Social factors as career obstacles for female oral and maxillofacial surgeons in three Middle Eastern countries.

Despite the feminization of dentistry in many areas of the world, female representation in the field of oral and maxillofacial surgery (OMFS) is poor. The purpose of this study was to identify factors perceived by female oral and maxillofacial surgeons in Egypt, Jordan, and Saudi Arabia as being obstacles to their career progression and to compare them to factors identified by their male colleagues. This was a cross-sectional questionnaire-based study. A Google Forms questionnaire was designed to collect data on socio-demographics and perceived career obstacles in OMFS. This was distributed to oral and maxillofacial surgeons in Egypt, Jordan, and Saudi Arabia. Statistically significant differences between the genders were evident in terms of marital status (P=0.001), spouse's education (P=0.005), and spouse's occupation (P<0.001). When compared to male surgeons, female surgeons more often considered that their spouse's occupation hindered their career progression (P<0.001). Female surgeons, but not male surgeons, perceived sexism and social factors such as marriage, children, and the attitudes of society to be major career obstacles (P<0.005). In conclusion, female maxillofacial surgeons in some Middle Eastern countries were found to have different socio-demographic characteristics compared to their male colleagues and they considered sexism, marriage, children, and the attitudes of society to be major career obstacles.

Relationship between dental impacts on daily living, satisfaction with the dentition and personality profiles among a Palestinian population.

INTRODUCTION: The aim of this study was to investigate the relationship between dental impacts on patients' daily living, satisfaction with the dentition and personality profiles. MATERIALS AND METHODS: Fifty-two patients (22 males and 30 females; mean age 22.7 +/- 5.5 years) were recruited for this study. A "dental impact on daily living" (DIDL) questionnaire was used to assess patients' satisfaction with their dentition and impacts on daily living. The NEO five factor inventory (NEO-FFI) was used to assess personality profiles. RESULTS: The dentition had measurable impacts on daily living as well as satisfaction with appearance, pain levels, oral comfort, general performance, and eating capability (p < 0.001). Older patients were more totally satisfied (p = 0.014), more satisfied with appearance (p = 0.034), and less satisfied with general performance (p = 0.024). Older patients had higher Conscientiousness scores (p = 0.001) and lower Openness scores (0.018). Females were more satisfied with eating (p < 0.001). Significant correlations were established between neuroticism and total DIDL scores (p = 0.006). Extraversion had significant correlations with total satisfaction (p < 0.001) as well as satisfaction with appearance (p = 0.047) and oral comfort (p = 0.008). Significant correlations were also established between openness and satisfaction with general performance (p < 0.001), between Agreeableness and satisfaction with eating (p = 0.001), and between Conscientiousness and total satisfaction (p = 0.001), satisfaction with pain (p = 0.004), and satisfaction with oral comfort (p = 0.043). CONCLUSIONS: The status of the oral cavity might impact on patients' daily living and satisfaction with the dentition. Patients' satisfaction with their dentition has definitive impacts on daily living and dental perceptions. Personality profiles (neuroticism; extraversion; openness; agreeableness and conscientiousness) may influence dental perceptions; play a significant role in shaping satisfaction with dentition, and help with prediction of dental impacts on daily living. Patient satisfaction and psychological profiles should be considered when formulating a treatment plan in order to achieve patient acceptance of the offered treatment.

Rituximab for refractory cases of childhood nephrotic syndrome.

Rituximab has been used over the last decade as a rescue therapy for refractory cases of nephrotic syndrome (NS). Here we report the use of rituximab in four children with idiopathic steroid-resistant nephrotic syndrome (SRNS) with various histological backgrounds (two cases with focal segmental glomerulosclerosis, one case with IgM nephropathy, and one case with minimal change disease), who failed to respond to other immunsuppressions. Their median age (range) was 10 (8-11) years. NPHS2 genetic mutation was negative in all of them. All patients received a single dose of rituximab (375 mg/m(2)) and achieved complete B cell depletion as CD19 was <1% for 3 months following rituximab infusion. Only one patient achieved non-sustained remission as he relapsed after 4 months despite zero CD19 level. Patients received no further doses of rituximab as B cell was depleted in the peripheral circulation. We conclude that a single dose of rituximab was not effective in inducing sustained remission in children with idiopathic SRNS, despite complete B cell depletion in the peripheral circulation. Further doses might be indicated to deplete non-circulating B cells.

Narghile smoking and its adverse health consequences: a literature review.

