Application and validation of a novel inflammatory score in the clinical grading of infectious endophthalmitis: The endophthalmitis management study – Report 2

Purpose: This study was conducted to describe and validate a novel inflammatory score (IS) system in the management of infectious endophthalmitis. Methods: This was a prospective comparative non?interventional observational study. The study included the patients with clinical signs and symptoms of acute post?cataract surgery endophthalmitis (surgery within 6 weeks) with visual acuity from 6/18 to light perception. IS was scored by the clinical picture at two?levels of four ocular tissues on a scale of 0 (normal) to 4 (severe). Four masked graders of different levels of experience evaluated slit?lamp photographs. The concordance correlation coefficient was assessed between the slit?lamp clinical grading and photographic grading. We measured the concordance correlation coefficient, Pearson’s correlation (indicating precision), and the bias correction factor (indicating the accuracy). Results: The study included 43 eyes of 43 patients. The concordance correlation coefficient was 0.99 (95% CI 0.995 to 0.998). Both Pearson’s correlation coefficient and the bias correction were 0.99. The interclass correlation coefficient (ICC) was measured. The intra?rater ICC was 0.833 with good agreement (95% CI, 0.711 to 0.906; P < 0.001). Inter?rater ICC for consistency was 0.92 (95% CI 0.87 to 0.95). Inter?rater ICC for absolute agreement was 0.86 (95% CI 0.66 to 0.93). Conclusion: Currently used IS scoring in the study is a reliable, reproducible, and easy?to?apply scale to measure inflammation severity in endophthalmitis. We propose that it can have applications in decision?making for primary treatment and monitoring progression in acute infectious endophthalmitis

Adaptación lingüística y psicométrica del Cuestionario de Estilos Atributivos Académicos (EAT-A) / Linguistic and psychometric adaptation of the Academic Attributional Style Questionnaire (EAT-A)

Resumen Antecedentes las atribuciones que los estudiantes hacen de sus resultados académicos pueden impactar en su rendimiento académico. Sin embargo, la medición de las atribuciones en este ámbito con frecuencia carece de evidencias de validez y confiabilidad. Objetivos: analizar la estructura factorial, validez convergente y confiabilidad de la adaptación para estudiantes mexicanos del Cuestionario de Estilos Atributivos Académicos (EAT-A). Método: participaron 557 estudiantes de ambos sexos, entre 15 y 19 años, de la Ciudad de México. Mediante el análisis factorial confirmatorio se sometió a prueba una estructura del EATA con siete factores y otra con cuatro que no distingue las atribuciones de éxito y fracaso. Se analizó la validez convergente, la consistencia interna y la confiabilidad compuesta del instrumento. Resultados: solo la estructura con siete factores presentó ajuste adecuado, con los índices RMSEA = .046; SRMR = .053; CFI = .961; TLI = .952 y χ²/gl = 2.72. El EAT-A muestra evidencias de validez convergente con la motivación de logro y de confiabilidad. Conclusión: El EAT-A se muestra como un instrumento de medida breve y fácil aplicación que dispone de evidencias de validez y estimación de confiabilidad para examinar las atribuciones que los estudiantes hacen de sus calificaciones.

Abstract Background Students' attributions of their grades may affect their academic performance. However, lack of evidence supporting the validity and reliability of the instruments measuring attribution is a major concern. Objective: To analyze the factor structure, convergent validity and reliability of the Academic Attributional Style Questionnaire adapted to Mexican high school students (EAT-A). Method: The sample consisted of 557 Mexico City students of both sexes aged between 15 and 19. Using a confirmatory factor analysis for both success and failure attributions, a 7-factor structure and a 4-factor structure of the EAT-A were tested. The instrument's convergent validity, internal consistency and reliability were examined. Results: Only the 7-factor structure showed adequate fit indices: RMSEA = .046; SRMR = .053; CFI = .961; TLI = .952 and χ²/gl = 2.72. In addition, the EAT-A evidenced convergent validity concerning success and reliability motivation. Conclusion: The EAT-A is a quick- and easyto- administer instrument for measuring students' attributions of their grades in a reliable and valid manner.

