Agreement between 2 raters' evaluations of a traditional prosthodontic practical exam integrated with directly observed procedural skills in Egypt / 보건의료교육평가

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.

Agreement between 2 raters' evaluations of a traditional prosthodontic practical exam integrated with directly observed procedural skills in Egypt / 보건의료교육평가

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.

Non-invasive different modalities of treatment for temporomandibular disorders: review of literature

Temporomandibular disorders (TMDs) are diseases that affect the temporomandibular joint and supporting structures. The goal of treatment for TMDs is elimination or reduction of pain and return to normal temporomandibular joint function. Initial treatment for TMDs is non-invasive and conservative, not surgical. Oral and maxillofacial surgeons should fully understand and actively care about non-invasive treatments for TMDs. The purpose of this study is to review the validity and outcomes of non-invasive and surgical treatment modalities for TMDs.

Growth kinetics of Egyptian isolates of trichomonas vaginalis: possible correlation to clinical presentation

Background: Trichomonas vaginalis is the most common non-viral sexually transmitted infection [STI] in the world. Trichomoniasis is an important risk factor for herpes simplex type II infections, human immunodeficiency virus [HIV] acquisition and transmission, pelvic inflammatory disease and cervical neoplasia. Studying the variation in growth patterns of the parasite can be used for biological characterization of the parasites and might be related to the severity of clinical presentation

Aim of the Work: Study the growth kinetics of Egyptian Trichomonas vaginalis isolates in term of log phase, growth peaks reached, division rate and generation time of each isolate and correlation of such parameters with the clinical presentation of the patients, if any

Material and Method: The study was carried on 300 vaginal washouts collected from Egyptian women patients aged 20-45 years suspected for trichomoniasis. Positive samples for Trichomonas vaginalis were cultured and sub cultured on modified Diamond's medium. Growth kinetics for each isolate was done by inoculated 104 trophozoites/ml into 2 tubes containing 10 ml of sterile culture medium followed by counting the trophozoites every 24 hours over seven days using a hemocytometer. Growth curves were done for each isolate by plotting the parasites numbers against the time. Division rates and generation times were calculated for each isolate

Results: Out of the 300 collected samples, twelve were found positive for Trichomonas vaginalis trophozoite by wet mount examination and culture technique. Comparison of the growth kinetics of the twelve Trichomonas vaginalis isolates revealed a salient difference among all isolates after 48 to 96 hours. Isolates 1, 2, 6, 8 and 10 had a log phase of 48 hours. Isolates 4, 5, 7, 11 and 12 had a log phase of 72 hours. Isolates 3 and 9 had a log phase of 96 hours. The fast growing isolates of Trichomonas vaginalis reached maximum growth after 48 hours and the highest yield was observed in isolate 10 [150.25+/-3.13]. Slowly growing isolates reached a maximum after 96 hours with the lowest yield in isolate 3 [40.5+/-21]. Regarding the clinical presentation, isolates 1, 2, 3, 4, 5 and 11 showed mild discharge and congested cervix. Isolates 6, 7, 8, 9, 10, and 12 showed profuse discharge with varying clinical findings on gynecological examination. Isolate 10 had the most severe pathology with cervical erosion. Isolate 9, 12 showed bleeding during examination, isolate 8 showed vaginal ulcer while isolate 6 showed just erythema of the vagina

Conclusion: Comparison of the growth kinetics of the twelve Trichomonas vaginalis isolates revealed a salient difference among all isolates after 48 to 96 hours. Regarding the clinical presentation, no clear correlation was found between the growth kinetics and clinical presentation of the patients. Methods other than growth kinetics such as genotyping and determination of genetic variability are needed to verify the relation between isolates of Trichomonas vaginalis and clinical presentation

Efficacies of intralesional zinc sulphate and hypertonic sodium chloride in the treatment of acute cutaneous leishmaniasis

Pentavalent antimonials are the mainstay drugs for the systemic and local intralesional treatment of cutaneous leishmaniasis. However, these drugs are expensive and may be associated with numerous serious side effects. Recently, 2% zinc sulphate and 7 % sodium Chloride have been tried for intralesional therapy of acute cutaneous leishmaniasis and found very effective and had high cure rates. In this study, the effectiveness of intralesional zinc sulphate and hypertonic sodium chloride for curing acute cases of cutaneous leishmaniasis was further evaluated. Patients with typical lesions of acute leishmaniasis, confirmed by parasitological methods were enrolled in this study. Using simple random distribution, patients were allocated into three treatment groups. Of the 97 patients initially selected, 59 completed the study, the first group comprised 22 patients having 32 lesions and treated with 2 % zinc sulphate; the second group comprised 18 patients having 28 lesions and treated with 7 % sodium chloride; and the third group comprised 19 patients having 30 lesions and treated with the standard sodium stibogluconate [pentostam]. The results showed that 2 % zinc sulphate and 7 % sodium Chloride are effective, safe, economic and quick medications for the intra-lesional treatment of few lesions of acute cutaneous leishmaniasis, where 93.8 % and 85.6 % of the lesions treated by both preparations, respectively, were cured after three intralesional injections. 90 % of the lesions treated bypentostam were cured after three intralesional injections