SAID SHEHATA

RATIONALE: This case report highlights the complex clinical course and successful multidisciplinary management of a pediatric patient with multisystem inflammatory syndrome in children (MIS-C), who posed clinical dilemma at presentation. It underscores the ongoing clinical relevance of MIS-C as a post-Coronavirus disease 2019 sequelae and emphasizes the importance of maintaining a high index of suspicion for MIS-C in pediatric differential diagnoses, especially when symptoms overlap with other common conditions.

PATIENT CONCERNS: An 11-year-old previously healthy Saudi girl presented with gastrointestinal symptoms initially suggestive of acute appendicitis. Her condition rapidly deteriorated with signs of cardiovascular compromise.

DIAGNOSES: Surgical exploration confirmed a perforated appendix. Cardiac workup revealed elevated troponin levels, corrected QT interval prolongation (500 ms), ST-segment changes, and echocardiographic evidence of mitral and aortic regurgitation with reduced ejection fraction, leading to a diagnosis of MIS-C fulfilling both Centers for Disease Control and Prevention and World Health Organization criteria. Schwartz et al's criteria are widely accepted for diagnosing long QT syndrome, which guided our interpretation of the corrected QT interval prolongation observed in this case. According to the Centers for Disease Control and Prevention, MIS-C is defined by a constellation of symptoms occurring in individuals under 21 years with recent severe acute respiratory syndrome coronavirus 2 infection or exposure.

INTERVENTIONS: Management included intravenous immunoglobulin, corticosteroids, inotropes, diuretics, aspirin, and broad-spectrum antibiotics, coordinated by a multidisciplinary care team.

OUTCOMES: The patient experienced full cardiac recovery, confirmed through serial electrocardiogram and echocardiography over 1 year.

LESSONS: This case underscores the importance of recognizing MIS-C in children presenting with atypical symptoms such as abdominal pain. Timely diagnosis and early multidisciplinary intervention are essential to prevent serious cardiac complications.

Sandestig-Stefanova syndrome (SANDSTEF) (OMIM: 618804) is a recently identified autosomal recessive disorder characterized by a complex phenotype affecting multiple organ systems. To date, only 10 cases have been reported in the literature. Here, we present a newly identified patient exhibiting a distinct clinical presentation, along with a novel homozygous splice variant in NUP188. The proband has multiple system involvement, including ophthalmology, central nervous system, skin, distinct facial features, congenital heart disease, and respiratory system; eventually, he passed away with respiratory failure. A novel splice variant was identified using ES (NM_015354.2c.1962-2A>C p.(?)). The variant was confirmed by Sanger sequencing and was found to segregate from the parents. RT-PCR analysis showed no detectable amplification in the proband, while parental samples displayed two bands, indicating carrier status. The identification of a novel pathogenic variant contributes to a deeper understanding of the molecular mechanisms underlying the disorder and expands its phenotypic spectrum.

BACKGROUND: Autoimmune hepatitis (AIH) is a chronic progressive inflammatory liver disease of immune-mediated origin, which causes long-term liver inflammation and damage. Traditionally, treatment includes azathioprine (AZA) combined with steroids, but recent studies have highlighted mycophenolate mofetil (MMF) as a potential alternative, particularly for patients who do not respond well to AZA.

AIMS: This study aimed to evaluate the efficacy and safety of MMF versus AZA combined with steroids as first-line treatment for the management of AIH patients.

METHODS: A comprehensive systematic review was conducted using the keywords: mycophenolate mofetil, Cellcept, and autoimmune hepatitis. Studies comparing MMF to AZA combined with steroids in treatment-naïve patients with AIH were included. Efficacy was assessed based on complete biochemical remission (CBR), non-response, and relapse rates. Safety was evaluated on the basis of the incidence of serious adverse effects that led to treatment discontinuation. Statistical analysis included calculation of odds ratios (OR) and 95% confidence intervals (CI).

RESULTS: Out of 344 search results, four studies met the inclusion criteria, encompassing a total of 512 patients. MMF combined with prednisolone significantly improved both short-term CBR rates (OR, 2.56; 95% CI, 1.18-5.55) and long-term CBR rates (OR, 5.51; 95% CI, 1.7-17.91) compared to AZA combined with prednisolone. Furthermore, MMF treatment was associated with a significantly lower occurrence of serious adverse events (OR, 0.15; 95% CI, 0.07-0.34).

