We investigated the feasibility of profiling and measuring the concentration of clusterin in urine and serum for individuals with transitional cell carcinoma (TCC) of the bladder and comparing it with nontumor controls. In addition, we analyzed the correlation of expression of clusterin in specimens of TCC to various clinicopathologic parameters and prognosis of bladder cancer. Blood and urine samples were used from 68 patients with TCC of the bladder and from 61 patients with benign urological diseases. Enzyme-linked immunosorbent assays (ELISA) were performed for clusterin from serum and urine. Quantitation of clusterin mRNA was carried out in 68 bladder tumor specimens from radical cystectomy or transurethral resection and 26 normal bladder specimens from BPH patients by using RT-PCR method. Correlation for the expression of clusterin mRNA with clinicopathologic parameters was analyzed. Serum and urine clusterin was significantly higher in individuals with bladder cancer than control (p = 0.001). Sensitivity and specificity of serum and urine clusterin as a tumor marker for TCC of the bladder was found to be 80%, 91%, 87.1% and 96.7% respectively. Clusterin expression was significantly higher in TCC specimens than normal tissue specimens (P < 0.001). Expression of clusterin was significantly higher in patients with invasive TCC of the bladder than that in patients with superficial TCC and control (P < 0.001). Overexpression of clusterin mRNA was significantly associated with tumor recurrence and overall survival (p < 0.001). The recurrence-free survival time of patients with overexpression of clusterin was significantly shorter than that of patients with weak expression of clusterin (9.8 months vs. 35.2 months). Clusterin may be considered as a potential diagnostic and prognostic biomarker for bladder cancer using urine, serum and/or molecular biology techniques.

Objective: The COVID-19 pandemic has become a worldwide, significant public health challenge. Dental care providers are at high risk due to the nature of their profession, which necessitates close proximity to the patient's oropharyngeal region and the use of droplet and aerosol-generating procedures. Methods: A review of the evolving literature on the COVID-19 pandemic was conducted. Published articles addressing SARS-CoV2 transmission modes and risks, and infection control procedures required in the dental office to protect dental patients and health care providers were assessed. Also, clinical guidelines on the management of dental patients during the pandemic were reviewed. Results: The established modes of transmission of SARS-CoV2 appear to be through respiratory droplets and through close contact with either symptomatic or asymptomatic patients. In addition to standard precautions of infection control widely followed in dental practices, extra precautionary measures are needed to control the spread of this highly infectious disease. Dental treatment during the pandemic is limited to emergent and urgent cases after a meticulous patient risk assessment and dental needs are triaged to minimize the risk of COVID-19 transmission and avoid cross-contamination. Conclusion: Dentists should be aware of the recently updated knowledge about COVID-19 modes of transmission and the recommended infection control measures in dental settings. Effective management protocols to regulate droplet and aerosol contamination in the dental clinic should be implemented to deliver dental care in a safe environment.

Background: The COVID-19 pandemic has exposed the global population to a high risk of infection that constitutes a major stress factor, especially for vulnerable groups such as dental students. Objective: To assess levels of COVID-19 related stress and anxiety, changes in hygienic and social habits, as well as subjective worries regarding the dental profession among dental students. Methods: A self-structured questionnaire was sent to students at the College of Dentistry, Umm Al-Qura University. It included demographic data, questions about the level of change in personal hygiene and social habits, students’ perception about the sufficiency of information received during the outbreak and its source, subjective worries regarding the dental profession, and the Generalized Anxiety Disorder 7-item (GAD-7) scale. Two hundred fifty-eight responses were received. Results: Moderate and severe anxiety were reported in 17% and 4% of students, respectively, with non-significant associations between anxiety and gender or level of study. A high percentage of students (46.5% to 62.4%) reported great change in most hygienic and social habits with a highly significant association between change in buying more sanitizers and anxiety levels. Forty-six percent agreed that their job performance was not at its best, and 31% reported a possible intention to change profession, with the latter reported more by male students (63.8%). Conclusion: A considerable percentage of dental students in our college are anxious and changed their hygienic and social habits due to COVID-19. This anxiety reflects worries about the dental profession in one-third of participants that necessitate counselling services and psychological support.

