Vitamin D deficiency and periodontitis are commonly prevalent among Saudi adults. However, the association between periodontitis and vitamin D status has not been well documented. This study aims to examine the association between periodontitis and vitamin D status among adults in the Albaha region of Saudi Arabia. A case-control study of 123 Saudi adults was conducted; 60 had severe or moderate periodontitis, and 63 were periodontally healthy. Data was collected by an online self-reported sociodemographic questionnaire. All participants then underwent a full periodontal examination. Blood samples were also provided to assess participants’ vitamin D statuses through serum levels of 25-hydroxyvitamin D (25(OH)D). A total of 60 cases and 63 controls matched for BMI (30.2 ± 4.86 kg/m2), age (40.01 ± 7.73 years), and sex (46.3% and 53.7% male and female, respectively) participated in the study. Mean levels of 25(OH)D were significantly lower in periodontitis participants than in controls (25.03 ± 8.55 ng/ml, 29.19 ± 12.82 ng/ml, p = 0.037, respectively). Lower odds of periodontitis were detected per unit of 25(OH)D level (OR 0.964, 95% CI; 0.931–0.999, p = 0.043). In conclusion, periodontitis is significantly associated with deficient and insufficient levels of vitamin D among Saudi adults in the Albaha region. Future longitudinal research with a larger sample size may be suggested to confirm these results.

Background: To evaluate the effect of screening for sepsis using an electronic sepsis alert vs. no alert in hospitalized ward patients on 90-day in-hospital mortality. Methods: The SCREEN trial is designed as a stepped-wedge cluster randomized controlled trial. Hospital wards (total of 45 wards, constituting clusters in this design) are randomized to have active alert vs. masked alert, 5 wards at a time, with each 5 wards constituting a sequence. The study consists of ten 2-month periods with a phased introduction of the intervention. In the first period, all wards have a masked alert for 2 months. Afterwards the intervention (alert system) is implemented in a new sequence every 2-month period until the intervention is implemented in all sequences. The intervention includes the implementation of an electronic alert system developed in the hospital electronic medical records based on the quick sequential organ failure assessment (qSOFA). The alert system sends notifications of “possible sepsis alert” to the bedside nurse, charge nurse, and primary medical team and requires an acknowledgment in the health information system from the bedside nurse and physician. The calculated sample size is 65,250. The primary endpoint is in-hospital mortality by 90 days. Discussion: The trial started on October 1, 2019, and is expected to complete patient follow-up by the end of October 2021. Trial registration: ClinicalTrials.gov NCT04078594. Registered on September 6, 2019

Estionnaire was composed of 21 questions that assessed the awareness and the clinical practice of the GDPs regarding endodontic treatment. The data were collected and statistically analyzed. Results: Fifty-seven (81.42%) out of 70 GDPs responded to the distributed e-questionnaire. Most of the respondents were practicing endodontics on molars (82.4%). A significant difference was observed in performing retreatment between the practitioners who worked in the private sector than peers who worked in the governmental sector (P = 0.015). Noticeably, almost 60% of the participated dentists were not using rubber dam isolation regularly for endodontic procedures. Furthermore, only about 50% of them used cold test for pulpal diagnosis, while 3.5% used electric pulp tester. Few were using intracanal medicament and follow the patients after completing the treatment. Conclusions: A clear deficiency in some aspects of the awareness and clinical endodontic practice of the GDPs in Albaha region was observed. The international and national guidelines of endodontic practice should be implemented....

Introduction and importance: Gitelman syndrome (GS) is an autosomal recessive, salt-losing tubulopathy, also referred to as familial hypokalemia-hypomagnesemia, caused by mutation of genes encoding the sodium chloride cotransporter (NCCT) and magnesium transporters in the thiazide sensitive segments of the distal convoluted tubule (DCT) of the nephron. Patients may present with a spectrum of clinical presentations and associations. Case presentation: Here, we report a case of a 39-year-old female with Gitelman syndrome and chronic pancreatitis in the absence of well-known causes of CP. Her clinical and radiographic profile constituted an indication for surgical intervention, namely pancreatic head and body coring and pancreaticojejunostomy (Frey's procedure) (FP). On follow up 3 month later, the patient is pain-free and is satisfied. To the best of our knowledge and based on literature review, this is the first reported case of GS with CP. Conclusion: The purpose of this paper is to describe a case of CP in association with established GS as a first published clinical association, raising a possibility of another possible clinical manifestation of GS. Further observational studies are encouraged to support this association. Highlights:

Background/Objectives: The interaction between malignant cells and the extracellular matrix (ECM) is a critical driver of tumor invasion. ECM remodeling and desmoplasia characterize the tumor microenvironment, facilitating both stromal fibrosis and malignant progression. This study was conducted to evaluate plasma cell infiltration across distinct stromal patterns in oral squamous cell carcinoma (OSCC) and investigate its association with stromal desmoplasia and immune evasion. Methods: A total of eighty-seven cases that were histopathologically diagnosed as OSCC were included in the study. Immunohistochemical staining for IgG4, CD138, VEGF, TGF-β 1, and CD31 was performed on deparaffinized tissue sections, and the plasma cell count was determined. Results: Distinct stromal architectural patterns were observed across different grades of OSCC. Stromal desmoplasia initiated with inflammatory cell infiltration into the stroma at an early stage, followed by infiltration of the dense collagenous stroma; both revealed dense plasma cell infiltrates. However, the difference in plasma cell density between OSCC grades was not shown to be statistically significant using the chi-square test and ANOVA (p = 0.761 and p = 0.152, respectively). Conclusions: Stromal desmoplasia and immune evasion are associated with dense plasma cell infiltration, suggesting that these cells may serve as a potential prognostic indicator of the invasive progression in OSCC.

Background To examine the effect of screening for sepsis using an electronic sepsis alert versus no alert in hospitalized patients admitted to wards on hospital mortality. Methods This study is conducted in 45 medical-surgical-oncology wards in five hospitals. Based on the quick Sequential Organ Failure Assessment (qSOFA), an electronic alert has been developed in the hospital Electronic Medical Record system. The alert system sends notifications of “Possible Sepsis Alert” to the bedside nurse, charge nurse, and primary medical team and requires an acknowledgment in the health information system from the bedside nurse and physician. In addition, data on the alert are displayed on management dashboards for each ward. Initially, all wards had a masked alert for 2 months. Hospital wards are then allocated in a randomized fashion to either active or masked alert, such that the alert is activated in five new randomly selected wards every two months until all wards have the active alert. The primary endpoint is in-hospital mortality by 90 days. Discussion The trial has started in October 2019 and is expected to continue for 22 months enrolling more than 62550 hospitalized patients. Trial registration ClinicalTrials.gov NCT04078594. Registered on September 6, 2019, https://clinicaltrials.gov/ct2/show/NCT04078594