Ibn Sina National College for Medical Studies

Shoulder dislocations are among the most frequently encountered joint injuries in emergency and orthopedic care, with anterior dislocations accounting for the majority of cases. The timing of reduction following dislocation plays a critical role in influencing short-term outcomes, procedural success, and long-term joint stability. Early reduction is often associated with decreased pain, improved ease of reduction, and lower sedation requirements. Delayed reduction, particularly beyond several hours post-injury, may increase the likelihood of reduction failure, nerve injury, or the need for operative intervention. Studies have shown that recurrence rates are higher in younger patients, especially when treatment is delayed or conservative methods are used without close follow-up. Functional recovery, including return to sport or daily activity, is significantly affected by the management approach and timing of reduction. Structural injuries such as Bankart lesions, Hill-Sachs defects, and rotator cuff tears further complicate outcomes and are more common in delayed or recurrent cases. The presence of risk factors like hyperlaxity, previous subluxations, and improper immobilization also contribute to instability. Imaging strategies, early rehabilitation protocols, and patient education are essential to support recovery and prevent re-dislocation. Variability in emergency department protocols, clinician experience, and resource availability can influence treatment timing and outcomes. Understanding how early versus delayed intervention shapes both immediate and extended recovery allows for more effective decision-making in both acute and follow-up care.

Nanoparticles used in enzyme immobilization offer a high surface area- to-volume ratio, high chemical and thermal stability, and resistance to microbial attack. The present investigation demonstrates the immobilization of Aspergillus oryzae β- galactosidase on silica nanoparticles via covalent binding. A greater yield of enzyme immobilization (89%) was attained on the developed nanobiocatalyst. It was observed that the immobilized and soluble enzymes had optimal pH and temperature values of 50°C and 4.5, respectively. It was monitored that at pH 4.0, soluble β- galactosidase (SβG) exhibited 59% activity. However, the immobilized enzyme showed 92% activity under identical conditions. Similarly, 41% enzyme activity was retained at 70 °C by the free enzyme. Conversely, immobilized β-galactosidase (IβG) retained 70% activity under similar experimental conditions. Additionally, it was observed that at 5% galactose concentration, IβG showed 55% activity under one hour of incubation. However, under comparable experimental conditions, SβG showed 24% activity. It was observed that the immobilized enzyme was reusable, maintaining 90% of its activity even after five uses. The soluble enzyme demonstrated 62% and 70% lactose hydrolysis under the same conditions after 8 hours, while IβG demonstrated 74% and 85% lactose hydrolysis at 40°C and 50°C, respectively, in a controlled batch reactor experiment that was run for 10 hours. Hence, owing to the greater reusability (90% after 5th repeated use) and excellent conversion of lactose at higher temperatures, the developed nanosupport may be used to produce lactose-free dairy products in continuous reactors on a large scale in biotechnology industries.