Oral squamous cell carcinoma (OSCC) is a world health problem with approximately 50% of patients having a 5-year survival rate. A change in the demographics of the disease is now being recognised, particularly in Europe, where it is increasingly being seen in young males. While a variety of risk factors are important in OSCC, it is tobacco that plays a central part in the pathogenesis of the disease. Narghile is an old form of tobacco use but in the past decade, there has been a resurgence in this form of smoking. The practice is particularly common in young males and females from the Middle East but with the advent of immigration and globalisation, its use is becoming more widespread. It is now not uncommon to see narghile smoking in western countries such as the UK and USA. Studies describing the oral effects of narghile are unfortunately scarce. While adverse effects such as periodontal bone loss and dry socket have been described, its association with OSCC cannot be excluded. Variation in the type of narghile, the type of tobacco and the presence of co-factors such as cigarette smoking may all influence clinical outcome. In the present study, the practice of narghile smoking is reviewed in terms of its effect on health, particularly oral health. The association of narghile smoking and adverse effects on the orofacial region will be outlined, namely, periodontal disease, potentially malignant lesions and oral cancer.

Willingness of dentists in Jordan to treat HIV-infected patients.

UNLABELLED: Reluctance of dentists to treat human immunodeficiency virus (HIV) positive patients represents a major concern. Many efforts have been extended towards the documentation of the extent of this reluctance and speculation of factors that influence it. OBJECTIVES: Assess the willingness of dentists in Jordan to treat HIV-infected patients. MATERIALS AND METHODS: Two hundred and forty-two general dental practices were surveyed for their willingness to provide treatment of toothache and routine dental care of an HIV-infected individual. RESULTS: Only 15% of the dental practices were willing to provide such care. Willingness to provide treatment did not seem to be influenced by financial factors or the local prevalence of HIV disease. CONCLUSION: Present data suggest that HIV-infected individuals will have difficulty in obtaining dental health care in Jordan.

Intravenous pulse cyclophosphamide--is it effective in children with steroid-resistant nephrotic syndrome?

UNLABELLED: Treatment of steroid-resistant nephrotic syndrome (SRNS) remains a challenge to pediatric nephrologists. Recently, intravenous cyclophosphamide (IV-CPM) infusion was shown to be effective, safe, and economical for the treatment of SRNS, particularly minimal change disease (MCD), as it results in more sustained remissions, longer periods without proteinuria, and fewer significant side effects at a lower cumulative dose. A prospective study was conducted to evaluate IV-CPM infusions in the management of children with SRNS secondary to MCD or IgM nephropathy. Five patients with SRNS (4 IgM nephropathy and 1 MCD) received six monthly IV-CPM infusions at a dose of 500 mg/m(2). No patient achieved complete or sustained remission. Three patients attained partial remission, which was not sustained for more than 1 month post therapy. One patient progressed rapidly to end-stage renal disease during treatment. Side effects included vomiting in four patients and alopecia in one patient. CONCLUSION: IV-CPM pulse therapy at a dose of 500 mg/m(2) is unsuccessful in obtaining complete or sustained remission in children with SRNS secondary to IGM nephropathy or MCD. Further randomized controlled studies with higher doses are required.

Familial hypomagnesemia with hypercalciuria and nephrocalcinosis.

Familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC) is a rare autosomal recessive tubular disorder that is frequently associated with progressive renal failure. The primary defect is related to impaired tubular reabsorption of magnesium (Mg) and calcium (Ca) in the thick ascending limb of Henle's loop. We have studied seven Arab patients with this syndrome who belong to four different families. The mean age at first presentation was 1.5+/-1.3 years (range 0.1-3 years) and at diagnosis 5.9+/-4.3 years (range 0.5-12 years). The presenting features were convulsions and carpopedal spasms (5 patients), polydipsia and polyuria (2 patients), rickets (2 patients), and recurrent urinary tract infections (1 patient). Bilateral nephrocalcinosis was observed in all patients. All patients had hypomagnesemia with a mean serum Mg of 0.45+/-0.09 mmol/l, an inappropriately high urine Mg of 2.07+/-0.73 mmol/24 h or fractional excretion of 15.3+/-7.1%, high urine Ca excretion of 4.1+/-1.2 mmol/24 h or urine Ca to creatinine ratio of 2.6+/-1.6, and normal serum potassium level of 4.4+/-0.34 mmol/l. All patients received Mg supplements and thiazide but exhibited slow worsening of their kidney function. After a mean follow-up of 4.4+/-3.9 years, one patient progressed to end-stage renal failure (ESRF). In conclusion, we report seven Arab patients with FHHNC syndrome. The clinical and biochemical data were similar to previous reports. However, they tend to show a slower rate of progression to ESRF.

Levamisole treatment in steroid sensitive nephrotic syndrome.