CONCLUSIONS: Compared to AZA-based regimens, MMF-based first-line therapy for AIH appears to be a more promising, effective, and safe treatment option, yielding higher CBR rates and fewer serious adverse events requiring treatment discontinuation.

INTRODUCTION: This study aimed to compare two different approaches for palatal wound healing following free gingival graft (FGG) harvesting: one involving Nano Bio-Fusion (NBF) gingival gel used in conjunction with a palatal stent, and the other using a palatal stent alone. Outcomes were assessed in terms of wound healing, post-operative pain, and patient satisfaction.

METHODS: This parallel-grouped, two-arm, single-blinded, randomized controlled trial (RCT) included twenty-six patients with mucogingival defects that required harvesting an epithelialized free gingival graft (FGG). Patients were randomly allocated into either test group (NBF gingival gel and palatal stent; n = 13) or control group (palatal stent only; n = 13). Wound healing, the primary outcome, was evaluated over a 30-day period, while secondary outcomes included post-operative pain-measured using the Visual Analog Scale (VAS) and analgesic consumption-and patient satisfaction.

RESULTS: In the test group, wound healing showed statistically significant higher healing index score than control group after 3 days (P = 0.017), then no statistical significance was noted. Regarding post-operative pain, the test group showed statistically significantly lower pain scores (VAS) than control group in the first week, followed by no statistical significance in the second week. In the third day, the test group showed statistically significant lower analgesic consumption dose (P = 0.024) with overall statistically significant higher satisfaction score than control group (P = 0.002).

CONCLUSION: Within the limitations of this study, the results suggest that NBF gingival gel may promote early-stage palatal wound healing, reduce postoperative pain and analgesic consumption during the first week, and enhance overall patient satisfaction.

CLINICAL TRIAL REGISTRATION: (NCT05442359 | | https://www.

CLINICALTRIALS: gov/ 30-June-2022).

AIMS: To explore how nurses working in a high-pressure academic healthcare setting in Saudi Arabia conceptualise, experience and sustain resilience in the face of professional stressors.

DESIGN: A qualitative, descriptive phenomenological study.

METHODS: Semi-structured interviews were conducted with 17 nurses from diverse clinical and academic backgrounds between March and May 2025. Data were analysed using reflexive thematic analysis, incorporating both inductive and interpretive approaches. Researcher reflexivity and methodological rigour were maintained throughout.

RESULTS: Four major themes were identified: (1) Navigating Emotional Demands, which captured nurses' experiences of compassion fatigue and emotional resilience; (2) Support Systems and Collegial Ties, emphasising peer collaboration and mentorship; (3) Organisational Culture and Leadership, which highlighted the role of managerial support, workload policies and institutional climate; and (4) Adaptive Coping Strategies and Personal Development, including mindfulness, spirituality and continuous learning. These themes demonstrate the multilevel nature of resilience, shaped by personal attributes, interpersonal relationships and systemic factors.

CONCLUSION: Nurses develop resilience through an interplay of individual, relational and organisational strategies. Supportive leadership, collegial networks and opportunities for professional growth are critical in mitigating stress and preventing burnout. Findings underscore the need for culturally responsive, system-wide interventions that embed emotional safety, reflective practice and mentorship into healthcare settings. Future research should evaluate the impact of resilience-oriented policies on workforce retention and patient care outcomes.

This study examined the possible defensive role of coenzyme Q10 (CQ10) against the impact of cadmium (Cd) and titanium dioxide nanoparticle (TNP) exposure on rat kidneys. Distilled water (1 mL/rat), corn oil (1 mL/rat), 10 mg CQ10/kg b.wt, 50 mg TNP/kg b.wt, 5 mg Cd/kg b.wt, TNP + Cd, or TNP + Cd + CQ10 was administered orally to seven groups of 70 male Sprague Dawley rats for 60 days. The findings demonstrated that TNP and/or Cd exposure considerably raised serum levels of several renal damage products, disturbed electrolyte balance including sodium, potassium, and calcium, decreased antioxidant enzyme concentration in the kidneys, and elevated malondialdehyde. In addition, rats exposed to TNP and/or Cd had significantly higher levels of renal titanium and Cd. In addition, rats exposed to TNP and/or Cd showed significant histopathological lesions and collagen deposition as revealed by H and E and Masson trichrome staining, respectively. The kidneys were severely damaged by the combined effects of TNP and Cd, although CQ10 greatly mitigated these effects. According to the study, exposure to TNP and Cd can damage the kidneys' function and structure, especially when combined. However, CQ10 can protect against TNP and Cd's nephrotoxic effects.

