibited higher biochemical markers of nicotine exposure and psychological dependence compared to non-users. However, the absence of a significant correlation between salivary cotinine and self-reported dependence suggests that adolescent nicotine addiction is influenced by multiple factors. These findings highlight the need for comprehensive cessation strategies that integrate both behavioral and biochemical interventions, particularly for youth with low motivation to quit.

Objectives: The protein Insulin-like growth factor II mRNA-binding protein 3 (IMP3) maintains mRNA stability thus enabling cellular multiplication as well as cell movement. The medical community links tumor progression in different malignancies to IMP3 overexpression. Aims: This research examines Insulin-like growth factor II mRNA-binding protein 3 (IMP3) expression patterns in colorectal carcinoma (CRC) tissue together with their impact on tumor properties as well as recurrence patterns and patient survival durations. Methods: The study examined 48 CRC patients after reviewing their follow-up reports along with histopathological data. The researchers performed immune staining of tumor tissue along with surrounding area using anti-IMP3 monoclonal antibody. An evaluation of IMP3 protein expression levels occurred between cancer cells and cells within the tumor stroma and this information was measured relative to common disease indicators as well as patient survival data. Results: Fourteen patients displayed IMP3 expression in tumor cells while ten patients and ten patients displayed IMP3 expression in tumor cells along with stromal cells respectively. Tumors displaying positive IMP3 in cancer cells demonstrated association with advanced Dukes stage and lymph node involvement, lymphovascular invasion and reduced both disease-free survival (39.87±9.25 months) and overall survival (43.79±9.27 months). Tumor cell IMP3 expression proved independent for survival prediction according to the multivariate analysis (HR = 4.96; p = 0.012). Results indicated that positivity of IMP3 markers within stromal tissue was directly associated with cancer recurrence occurrences. Conclusion: CRC patients often demonstrate high IMP3 expression levels which relates to increased chance of condition recurrence and decreased survival rates. Studying IMP3 represents both a promising candidate biomarker for assessment of patient risk levels as well as intervention aims. Limitations: The results of our study face limitations because the study used small numbers of participants in a single research center.

Background: Nicotine, the principal psychoactive compound in tobacco, alters key neurochemical pathways, particularly those involving dopamine and acetylcholinesterase (AChE). These neurotransmitter changes may underlie the development of nicotine dependence and its cognitive and behavioral consequences. Comparing these biomarkers in smokers and non-smokers provides insight into the neurophysiological impact of chronic tobacco use. Objective: To assess and compare salivary dopamine levels and acetylcholinesterase (AChE) activity in smokers and non-smokers. Methods: An in vivo cross-sectional study was conducted among 240 healthy male participants aged 30 to 35 years, comprising 120 smokers and 120 non-smokers. Salivary levels of dopamine and AChE were measured using enzyme-linked immunosorbent assay (ELISA). Due to non-normal data distribution, the Mann-Whitney U test was used for statistical analysis, with significance set at p<0.05. Results: Smokers demonstrated significantly higher AChE activity (mean: 126.38 nmol/l) compared to non-smokers (mean: 112.9 nmol/L; p<0.001), suggesting altered cholinergic function. Dopamine levels were also significantly elevated in smokers (mean: 29.84 ng/ml) versus non-smokers (mean: 23.83 ng/ml; p = 0.002), indicating stimulation of the dopaminergic system likely linked to nicotine exposure. These results underscore the biochemical influence of chronic smoking on neural regulation and addiction pathways. Conclusion: The study found elevated salivary dopamine and AChE levels in smokers, indicating that nicotine use may contribute to both dopaminergic overactivation and cholinergic dysregulation. These neurochemical changes may reinforce addiction and impair cognitive processes. The findings support the need for neurobiologically informed smoking cessation strategies. Further research should investigate whether these biochemical alterations are reversible following smoking cessation.

Background: Advanced glottic cancer often poses significant challenges in postoperative wound healing after total laryngectomy and radiation. Case Presentation: A 76-year-old male diagnosed with T3N0M0 glottic cancer experienced severe wound-healing complications, including a pharyngocutaneous fistula (PCF) and persistent wound dehiscence, after undergoing extensive surgery and radiation therapy. Management and Outcome: A tailored nutritional intervention involving arginine supplementation was introduced to support tissue repair for four weeks. Arginine was selected for its role in stimulating collagen synthesis and enhancing immune function. This approach resulted in substantial improvement in wound healing and overall recovery. Discussion: This case demonstrates the role of arginine supplementation in supporting wound healing and recovery in cancer patients after surgery and radiation. By enhancing collagen synthesis, immune function and tissue repair, arginine provides a targeted nutritional strategy for improving postoperative outcomes.

