Background To categorise the content and assess the quality and readability of the web-based information regarding treatment of the mouth in systemic sclerosis. Methods An online search using three different search terms regarding the treatment of the mouth in SSc was undertaken using the Google search engine. The first 100 websites from each search were selected for analysis. Data recorded included DISCERN instrument scores along with the Journal of the American Medical Association (JAMA) benchmarks and the presence of the Health on the Net seal (HON). Flesch Reading Ease Scores, Flesch-Kincaid Grade Level, the Simplified Measure of Gobbledygook Index and Coleman-Liau index were calculated to assess readability. Results Fifty seven of the first websites remained for analysis after applying appropriate exclusion criteria. The mean overall DISCERN score was 2.37 (±1.01). Only 4 websites (7%) achieved all four JAMA benchmarks. Only 12 websites (21.1%) displayed the HON seal. The reading level was found to be difficult to very difficult among the majority of websites. Conclusion The overall quality of the available online information concerning the treatment of the mouth of systemic sclerosis is questionable and requires a high level of reading skill. Further efforts should be directed toward establishing higher quality, reliable online information sources on the treatment of oral disease relevant to patients with systemic sclerosis.

Background. Multiple studies have reported that cannabis administration in multiple sclerosis patients is associated with decreased symptom severity. This study was conducted to evaluate the prevalence of cannabis abuse in multiple sclerosis cases and to evaluate the effect of cannabis on serum cytokines in such cases. Patients and Methods. A total of 150 multiple sclerosis cases along with 150 healthy controls were included during the study period. All cases were subjected to history taking, neurological examination, and routine investigations. Cases were asked about cannabis intake which was confirmed by a urine test. Serum cytokines including IL-1, IL-2, IL-4, IL-10, IL-12, IL-17, IL-22, IFN-γ, IFN-β1, and TNF-α were ordered for all cases and controls. Results. Twenty-eight cases were cannabis abusers (MS/cannabis group, 18.67%). The remaining 122 cases represented the MS group. There was no significant difference between the three groups regarding age, disease duration, or MS type. Male gender was more predominant in the MS/cannabis group, and the number of relapses was significantly lower in the same group. Fifteen cases (53.6%) reported that their symptoms were improved by cannabis. Proinflammatory cytokines were significantly elevated in the MS group compared to the MS/cannabis and control groups. Additionally, anti-inflammatory cytokines had significantly lower values in the MS group compared to the MS/cannabis and control groups. Most clinical symptoms were significantly improved in the MS/cannabis group compared to the MS group apart from sexual dysfunction, bladder symptoms, and visual disturbances. Mild side effects of cannabis were also reported. Conclusion. Cannabis may have a positive impact on the cytokine and clinical profiles in cases with multiple sclerosis.

Background MR imaging plays a significant role in detection and characterization of different brain diseases. The role of the post-contrast T1-weighted image magnetic resonance imaging (T1W MRI) sequence has been widely established in previous studies and clinical practice. In this study, we aim to share our experience as regards the added value of contrast-enhanced fluid-attenuated inversion recovery (CE-FLAIR) sequence in the diagnosis of various intracranial pathological conditions and evaluate its usefulness in comparison with post-contrast T1W images. Results Based on the final radiological diagnosis, the total cases were subdivided into three categories, and the majority of our cases were tumors (81.2%), followed by multiple sclerosis (11.8%), and the least was central nervous system infection (7.1%). CE-FLAIR showed superior enhancement in 35 cases (50.7) and equal enhancement in 25 cases (36.3%). However, it showed less enhancement than post-contrast T1W images in 9 cases (13%). Excellent inter-observer agreement (97.65%) was noted. Regarding lesion conspicuity, good delineation was found in the majority of cases (64.7%), fair delineation in 12.9%, and no delineation in 22.4%. A statistically significant difference was found in signal intensity of lesion between pre- and post-contrast FLAIR sequences. Contrast to background ratio was statistically significant in CE FLAIR images in comparison to CE T1 images. Conclusion CE-FLAIR imaging should be used as a routine or adjunctive sequence to CE-T1WI to enhance early detection and increase the diagnostic confidence in MRI examination of different brain pathological conditions.