BACKGROUND: Kidney failure with replacement therapy (KFRT) such as dialysis or transplantation represents a severe stage of chronic kidney disease (CKD) and poses a major global health burden. Although many CKD cases are diagnosed in the earlier stages, the greatest risk occurs when CKD progresses to KFRT. Despite its considerable financial and imposing impact on public health, there is a notable gap in international policies addressing CKD and KFRT. To bridge this gap and help policy makers and health systems effectively tackle the public health challenge of KFRT, a better understanding of the disease burden is essential. Thus, this analysis aims to provide a detailed overview of the global prevalence of KFRT and its associated aetiologies with estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) from 1990 to 2023.

METHODS: This study defined KFRT as individuals on maintenance dialysis for 90 days or more or those who have undergone a kidney transplant, aligning with the Kidney Disease: Improving Global Outcomes (KDIGO) 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Renal registries served as the primary data sources. Prevalence and underlying aetiology estimates (type 1 diabetes, type 2 diabetes, hypertension, glomerulonephritis, and other causes) were generated with DisMod-MR 2.1, an epidemiological Bayesian mixed-effects meta-regression modelling tool. Both all-age and age-standardised estimates were reported and accompanied with 95% uncertainty intervals (UIs).

FINDINGS: In 2023, the number of global cases of KFRT was 4·59 million (95% UI 4·17-5·08) for both sexes and all ages, with an age-standardised prevalence of 50·7 (46·1-56·0) per 100 000 population. Over the past three decades, there has been a steady increase in KFRT prevalence globally. The highest prevalence was found in the GBD high-income regions, while the lowest was observed in sub-Saharan Africa. KFRT prevalence was generally higher in countries classified within the World Bank's high-income and upper-middle-income groups, while lower prevalence was more common in countries within the World Bank's low-income and lower-middle-income groups. Additionally, a pronounced sex disparity was identified, where male dialysis and transplant prevalence estimates were consistently higher than those for females in most countries. Type 2 diabetes and hypertension were among the leading associated aetiologies of KFRT globally. From 1990 to 2023, the all-age and age-standardised prevalence estimates across the ascribed aetiologies increased for KFRT, with the largest increases associated with type 2 diabetes and hypertension.

INTERPRETATION: KFRT affects approximately 5 million people globally, with high treatment and mortality costs. Our study unveiled considerable geographical variation in KFRT prevalence, which should be seen as indicators of health-care system opportunities. As the prevalence of the leading aetiologies of KFRT-type 2 diabetes and hypertension-continues to rise, there is a crucial need to prioritise the development and implementation of cost-effective strategies aimed at preventing CKD and its progression to KFRT, particularly in low-resource settings. These preventive efforts must happen in tandem with efforts to expand capacity for dialysis and transplant services.

FUNDING: Gates Foundation.

VitA/i-PRF and i-PRF alone improved clinical and radiographic outcomes of M-MIST in periodontal intraosseous defects of patients with stage-III grade B periodontitis. VitA/i-PRF showed a minor, clinically non-significant advantage in defect depth reduction and bone fill at 6 months, with effects diminishing by 9 months in patients with stage-III grade B periodontitis.