Background and Objectives: A systematic review investigated adverse event frequencies and types occurring during pediatric dental sedation and general anesthesia administration to children using different medications through multiple delivery methods. Methods: A complete database search based on PRISMA guidelines spanned from 2015 until 2024. The initial screening process yielded 211 articles which was reduced to 20 studies comprising three RCTs and seventeen cross-sectional types. The evaluation of bias risk applied the ROBINS-E along with RoB 2.0 assessment tools. Results: Twenty studies were assessed for the research with 13 featuring data about GA and 7 providing data about PDS. The sedative agents commonly selected for sedation included propofol, sevoflurane, ketamine and midazolam. Data showed a wide range of adverse event incidence between 8% to 47.5% that included agitation at 47.5% and postoperative pain reaching 90% and nausea affecting 19.6% and laryngospasm that rose up to 36.8%. Cognitive and financially speaking office-based sedation proved better than treating patients with GA. Conclusion: Successful reduction of adverse events depends on selecting suitable patients followed by personalized sedation methods and continuous intraoperative alongside postoperative surveillance. Professional sedation guidelines along with specialized pediatric dental sedation training demonstrably need implementation according to this research.

Background: Conditions concerning high blood pressure create substantial health risks both worldwide and within the Gulf nations because of accelerated changes in lifestyles and expanding young demographic statistics. Objective: The current cross-sectional research evaluated hypertension frequency in Saudi Arabian girls along with its relationship between obesity factors and cholesterol levels. Methods: Researchers obtained data from 120 young Saudi females between the ages of 18-25 years who were students at Umm Al-Qura University in Makkah. The study evaluated blood pressure levels and body mass index alongside waist circumference and waist-hip ratio and fasting blood glucose and lipid profile including HDL, LDL and TC among young Saudi female subjects. Results: The data showed that 41.7% of participants maintained normal blood pressure levels yet stage 2 hypertension affected 18.3% of the sample size. Additionally 30.8% experienced stage 1 hypertension and 9.2% had elevated BP. Statistical research showed hypertension related significantly to WC (p = 0.007) and WHR (p = 0.020) measurements though BMI, FBG, HDL, LDL and TC did not demonstrate statistical significance. Conclusion: Young Saudi female subjects showed waist-hip ratio (WHR) and WC as important indicators for hypertension development. The research shows that preventive approaches along with lifestyle changes need to be directed specifically toward developing populations. Further multi-centered studies are warranted.

Objectives: The healing process of endodontically treated teeth requires special attention due to lost tooth structure. The collective use of fiber post systems for reinforcement in dentistry requires further evaluation regarding their response to repetitive load tests. This research investigates the fracture resistance of teeth with endodontic treatment that received various fiber post systems when subject to cyclic loading conditions. Methods: A total of sixty human premolars received endodontic therapy after which researchers divided the specimens randomly into three groups (n = 20) for testing different fiber post systems. The studies used Group I (Glass fiber posts), Group II (Carbon fiber posts), and Group III (Quartz fiber posts). The researchers standardized the post space to which they used dual-cure resin cement for the posts' placement. Full-coverage crowns received the composite resin core buildup treatment. The research specimens faced 500,000 cycles of 100 N tensile force under conditions of 5°C–55°C in a thermocycling chamber. A universal testing machine operated at a crosshead speed of 1 mm/min until failure to evaluate the specimen fracture resistance after loading. Results: One-way ANOVA statistical analysis demonstrated significant variation across groups at a 0.003 p-value while post hoc Tukey’s test established a 0.001 p-value difference between carbon and quartz fiber post groups (95% confidence interval: -160 to -60). The comparison between glass and quartz fiber posts yielded results without a significant statistical variation (p = 0.08; 95% CI: -110 to 10). Conclusion: Quartz fiber posts displayed the best fracture resistance under functional simulation conditions which suggests they should be considered as the top reinforcement option for endodontically treated teeth in clinical applications.

