Background: Vitamin D plays an important role in the development of bone health and possibly non-communicable diseases. Arab countries had made their own national studies to assess serum vitamin D level among women, yet in Egypt there is no national survey done. The aim of the current study was to identify risk factors affecting vitamin D level among Egyptian females during the child-bearing period. Subjects and methods: A total of 100 healthy adult females in their childbearing period who were attending a Family Medicine Center were included in our study. The age of the included women ranged from 19 to 49 years old with a mean age of 34 (SD 8.47) years. The majority of participants had deficiency (43%) and insufficiency (13%) of vitamin D level. Results: Unemployed women were more likely to have vitamin D deficiency than employed women (P<0.05). Participants who were exposed to sun ˃30 minutes/day were more likely to have sufficient vitamin D level (P<0.05). All participants who consume fish ≥3 times/week had sufficient vitamin D level. Therefore, there was a statistically significance association between a number of consuming fish/week and vitamin D3 level groups. Also, there was statistically significant association between number of consumed milk cups/day and vitamin D3 level groups. All participants who drink 2 cups of milk have sufficient vitamin D level. No statistically significance association was found between using multivitamins and vitamin D3 level groups. Conclusion: Unemployment, low fish consumption and infrequent sun exposure were significant risk factors for vitamin D deficiency. Future research on the role of multivitamins supplements in improving vitamin D nutrition is warranted.

Acute diarrhea is a common affection, among children under 59 months old in Sub-saharan Africa and Asia known to be a global public health concern. It is responsible for significant mortality in developing countries. The main purpose of this study was to identify drivers of acute diarrhea in mothers of children aged 6-59 months in Kinshasa households. This study was conducted in two health areas in Kinshasa namely Centre Supérieur Militaire Mobikisi and Hopital Militaire Central. It is a cross-sectional study of analytical type having a correlational design. In fact, 114 mothers having children aged 6 to 59 months old who had experienced at least three diarrheal episodes were selected and this research was carried out in January 2020. Independent variables were socio-economic factors and dependent variables were biological factors. Descriptive statistical analyses of which frequency and percentage were performed to describe the sampling profile. To measure the strength of association between different variables, the Pearson's Chi-Square (X²) test was used. The findings showed that 57% live in a high socio-economic environment compared to 43% who have a low socio-economic environment responsible for the occurrence of acute diarrhea. It was observed that 67.7% of participants knew the importance of access to health care services, compared to 32.3% who did not know. Meanwhile, 50.8% lived in a healthy environment versus 49.2% who had an unhealthy environment. Furthermore, 53.8% were in an acceptable demographic and biological situation, compared to 46.2% who were in a precarious demographic and biological situation. Acute diarrhea in children aged 6-59 months is one of the causes of morbidity and mortality in Kinshasa city. Obstacles to effective care are related to the lack of quality service provision. Policy makers must therefore put in place interventions to address these challenges in order to reduce infant morbidity and mortality in this area.

The purpose of this study was to assess different periodontitis groups affected with mild, moderate and severe alveolar bone levels and treated using the Sandwich’s procedures. A total of 53 subjects, who had taken two sets of full-mouth standarized paralleling radiographs with mean observation time was 10.18±3.89 years and (ranges: 5.1 to 18.3 years) were collected for the past 20 years. The radiographic alveolar bone levels (RABL) at mesial and distal aspects of teeth were assessed by measuring the distance between cemento-enamel junction (CEJ) and the bone crest using an electronic digimatic caliper (EDC) under 7.5 magnified radiographs. The patients, who presented with SAP, were between 24 and 84 years of age, with a mean age of 54.8±10.2years. Although, the treatment of angular defects in molars with guided tissue regeneration, emdogain has been reported and has exhibited significant and predictable results, however, afforded very limited and less predictable results in the treatment of advanced class II and III maxillary furcation defects. The majority of root resection procedures are commonly recommended for treating advanced molar furcation, in particular located at molars with class III furcation involvement, there is still some controversy regarding the long-term prognosis after different treatment modalities. In general, the root resection procedure is a surgical approach for simultaneously performing a periodontal flap operation at first and followed by the amputation and/or resection of maxillary root(s). There are some complications and disadvantages, such as post-operative pain and bleeding, swelling, infection, etc. The present report is to describe the combination of therapeutic provisional prosthesis (TPP), fixed prosthesis, non-surgical procedure using root separation and/or resection (RSR) and for the treatment of advanced Class II and III furcation-Involved molars. In addition, evidenced-based clinical trials of retrospective and longitudinal data were also prescribed here. The purpose of this study was to present treatment procedures of Sandwich’s technique and retrospectively to evaluate the long-term clinical trials of this method in treating molar teeth with SAP and molar FI who were diagnosed as guarded and/or hopeless prognosis.

