Dr Mohammed Mahmoud Youssif

BACKGROUND: Sinus floor elevation is one of the predictable techniques for augmentation of vertically deficient posterior maxillary alveolar ridges. Several biomaterials were reported to be successful for sinus augmentation, including xenografts and hydroxyapatite. The aim of this study was to compare the quality and quantity of generated bone using xenografts versus nanohydroxyapatite in sinus augmentation.

METHODOLOGY: Twenty-four patients/sinuses were randomly assigned into two groups; in the control group, patients underwent sinus floor elevation and augmentation using deproteinized bovine bone (DBB), whereas in the study group, the sinus was augmented using nanohydroxy-apatite bone (NHA). For each patient, the amount of bone height was assessed preoperatively, immediately postoperatively, and 6 months postoperatively. Furthermore, the quality of the newly formed bone was assessed via histological and histomorphometric analyses after 6 months postoperatively.

RESULTS: Both biomaterials showed a good level of consolidation. In the study group, the mean bone height after 6 months was 11.72 ± 1.24 compared to 12.01 ± 1.16 mm in the control group which was not statistically significant (p > 0.05). The mean bone area percent of newly formed bone was 29.84% ± 6.7% for NHA group and 34.73 ± 7.9 for DBB group. Moreover, the mean percent of residual grafting material was 32.43% ± 11.53% for NHA group compared to 30.43% ± 8.27% for DBB group. Histologically, there was no significant difference between both groups regarding different parameters (p > 0.05).

CONCLUSION: The two-stage sinus floor augmentation using NHA and DBB revealed no statistically significant difference regarding both the quality and the quantity of the regenerated bone. Studies with larger samples and longer follow up are recommended.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03184857.

AIM: The purpose of this study was to assess the accuracy of a customized deep learning model based on CNN and U-Net for detecting and segmenting the second mesiobuccal canal (MB2) of maxillary first molar teeth on cone beam computed tomography (CBCT) scans.

METHODOLOGY: CBCT scans of 37 patients were imported into 3D slicer software to crop and segment the canals of the mesiobuccal (MB) root of the maxillary first molar. The annotated data were divided into two groups: 80% for training and validation and 20% for testing. The data were used to train the AI model in 2 separate steps: a classification model based on a customized CNN and a segmentation model based on U-Net. A confusion matrix and receiver-operating characteristic (ROC) analysis were used in the statistical evaluation of the results of the classification model, whereas the Dice-coefficient (DCE) was used to express the segmentation accuracy.

RESULTS: F1 score, testing accuracy, recall and precision values were 0.93, 0.87, 1.0 and 0.87 respectively, for the cropped images of MB root of maxillary 1st molar teeth in the testing group. The testing loss was 0.4, and the area under the curve (AUC) value was 0.57. The segmentation accuracy results were satisfactory, where the DCE of training was 0.85 and DCE of testing was 0.79.

CONCLUSION: MB2 in the maxillary first molar can be precisely detected and segmented via the developed AI algorithm in CBCT images.

TRIAL REGISTRATION: Current Controlled Trial Number NCT05340140. April 22, 2022.

We studied the characteristics and survival of patients with sorafenib-treated HCC and impact of underlying etiology on outcomes. This retrospective multicenter study recruited patients with sorafenib-treated advanced HCC (12/2016 to 4/2023) till death or the study end (2/2024). Time to progression (TTP) and overall survival (OS) were recorded. We evaluated; Clinico-laboratory and imaging predictors of OS, The impact of underlying etiology on tumor variables, outcomes and tolerance for sorafenib > 6 months. This study included 706 patients. Median duration of Sorafenib therapy was 240.00 (90.00-360.00) days. Median OS was 314.00(146.00-601.00) days. Median TTP was 180.00(90.00-330.00) days. COX regression revealed that the independent factors of mortality were baseline AST, Tumor size, hepatic vein thrombosis (HVT), development of jaundice and shifting to Regorafenib. Advanced HCCs were more common on top of non-cirrhotic non-viral and HBV-related liver disease. Adverse events, TTP and tumor response didn't differ with the underlying etiology. Median OS was lower in non-viral-related HCC than HCV-related HCC (218.00 versus 326.50 days, P-value = 0.048). Patients who continued sorafenib > 6 months had lower AFP, HVT, adverse effects and better tumor response after 3 months. OS is lower in non-viral Sorafenib-treated HCC compared with viral-related HCC and Sorafenib was well-tolerated among different HCC etiologies.

Gouty arthritis is a prevalent inflammatory illness. Gout attacks begin when there is an imbalance in the body's uric acid metabolism, which leads to urate buildup and the development of the ailment. A family of conserved, short non-coding RNAs known as microRNAs (miRNAs) can regulate post-transcriptional protein synthesis by attaching to the 3' untranslated region (UTR) of messenger RNA (mRNA). An increasing amount of research is pointing to miRNAs as potential players in several inflammatory diseases, including gouty arthritis. miRNAs may influence the progression of the disease by regulating immune function and inflammatory responses. This review mainly focused on miRNAs and how they contribute to gouty arthritis. It also looked at how miRNAs could be used as diagnostic, prognostic, and potential therapeutic targets.

Multiple sclerosis (MS) is an autoimmune disease associated with neurological impairments. The study aimed to evaluate the role of the noncoding RNAs THRIL/miR-137 in MS pathogenesis via studying their effect on the immunological transcriptional loop STAT4/STAT6/GATA3, and their association with MS-related neurological impairments and disease subtypes. Overall, 148 participants were included: 74 MS patients and 74 matched healthy controls. Gene expressions of THRIL, miR-137, STAT4, STAT6, and GATA3 were assessed using reverse transcription quantitative polymerase chain reaction (RT-qPCR). The potential protein interaction networks of these genes were predicted using bioinformatic analysis. Compared with the control group, THRIL, STAT4, and GATA3 were upregulated, whereas miR-137 and STAT6 were downregulated in MS patients. Furthermore, THRIL, STAT4, and GATA3 were upregulated, while miR-137 and STAT6 were downregulated in MS patients with Expanded Disability Status Scale (EDSS) ≥ 3.5, relative to patients with EDSS < 3.5. Similarly, THRIL, STAT4, and GATA3 were upregulated, while miR-137 and STAT6 were downregulated in Secondary Progressive MS (SPMS) patients relative to Relapsing-Remitting MS (RRMS). Notably, receiver operating characteristic (ROC) curve analysis revealed that THRIL, miR-137, and STAT4/STAT6/GATA3 can be used in differentiating between MS patients with neurological impairments as well as MS subtypes. Significantly, logistic analysis revealed that THRIL, miR-137, and STAT4/STAT6/GATA3 could act as predictors to diagnose MS and the associated neurological impairments. In conclusion, the study demonstrated for the first time the role of THRIL/miR-137 in regulating the immunological transcriptional loop STAT4/STAT6/GATA3, which may contribute to neurological complications. These findings provide insights into MS pathogenesis and highlight the potential of these genes as biomarkers or therapeutic targets.