http://localhost:8080/xmlui/handle/123456789/6733 1 - 133 2026-04-08T23:00:16Z http://localhost:8080/xmlui/handle/123456789/6764 Title: The role of exercise therapy in managing post-radiotherapy trismus in head and neck cancer Authors: Ezzat, Yousef E.; Sharka, Rayan M.; Huzaimi, Adel A.; Al-Zahrani, Khaled M.; Abed, Hassan H. Abstract: Trismus is a post-radiotherapy complication that affects survivors of head and neck cancers. It is described as the reduction of mouth opening to less than 35 mm. The condition is a progressive process; hence early intervention is crucial to prevent further damage and weakness to the elevator muscles of the mandible. Here, we report a 40-year-old woman with known squamous cell carcinoma of the maxillary sinus in stage T3N0M0 who had undergone upper right partial maxillectomy with subsequent 33 fractions of radiotherapy (66 Gy; intensitymodulating radiotherapy). Five months postradiotherapy, the patient showed interest in replacing her missing teeth to restore her oral functions and facial appearance. At her post-radiotherapy visit in the dental assessment clinic, she showed a mouth opening of 12 mm. The TheraBite Jaw Motion Rehabilitation System and wooden tongue depressors were alternatively used for 6 weeks (4e5 stretches/day; each stretch held for 15 s). Mouth opening gradually increased to 20 mm. Consequently, a definitive obturator prosthesis was fabricated using computer-aided design and computer-aided manufacturing technologies with the 3Shape D900 model scanner. These were challenging and time-consuming steps, but acceptable facial appearance and mouth opening were restored for the patient. This case suggests that Therabite Jaw Motion Rehabilitation SystemTM and wooden tongue depressors help to increase mouth opening significantly if used together and alternatively. 2021-01-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/6763 Title: A case report of isolated rheumatic tricuspid regurgitation and pericarditis Authors: Alhadramy, Osama Abstract: Rheumatic fever (RF) is a complex syndrome in which the human body develops antibodies against b-haemolytic streptococcus, and triggers inflammation in various organs. RF valvulitis mostly affects the mitral valve (MV) and, to a lesser extent, the aortic valve (AV). Isolated rheumatic tricuspid valve (TV) disease and pericarditis is extremely rare and is not well described in the RF guidelines. The current case demonstrates the echocardiographic findings of TV valvulitis of RF and describes the presentation and electrocardiogram (ECG) changes in pericarditis. We present the case of a 16-year-old male patient who developed upper respiratory tract infection followed by typical pericarditis chest pain. The patient had no history of joint pain or swelling, but was found to have a tricuspid regurgitation (TR) murmur upon examination. Laboratory investigations revealed an elevated erythrocyte sedimentation rate, and elevated Creactive protein and antistreptolysin O titres. ECG showed a wide-spread 1.5 mm upward concave STsegment elevation. In echocardiography, the TV opened well with markedly thickened leaflets and severe TR, while the MV and AV were normal in both structure and function. The diagnosis of RF was established and treatment with high-dose aspirin and antibiotics was initiated. The treatment led to resolution of the chest pain. Our case highlights that the physical and lab findings of rheumatic TR are similar to those of rheumatic mitral regurgitation, with the exception of a high-velocity jet. Similarly, the presentations of rheumatic pericarditis are similar to other types and may also respond to highdose aspirin. Finally, physicians should be familiar with both the common and rare complications of RF because the guidelines have placed Middle East region among the high-risk countries. 2021-01-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/6761 Title: Letrozole and zoledronic acid changed signalling pathways involved in the apoptosis of breast cancer cells Authors: Sheweita, Salah A.; Ammar, Rania G.; Sabra, Sally A.; Sultan, Ahmed S. Abstract: Objectives: Oestrogen plays a key role in the development of breast malignancies. Therefore, aromatase inhibitors (e.g. letrozole [LTZ]) are widely used in the treatment of breast cancer. On the other hand, oestrogen is important to the integrity of bone mass. Research has shown that zoledronic acid (ZLA) may prevent osteoporosis. Therefore, the present research aims to investigate the effect of a combination of LTZ and ZLA in the treatment of breast cancer and in reducing osteoporosis in patients with breast cancer. Methods: We used immunocytochemistry and Western immunoblotting techniques in this study. Results: We observed that LTZ inhibited cellular growth of Michigan Cancer Foundation-7 (MCF-7) and T-47D at IC50 (70 0.001) and (140 0.004) nM, respectively, whereas ZLA inhibited cellular growth at IC50 (50 0.005) mM and (150 0.004) mM for MCF-7 and T-47D cell lines, respectively. Interestingly, the LTZ and ZLA combination down-regulated the protein expression of signal transducer and activator of transcription 3 (STAT3) and up-regulated BRCA1 protein expression in both cell lines. Moreover, a notable enhancement in the nuclear localisation of the BRCA1 protein was obtained after treatment of T-47D cells with LTZ for 24 h compared to the control cells. In contrast, there was a reduction in the nuclear localisation of STAT3 protein, which could be an attractive target for inhibition of breast cancer proliferation and progression. Conclusion: Our study has shown that a combination of LTZ and ZLA enhanced apoptosis and inhibited growth of both breast cancer cell lines. This combination can be used to maintain bone integrity in women with breast cancer. 2021-01-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/6758 Title: Rising prevalence of multidrug-resistant uropathogenic bacteria from urinary tract infections in pregnant women Authors: Asmat, Umema; Mumtaz, Muhammad Z.; Malik, Arif Abstract: Objectives: This study aimed to determine the prevalence of urinary tract infections (UTI) in pregnant women and characterise the uropathogenic bacterial strains associated with symptomatic and asymptomatic bacteriuria in Lahore, Pakistan. Methods: Between December 2018 and June 2019, we analysed the uropathogenic bacterial strains from midstream urine samples in 80 pregnant women. The age of the pregnant women ranged from 19 to 45 years, and they resided in urban and rural areas. We also recorded socioeconomic factors in this cohort. The isolated strains were phenotypically identified and evaluated for multiple drug resistance (MDR) patterns against recommended antimicrobial drugs. Results: Of the 80 pregnant women, 65 had UTI, reflecting an 81% prevalence of UTI in women during pregnancy. The majority of participants aged 24e35 years, were multipara, and were in their third trimester. Results showed that 67 uropathogenic bacterial strains belonged to Escherichia (31%), Klebsiella (23%), Pseudomonas (16%), Streptococcus (4%), Enterococcus (4%), Staphylococcus (4%), and Proteus (3%) genera, as identified using biochemical characterisation. The highest overall resistance of Escherichia was seen against amoxicillin, pipemidic acid, and ampicillin; for Klebsiella against pipemidic acid, ampicillin, and cefotaxime; and for Pseudomonas against ciprofloxacin and cefotaxime. The three strains with the highest MDR were identified using 16S rRNA as Pseudomonas aeruginosa strain UA17, Escherichia coli strain UA32, and Klebsiella pneumoniae strain UA47. Conclusion: In this study, the MDR uropathogenic strains showed the highest resistance pattern. The alarming signs of MDR uropathogenic infections are infrequently addressed and thus, urgent attention to this matter is essential. 2021-01-01T00:00:00Z