Active Pharmaceutical Ingredients (APIs) form the backbone of pharmaceutical formulations, influencing their efficacy, safety, and stability. Essence control of APIs involves stringent regulation and optimization of their chemical, physical, and biological properties to ensure consistent quality and therapeutic outcomes. This manuscript explores the critical aspects of essence control in APIs, including synthesis, characterization, quality assessment, and regulatory considerations. The synthesis of Active Pharmaceutical Ingredients is a pivotal stage in pharmaceutical manufacturing, where precise control over chemical reactions and process conditions is paramount to achieving high-quality, safe, and effective medicines. Advances in synthetic methodologies, optimization strategies, sustainability practices, and the implementation of PAT technologies continue to drive innovation in API synthesis, supporting the development of novel therapeutic agents and enhancing pharmaceutical manufacturing efficiency.

The aim of the present study was to assess the cumulative radiographic periodontal attachment loss (CRPAL) and annually radiographic periodontal attachment loss (ARPAL) of different disease groups over 5 years or more. A total of 53 subjects, who had taken two sets of full-mouth standarized paralleling radiographs with separated periods of 5 years or more in teaching hospital during 1981-2001, were collected for the past 20 years. The radiographic periodontal attachment levels at mesial and distal surfaces of teeth were assessed by measuring the distance between cement-enamel junction and the bone crest using an electronic digital caliper (EDC) under a 10X magnified radiographs. The results revealed that mean CRPAL was highest in the generalized aggressive periodontitis (GAgP) group (-5.523.27 mm), then the chronic periodontitis (CP) group (-4.823.47 mm), and the localized aggressive periodontitis (LAgP) group (-4.473.47 mm) followed, and lowest in the periodontal healthy (PH) group (-1.050.59 mm). The mean ARPAL was highest in the LAgP group (-0.260.25 mm/yr.), then the GAgP group (-0.200.13 mm/yr.), and the CP group (-0.120.09 mm/yr.) followed, and lowest in the periodontal healthy group (0.070.06 mm/yr.). Conclusions showed that mean CRPAL was highest in the generalized aggressive periodontitis group, then the CP group, and the LAgP group followed, and lowest in the periodontal healthy group. In addition, there existed a strong statistical significance (p<0.0001) in both CRPAL and ARPAL (mm) among individuals affected GAgP, LAgP, CP, and PH groups among mild, moderate, and severe periodontitis using paired t-test.

Background: Oral health plays an important role in maintaining life functions and quality of life. Gingivitis and periodontitis are two forms of periodontal disease that exist on a spectrum ranging from bleeding, erythematous, and inflamed gingival tissue to the loss of attachment and alveolar bone. Dental caries and periodontal diseases are the most common oral ailments and the major causes of tooth loss. Objectives: The study aimed to evaluate the haematological alterations among patients with oral and dental health problems in the Tripoli region. Material and Methods: The present study was conducted on 200 patients with oral and dental health problems attending six medical centers in Tripoli region from the 01^st March 2022 to the 01^st June 2022. Also, 100 healthy individuals without any oral and dental health problems or any other diseases were recruited as a control group. This study was approved by the Research and Ethical Committee of the Libyan Academy of graduate studies and medical centers. One ml of venous blood was withdrawn from each participant in the study for the determination of haematological parameters. The data were compared using SPSS Statistics for Windows, Version 26. Results: The results showed that red blood corpuscles (RBCs) count, hemoglobin concentration, hematocrit value, MCV, MCH, and MCHC in patients with oral and dental health problems were decreased significantly (P<0.01) compared to the control group. White blood cell count, neutrophils%, and platelets count in patients with oral and dental health problems were significantly (P<0.01) increased compared to the control group. On the other hand, lymphocytes% and mixed % WBCs were significantly (P<0.01) decreased compared to the control group. Conclusion: It can be concluded that oral and dental health problems were associated with a significant alterations in haematological parameters. Red blood corpuscles count, hemoglobin concentration, hematocrit value, MCV, MCH, MCHC, lymphocytes%, and mixed % WBCs were decreased significantly and White blood cell count, neutrophils%, and platelets count were significantly increased in patients with oral and dental health problems compared to the control group. Further studies are needed to confirm these results.

Objective: The study investigated the biological effects and molecular mechanisms of platelet-rich plasma (PRP) on periodontal bone regeneration. Methods: Electronic and manual searches were searched up to 1 October 2022 in the following databases: Pubmed, Scopus, Cochrane Library and Embase. [Platelet rich plasma or platelet or growth factors] and [periodontal] or [bone regeneration or bone defect or bone reconstruction] were used for searching. This study reviewed and analyzed published papers associated with PRP and periodontal bone defect restoration or bone regeneration or bone reconstruction. Results: Different growth factors exhibited varied biological characteristics and function. In-vitro studies, animal experiments and clinical studies confirmed that PRP displayed assorted role in periodontal bone defects repair. The growth factors secreted from PRP can promote new bone formation, soft tissue regeneration and wound healing. The fiber three-dimensional structure in PRP is conducive to the growth and migration of cells and provides strong support for the regeneration of periodontal soft and hard tissues. The anti-inflammatory characteristics of PRP are also closely related to the repair of periodontal bone defects. Conclusion: PRP played an important biological effect on periodontal bone regeneration. The mechanism is closely related to PRP promoting the growth, proliferation, differentiation and migration of periodontal ligament cells and osteoblasts, and the fiber stereo configuration of PRP and the anti-inflammatory effect of leukocytes.