Objectives: Dental crown clinical longevity mainly depends on how materials resist wear and maintain their surface quality. Three-Dimensionally (3D) printed resin-based crowns and CAD-CAM ceramic crowns exist as preferred choices for tooth restoration because of their separate material components. The objective of this work involves examining the wear resistance properties and surface quality of CAD-CAM ceramic crowns and 3D-printed resin-based crowns so researchers can evaluate their clinical service life. Methods: Two hundred crowns were created including fifty CAD-CAM ceramic and fifty 3D-printed resin-based products. A simulator with five-year simulation duration evaluated wear resistance. The profilometer assessed material surface roughness (Ra) both before and after subjecting them to wear simulation tests. The independent t-tests evaluated the collected data with an alpha level of p = 0.05. Results: The wear damage produced by CAD-CAM ceramic crowns reached 14.8±2.3 µm yet resin crowns required 29.1±3.7 µm to finish their wearing process (p = 0.001). The ceramic crowns experienced an increase in surface roughness from 0.30±0.06 µm to 0.47±0.07 µm after wear testing while resin crowns went from 0.42±0.08 µm to 0.75±0.10 µm (p = 0.002). Conclusion: CAD-CAM ceramic crowns behave better under high-mechanical loads due to their improved wear resistance which preserves their smooth surface finish. Resin-based crowns represent potential candidates for short-term uses or situations where small masticatory loads are present. The results from clinical trials should validate the in vitro testing outcomes

Objectives: Restoration of structurally damaged endodontically treated teeth (ETT) requires post and core treatments to withstand functional forces. Post type selection together with core material substance determines the stress distribution patterns and breaks down resistance properties of teeth requiring treatment. Researchers conducted this in vitro study to assess different post and core combination models which received full-coverage crowns for their biomechanical outcomes in ETT teeth. Methods: Sixty endodontically treated single-rooted human mandibular premolars were distributed into six experimental groups (n = 10) according to the combination of post material and core cement: Group 1: Fiber post with composite core, Group 2: Fiber post with glass ionomer core, Group 3: Metal post with composite core, Group 4: Metal post with glass ionomer core, Group 5: Zirconia post with composite core, Group 6: Zirconia post with glass ionomer core. The dental specialists prepared all post spaces to 10 mm depth and cemented each post with resin-based luting cement. The core materials were placed following the manufacturer-specified guidelines. Zirconia crowns produced through CAD/CAM fabrication received their cementation from resin-modified glass ionomer cement. Laboratory tests of compressive strength included thermocycling the samples through 10,000 temperature changes between 5°C and 55°C before testing. The universal testing machine determined fracture resistance by testing at 135° inclination to the tooth axis at 1 mm/min cross speed. The assessment distinguished restorable from non-restorable failure patterns. Finite element analysis (FEA) provided data regarding the way stress distributed between components. Results: The group using Zirconia posts with composite core (Group 5) exhibited the highest fracture resistance at 1750±120 N, followed by metal post with composite core (Group 3) at 1620±110 N, while the lowest resistance was recorded for zirconia post with glass ionomer core (Group 6) at 980±90 N. Fiber post groups demonstrated more favorable failure modes, with 70% restorable failures in Group 1. Conclusion: Fiber posts with composite cores demonstrated superior stress distribution and favorable failure modes, making them clinically preferred for restoring endodontically treated teeth with full-coverage crowns, particularly in patients with high occlusal load.

Objectives: Success rates of dental implants heavily depend on the process of osseointegration. The standard practice in dentistry uses titanium implants because these materials demonstrate exceptional compatibility and structural integrity with bone tissue. Medical experts have adopted Zirconia and polyether ether ketone (PEEK) as implant choices because these offer better aesthetics together with superior biomechanical performance. In this laboratory research scientists examined the potential for root integration between titanium and zirconia and PEEK implant materials through synthetic bone model testing. Methods: Thirty titanium implants accompanied by thirty zirconia implants and thirty PEEK implants received placement inside simulated bone blocks. Surface wettability combined with roughness and insertion and removal torque measurements were the assessed parameters. The evaluation of bone-to-implant contact (BIC) through histomorphometric analysis took place after the blocks spent eight weeks in the incubator. A one-way ANOVA technique performed the statistical analysis with a threshold value of p<0.05. Results: The titanium implants achieved the greatest insertion torque level at 45.2±5.1 Ncm together with 30.5±3.2 Ncm removal torque levels and 65.8±4.5% bone-to-implant contact. The insertion torque amount for zirconia implants reached 38.4±4.3 Ncm but their BIC percentage achieved 58.2±3.9% while PEEK implants maintained the lowest quantitative performance with BIC 40.6±5.1%. Conclusion: During every evaluation step titanium outperformed other materials for bone integration processes. Zirconia represents an appropriate metal-free solution for applications where load-bearing is not necessary. The integration of PEEK materials remains restricted while their surface needs adjustment for better attachment. Additional in vivo tests and sustained studies need to take place to confirm these findings.