Objectives: The objective of the study is to evaluate the effectiveness of methylprednisolone, dexamethasone, and hydrocortisone in reducing mortality, length of stay, respiratory support requirement, and cytokine storm-related inflammatory markers (C-reactive protein [CRP], lactate dehydrogenase [LDH], ferritin, D-dimer, and procalcitonin) among patients with severe inflammation induced by COVID-19. Material and Methods: This single-center, retrospective observational study included all severe inflammation cases of COVID-19 treated with methylprednisolone, dexamethasone, or hydrocortisone. A convenience sampling method was used, and data from 74 patients were collected and analyzed. Patients aged ≥18 years who received methylprednisolone 40 mg intravenous (IV) twice daily for ≥3 days, dexamethasone 6 mg IV once daily for ≥7 days, or hydrocortisone 50 mg IV every 6 h for ≥7 days were included. Patients treated with any other corticosteroid regimen were excluded. Primary outcomes included mortality and changes in inflammatory markers: CRP, erythrocyte sedimentation rate, D-dimer, LDH, serum ferritin, and procalcitonin. Results: Among the 74 patients admitted to the intensive care unit (mean age 57 ± 5.2 years), 62% were male. Comorbidities included diabetes mellitus (49%) and hypertension (42%). All treatment groups were matched for baseline characteristics. Methylprednisolone significantly reduced CRP levels on day 5 ± 2 (mean reduction 30 ± 43.4 mg/L, P = 0.003). In contrast, CRP reduction was not statistically significant in the dexamethasone (16.1 ± 30.2 mg/L, P = 0.058) and hydrocortisone (14.8 ± 36.3 mg/L, P = 0.667) groups. Methylprednisolone also showed a significant absolute reduction in mortality of 22.5% (10.8% vs. 33.3%), with an odds ratio of 0.23 (95% confidence interval: 0.05–1.03), P = 0.05, compared to dexamethasone in patients requiring mechanical ventilation. Conclusion: Methylprednisolone demonstrated superior efficacy in reducing inflammatory markers, particularly CRP and LDH serum levels, compared to dexamethasone and hydrocortisone. Furthermore, it was associated with a significantly lower mortality rate in critically ill COVID-19 patients requiring mechanical ventilation, suggesting a potential therapeutic advantage in severe cases.

Artificial intelligence (AI) has emerged as a transformative force in cardiovascular medicine, particularly in the diagnosis, management, and prognostication of acute myocardial ischemia (AMI). This systematic review synthesizes current evidence on AI applications across diagnostic modalities, risk stratification, therapeutic decision-making, and outcome prediction in AMI. A total of 30 peer-reviewed studies were included, encompassing machine learning (ML), deep learning (DL), and hybrid models applied to electrocardiography (ECG), imaging, and electronic health records (EHRs). AI demonstrated superior diagnostic accuracy, enhanced triage efficiency, and improved prognostic modeling compared to conventional methods. Notably, AI-enabled ECG interpretation and coronary imaging have shown cardiologist-level performance in detecting ischemia. Risk prediction models using ML have outperformed traditional scoring systems, while AI-driven decision support tools have optimized therapeutic pathways. Despite promising results, challenges remain in clinical integration, interpretability, and generalizability. This review underscores the potential of AI to revolutionize AMI care and highlights future directions for research, validation, and ethical implementation.

Replacing missing teeth has always been a priority in dentistry. With recent clinical advancements, dental implants are the treatment of choice and the global demand for implants has drastically increased. Implant maintenance is fundamental to its long-term success. This study aimed to assess the attitudes towards clinical assessment, radiographic protocols and overall knowledge of implant maintenance protocols among dentists in the Makkah region. A cross-sectional study was conducted among registered dentists of the Saudi Commission for Health Specialties (SCFHS) in the Makkah region using an electronic questionnaire. A total of 183 dentists were conveniently sampled and categorised into groups based on their years of clinical expertise and chronological generations: Generations (B), (X), (Y) and (Z). Holistic knowledge and clinical compliance were sorted into low, moderate and high levels. The study showed significance among expert dentists (95.3%, n = 41) for the evaluation of keratinised tissue adjacent to implants as compared to that among novice dentists (82.9%, n = 116; p = 0.040), and in the routine use of panoramic radiographs for examination of implants among different generations of dentists (p = 0.017). The total scores showed moderate overall knowledge and clinical compliance among dentists in the Makkah region. Generational differences were detected among different dentists in only a few minor aspects of the implant maintenance protocol, with moderate overall levels of knowledge and clinical compliance. Nevertheless, it is critical to understand that generation is simply one factor that determines behaviour. Continuing education and cumulative clinical expertise throughout the years of practice have an impact on implant maintenance practices.