The increasing interest in the pro-apoptotic function of calpain-2 in the course of Huntington's disease (HD) is attributed to the involvement of its substrate, cyclin-dependent kinase 5 (Cdk5), in neuronal death during neurodegeneration. Oxytocin has been demonstrated to suppress apoptosis in many neurodegenerative disorders. This research aimed to investigate the effect of oxytocin on several calpain 2-induced apoptogenic factors in 3-nitropropionic acid (3-NP) animal model of HD in rats. For 14 days, rats received 3-NP (10 mg/kg, i.p.), and oxytocin (160 µg/kg, i.p.) 1 h before 3-NP administration. Oxytocin reversed the detrimental effects of 3-NP on the striatum, which was evidenced by improvement of motor behavior, as well as histological picture and neurochemical balance. Oxytocin markedly reduced striatal calpain-2 and p25 Cdk5 protein expressions and increased the endogenous calpain inhibitor, calpastatin expression along with the pro-survival factor, myocyte-enhancer factor 2 (MEF-2) contents. Moreover, it suppressed striatal content of the pro-apoptotic biomarkers (BCl-2-associated X protein (Bax), tumor suppressor protein (p53), and caspase-3) and elevated striatal anti-apoptotic B-cell lymphoma/leukemia 2 (BCl-2) content. It repressed the release of mitochondrial cytochrome c and apoptosis-inducing factor (AIF) to hinder caspase-dependent and caspase-independent apoptotic neuronal death. Oxytocin could be a promising candidate for HD management by hampering both mitochondrial and non-mitochondrial apoptosis through inhibition of calpain-2/p25 Cdk5/MEF-2 pathway.

The increasing interest in the pro-apoptotic function of calpain-2 in the course of Huntington's disease (HD) is attributed to the involvement of its substrate, cyclin-dependent kinase 5 (Cdk5), in neuronal death during neurodegeneration. Oxytocin has been demonstrated to suppress apoptosis in many neurodegenerative disorders. This research aimed to investigate the effect of oxytocin on several calpain 2-induced apoptogenic factors in 3-nitropropionic acid (3-NP) animal model of HD in rats. For 14 days, rats received 3-NP (10 mg/kg, i.p.), and oxytocin (160 µg/kg, i.p.) 1 h before 3-NP administration. Oxytocin reversed the detrimental effects of 3-NP on the striatum, which was evidenced by improvement of motor behavior, as well as histological picture and neurochemical balance. Oxytocin markedly reduced striatal calpain-2 and p25 Cdk5 protein expressions and increased the endogenous calpain inhibitor, calpastatin expression along with the pro-survival factor, myocyte-enhancer factor 2 (MEF-2) contents. Moreover, it suppressed striatal content of the pro-apoptotic biomarkers (BCl-2-associated X protein (Bax), tumor suppressor protein (p53), and caspase-3) and elevated striatal anti-apoptotic B-cell lymphoma/leukemia 2 (BCl-2) content. It repressed the release of mitochondrial cytochrome c and apoptosis-inducing factor (AIF) to hinder caspase-dependent and caspase-independent apoptotic neuronal death. Oxytocin could be a promising candidate for HD management by hampering both mitochondrial and non-mitochondrial apoptosis through inhibition of calpain-2/p25 Cdk5/MEF-2 pathway.

Fibromyalgia syndrome (FMS) is characterized by prolonged, widespread musculoskeletal pain accompanied by various physical and psychological disturbances. Modafinil, a wake-promoting drug, manages pain symptoms in several diseases by inhibiting dopamine reuptake and exhibiting anti-inflammatory and immunomodulatory effects, including the impairment of cytokine production, microglia, and mast cell activation. Central inflammation may involve microglial activation, which is correlated with mast cell activation. Restoring dopamine levels and modulating the communication between mast cells and microglia may represent a promising approach to managing pain symptoms in FMS. Thus, this study intended to explore the interplay between brain mast cells and microglia as an underlying mechanism in the pathophysiology of FMS and how this interaction is controlled by modafinil, with a focus on dopamine/SP/MRGPRX2/histamine and PI3K/p-Akt/NF-κB signaling pathways. Rats were arbitrarily distributed between 4 groups. Group 1 served as normal control. Reserpine (1 mg/kg/day; s.c) was injected into the remaining groups for three consecutive days. In groups 3 and 4, modafinil (100 mg/kg/day; p.o) was administered either alone or in conjunction with haloperidol (1 mg/kg/day; ip), respectively, for the following 21 days. Modafinil ameliorated reserpine-induced thermal/mechanical allodynia (1.3-fold, 2.3-fold) and hyperalgesia (0.5-fold), attenuated depression (0.5-fold), and enhanced motor coordination (1.2-fold). It mitigated the histopathological alterations and increased dopamine levels in the thalamus of rats by 88.5%. Modafinil displayed anti-inflammatory effects via inhibiting mast cells and microglia activation, manifested by reductions in SP/MRGPRX2/IL-17/histamine (52%, 58%, 56.7%, and 63.7%) and PI3K/p-Akt/t-Akt/NF-κB/TNF-α/IL-6 (31.7%, 55.5%, 41%, 47.6%, and 76.9%), respectively. Ultimately, modafinil alleviated FMS behavioral, histopathological, and biochemical abnormalities and suppressed mast cell-microglial neuroinflammation in the thalamus of rats exposed to reserpine. This study highlights the potential of repurposing modafinil to improve FMS symptoms.