Background: Physiotherapy is a rapidly evolving healthcare profession in Saudi Arabia, playing a crucial role in rehabilitation and physical well-being. Understanding the knowledge and attitude of physiotherapy students towards their profession is essential for assessing their preparedness, motivation and future contributions to the healthcare system. This study aims to evaluate the level of knowledge and attitude of physiotherapy students regarding their profession, their perception of career prospects and the factors influencing their professional outlook. Methods: A cross-sectional study was conducted among physiotherapy students enrolled at Al Majmaah University. A structured, self-administered questionnaire assessed demographic details, knowledge about physiotherapy scope and practice and attitudes toward the profession. Data was analyzed using SPSS, with descriptive statistics and chi-square tests to examine group differences. Results: A total of 170 individuals participated in the study, comprising 87 females (51.18%) and 83 males (48.82%). Helping people/patients (52.94%) emerged as the primary reason for choosing the profession, while family influence (42.94%) was the most common source of initial information. While 74.71% reported satisfaction with the profession itself, 70% expressed satisfaction with job opportunities in Saudi Arabia. Statistically significant differences in perception were noted based on age and year of study (p<0.05). Conclusion: The study highlights a generally positive attitude among physiotherapy students toward their profession, supported by a moderate to high knowledge base. It is recommended that educational institutions implement targeted career counselling, expand clinical exposure and launch public awareness initiatives to enhance professional identity, address misconceptions and improve career satisfaction among future physiotherapists.

Objective: The aim of this study was to investigate gender differences while comparing dynamic stability and core strength and to identify relations among professional padel players. Methods: This cross-sectional study was planned in Jeddah city of Saudi Arabia. A total of 30 players was recruited out of which 15 were males and 15 were females. Each participant was informed about the nature and importance of studying prior data before data collection and an informed consent was also obtained. The data was collected from six padel centers as per plan located across the city using physical examination form divided into three sections: Demographic details, Plank test time and SEBT (star excursion balance test). Results: Findings of this study suggested that despite SEBT mean reach distance score (males>females) was comparable based on gender, the difference remained non-significant (p>0.05). Plank test time between males and females were also found to be non-significant. Correlation analysis showed weak to moderate positive relation between plank time and SEBT for both dominant and non-dominant leg side, however, only significance was found for anterior reach direction (r = 0.407, p-value = 0.026). Conclusion: The findings of this study showed that dynamic stability and core endurance between male and female players of padel sport does not show any significant reach differences attributed to similar levels of training adaptations. On analyzing the association between core strength and reach distance, it was found that the anterior direction movements were more stabilized than others in both the genders suggesting the importance of forward leaning position more prominent in padel sport. This study also reinforces the importance of core strength in maintaining dynamic stability related to this sport.

Objectives: The connection between implant and abutment establishes essential conditions for lasting success of dental implant therapy. Bacterial colonization at the implant-abutment connection causes microleakage which subsequently leads to peri-implant diseases as well as eventual implant failure. The Morse taper together with internal hexagon and external hexagon represent three implant-abutment connection designs which seek to decrease bacterial penetration. The present study examines how variations in implant-abutment connections affect both microleakage and bacterial infiltration between components. Methods: This in vitro research examined 60 titanium dental implants through three distinct connection design categories consisting of Morse taper with 20 units and internal hexagon with 20 units and external hexagon with 20 units. A bacterial exposure with Streptococcus mutans occurred on each implant-abutment unit before placing them in a 37°C environment during a seven-day period. Laboratory examination of bacterial penetration included RT-PCR tests and evaluation of bacterial cultures. A spectrophotometric analysis of dye penetration technique was employed to measure microleakage between groups. The statistical analysis employed one-way ANOVA for data assessment while post-hoc Tukey’s test provided supplemental evaluations at a p value below 0.05. Results: The Morse taper connection group demonstrated better microleakage resistance through its 0.25±0.05 mm readings when compared to the 0.67±0.08 mm readings from internal hexagon and 1.12±0.10 mm readings from external hexagon groups (p<0.05). Bacterial penetration occurred in 10% of Morse taper implants whereas 45% of internal hexagon implants presented bacterial penetration and 75% of external hexagon implants showed bacterial penetration. The Morse taper connection provided advanced sealing ability that reduced both microleakage and bacterial passage through the connection. Conclusion: Design specifications for implant-abutment connections determine how well bacterial agents and fluid can pass through the connection. Morse taper connections show enhanced sealing capabilities which lowers the chance of bacterial infections during the procedure. Clinical application of Morse taper implants should be favored because research shows they help extend implant life and decrease peri-implant bacterial infections. The research demonstrates that Morse taper connections decrease peri-implant diseases effectively because they block bacterial penetration. The clinical use of Morse taper implants should be considered when sustaining implant longevity together with controlling infection rate is essential.