Comparison of efficacy and safety of oral azithromycin and oral doxycycline in acne vulgaris

Background: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit with considerable psychosocial impact. Oral azithromycin or oral doxycycline can be used for the management of moderate and severe acne vulgaris. However, there is no consensus on which antibiotic is superior and the optimal dose for management.Methods: A prospective randomized interventional study was carried out among 120 patients of moderate to severe acne vulgaris. The patients were randomized into group A and B. While group A was prescribed oral azithromycin 500 mg three times a week, group B was given oral doxycycline 100 mg daily for 12 weeks. Topical clindamycin twice daily application was also given. Global Acne Grading Scale (GAGS) score was recorded at baseline and at 2nd, 4th, 8th and 12th weeks.Results: GAGS score at baseline in azithromycin (n = 53) and doxycycline (n = 55) group was 31.98±4.49 and 30.63±3.78 respectively (p value >0.05). 83.91±6.83% (p <0.001) and 81.87±6.75% (p <0.001) improvement was seen in azithromycin group and doxycycline group after 12 weeks of treatment. However, there was no difference in the GAGS score between the groups at any follow-up (p value >0.05). 15.09% patients in azithromycin group and 20% patients in doxycycline group reported adverse effects. The most commonly reported adverse effect was diarrhoea. All adverse effects were of ‘mild’ category and causality assessment was ‘possible’.Conclusions: Oral azithromycin is equally efficacious but safer alternative to oral doxycycline for the management of acne vulgaris.

Effect of a Polyherbal Unani formulation in acne vulgaris: A preliminary study.

Acne vulgaris is the most common disorder treated by dermatologists. Acne is a disease of pilosebaceous units characterized by the formation of the open and closed comedones, papules, pustules, nodules and cysts. A preliminary trial was conducted in the department of Medicine, National Institute of Unani Medicine, Bangalore, India, to assess the safety and efficacy of a Polyherbal Unani Formulation (PHUF) in the management of Acne Vulgaris on scientific parameters. Twenty five patients, diagnosed with acne, were included in the study after obtaining their informed consents. All the patients were clinically assessed and diagnosed on the basis of thorough history and dermatological examination. Then, PHUF was administered locally once at night for a period of 45 days. The severity of acne and efficacy of treatment was assessed by Cook’s acne grading scale. The results showed significant reduction in the Cook’s acne grading scores of post-treatment group (P<0.01) as compared to pre-treatment scores. Further, PHUF was found safe and fairly well accepted by the patients. It was therefore, concluded that PHUF can be used safely and effectively for the treatment of acne vulgaris.

Reevaluation by Clinical Grading Scale for Malignant Hyperthermia Reported in Korean Journal of Anesthesiology / 대한마취과학회지

BACKGROUND: Malignant hyperthermia (MH) is a disorder of the skeletal muscle manifested as a life threatening hypermetabolic crisis in susceptible individuals following exposure to inhalation anesthetics and depolarizing muscle relaxants. The gold standard for determination of MH susceptibility is the in vitro contracture test (IVCT). However, it is invasive, requiring skeletal muscle biopsy and is not widely available. We attempted to reevaluate the MH in Korea using a Clinical Grading Scale (CGS) developed by Larach and colleagues to assist in clinical diagnosis. We intend to study CGS as a standardized means for estimating the qualitative likelihood of MH and establishing a Korean MH registry system. METHODS: We obtained twenty-seven case reports from the Korean Journal of Anesthesiology and applied a CGS developed by Larach and colleagues. The raw score of each case was obtained by scoring rules for the MH clinical grading scale, translated to a MH rank, and ranked by the MH likelihood. RESULTS: The overall mortality rate of reported MH was 44.4%. We described for MH rank and likelihood by CGS of cases. The CGS was missing a process in 13 cases for process II, 5 cases for process III and 4 cases for others. CONCLUSIONS: MH CGS is useful to aid the objective definition of this disease and for establishing a national registry system.

Clinical evalution of a new ICH Score / 重庆医科大学学报

Objective:To assess clinical value of grading scale for intracerebral hemorrhage(ICH).Methods:By using the grading scale for ICH suggested by Hemphill and colleagues, 205 patients with acute ICH presenting to our department during 2000～2001 were studied retrospectively.Results:Thirty-mortality of ICH patient increased steadily with ICH Score.Conclusion:The grading scale for ICH is a simple amd reliable method of ICH score,worthy of clinical application.