IN BRIEF: Bulls are selected for field fertility and semen quality, but traits such as polyspermy are not considered and can increase aneuploidy during in vitro embryo production. This study links bull-specific proteomic signatures to polyspermy and embryo quality, further refining bull selection criteria.

ABSTRACT: Male fertility plays a pivotal role in the success rates of in vitro embryo production. While livestock breeding programs rigorously select bulls according to their predicted field fertility, specific traits such as polyspermy rates are not routinely evaluated. Despite the known negative impact of polyspermy on embryo survival, the paternal factors involved remain unclear. In this study, we aimed to address this gap by evaluating the in vitro outcomes of four bulls, focusing on sperm motility, fertilization rates, polyspermy incidence, embryo development and quality. In addition, we analyzed the proteome profiles of sperm, 2-4 cell stage embryos and blastocysts derived from those bulls to identify potential molecular factors associated with male fertility. Bulls with comparable sperm motility parameters displayed varying in vitro fertilization outcomes. Notably, the bull with the highest polyspermy rate achieved blastocyst rates similar to those of bulls with lower polyspermy rates. The number of apoptotic cells in the blastocysts was bull-dependent. Proteomic analysis revealed bull-specific signatures in sperm and blastocysts, with no differences at the 2-4 cell stage. Differences in the sperm proteome suggested that bull-dependent penetration and polyspermy rates might be associated with the ability of the sperm to undergo capacitation and acrosomal reaction. At the blastocyst level, the bull with the highest polyspermy rates produced lower quality blastocysts due to imbalances in key proteins and pathways for embryo development. In conclusion, bulls with similar blastocyst rates may differ in polyspermy rates and resulting embryo quality underscoring the importance of careful bull selection for in vitro embryo production.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by irregular menstrual cycles, hyperandrogenism, and polycystic ovarian morphology, leading to infertility and an increased risk of metabolic dysfunction. This study investigated the protective effects of Lepidium sativum seed extract (LSSE) on fertility and pregnancy outcomes in a rat model of PCOS induced by letrozole and a high-fat diet (HFD) (68% regular rat food pellets, 6% maize oil, 20% milk powder, and 6% ghee). PCOS was induced by oral administration of letrozole, an aromatase inhibitor, (1 mg/kg in 2% DMSO) along with an HFD for four weeks and the results were compared to the metformin antidiabetic agent. Sixty rats were divided into five groups (n = 12): control, PCOS, PCOS + LSSE (250 mg/kg), PCOS + LSSE (500 mg/kg), and metformin (200 mg/kg). Half of the rats were euthanized after four weeks, while the remaining rats were housed with males (1 male: 2 females) for testing pregnancy outcomes. LSSE led to remarkable improvements in body weight, glucose, sex hormonal balance, liver and kidney functions, antioxidant and anti-inflammatory systems, mating and fertility indices, pregnancy outcomes, and fetal morphology. Histologically, LSSE treatment reduced ovarian cyst number and size, and enhanced the blood vessel, Graafian follicle, and endometrial morphologies. LSSE showed dose-dependent effects, with the high-dose demonstrating superior results in the biochemical parameters, while the low-dose showed the most promising pregnancy outcomes. LSSE exhibits potent protective effects against PCOS, surpassing metformin in several aspects. LSSE acts through multi-mechanistic action, including anti-inflammatory, antioxidant, metabolic, and hormone-balancing properties, along with its positive impact on fertility, suggesting that LSSE could be a promising natural alternative for PCOS management.