Background: Neural Tube Defects (NTDs) are preventable congenital malformations that can be avoided through early interventions, specifically through the consumption of folic acid. The main goal of this research was to assess awareness, knowledge and attitudes among medical students about neural tube defects during pregnancy and to analyze demographic and educational predictors of awareness. Methodology: A postal questionnaire cross-sectional survey was sent to around 450 medical students who had successfully completed one semester of their undergraduate medical course. A validated and standardized questionnaire with three sections-demographic information, knowledge about neglected tropical diseases (NTDs) and attitude towards NTDs-was sent either by post or personally. Descriptive statistical analysis in the form of percentages, frequencies and mean scores and inferential statistical analysis like chi-square tests and ANOVA was used to analyze the data and determine factors that were associated with differences in confidence and awareness in counseling. Results: The age range of the participants ranged from 19 to 24 years and the female participants ranged between 55% to 62% of the sample size being analyzed. The correct identification percentage of NTDs was greater among fourth-year (85%) students than among first-year (45%) students and a value of chi-square was 21.76 (p = 0.008). Knowledge in the form of awareness about risk factors, characteristics and prevention significantly related to the educational level as well as the age group (χ² = 23.49, p = 0.002). The female students consistently showed higher awareness levels in all aspects when compared with male students and it was found to be statistically significant (p<0.05). The maximum mean scores in knowledge were observed for fourth-year and internship students, i.e., 7.4±0.7 and 7.6±0.7, respectively; F was 19.82 in ANOVA analysis (p<0.001). Also, the students who underwent formal training showed increased confidence, of which 78% were "very confident" compared to 45% of the no-training group (χ² = 28.94, p<0.001). Also, the confidence level and knowledge had a positive correlation with age as well as the specialty field, particularly obstetrics and gynecology. Conclusion: The results revealed that exposure to training, gender, educational level and course of study had a significant effect on the knowledge and attitudes of medical students regarding neural tube defects. Additionally, the results showed a stronger correlation between education level and training and self-efficacy in counseling. The results showed that there should be inclusion of formal education interventions within medical training to increase the knowledge and preventive counseling skill of upcoming health professionals.

Objective: Information about the perspective of dental patients regarding the clinical attire and the presentation of oral and maxillofacial surgeons (OMFSs) is lacking in Saudi Arabia. Investigating the diversity of elements that influence patients' opinions to improve the services and care that their surgeons deliver and to meet patients' needs has been a topic that is debated across the medical field. This study's objectives are to assess patients' overall satisfaction and trust in their OMFSs and identify areas for improvement. Methods: A self-reported questionnaire-based cross-sectional survey was piloted among adult patients who visited the Department of Oral and Maxillofacial Surgery at Riyadh Elm University Dental Hospital in Riyadh City between August 2021 and July 2022. Data on patient preferences for the surgeons' gender, educational background, experience, appearance, notoriety and social media activity was gathered. Results: A total of 503 participants were evaluated for the current study. The age of the study participants showed significant differences in preferences toward the selection of OMFS based on gender (p<0.05). The marital status of the subjects showed statistically significant differences in preferences in the selection of OMFS based on gender and age, reputation on social media of OMFS and selection of the OMFS after internet research (p<0.05). Key findings indicated that 69.4% of patients preferred surgeons in official attire and 67.2% were influenced by social media presence (p<0.05). Conclusions: This cross-sectional survey demonstrated how patients' expectations and preferences when selecting their OMFSs are influenced by age, education, marital status and gender. These insights highlight the importance of professional appearance and digital reputation in patient selection. Future research should explore strategies for enhancing OMFS-patient trust through attire standards and digital engagement.

Objective: The research examined postmenopausal women with osteoarthritic (OA) knee joints to understand their exercise adherence rate for an 8-week period as well as its impact on their balance and lower extremity function. Methods: Two groups of thirty participants received random assignment which placed half into Group A stable surface exercises and half into Group B unstable surface exercises. The research included Knee Injury and Osteoarthritis Outcome Score (KOOS) and Timed Up and Go (TUG) test assessments before and after the intervention period. A logbook and self-report questionnaire were used to monitor both adherences and feasibility levels. Results: The subjects in both exercise groups showed significant improvements in KOOS scores (Group A: 65.9±6.39 to 75.4±4.14; Group B: 58.1±3.91 to 64.3±4.83) yet participants in Group A achieved a larger improvement of 14.4% compared to Group B's improvement rate of 10.7%. The scores for TUG improved significantly in both groups (p<0.001) and showed no statistically important difference between the groups (p = 0.535). A high number of 82.5% patients experienced exercise tolerance through participation in the program. Conclusion: Postmenopausal women with OA underwent an 8-week exercise protocol that produced meaningful improvements in both balance abilities and lower limb functionalities. The improvements from stable surface training practices (Group A) exceeded those of unstable surface exercises which provides valuable knowledge for physiotherapy treatment protocols.