OBJECTIVE: To evaluate the effectiveness of levamisole in maintaining remission in children with steroid-sensitive nephrotic syndrome (SSNS) who had a frequent relapsing or steroid-dependent course. METHODS: All children with SSNS who had a frequent relapsing or steroid-dependent course and were treated with levamisole between 1997 and 2001 at King Abdul-Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia were reviewed. All patients were treated by the same steroid protocol used in our unit. Levamisole was considered effective if the patient successfully remained in remission on Prednisolone 0.5 mg/kg/48 hours or less. RESULTS: Nine children were treated with levamisole (3 mg/kg/48 hours) with median (range) age of 6 (3.5-10) years. Seven received levamisole for more than 6 (6-24) months and 2 were excluded because they did not adhere to treatment. Levamisole was effective in 4 patients (57%) with remarkable reduction in the number of relapses and the steroid maintenance dose. Renal biopsy was performed in 4 patients: 2 responders with biopsy findings of minimal change disease (MCD) and mesangioproliferative glomerulonephritis and another 2 non responders with biopsy findings of MCD and focal segmental glomerulosclerosis. No significant side effect was observed. CONCLUSION: Levamisole is effective in maintaining remission in steroid SSNS in Arab children and has few side effects.

The effect of a hydroxyapatite-reinforced polyethylene stress distributor in a dental implant on compressive stress levels in surrounding bone.

This study investigated various designs of stress breakers incorporated into the dental implant using 3-D finite element analysis. These designs employed hydroxyapatite-reinforced polyethylene (HRP), a material capable of inducing osseointegration. The most successful design was that of a dental implant with a peripheral HRP component that was in direct contact with the bone surrounding the neck of the implant. This design lowered the compressive stress values in bone around the neck of the implant. Attempts were also made to optimize this design.

Stress distribution associated with loaded ceramic onlay restorations with different designs of marginal preparation. An FEA study.

The design of marginal finish of an inlay or onlay could influence the prognosis of the restoration since this area is subjected to various mechanical or chemical actions during function. This study was carried out to determine the tensile stresses which develop at the marginal area when subjected to vertical and horizontal loads. Onlay restorations with three different types of marginal finish, i. e. shoulder, chamfer and bevel, were modelled in three dimensions using the finite element method, and were then subjected to vertical and horizontal load at three different sites. The results show that horizontal forces acting on the restoration generate the highest tensile stresses whilst the vertical forces generate high tensile stresses at the margins of the chamfer and bevel designs.

Strains and tensile stress distribution in loaded disc-shaped ceramic specimens. An FEA study.

Disc-shaped specimens are frequently tested in order to establish an understanding of the properties of ceramic material. In this study three-dimensional finite element stress analysis has been used to investigate the loading characteristics of this shape of specimen and the effect of incorporating scratches and voids into its structure. The results indicated that stress increased as loading was carried out nearer to the centre of the specimen. The presence of cracks did not affect these stresses whereas the presence of a void resulted in a very high stress concentration.

An evaluation of self-cured and visible light-cured denture base materials when used as a denture base repair material.

The aim of this study was to compare some of the physical properties of a heat-cured, a self-cured and a visible light-cured acrylic resin, and to evaluate the suitability of visible light-cured resin as a repair material for dentures made of heat-cured acrylic resin. Transverse strength, surface hardness and impact strength were determined for the three materials and the efficiencies of light-cured and self-cured resins, when used as a repair material, were evaluated by testing the transverse strength of repaired heat-cured specimens 1 hour, 1 week and 1 month after repair. The results showed that the rigidity of specimens repaired with light-cured resin improved with longer water storage. However, their transverse strength reached a maximum after one day and was reduced after 1 month. The rigidity and transverse strength of specimens repaired with self-cured resin were not influenced significantly by water storage and the transverse strength was significantly higher than the light-cured repaired specimens.

Comparison of the efficacy, safety and cost of cefixime, ceftriaxone and aztreonam in the treatment of multidrug-resistant Salmonella typhi septicemia in children.

An increase in the incidence of Salmonella typhi strains resistant to chloramphenicol, ampicillin and trimethoprim-sulfamethoxazole causing enteric fever in Egyptian children stimulated the evaluation of alternative drugs. Children with positive blood cultures were treated with cefixime, ceftriaxone or aztreonam, and the efficacy, safety and cost of these regimens were evaluated and compared. Cefixime (7.5 mg/kg) was given orally twice daily to 50 children for 14 days, ceftriaxone (50 to 70 mg/kg) was given im once daily for 5 days to 43 children and aztreonam (50 to 70 mg/kg) was given im every 8 hours for 7 days to 31 children. Children in the 3 groups were comparable with regard to age, sex, duration and severity of illness before admission. All children were cured. A significant difference (P < 0.05) in duration of treatment before becoming afebrile seemed to favor ceftriaxone (3.9 days) over aztreonam (5.5 days) and cefixime (5.3 days). During the 4-week follow-up period relapses occurred in 3 (6%) children in the cefixime group, in 2 (5%) in the ceftriaxone group and in 2 (6%) in the aztreonam group. Safety and efficacy were comparable for all 3 drugs. Ceftriaxone was most cost-effective on an inpatient basis, because of a more rapid clinical cure, and cefixime was the most cost-effective on an outpatient basis, because of drug cost.