Aim. This study is aimed at combining the sample sizes of all studies on permanent maxillary teeth conducted in different regions of the Kingdom of Saudi Arabia (KSA) to obtain a large sample size that represents the population of the KSA. The outcome of these combined studies is compared with international studies in terms of the number of roots, number of canals, and canal configurations on the basis of Vertucci’s classification. Methodology. The studies were systematically reviewed using the Preferred Reporting Items for Systematic Review and Meta-analysis chart. Studies were included in the analysis if they were conducted in the KSA, involved permanent human maxillary teeth, and had a sample of more than 10 teeth (power). By contrast, studies were excluded if they involved deciduous teeth in the sample size, investigated nonhuman teeth, were not conducted in the KSA, and were case reports, case series, review studies, and anomalies. Relevant literature was searched from PubMed, Scopus, Web of Science, Embase, Cochrane, and Direct Science by two calibrated teams, starting in August 2020, without time limits or language restrictions. Results. The database searches and cross-referencing identified a total of 19 relevant studies. All maxillary canines ( N = 1,018 ) had one root, whereas 98.4% had one canal and 98.3% had Vertucci type I. Moreover, 63.2% of the maxillary first premolars had two roots, and 91.4% had two canals. The most common Vertucci root canal configuration was type IV (64.6%). The maxillary second premolars mostly had one root (84.4%) and one canal (50.4%). The most common canal configuration was Vertucci type I (47.1%). The majority of maxillary first molars had three roots (98.9%), 48.7% of which had three canals, and 46.4% had four canals. The most prevalent feature of the canal morphology of mesiobuccal roots was Vertucci type II (35.3%). The investigated maxillary second molars had three roots, 88.0% of which had three canals. Conclusion. This systematic review represents the Saudi population since samples were combined from different studies from different regions of the country. Variations in findings were observed in the same group of teeth from different regions and the same region, while the overall combined samples results fell within the range of other international studies.

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Background: Severe coronavirus disease 2019 (COVID-19) can boost the systematic inflammatory response in critically ill patients, causing a systemic hyperinflammatory state leading to multiple complications. In COVID-19 patients, the use of inhaled corticosteroids (ICS) is surrounded by controversy regarding their impacts on viral infections. This study aims to evaluate the safety and efficacy of ICS in critically ill patients with COVID-19 and its clinical outcomes. Method: A multicenter, noninterventional, cohort study for critically ill patients with COVID-19 who received ICS. All patients aged ≥ 18 years old with confirmed COVID-19 and admitted to intensive care units (ICUs) between March 1, 2020 and March 31, 2021 were screened. Eligible patients were classified into two groups based on the use of ICS ± long-acting beta-agonists (LABA) during ICU stay. Propensity score (PS)-matched was used based on patient’s Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, systemic corticosteroids use, and acute kidney injury (AKI) within 24 h of ICU admission. We considered a P-value of < 0.05 statistically significant. Results: A total of 954 patients were eligible; 130 patients were included after PS matching (1:1 ratio). The 30-day mortality (hazard ratio [HR] [95% confidence interval [CI]]: 0.53 [0.31, 0.93], P-value = 0.03) was statistically significant lower in patients who received ICS. Conversely, the in-hospital mortality, ventilator-free days (VFDs), ICU length of stay (LOS), and hospital LOS were not statistically significant between the two groups. Conclusion: The use of ICS ± LABA in COVID-19 patients may have survival benefits at 30 days. However, it was not associated with in-hospital mortality benefits nor VFDs.

This study aimed to conduct a compendious review of root canal morphology of “permanent mandibular teeth in different regions of Saudi Arabia” to obtain a large sample representing the total population. A detailed search through the databases Web of Science, Scopus, and PubMed was conducted following the PRISMA guidelines. The data were analyzed based on the following inclusion criteria: original full-length original articles that reported the variables of interest “(number of roots, number of canals, Vertucci’s classification system and C-shaped canals or mid-mesial canals)” of the mandibular teeth and conducted on Saudi subjects. The retrieved data were presented as frequencies and percentages. The results revealed that 56.6% of mandibular central incisors had one canal and Vertucci type I (56.6%), while 57.4% of the mandibular lateral incisors had one canal, with Vertucci types I and III most frequent. In mandibular canines, 91.8% had one canal and 8.2% had two canals. Most of the mandibular first premolars had one root (86.6%), while almost all mandibular second premolars (91.5%) had one canal, and 96.9% had Vertucci type I configuration. Among the mandibular first molars, three and four canals were prevalent in 58.7% and 40.6%, respectively. The majority of mesial roots had Vertucci type IV (60.6%), and most of distal roots had Vertucci type I (72.2%). Most of the mandibular second molars had three canals (87.3%) and showed Vertucci type IV (39.4%) canals for mesial roots and Vertucci type I (95.6%) for distal roots. The C-shaped canals were seen in 8% of first premolars and 9.8% of second molars. The middle mesial canal was found in 4.2% and 0.4% of first and second molars, respectively. This review could represent “the population of Saudi Arabia as the included samples were combined from different regions of the country.” Some variations were noticed within the same group of teeth from different regions. However, the overall results of combined samples were comparable to the other international studies.

Background and objectiveDry eye disease (DED) is one of the most prevalent ocular diseases worldwide. DED symptoms can result from disturbances to the homeostasis of the middle tear film layer (aqueous layer), including inflammation, pain, and eye discomfort, which can have a negative impact on individuals' quality of life and daily activities. Sleep disorders are highly prevalent among patients with DED, and the incidence of sleep disturbances in DED patients has been reported to be as high as 40%. Decreased sleep quality can aggravate dry eye symptoms by increasing tear osmolarity and decreasing tear production. In this study, we aimed to investigate the association between DED and sleep quality in the adult population of Saudi Arabia. MethodsThis cross-sectional study was conducted among adult patients aged 18 years and above in Saudi Arabia in August 2021. A validated Arabic version of the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality, and the Ocular Surface Disease Index (OSDI) questionnaire was employed to diagnose DED. Data collection and analysis were performed using the SPSS Statistics software (IBM, Armonk, NY). ResultsA total of 234 subjects were analyzed, and 59.8% of the participants were women. Our tool suggested that 71.4% of the included participants had severe DED, 15% had moderate DED, and 13.7% had mild DED. However, 40.6% of the participants reported that they had not been diagnosed with DED previously and 34.6% had no previous DED symptoms. The mean total PSQI score was 8.63 ±2.23, with the highest score recorded for component 2: sleep latency (1.73) and the lowest score recorded for component 4: habitual sleep efficiency (0.20). Poor sleep quality as assessed by PSQI showed a significant positive correlation with the severity of DED as assessed by OSDI. ConclusionThe significant positive correlation between poor sleep quality and DED indicated that patients with DED had a higher risk of poor sleep quality compared to healthy patients. Patients with DED should be educated about the steps and techniques to improve their sleep patterns.