Background: Diabetes, a prevalent metabolic disorder, is influenced by a complex interplay of genetic, lifestyle and environmental factors. This study aimed to identify and analyze the correlation between various factors, including hepatitis B vaccination (HBV) and the incidence of diabetes. Methods: A case-control study was conducted with 487 cases of diagnosed diabetes and an equal number of age- and gender-matched controls that reported to the health record database. Participants' demographic, lifestyle factors, medical history, socioeconomic factors, dietary habits and HBV status were collected. The data were analyzed using descriptive statistics, chi-square tests for categorical variables and regression analyses to determine the associations between the factors and diabetes incidence. Results: The study revealed statistically significant differences between cases and controls concerning numerous variables. BMI, lifestyle factors such as exercise, smoking and regular alcohol consumption, family history of diabetes and certain medical conditions like hypertension, heart disease and kidney disease were all associated with diabetes incidence. Interestingly, an inverse relationship was observed between HBV and diabetes incidence. Lower education levels, lower income, poor access to healthcare, higher daily caloric intake and higher daily sugar intake were linked to a higher likelihood of having diabetes. The use of statins and antihypertensives was more prevalent among cases with diabetes. Conclusion: The study underscored the complex and multifactorial etiology of diabetes, revealing multiple determinants of its incidence. The intriguing inverse relationship between HBV and diabetes incidence calls for further investigation. The findings suggest that targeted interventions, considering lifestyle, genetic, medical and socioeconomic factors, can be effective in preventing and managing diabetes.

Background: Hospital readmissions are a key indicator of healthcare quality, particularly in ophthalmology where complications following surgery or inadequate postoperative care can lead to unplanned returns. Nurses play a critical role in patient education, follow-up care, and complication management. However, the association between nurse demographics and readmission rates in ophthalmology remains underexplored in India. This study aimed to assess the relationship between nurse demographic factors and hospital readmissions in a tertiary eye care setting. Methods: A descriptive cross-sectional study was conducted at a tertiary care ophthalmic hospital in South India. A total of 109 nurses were selected through simple random sampling. Inclusion criteria were a minimum of one year of clinical ophthalmology experience. A structured and validated questionnaire, with a Cronbach’s alpha of 0.82, was used to gather data on age, gender, years of experience, education level, department, and shift type. Logistic regression and chi-square tests were applied to analyze associations between these factors and patient readmission rates. Results: The mean age of nurses was 40.36±11.02 years, and the average experience was 7.85±3.33 years. The majority were female (85.3%) and held GNM or higher degrees. Logistic regression showed slightly higher odds of readmissions for male nurses (OR = 1.63) and those in specific departments (OR = 1.17), while higher education levels showed a protective effect (OR = 0.87). However, none of these associations were statistically significant. Chi-square tests also found no significant associations between categorical variables and readmission rates. Conclusion: While not statistically significant, trends suggest nurse education and departmental assignment may influence ophthalmology readmissions. Larger, multi-center studies are recommended. Improving nursing education and structured follow-up protocols may help reduce readmission rates and enhance care quality.

Background: The available literature on Total Knee Replacement (TKR) surgery has substantially increased, since it has a proven track record of improving quality of life, function and pain alleviation for patients with varying knee ailments. Despite its general effectiveness, some patients still struggle with post-operative functional limits and discontent. Therefore, the purpose of this systematic review and meta-analysis was to assess the effect of TKR on kneeling capacity as a Patient-Rated Outcome (PRO). Methods: A comprehensive search strategy was developed and applied across major medical databases to identify relevant studies. The studies included in the analysis assessed the impact of TKR on kneeling ability using various patient-reported outcome measures. Data extraction and bias assessment were performed following established protocols. Results: The meta-analysis indicated that total knee replacement significantly influenced kneeling capability. The pooled analysis of the 13 included trials indicated a marginally significant effect of TKR on enhancing patients' capacity to kneel. The research focused on the overall number of patients who indicated significant improvement relative to those who reported little improvement in their capacity to kneel after TKR. The results suggested a relatively significant connection between TKR and increased kneeling skill with an Odds Ratio (OR) 0.83 [0.80, 0.86]and risk ratio (RR) 0.91 [0.89, 0.92], while substantial heterogeneity was detected as well within the studies’ reported outcomes. Conclusion: This systematic review and meta-analysis presented data confirming the favourable influence of TKR on kneeling ability. The findings indicated that TKR may result in significant enhancements in patients' capacity to kneel. These results have implications for clinical decision-making and patient counseling on the predicted outcomes of TKR surgery.