Push-out bond strength (POBS) and failure analysis of gutta-percha and Martens hardness (MH) of canal dentin sealed with Bio-ceramic sealer (BCS). Specimens underwent endodontic treatment. Based on the method of disinfectants, specimens were classified into 4 groups. Group 1:5.25% NaOCl+Q-mix, group 2:ECYL+Q-mix, group 3:LGE+Q-mix, and group 4:RBP+Q-mix. Before obturation MH was assessed using a microhardness tester. Canals were obturated, and sealed with Bio-Root RCS. Each root was cut horizontally in 2 mm thickness and placed under the indenter of the universal testing machine. One-way analysis of variance and the Post Hoc Tukey test for group comparisons as statistical analysis. Samples with (5.25% NaOCl+Q-mix) displayed the highest bond integrity of BCS (8.00±0.24 MPa). The lowest POBS was demonstrated by the apical section of group 4 (RBP+Q-mix 2 in 1) (4.10±0.94 MPa) specimens. Group 2 (ECYL+Q-mix) and group 3 (LGE+Q-mix) exhibited comparable outcomes of bond scores to group 1 specimens (p > 0.05). MH was significantly lower in group 4 compared to group 1, group 2, and group 3 (p <0.05). The bond strength of BCS and MH of canal dentin is influenced by the type of irrigation.

Background The objective of the present study was to identify the impact of systemic sclerosis (SSc) upon oral health‐related quality of life (OHRQoL) of affected individuals resident in the UK. Methods A total of 100 patients and their partners or carers were invited to complete questionnaires regarding the impact of SSc on quality of life and psychological well‐being using valid and reliable patient‐reported outcome measures (OHIP‐14, MHISS, OIDP, MDAS and HADS). A total of 50 patients with SSc and 18 partners or carers who acted as controls returned the completed questionnaires. Statistical analyses were performed for comparisons of different variables. Results All the mean scores of OHIP‐14 (SSc [16.5 ± 12.4] Vs controls [6.06 ± 7.6, p = 0.001]) and MHISS components were significantly higher in patients than those of control group (SSc [21.26 ± 12] Vs controls [4.8 ± 7.3, p < 0.0001]). Majority of OIDP mean scores were significantly worse in patients compared with controls [SSc (10 ± 8.7) Vs controls (1.72 ± 3.4, p < 0.0001)]. The mean of total MDAS [SSc (11.7 ± 5.3) Vs controls (9.5 ± 4.4)] and HADS scores were higher in patients compared to controls (SSc depression [4.8 ± 3.3] and anxiety [6 ± 4.6] Vs controls [3.7 ± 3.1] [4.7 ± 3.9]). Conclusions Although the present study is limited by the low response rate and its cross‐sectional design, present results highlighted that systemic sclerosis has a negative impact on OHRQoL of the affected individuals; hence, the evaluation of associated psychological impact including anxiety and depression symptoms is needed to better understand, monitor and evaluate the disease comorbidity in patients with SSc.

Background and Objectives: Fasting over a prescribed period of time is a common religious tradition practiced by several prominent faiths in the world. It is also currently regaining interest as a medical practice, both as preventive and as therapy and/or simple choice of lifestyle. For the first time, we evaluate how Ramadan (an Islamic month) fasting can influence the incidence of intracerebral hematoma and its outcome. Methods: 69 patients with primary intracerebral hemorrhage enrolled in this study, 32 patients were enrolled during Ramadan (18 patients were fasting, 14 patients were not fasting) and 37 patients were enrolled one month later (Shawal) which is not a mandatory fasting month among Muslims. All patients were admitted to Neurology department, Mansoura university hospital. The clinical characteristics and mortality during hospital admission were noticed. They were all assessed using routine lab, CT brain, “National Institutes of Health Stroke Scale” (NIHSS) and “Modified Rankin Scale” (mRS). Results: About 22 percentage of fasting patients with intracerebral hematoma died, 28.6% non-fasting patients died and 20.5% of patients died in the month after Ramadan without significant difference among the three groups (ρ>0.05). Also regarding NIHSS, hematoma expansion and mRS, there was no statistically significant difference among the three groups (ρ>0.05). Conclusion: Ramadan fasting showed neither protective effect nor worsening as regard incidence or bad impact on patients with spontaneous intracerebral hemorrhage.

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