Methylimidazolium ionic liquids (MILs) are solvents used in an increasing variety of industrial applications. Recent studies identified the 8C MIL (M8OI) contaminating the environment, detected exposure in humans and proposed M8OI to be a potential trigger for the autoimmune liver disease primary biliary cholangitis (PBC). To gain a better understanding of any PBC trigger mechanism(s), the interaction of M8OI with mitochondria has been examined. M8OI inhibited oxygen consumption in intact cells and induced cell death (IC-10 μM). Results from permeabilized cells indicated M8OI inhibits the mitochondrial electron transport chain at complex I, not complexes II, III or IV. Accordingly, succinate supported mitochondrial oxygen consumption and reduced cell death in the presence of M8OI. M8OI inhibited NADH oxidation by both mitochondrial membranes and purified complex I with IC values of 470 μM and 340 μM respectively. Based on direct determinations of M8OI in non-mitochondrial and mitochondrial compartments, toxic M8OI concentrations were estimated to result in mitochondrial concentrations commensurate with complex I inhibition. Mitochondrial accumulation followed by complex I inhibition is therefore a possible molecular initiating event for M8OI-dependent cell death. NADH oxidation by purified complex I in combination with a flavin-site electron acceptor was not inhibited by M8OI, indicating no interaction of M8OI at the NADH-binding active site. Modelling supported M8OI binding to the ubiquinone-binding site. By inhibiting turnover, M8OI also gave rise to increases in complex-I-linked reactive oxygen species. However, inhibitors of oxidative stress did not affect M8OI-mediated cell death. The metabolic consequences of M8OI-mediated complex I inhibition, not increased reactive oxygen species production, are therefore the likely cause of apoptotic cell death. Understanding the effects on complex I and the pathways activated and leading to cell death may be informative regarding mitochondrial stress, cell death and diseases such as PBC.

AIM: Injectable platelet-rich fibrin (I-PRF), a second-generation platelet concentrate, is widely used to enhance soft and hard tissue healing alone or in combination with biomaterials, relying on its harboring of various pivotal growth/differentiation factors. This randomized trial assessed the effect of clindamycin (CLN) augmented injectable platelet-rich fibrin (I-PRF) with modified minimally invasive surgical technique (M-MIST) versus I-PRF alone with M-MIST on the clinical and radiographic parameters in the management of periodontal intra-bony defects in patients with stage-III grade B periodontitis.

METHODS: This is a 9-month parallel-grouped, two arm, double-blinded, randomized controlled trial (RCT) that included 28 patients (n = 28) with stage-III grade B periodontitis, who were allocated randomly to test- (CLN/I-PRF + M-MIST, 50 μL of CLN per 1 mL of I-PRF; n = 14) or control-group (I-PRF + M-MIST; n = 14). Clinical attachment level (CAL; primary outcome), probing depth (PD), gingival margin level (GML), plaque index (PI), and gingival index (GI) were recorded at baseline, 3, 6, and 9 months, whereas radiographic parameters radiographic linear defect depth (RLDD), and radiographic defect area (RDA) were recorded at baseline, 6, and 9 months. The CLN release kinetics from the I-PRF were further characterized.

RESULTS: Compared to baseline, both groups independently demonstrated significant improvements in CAL, PD, GML, GI, PI, RLDD and BDA at 3, 6 and 9 months (p < .05). A significant reduction in CAL measurements was noticeable in the CLN/I-PRF + M-MIST and I-PRF + M-MIST group independently over time (p < .05). CLN/I-PRF + M-MIST showed significantly lower CAL than PRF + M-MIST group at baseline, after three as well as 9 months (p < .05). Intergroup comparisons at 9 months demonstrated that CAL-gain was non-significant between groups (p > .05), GI significantly lower in CLN/I-PRF + M-MIST, whereas PD-reduction significantly higher I-PRF + M-MIST group (p < .05). CLN was steadily released for the I-PRF for up to 48 h, with a peak concentration at 24 h, which then gradually declined till the seventh day.

CONCLUSIONS: I-PRF with M-MIST provided significant clinical and radiographic improvement up to 9 months postoperatively in stage-III grade B periodontitis. CLN, at the applied concentration and release duration, does not appear to further positively impact these observed I-PRF effects.