Background: Fatigue and impaired quality of life (QoL) are common and disabling symptoms in patients with multiple sclerosis (MS), which often hamper their physical, emotional and social functioning. It is important to appreciate the interrelation of fatigue and QoL and their individual demographic and clinical determinants, in order to organize management based on patient needs. Methods: This cross-sectional descriptive study was conducted over a span of 12 months during the period of January to December 2023. 286 patients with MS, aged between 18 to 65 years, diagnosed for ≥ six months, were enrolled via convenience sampling from the tertiary care and rehabilitation hospital OPDs and inpatient facilities. The Fatigue Severity Scale (FSS) and Multiple Sclerosis Quality of Life-54 (MSQoL-54) questionnaire were used to acquire data. Data analysis was carried out using Pearson's correlation, t-tests, ANOVA and multivariate linear regression with the use of SPSS version 25.0 and considering p-values of<0.05 to be significant. Results: The mean age of participants was 38.4±9.6 years with female predominance (60.8%). Most of the participants had relapsing-remitting type of MS (63.6%), with a mean disease duration of 7.2±5.1 years. The mean FSS score was 4.5±1.4 and 48.3% of participants had moderate fatigue. The mean overall QoL score was 61.1±15.1, with mean physical and emotional health composites of 58.4±15.7 and 63.7±14.9, respectively. Fatigue was significantly and inversely correlated with all QoL dimensions (physical health: r = -0.63; emotional health: r = -0.58; overall QoL: r = -0.66; all p<0.001). Female gender, older age, lower education, higher EDSS score, progressive type of MS and longer disease duration were significantly correlated with greater fatigue and lower QoL scores (all p<0.05). Multivariate regression analysis revealed EDSS score (β = -2.43), progressive type of MS (β = -8.94) and severity of fatigue (β = -4.89) as independent predictors of poor QoL. Conclusion: This study validated the general high level of fatigue and moderate level of quality of life impairment in MS patients. Fatigue was significantly correlated with lower physical and emotional well-being and several demographic and clinical variables independently predicted poorer outcomes. These results emphasize the necessity of multi-faceted, patient-focused interventions targeting fatigue as well as disease management to enhance patient quality of life.

Background & Objectives: Spasticity is a common motor impairment following stroke, significantly impacting patient functionality and quality of life. Repetitive transcranial magnetic stimulation (r-TMS) has gained attention as a non-invasive neuromodulation technique potentially beneficial for reducing spasticity. However, evidence regarding its impact on spinal motor neuron excitability remains inconclusive. This study aimed to investigate the effects of r-TMS combined with conventional physiotherapy on spasticity and spinal motor neuron excitability in stroke patients. Improving understanding of these interventions may help stroke patients achieve better movement control and enhance their overall rehabilitation outcomes. Methods: A randomized controlled trial was conducted involving 30 chronic stroke patients divided into two groups: Group-A (experimental; r-TMS with conventional physiotherapy) and Group-B (control; conventional physiotherapy alone). Intervention lasted 4 weeks, with 12 sessions administered (3 sessions/week). Clinical assessment of spasticity (Modified Ashworth Scale, MAS) and electrophysiological evaluations (H-reflex latency and amplitude) were measured pre- and post-intervention. Results: Post-intervention, Group-A demonstrated significant reductions in spasticity (MAS scores decreased from 2.4±0.6 to 1.2±0.5, p<0.001) compared to Group-B (2.3±0.7 to 1.9±0.6, p=0.02). Electrophysiological outcomes revealed significantly increased H-reflex latency (30.2±1.9ms to 32.8±1.6ms, p<0.001) and decreased amplitude (2.9±0.6mV to 1.7±0.5mV, p<0.001) in Group-A, indicating reduced spinal excitability, with minimal changes observed in Group-B. Conclusions: Integrating r-TMS with conventional physiotherapy effectively reduces spasticity and modulates spinal motor neuron excitability post-stroke. These findings support r-TMS as a valuable adjunct intervention in stroke rehabilitation protocols.

