PURPOSE: This study aimed to assess the agreement between 2 raters in evaluations of students on a prosthodontic clinical practical exam integrated with directly observed procedural skills (DOPS). METHODS: A sample of 76 students was monitored by 2 raters to evaluate the process and the final registered maxillomandibular relation for a completely edentulous patient at Mansoura Dental School, Egypt on a practical exam of bachelor’s students from May 15 to June 28, 2017. Each registered relation was evaluated from a total of 60 marks subdivided into 3 score categories: occlusal plane orientation (OPO), vertical dimension registration (VDR), and centric relation registration (CRR). The marks for each category included an assessment of DOPS. The marks of OPO and VDR for both raters were compared using the graph method to measure reliability through Bland and Altman analysis. The reliability of the CRR marks was evaluated by the Krippendorff alpha ratio. RESULTS: The results revealed highly similar marks between raters for OPO (mean= 18.1 for both raters), with close limits of agreement (0.73 and −0.78). For VDR, the mean marks were close (mean= 17.4 and 17.1 for examiners 1 and 2, respectively), with close limits of agreement (2.7 and −2.2). There was a strong correlation (Krippendorff alpha ratio, 0.92; 95% confidence interval, 0.79–0.99) between the raters in the evaluation of CRR. CONCLUSION The 2 raters' evaluation of a clinical traditional practical exam integrated with DOPS showed no significant differences in the evaluations of candidates at the end of a clinical prosthodontic course. The limits of agreement between raters could be optimized by excluding subjective evaluation parameters and complicated cases from the examination procedure.

PURPOSE: This study aimed to assess the agreement between 2 raters in evaluations of students on a prosthodontic clinical practical exam integrated with directly observed procedural skills (DOPS). METHODS: A sample of 76 students was monitored by 2 raters to evaluate the process and the final registered maxillomandibular relation for a completely edentulous patient at Mansoura Dental School, Egypt on a practical exam of bachelor’s students from May 15 to June 28, 2017. Each registered relation was evaluated from a total of 60 marks subdivided into 3 score categories: occlusal plane orientation (OPO), vertical dimension registration (VDR), and centric relation registration (CRR). The marks for each category included an assessment of DOPS. The marks of OPO and VDR for both raters were compared using the graph method to measure reliability through Bland and Altman analysis. The reliability of the CRR marks was evaluated by the Krippendorff alpha ratio. RESULTS: The results revealed highly similar marks between raters for OPO (mean= 18.1 for both raters), with close limits of agreement (0.73 and −0.78). For VDR, the mean marks were close (mean= 17.4 and 17.1 for examiners 1 and 2, respectively), with close limits of agreement (2.7 and −2.2). There was a strong correlation (Krippendorff alpha ratio, 0.92; 95% confidence interval, 0.79–0.99) between the raters in the evaluation of CRR. CONCLUSION: The 2 raters' evaluation of a clinical traditional practical exam integrated with DOPS showed no significant differences in the evaluations of candidates at the end of a clinical prosthodontic course. The limits of agreement between raters could be optimized by excluding subjective evaluation parameters and complicated cases from the examination procedure.
Centric Relation ; Dental Occlusion ; Education, Dental ; Educational Measurement ; Egypt ; Humans ; Methods ; Prosthodontics ; Schools, Dental ; Vertical Dimension

Objectives: While the protective effects of Alhagi maurorum have been shown against various ailments, its role against norfloxacin-induced adverse effects has not been studied. The current study was conducted to determine the effect of A. maurorum aqueous extract against norfloxacin-induced side effects in rats. Methods: Twenty-four male albino rats were randomly assigned into four groups, which received normal saline, norfloxacin (50 mg/kg b.wt orally once a day), A. maurorum aqueous extract (300 mg/kg b.wt orally once a day), and norfloxacin with A. maurorum aqueous extract by the same previous mentioned dosages. Blood samples were collected for hematological examination to evaluate liver and kidney function tests. Hepatic and renal tissue samples were obtained to assess antioxidant activity and histopathological examination. Results: A. maurorum aqueous extract significantly ameliorated norfloxacin-induced elevation in tissue malondialdehyde, and reduction in tissue antioxidant enzymes such as catalase, glutathione peroxidase, and superoxide dismutase activities as well as reduced glutathione concentration. Concurrent administration of A. maurorum aqueous extract with norfloxacin significantly reduced serum alkaline phosphatase, aminotransferases, urea, creatinine, and uric acid and increased RBCs count, Hb concentration, PCV, leucocyte, and monocyte counts compared with the norfloxacin-treated group. Co-administration of A. maurorum aqueous extract with norfloxacin prevented the degenerative changes induced by norfloxacin alone in liver and kidney tissues. The phytochemical profile of the extract showed the presence of carbohydrates, alkaloids, saponins, tannins, phenolics, and flavonoids. Conclusion: These findings indicated that A. maurorum possesses potent antioxidant activities and could be used to attenuate norfloxacin-induced side effects.

