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   Table of Contents - Current issue
April-June 2022
Volume 1 | Issue 2
Page Nos. 63-119

Online since Friday, April 29, 2022

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Understanding the interprofessional phenomenon: Transforming health professions’ education from within p. 63
Hugh Barr
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Postgraduate dental education: Training the future specialist and clinical leader of tomorrow p. 65
AR Samsudin
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Integrons as emerging contaminants facilitating the widespread of antimicrobial resistance in Enterobacteriaceae p. 68
Anthony Ifeanyin Okoh, Folake Temitope Fadare
Antibiotic resistance genes (ARGs) are classified as emerging environmental pollutants of global public health concern. These ARGs are disseminated through genetic elements such as integrons. Integrons can acquire, integrate, and express various rearrangeable gene cassettes (GCs), harboring different ARGs that may be readily spread to other bacteria in widely varied niches. Different classes of integrons possessing diverse arrays of ARGs located within its GCs are commonly distributed in the Enterobacteriaceae family and are responsible for the high rate of multidrug resistance observed. The members of this family are natural commensals of the gastrointestinal tracts of humans and animals released into the different aquatic environments. Various water sources further disseminate the organisms and their diverse resistance gene repertoires. Thus, understanding the distribution and diversity of the significant integron classes in the clinically relevant Enterobacteriaceae members will be of utmost importance. It will provide a framework for health authorities to make decisions on surveillance of these contaminants in the environment.
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Identification of unique immune response expression profiles to SARS-CoV-2 in non-small cell lung cancer using systems immunology approach p. 79
Saba Al Heialy, Mahmood Yaseen Hachim, Ibrahim Yaseen Hachim, Rifat Hamoudi, Qutayba Hamid
Background: COVID-19 severity and mortality are higher in patients with lung cancer due to pulmonary complications. Understanding the mechanisms of SARS-COV-2 effect on lung cancer cells in comparison to healthy lung cells can improve our knowledge of the disease biology to discover new therapeutic targets with the aim of improving the management protocols. Methods: We aimed to investigate the immune response signature generated from COVID-19-infected NSCLC patients and compare with noninfected patients. To achieve this, publicly available transcriptomic data of lung adenocarcinoma cancer cells A549 versus healthy lung epithelium which were SARS-COV-2-infected and mock-infected were retrieved and reanalyzed to identify differentially expressed genes (DEGs) that are dysregulated in SARS-COV-2-infected A549. Identified genes were explored for enriched pathways and further validated in silico for their expression in larger NSCLC lung samples. C57BL/6J mice infected with MA15 (mouse-adapted SARS-CoV) were used to confirm the findings. Results: A total of 7852 DEGs were identified between A549 (mock and SARS-COV-2 infected) compared to healthy epithelial cells (mock and SARS-COV-2 infected). On the contrary, 142 genes were DEGs between all mocked-infected cells (healthy and cancer) versus SARS-COV-2 infected (healthy and cancer). Those 142 genes were intersected with DEGs from the first step and were shown to be involved in cytokine-mediated signaling pathway and lymphocyte activation. A549-infected cells upregulated (IL11, RBCK1, CEBPD, EBI3, and ISG15) to a higher proportion but downregulated RELB compared to the healthy epithelium. Most of the genes (Nr1h4, Ebi3, Snai2, IL2rb, IL11, Clec4e, Cebpd, and Relb) were differentially expressed in the lung of infected mice. In silico validation confirm that IL11 expression is higher in lung adenocarcinoma compared to healthy controls. COVID-19 infection in NSCLC patients lead to the activation of specific cytokines. Conclusions: Our analysis showed IL11 to be the most differentially expressed between cancer and non-cancer patients and was associated with poor prognosis suggesting that COVID-19 infection in cancer patients leads to the synergistic increase in expression of CD4+ T cells, M1 macrophages, and follicular helper T cells.
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Attitude of complete denture wearers to denture maintenance and recall visits: A 10-year observational study p. 92
Bolanle Oyeyemi Akinboboye, Olugbenga Adetokunbo Adenuga-Taiwo, Oluwafeyisayo Francis Ikusika, Oluwole O Dosunmu
Background: The demand for complete dentures will persist due to population growth and people living longer. The study assessed denture hygiene and maintenance practices over a period of 10 years. Methods: This was a 10-year prospective study of individuals rehabilitated with complete dentures. Data on socio-demographics, reasons for denture demand, and causes of tooth loss were retrieved before denture prescription. Data regarding denture maintenance practices, frequency and rationale for recall visits, quality of health, and patients’ perceived overall satisfaction were recorded after dentures had been in use by the participants. Data were collected over the course of review appointments and were retrieved using structured questionnaires based on the American College of Prosthodontists denture care and maintenance guidelines and the Oral Impacts on Daily Performance indicator. Retrieved data were analyzed with IBM SPSS Statistics version 21. Level of statistical significance was set at P ≤ 0.05. Results: Forty patients with a mean age of 69.5 ± 16.7 years were enrolled in the study. About 63.2% were male, and many (57.9%) were without co-morbidities. Most (68.4%) had dentures replacing both arches. At recall, 15.8% reported brushing dentures with toothpaste and 34.2% slept with dentures. There was a low (25%) compliance with recall appointments. This was mainly (73.3%) due to lack of motivation. Most (68.4%) of participants were satisfied with their dentures. Conclusion: The adherence to denture hygiene guidance within the limit of this study among complete denture wearers was found to be good but there was poor adherence to the denture maintenance regime.