Functionalized nanoclays are a type of 2D nanomaterial that triggered a lot of attention owing to their promising chemical and physical properties. This is in addition to their commercial viability. To this end, various functionalized nanoclays, versatile nanomaterials with exceptional properties, have revolutionized multiple industries, including textiles. This chapter introduces an engaging introduction to nanoclays and their functionalization, showcasing their wide-ranging applications beyond traditional fabrics. The significance of nanoclays in addressing the evolving needs of the textile industry is emphasized. A comprehensive overview of nanoclays is presented, covering their different types, functionalization techniques, and characterization methods. The remarkable potential of functionalized nanoclays in enhancing flame retardancy, UV protection, mechanical strength, durability, and resistance to odors and stains in textiles is explored. Additionally, functionalized nanoclays are lightweight materials; therefore, the use of functionalized nanoclays in the textile industry has enabled manufacturers to produce light and more durable fabrics with improved performance characteristics. This technology is expected to continue to grow in popularity as it provides a cost-effective way for manufacturers to improve the quality of their products while reducing production costs. Thus, this chapter highlights the transformative impact of nanoclays and paves the way for future advancements in the textile sector.

The aim of the current study was to evaluate the clinical performance of the novel radio-opaque universal adhesive “Scotchbond™ Universal Adhesive Plus” compared to conventional universal adhesive “Single Bond Universal” over 24 months in cervical carious lesions. Fifty participants with cervical carious lesions were randomly allocated into two groups (n = 25); either Scotchbond™ Universal Plus Adhesive (intervention) or Single Bond™ Universal Adhesive (control). Restorations were assessed at baseline, 12 and 24 months using the modified USPHS criteria. Data analysis was conducted using MedCalc software, version 22 for Windows. Intergroup comparisons at each follow-up were performed using the Chi-Square test (p ≤ 0.05). Intragroup comparisons within each intervention were conducted using Cochran’s Q test (p ≤ 0.016). After 24 months, all restorations in Scotchbond™ Universal Plus scored alpha, while in Single Bond™ Universal group, three restorations scored bravo after 24 months in marginal adaptation and discoloration. There was no statistically significant difference between both adhesives (p > 0.05) at all follow-up periods. Intragroup comparison within both adhesives has shown no statistically significant change across follow-up periods regarding all tested outcomes (p > 0.016) except for marginal adaptation within Single Bond Universal, where there was statistically significant difference (p = 0.005). Both adhesives exhibited satisfactory clinical performance in cervical restorations after 24-months. The present study emphasizes the clinical significance of using a new radio-opaque universal adhesive for restoring carious cervical lesions, providing radio-opacity, low viscosity, excellent handling, eliminating misinterpretation of MDP-based adhesive layer and generating reliable bonding performance to support long-term success in restorative dentistry.

The aim of the current study was to evaluate the clinical performance of the novel radio-opaque universal adhesive “Scotchbond™ Universal Adhesive Plus” compared to conventional universal adhesive “Single Bond Universal” over 24 months in cervical carious lesions. Fifty participants with cervical carious lesions were randomly allocated into two groups (n = 25); either Scotchbond™ Universal Plus Adhesive (intervention) or Single Bond™ Universal Adhesive (control). Restorations were assessed at baseline, 12 and 24 months using the modified USPHS criteria. Data analysis was conducted using MedCalc software, version 22 for Windows. Intergroup comparisons at each follow-up were performed using the Chi-Square test (p ≤ 0.05). Intragroup comparisons within each intervention were conducted using Cochran’s Q test (p ≤ 0.016). After 24 months, all restorations in Scotchbond™ Universal Plus scored alpha, while in Single Bond™ Universal group, three restorations scored bravo after 24 months in marginal adaptation and discoloration. There was no statistically significant difference between both adhesives (p > 0.05) at all follow-up periods. Intragroup comparison within both adhesives has shown no statistically significant change across follow-up periods regarding all tested outcomes (p > 0.016) except for marginal adaptation within Single Bond Universal, where there was statistically significant difference (p = 0.005). Both adhesives exhibited satisfactory clinical performance in cervical restorations after 24-months. The present study emphasizes the clinical significance of using a new radio-opaque universal adhesive for restoring carious cervical lesions, providing radio-opacity, low viscosity, excellent handling, eliminating misinterpretation of MDP-based adhesive layer and generating reliable bonding performance to support long-term success in restorative dentistry.