Objectives: In Northern Africa, the region Egypt belongs to, about 10.7% of women are estimated to harbour cervical human papillomavirus (HPV) infection and 78.4% of invasive cancers are attributed to HPVs 16 or 18. We aimed at comparing HPV detection by ISH-PCR tissue with other conventional available cheaper techniques, finding which of them can be relied upon in a developing country like Egypt for HPV detection. Methods: Sixty patients were included. For them colposcopy, PAP smear, histopathology and detection of HPV using ISH PCR tissue and PCR swab were achieved. Results: PCR-ISH tissue was positive in 53.33%, 46.6% were negative. Pap smear was negative in 26 cases (43.33%) and 43 cases (56.67%) were positive. LSIL with perinuclear halo represented nearly half of the positive cases (16/34; 47.05%), 10 cases were diagnosed as HSIL, 4 cases as ASCUS and 4 as AGC. Histopathology was negative in 12 (20%) cases and 48 (80%) cases were positive. CIN I and CIN I+ koliocytosis represented half of the cases (30/60) and more than half of positive cases (30/48; 62.5%). Comparing the results of pap smear, histopathology, colposcopy and PCR swab with ISH PCR tissue, highly significant results were seen with sensitivity of 87.5%, 100%, 62.5% and 56.2% respectively but the specificity were 78.6%, 42.9%, 28.6% and 100% respectively. Conclusion: Conventional cytology and histopathology were sensitive tests for detection of HPV. This may help for early detection of cancer cervix in a developing country like Egypt. PCR swab showed the highest specificity and the lowest sensitivity.

PURPOSE: The purpose of this prospective study was to determine correlation between coronal mechanical alignment measured on preoperative standing full-length radiographs and navigation during total knee arthroplasty (TKA) in the presence of an associated sagittal deformity (hyperextension and flexion deformity). MATERIALS AND METHODS: Coronal mechanical alignment measured on preoperative, standing, full-length, hip-to-ankle anteroposterior radiographs was compared with intraoperative measurements recorded with computer navigation in 200 primary navigated TKAs. RESULTS: The mean difference in mechanical alignment between the two techniques was significantly greater (p=0.001) in patients with an associated flexion deformity >10° when compared to knees with associated flexion deformity ≤10°; 48% of knees with a flexion deformity >10° had a difference of ≥3° between the full-length radiograph and navigation alignment measurements. There was a strong correlation between the radiographic and navigation measurement techniques. CONCLUSIONS: The mean difference in coronal mechanical alignment between the two techniques was significantly higher in patients with an associated flexion deformity >10°. Hence, surgeons should take caution when relying on preoperative full-length radiographs for determining coronal mechanical alignment in patients with an associated flexion deformity >10° where using navigation may be more reliable.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Congenital Abnormalities ; Humans ; Knee ; Prospective Studies ; Surgeons ; Surgery, Computer-Assisted

Objective: To determine the risk of acquiring acute respiratory syncytial virus (RSV) bronchiolitis in infants and children delivered by the mode of cesarean section (C-section). Methods: A retrospective and descriptive study was conducted at Hamad Medical Corporation. Patients with ages 0 to 36 months hospitalized with acute bronchiolitis were included in the study. Results: The risk of RSV bronchiolitis was observed to be higher among C-section delivery compared to normal spontaneous vaginal delivery [odds ratio=1.10; 95% confidence interval (0.57, 1.80); P=0.965]; however, it was not statistically significant. Gestational age ≤35 weeks was significantly associated with increased risk of RSV bronchiolitis compared to gestational age >35 weeks [odds ratio=3.12; 95% confidence interval (1.53, 6.38); P=0.002]. Conclusions: Delivery by C-section does not appear to increase the risk of RSV bronchiolitis in infants compared with normal spontaneous vaginal delivery.