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Comparing the pre–post knowledge score of health-care professionals on a simulation course for COVID-19 PCR sampling p. 99
Mode Al Ojaimi, Megan Khairallah, Rania Al Najjar
Background: This study describes the effectiveness of a simulation course for polymerase chain reaction (PCR) sampling for coronavirus disease of 2019 (COVID-19) on a heterogeneous cohort of 37 health-care professionals (HCPs) in North Lebanon. Materials and Methods: A pre–post repeated measure on a simulation course PCR sampling for COVID-19 was designed and conducted on a sample of 37 HCPs involved in COVID-19 PCR sampling in Lebanon. Attendees anonymously completed pre–post course questionnaires following the simulation training session. Data collected were analyzed on SPSS using the Wilcoxon signed-rank test and McNemar’s test to compare the knowledge score (Kscore) of participants and their perceptions measures related to the training. Results: Kscore increased and was significantly different pre (µ = 2.22,) and post-session (µ = 5.54). A Wilcoxon signed-rank test showed that post-session, only two remained the same, whereas all the rest (35) had higher post score. The proportion of correctly answered questions varied significantly pre–post session for all six questions. Years of experience and gender did not have an effect on Kscore pre–post session. The Kscore also varied for participants with previous COVID-19 PCR swab training or with current role related to COVID-19 with higher pre-Kscore and surprisingly lower post-Kscore. Conclusion: Our study shows that a simulation course regarding COVID-19 testing should be a requirement, regardless of years of experience or previous training, before allowing HCPs to perform sampling techniques on a patient having or suspected to have COVID-19 in order to ensure international standards.
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Echocardiography as an important tool for teaching and learning in the preclinical phase of the medical school curriculum p. 109
Mohamed Seif Allah Shehata, Mohamed Ahmad Eladl, Majd Al-Deen Alhuarrat, Adel B Elmoselhi
Background: A transformation in medical education is currently underway, prioritizing competency and clinical integration with basic sciences. This study explores the feasibility of the early echocardiography (Echo) experience as an adjunct tool for teaching heart anatomy and physiology to second-year medical students. Methods: The study was conducted on 99 students in a problem-based learning curriculum. Students were introduced to cardiac anatomy and physiology as well as to the basic principles of ultrasonography before the Echo sessions. A pretest was conducted at the beginning of the Echo theoretical session, consisting of 10 questions on Echo images. The practical sessions included hands-on experience on standardized patients with a checklist of commonly demonstrated structures in left parasternal and apical four-chamber windows. A posttest with the same questions was repeated after the clinical sessions. Results: The posttest outcome revealed a significant improvement in identifying the cardiac structures and function compared with the pretest (P-value ≤ 0.0001). Although the students were very accurate in identifying heart chambers and valves without assistance, the pulmonary artery and valve in the parasternal short axis were mainly able to be identified with assistance. Further, 92% of students admitted that prior basic knowledge is essential for Echo image identification, and 86% stated that integrating this experience helps consolidate different phases of the cardiac cycle. Conclusion: The Echo’s spatial orientation with prior basic knowledge seems to provide an effective tool in consolidating medical students’ understanding of heart anatomical relations and cardiac physiology.
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A novel endodontic extractor needle for separated instrument retrieval: A new patent technology p. 116
Saaid Al Shehadat, Colin Alexander Murray, Sunaina Shetty Yadadi
A novel needle that can be used to retrieve endodontic separated instruments (SIs) from the root canal of a tooth is described in this article. The needle tip is fabricated with a thermomechanically treated NiTi alloy exhibiting both shape memory and super-elasticity. The alloy demonstrates martensitic phase at certain low temperatures (25°C or less) and austenitic phase at certain slightly higher temperatures (35°C or more). These properties facilitate the needle to be straight at room temperature but incorporate a specific snakelike shape when inserted in the root canal of the tooth from which the endodontic SI is to be removed. The suggested lengths for the needles are 21, 25, and 31 mm with five different sizes of the lumina (the internal diameter is 0.25, 0.40, 0.60, 0.80, or 1 mm). The wall thickness of the needle is 0.20 for the last 3 mm of the needle then gradually increases to 0.35 for the coronal aspects. The design of this needle has the US patent application number US 2020/0129268 A1, April 30, 2020.
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