Introduction Surgical site infections (SSI) are the most common nosocomial infections in surgical patients and lead to prolonged hospital stay, readmissions to the hospital, and increased morbidity and mortality. 1 It accounts for 14 %-16% of all infections among hospital inpatients. This is a major health problem and orthopaedic surgery Abstract a 3-month prospective study, with 30 days follow up after surgery, or to the end of the study for patients with implant, was conducted on 121 patients undergoing surgery and completed their follow up visits at Orthopaedic department, Tanta University hospital. SSI was revealed in 10 patients with overall cumulative incidence rate of 8.264 % for which bacteriological culture and sensitivity was done. Descriptive and logistic regression analyses were performed to determine risk factors for such infections. Univariate analysis showed that SSI was significantly associated with age more than 50 years, diabetes mellitus, ASA score more than 2, duration of surgery more than 2 hours and use of drains. While binary logistic regression analysis showed that use of drains is the only independent risk factor in our cases. The most commonly isolated organisms were Staphylococcus aureus, Pseudomonas spp. and E. coli (20% each). The high incidence of SSI in our hospital in comparison with developed countries and some studies done in Egypt has encouraged the development of recommendations for prevention of such infections in university hospitals.

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To compare the antimicrobial effect of Calcium hydroxide paste (CaOH), Chlorhexidine gluconate (CHX) gel and AntibioticCorticosteroid paste against Streptococcus mutans, Enterococcus faecalis and Candida albicans in root canal lumen and radicular dentin. Materials and methods: Eighty four single rooted extracted human teeth with straight root canals were selected, decronated leaving root segments of 15 mm length. All canals were prepared up to size 40 master apical file under irrigation with sodium hypochlorite solution. Roots were sterilized, infected by mixed suspension of the three types isolated microorganisms and incubated at 37 C for 14 days. The roots were divided into 4 equal groups according to the intracanal medications used. Group I: CaOH, Group II: CHX, Group III: Antibiotic-Corticosteroid paste and Group IV: saline. Each main group was further equally subdivided into 3 subgroups according to the isolated organism. Subgroup (A): S. mutans, Subgroup (B): E. faecalis and Subgroup(C): C. albicans. The medicated roots were incubated for 7 days at 37 C then irrigated to remove the medications. Two samples were taken from each canal, one from root canal lumen and the other from radicular dentin and cultured on three media selective for each tested microorganisms. The growing colonies were counted and recorded as colony forming units CFU. Results: Chlorhixidine gel showed the best effect against all tested microorganisms at both experimental sites, while AntibioticCorticosteroid paste was the worest one. Conclusion: CHX was the best medication used to eliminate the different tested organisms at the two experimental sites. S. mutans was the most sensitive microorganism to the whole tested medications, while C. albicans was the most resistant one.

Introduction. Salvadora persica L. (S. persica, Siwak) has been used for many centuries as oral hygiene tools, particularly in Saudi Arabia. This study aimed to assess the effectiveness of S. persica petroleum ether extract (SPE) as an intracanal bactericidal for endodontic treatment against Enterococcus faecalis. Calcium hydroxide Ca(OH)2 gold standard intracanal medicament was used for comparison. Methods. The gas chromatography mass spectrometry (GC/MS) analysis was carried out to identify the components of SPE. First, the consistency of SPE was accomplished according to ANSI/ADA specification no 57. Forty-five single-rooted mandibular premolars were infected with that of E. faecalis suspension. Colony-forming units (CFU) were counted before the medicaments’ application (CFU-1) and after seven days of their applications (CFU-2). Group I: SPE, Group II: positive control Ca(OH)2, and Group III: saline solution negative control. The microdilution method was applied to determine minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of SPE. Results. Thirty-two compounds were identified (89.09%), with main components of benzyl isothiocyanate (BITC) (33.32%) and steroids (34%). CFU before and after using SPE and Ca(OH)2 recorded a statistically significant reduction in bacterial count ( P = 0.006 ) and ( P = 0.01 ), respectively. There was an insignificant difference between CFU after using SPE and Ca(OH)2 ( P = 0.210 ). On the contrary, comparing both medicaments with the negative control saline group resulted in significant differences, ( P = 0.001 ) and ( P = 0.007 ), respectively. Moreover, the equality of minimum bactericidal concentration (MBC) and minimum inhibitory concentration (MIC) of SPE is recorded. Conclusion. This finding could be referred to the high content of bactericidal BITC in synergism with other antimicrobial components, representing 70.71% of SPE. Thus, SPE is a good candidate as an intracanal medicament, which warrants further investigation.

'Gram negative is still more common than gram positive' infections and fungal infection is also a common cause of fever in patients with hematological malignancies during neutropenia and must be taken in consideration in every case of febrile neutropenia.