Hip firearm injuries are rare injuries that could lead to serious complications, such as posttraumatic hip arthritis and coloarticular fistula. We report a case of a 25-year-old male who sustained a pelvic injury caused by a single bullet which led to a bilateral acetabular fracture, concomitant with a colon injury treated on an emergency basis by a diverting colostomy; acetabular fractures were treated conservatively by traction. After the patient recovered from the abdominal injury, he was presented with bilateral hip pain and limited motion; plain radiographs showed bilateral hip arthritis with proximal migration of the femoral head and bilateral acetabular defect classified as Paprosky type ⅢA. Reconstruction of the hips was performed using the same technique: impaction bone grafting for acetabular defect reconstruction and a reversed hybrid total hip arthroplasty (THA) 6 months apart. The patient presented with loosening of the left THA acetabular cup 3 years later, which was revised; then he presented with a discharging sinus from the left THA with suspicion of coloarticular fistula, which was confirmed using CT with contrast material. A temporary colostomy and fistula excision were performed, and a cement spacer was applied to the hip. After clearing the infection, a final revision THA for the left hip was performed. Treating post-firearm hip arthritis by THA is challenging, especially in the situation of neglected cases with the presence of an acetabular defect. Concomitant intestinal injury increases the risk of infection with the possibility of coloarticular fistula formation, which could present later. Working with a multidisciplinary team is paramount.
Male ; Humans ; Adult ; Arthroplasty, Replacement, Hip ; Firearms ; Wounds, Gunshot/surgery* ; Acetabulum/injuries* ; Hip Fractures/surgery* ; Arthritis/surgery* ; Spinal Fractures/surgery* ; Reoperation ; Fistula/surgery* ; Treatment Outcome ; Follow-Up Studies ; Prosthesis Failure ; Retrospective Studies

PURPOSE"Polytrauma" patients are of a higher risk of complications and death than the summation of expected mortality and morbidity of their individual injuries. The ideal goal in trauma resuscitation care is to identify and treat all injuries. With clinical and technological advanced imaging available for diagnosis and treatment of traumatic patients, point of care-rapid ultrasound in shock and hypotension (RUSH) significantly affects modern trauma services and patient outcomes. This study aims to evaluate the accuracy of RUSH and patient outcomes by early detection of the causes of unstable polytrauma.

METHODSThis cross-sectional, prospective study included 100 unstable polytrauma patients admitted in Suez Canal University Hospital. Clinical exam, RUSH and pan-computed tomography (pan-CT) were conducted. The result of CT was taken as the standard. Patients were managed according to the advanced trauma life support (ATLS) guidelines and treated of life threatening conditions if present. Patients were followed up for 28 days for a short outcome.

RESULTSThe most diagnostic causes of unstability in polytrauma patients by RUSH are hypovolemic shock (64%), followed by obstructive shock (14%), distributive shock (12%) and cardiogenic shock (10%) respectively. RUSH had 94.2% sensitivity in the diagnosis of unstable polytrauma patients; the accuracy of RUSH in shock patients was 95.2%.

CONCLUSIONRUSH is accurate in the diagnosis of unstable polytrauma patients; and 4% of patients were diagnosed during follow-up after admission by RUSH and pan-CT.

Adolescent ; Adult ; Aged ; Child ; Cross-Sectional Studies ; Female ; Humans ; Hypotension ; diagnostic imaging ; Male ; Middle Aged ; Multiple Trauma ; complications ; diagnostic imaging ; mortality ; Point-of-Care Systems ; Prospective Studies ; Shock ; diagnostic imaging ; Young Adult

Drug Resistance, Bacterial ; genetics ; Food Microbiology ; Gram-Negative Bacteria ; genetics ; isolation & purification ; Integrons ; Japan ; Seafood ; microbiology

Despite advances in the field of male reproductive health, idiopathic male infertility, in which a man has altered semen characteristics without an identifiable cause and there is no female factor infertility, remains a challenging condition to diagnose and manage. Increasing evidence suggests that oxidative stress (OS) plays an independent role in the etiology of male infertility, with 30% to 80% of infertile men having elevated seminal reactive oxygen species levels. OS can negatively affect fertility via a number of pathways, including interference with capacitation and possible damage to sperm membrane and DNA, which may impair the sperm's potential to fertilize an egg and develop into a healthy embryo. Adequate evaluation of male reproductive potential should therefore include an assessment of sperm OS. We propose the term Male Oxidative Stress Infertility, or MOSI, as a novel descriptor for infertile men with abnormal semen characteristics and OS, including many patients who were previously classified as having idiopathic male infertility. Oxidation-reduction potential (ORP) can be a useful clinical biomarker for the classification of MOSI, as it takes into account the levels of both oxidants and reductants (antioxidants). Current treatment protocols for OS, including the use of antioxidants, are not evidence-based and have the potential for complications and increased healthcare-related expenditures. Utilizing an easy, reproducible, and cost-effective test to measure ORP may provide a more targeted, reliable approach for administering antioxidant therapy while minimizing the risk of antioxidant overdose. With the increasing awareness and understanding of MOSI as a distinct male infertility diagnosis, future research endeavors can facilitate the development of evidence-based treatments that target its underlying cause.
Antioxidants ; Classification ; Clinical Protocols ; Diagnosis ; DNA ; Embryonic Structures ; Female ; Fertility ; Health Expenditures ; Humans ; Infertility ; Infertility, Male ; Male ; Membranes ; Ovum ; Oxidants ; Oxidation-Reduction ; Oxidative Stress ; Reactive Oxygen Species ; Reducing Agents ; Reproductive Health ; Semen ; Spermatozoa ; Subject Headings