For the adequate treatment of bone fractures, it is necessary to have knowledge about mechanical concepts as the interaction of implants and bone. The understanding of the concept of stress riser must be clear for surgeon for adequate surgical planning, thus preventing refracture due to incorrect application of implants. This article presents the concept of stress riser applied to orthopedics and briefly discussion.

Background: Everyone, irrespective of age, sex, colour, ethnicity, or present overall fitness level, can benefit from regular exercise. To improve one's health, one must engage in regular physical activity. People with underlying illnesses like long-term impairment can benefit from regular physical activity at the individual level, especially young women. Thus, the current study aimed to assess the prevalence and determinants of physical activity among female school-aged adolescents in the West Coast Region of The Gambia. Methods: The present study used an institutional-based cross-sectional analytical study to collect quantitative data from 384 female high school students in The Gambia. The study used a content-validated, pretested structured questionnaire that consisted of both open and closed-ended questions on physical activity. The data were processed and analyzed using IBM SPSS version 26.0. Descriptive statistics and Chi-square and/or Fisher exact test were used with a p-value <0.15 for inclusion in the logistic regression model. Adjusted odds ratios (aORs) and 95% confidence intervals were calculated, while p-value <0.05 was considered for statistical significance. Results: The proportion of female students involved in physical activity was 37.5%. The mean age of students was 18.8 years with a standard deviation of 1.7 years. Factors such as female students between 17 – 20 years (aOR:3.05, 95% C.I. (1.807 – 5.138)), father never been to school (aOR: 2.82, 95% C.I. (1.495 – 5.334)), primary education (aOR: 2.15, 95% C.I. (1.027 – 4.493)), upper basic school (aOR: 2.31, 95% C.I. (1.055 – 5.074)) and science major students (aOR: 2.21, 95% C.I. (1.203 – 4.047)) had increased odds of involving in PA. Furthermore, students who knew that exercise would strengthen bones (aOR: 2.62, 95% C.I (1.444 – 4.739)), do a planned brisk walking (aOR: 19.16, 95% C.I. (6.698 – 54.811)), basketball/football (aOR: 29.76, 95% C.I. (10.004 – 88.512)) and skipping with rope (aOR: 29.15, 95% C.I. (9.726 – 87.333)) had increased odds to involved in PA after controlling for confounders. Other factors such as students whose mother never been to school (aOR: 0.31, 95% C.I. (0.140 – 0.674)), primary level (aOR: 0.25, 95% C.I. (0.123 – 0.518)), senior secondary level (aOR: 0.42, 95% C.I. (0.189 – 0.935)), nuclear family (aOR: 0.23, 95% C.I. (0.119 – 0.458)) and extended family (aOR: 0.45, 95% C.I. (0.225 – 0.915)) had reduced odds of involving in PA. Conclusion: There is low physical activity among female adolescents in schools. For this, it is imperative that suitable interventions be implemented to raise the level of physical activity among secondary school students. A future intervention for school-aged adolescents could benefit from these findings.

Modern organizations leverage highly distributed, global deployments to provide high availability and resiliency for cloud-first applications. By hosting these applications across multiple geographic locations and relying on highly available services, organizations can prevent disruption to their business and reduce complexity by employing the scale of infrastructure offered by major cloud providers. Global deployments in the cloud are built on well-known models such as failover, load balancing, and scalability. However, traditional methods used to recover from regional failure—while effective—can be complex. Typical multi-region recovery and high availability system architectures have latency and cost risks that should be considered when facing other limitations such as deployment models in the cloud. This document describes the different traffic management techniques that can be applied to multi-region strategies, focusing on trade-offs and costs. The introduction of new traffic management techniques being applied to the traditional global architectures now allows organizations to adopt cloud services more efficiently. Traffic management is much more straightforward in some environments, while others have started to leverage their traffic management platform via routing. In multi-region deployments, active-active and active-passive are the most common architectural models, allowing organizations to seamlessly handle failover, scalability, and global distribution based on business goals and requirements. However, traffic management for these infrastructures is critical to ensure just data distribution and efficiency, maintaining costs under control and workloads rerouted when necessary. Using the new traffic management techniques will allow organizations to evolve system architectures easily based on business requirements, taking advantage of cost benefits from multiple infrastructures. In these scenarios, traffic management becomes a crucial backbone of success to ensure that traffic is being efficiently and intelligently distributed [1].