BackgroundHead and neck squamous cell carcinoma (HNSCC) significantly impairs critical functions such as speech, swallowing, and breathing, often resulting in disfigurement and a substantial decline in quality of life. Despite advances in treatment, the 5-year survival rate remains approximately 60–65%. This study aimed to assess the impact of induction chemoradiotherapy on organ preservation in HNSCC and to explore the potential role of DPP7 as a diagnostic and prognostic biomarker.MethodsA total of 104 patients with locally advanced, non-metastatic HNSCC were enrolled in the study. Induction chemotherapy comprising three cycles of docetaxel, cisplatin, and fluorouracil (TPF) was followed by concurrent chemoradiotherapy. DPP7 expression was analyzed in HNSCC tissues using quantitative reverse transcription PCR (qRT-PCR) and in patient serum through enzyme-linked immunosorbent assay (ELISA).ResultsInduction chemotherapy achieved a complete response (CR) rate of 16.4% and a partial response (PR) rate of 36.5%. Following radiotherapy, the CR rate increased to 59.1%, with 15.9% of patients achieving substantial partial responses. DPP7 expression was significantly elevated in HNSCC tissues and serum compared to normal controls (p < 0.0001). High DPP7 levels correlated with adverse clinical characteristics, including advanced age, female sex, poor tumor differentiation, and higher clinical stage (all p < 0.0001). DPP7 expression increased significantly with worsening response (p < 0.0001) in both tissue and serum, from lowest in CR to highest in progressive disease (PD). Multivariate analysis identified DPP7 as an independent prognostic biomarker, and its strong presence in serum highlights its potential for non-invasive risk stratification. Elevated expression was significantly associated with reduced overall and disease-free survival (p < 0.005).ConclusionThis study suggests that patients with HNSCC can achieve favorable response and organ preservation rates through induction chemoradiotherapy. Furthermore, DPP7 appears to be a potential biomarker of clinical interest; its expression increased significantly with worsening response (p < 0.0001) in both tissue and serum. Elevated DPP7 levels in tissue and serum correlate with adverse clinical features and reduced survival outcomes. These findings highlight the potential of clinical relevance of DPP7; further validation in larger, independent cohorts is recommended to confirm its prognostic and diagnostic effectiveness.

ABSTRACTPurpose:Root canal disinfection plays a critical role in the success of endodontic treatment. This study evaluates the antimicrobial efficacy of three commonly used root canal irrigants: “sodium hypochlorite (NaOCl)”, “chlorhexidine gluconate (CHX)”, and “ethylenediaminetetraacetic acid (EDTA)”, in reducing microbial loads during endodontic treatment.Methods:Ninety patients with primary endodontic infections were randomized into three groups. Each group received irrigation with one of the three solutions. Preirrigation and postirrigation microbial samples were collected and cultured to determine “colony-forming unit (CFU)” counts. Statistical analysis was performed using paired t-tests and analysis of variance (ANOVA).Results:NaOCl showed the highest antimicrobial efficacy, achieving a 90% bacterial reduction, followed by chlorhexidine (85%) and EDTA (70%). ANOVA revealed significant differences between the groups (P < 0.01), with NaOCl demonstrating statistically superior efficacy compared with the other irrigants.Conclusions:NaOCl remains the most effective root canal irrigant, followed by chlorhexidine and EDTA. Clinicians should select irrigants based on their antimicrobial properties and clinical context to optimize treatment outcomes.

ABSTRACTPurpose:This study aims to evaluate the stability of cast partial dentures (CPDs) in elderly patients, assessing key factors influencing clinical performance and patient satisfaction.Methods:A total of 50 elderly patients (mean age 68.3 years) requiring CPDs were recruited. Stability was assessed through retention, patient feedback, and clinical evaluations over six months. Statistical analyses were performed to compare stability at different time points.Results:CPDs demonstrated satisfactory stability initially, with significant improvement after three months of use (P < 0.05). Key factors affecting stability included occlusal adjustments and patient adaptation. Two summary tables highlight clinical stability scores and patient-reported outcomes.Conclusion:CPDs provide reliable stability in elderly patients when appropriately fabricated and adjusted. Regular follow-ups and proper oral hygiene maintenance are essential for optimal results.