Objective: Intestinal tuberculosis (ITB) is an important form of extrapulmonary TB that often mimics other gastrointestinal diseases, making early diagnosis and management challenging. This study aimed to assess the clinical features, diagnostic approaches and treatment response of patients with ITB who received short-course anti-tuberculosis therapy (ATT). Methods: A prospective study was conducted on 48 patients with clinical, radiological, endoscopic and histopathological evidence of ITB at a tertiary care hospital between March 2023 and March 2024. Patients underwent diagnostic tests including the Mantoux test, abdominal ultrasonography, barium studies and colonoscopy with biopsy. All patients were treated with a standard 6-month ATT regimen and their clinical response was evaluated at 2 months and 6 months. Results: The most common symptoms were abdominal pain (89.6%), weight loss (81.3%) and fever (77.1%). The Mantoux test was positive in 69% of cases and elevated ESR was found in 91.7% of patients. Imaging and endoscopy showed frequent findings such as ulcers (85.4%) and ileocecal involvement (75%). After 2 months of ATT, 56.25% of patients showed significant clinical improvement, which increased to 89.6% after completing 6 months of therapy (p<0.001). However, 8 patients were later diagnosed with Crohn’s disease instead of ITB. Conclusions: Most patients with ITB showed marked improvement with a 6-month ATT regimen, highlighting the effectiveness of this treatment approach. However, diagnosing ITB remains challenging because it shares symptoms with Crohn’s disease. This study underscores the need for careful evaluation and follow-up to help doctors diagnose intestinal TB accurately and provide timely, effective treatment.

Background: Androgenetic alopecia (AGA) is the most common disorder of hair loss in men and women. Minoxidil is one of the drugs that are widely used for the treatment of hair loss and commercially available as oral or topical preparations. This systematic review with meta-analysis was thus intended to compare the efficacy and safety profile of oral minoxidil and topical minoxidil in the treatment of AGA. Methods: A systematic literature search was conducted across seven major databases: PubMed, Scopus, Web of Science, Cochrane Library, Embase, CINAHL and PsycINFO. After close filtering, four studies were selected for meta-analysis where the efficacy and safety of oral and topical minoxidil for the treatment of AGA were studied. Results: Meta-analytic results did not express a statistically significant superiority of oral minoxidil over the topical minoxidil in promoting healthy hair growth, that is, the odds ratio 2.23 (95% CI: 0.84, 5.93) with a p-value 0.11 for a test of overall effect and Z = 1.60, with heterogeneity (Tau²=0.00); meaning homogeneity among the studies. The incidence of adverse events was also more in the oral minoxidil compared to the oral finasteride. However, it included hypertrichosis, tachycardia and scalp pruritus with OR, 3.33 (95% CI: 1.40, 7.90) and p-value of 0.006. Qualitatively, the studies unveiled that oral and topical minoxidil have efficacy in the treatment of AGA but to different degrees of efficacy and tolerability. Conclusion: The clinical benefits of oral and topical minoxidil were the same when used in the treatment of AGA, however, hair density improved better with topical minoxidil and adverse effects were minimum.

Introduction: Total knee arthroplasty (TKA) is a widely approved procedure for treating end-stage knee osteoarthritis and offers significant benefits in terms of mobility, pain relief and overall quality of life. Pain control and post-operative range of motion are key factors affecting patient satisfaction, making it crucial to assess the quality of life post-surgery. While TKA is becoming more popular in Saudi Arabia, particularly in the Qassim province, there is still limited research on patient experiences and satisfaction, highlighting the need for further studies to improve care. Methods: This cross-sectional study included 26 post-TKA patients from a single center. Data on demographics, pain levels, range of motion and satisfaction were collected using self-administered questionnaires. Data were cleaned in Excel and analyzed using the International Business Machines Statistical Package for the Social Sciences (IBM SPSS) 29.0.0. Results: Our study included 26 participants, predominantly females (n = 21, 80.8%), with a mean age of 59.5 years (SD = 6.5). Nearly half (n = 12, 46.2%) reported severe knee pain TKA. Despite challenges in routine tasks, (n = 20, 76.9%) described surgery results as excellent. Moderate to severe knee pain significantly interfered with routine tasks (p<0.001), particularly among those with less than a high school education (n = 14, 87.5%, p = 0.032). Decreased range of motion (ROM) was significantly associated with lower weight (p = 0.029) and severe pain (p<0.001). Patient satisfaction was high (n = 22, 84.6%), although those with moderate pain were less likely to be satisfied (n = 3, 60.0%; p = 0.200). The education level approached significance in terms of satisfaction (p = 0.052). Conclusions: Our study highlights the importance of pain management, ROM and social factors such as education in TKA outcomes. Comprehensive multidisciplinary care is essential for addressing both physical and psychosocial needs. Further research with larger sample sizes and longer follow-up periods is recommended.