Validation of the Arabic version of the EORTC quality of life questionnaire among cancer patients in Lebanon

Purpose

The objective of this article was to evaluate the psychometric properties of the translated Lebanese Arabic version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 in a sample of adult cancer patients in Lebanon.

Methods

The EORTC QLQ-C30 was translated into Lebanese Arabic and administered to a convenient sample of 200 adult patients diagnosed with cancer at a tertiary care center in Lebanon between 2009 and 2010. The psychometric indices assessed were reliability, multitrait scaling analysis, construct validity, and confirmatory factor analysis.

Results

Six out of nine subscales had Cronbach’s alpha coefficients above 0.70. Multitrait scaling analysis showed that all item-scale correlation coefficients met the set standards of convergent validity with the exception of item 5 only (95.8 %). In addition, 79.7 % of the item-scale correlation coefficients met the criterion for discriminant validity. In inter-scale correlations, all conceptually related scales had correlation coefficients of ≥0.40 with the exception of role functioning and fatigue scales having an undesirable correlation coefficient of ?0.76. In known-groups comparison, the instrument differentiated significantly between some of the subscales with respect to education, employment, and age. CFA showed an almost good fit (GFI = 0.87) with respect to our current data set.

Conclusion

The translated Lebanese Arabic version of the EORTC QLQ-C30 is a reliable and valid instrument that can be used to assess the quality of life of Lebanese cancer patients.     

Echogenic intracardiac focus on second trimester ultrasound: prevalence and significance in a Middle Eastern population

Objective: The association between echogenic intracardiac focus (EIF) and trisomy 21 is well established, with a recognized ethnic variation. Our study aimed to determine the prevalence of EIF in a Middle Eastern population and to examine its association with trisomy 21 and other adverse pregnancy outcomes.

Methods: Retrospective case-control study of second-trimester obstetric sonograms (16–28 weeks) performed at a tertiary care center over a 5-year period. Cases with EIF were retrieved, and a matched control group with no EIF was identified. The incidence of trisomy 21 and other adverse pregnancy outcomes was compared.

Results: A total of 9270 obstetric sonograms were examined, with an EIF prevalence of 2.5% (95% CI: 2.2–2.8%). Of patients with available outcome data, EIF was not associated with trisomy 21 (0/163 versus 1/163; p value = 1.00). Additionally, EIF was not associated with trisomy 18, trisomy 13, small for gestational age, preterm birth, fetal demise, cesarean delivery, operative vaginal delivery, or admission to the neonatal intensive care unit.

Conclusion: In a contemporary Middle Eastern population, EIF is a rare occurrence. As an isolated finding, it is not associated with aneuploidy or other adverse pregnancy outcomes. EIF appears to be incidental with no impact on clinical practice.     

Age‐ and gender‐specific reference intervals for serum lipid levels (measured with an Advia 1650 analyzer) in school children

Background: Due to the lack of country‐specific norms in Saudi Arabia, age‐ and gender‐specific lipid reference intervals are needed to be established for Saudi children. Methods: Blood samples were collected from 1168 children aged 6–16 years: 500 boys (43%) and 668 girls (57%), and were analyzed for cholesterol, high‐density lipoprotein (HDL) and low‐density lipoprotein (LDL). Reference intervals were established by calculating the mean and the 2.5th and 97.5th percentiles. Results: There were significant differences between boys at each Tanner stage with respect to cholesterol (P < 0.001); and HDL (P < 0.0001) but not LDL (P < 0.06) among girls. There were significant differences between boys and girls during puberty with respect to cholesterol (P < 0.0001), HDL (P < 0.0001), and LDL (P < 0.001). There was a significant positive correlation between total cholesterol levels, LDL and HDL levels at all Tanner stages in both genders. In girls, the only significant inverse correlation was at stage I (r=?0.243, P= 0.001); there was no significant correlation at other stages. Conclusions: Unlike children in other developing countries, Saudi children do not have lower serum cholesterol than their Western counterparts. These findings reflect changing dietary habits and increasing affluence in Saudi Arabia. These reference intervals may be used to aid in the early assessment of cardiovascular risk in Saudi pediatric populations.     

Prevalence of antibodies against hepatitis C virus among blood donors in Lebanon, 1997–2000

Chronic hepatitis C virus (HCV) infection in many individuals is asymptomatic and the prevalence of antibodies to hepatitis C virus (anti‐HCV) among blood donors in Lebanon is scarce. This study aimed to address the prevalence of anti‐HCV in 8700 blood donors, the data obtained was compared to other world regions. Between 1997 and 2000, 8700 blood donors were screened for the presence of anti‐HCV in their sera. Initially reactive specimens were retested in duplicate, and repeatedly positive samples were subsequently retested by a third generation microplate enzyme immunoassay. Of the 8700 blood donors screened, 51 were confirmed positive for anti‐HCV, giving a prevalence rate of 0.6%. While there was no difference in anti‐HCV prevalence in relation to age or gender, higher rates were seen in non‐Lebanese compared to Lebanese subjects (6.17% vs. 0.48%, P < 0.001). None of the anti‐HCV positive individuals had an identifiable risk factor for contracting HCV (intravenous drug user, prior transfusion, etc.), and their transaminases were comparable to anti‐HCV‐negative donors, suggesting that HCV‐positive donors were asymptomatic. These results demonstrate low prevalence of anti‐HCV among Lebanese blood donors, which was comparable to those established for Western countries.     

Louse‐borne relapsing fever in Finland in two asylum seekers from Somalia

We report two cases of louse‐borne relapsing fever (LBRF) in young Somali asylum seekers having recently arrived to Finland. They had sought medical attention for a febrile illness. Blood smears were examined for suspected malaria, but instead, spirochete shaped bacteria were observed. The bacteria were confirmed as Borrelia recurrentis by PCR and sequencing. The patients survived, but their treatment was complicated by Jarisch–Herxheimer reaction. We conclude that LBRF must be considered as a diagnostic option in febrile refugees also in the northernmost parts of Europe.     

Impact of maternal age on preterm delivery and low birthweight: a hospital-based collaborative study of nulliparous Lebanese women in Greater Beirut.

OBJECTIVES: To analyze the impact of maternal age at first childbirth on the incidence of preterm delivery and low birthweight among single live births delivered to nulliparous Lebanese women in Greater Beirut. STUDY DESIGN: Eligible subjects were selected from a consecutive sample of neonatal admissions to nine National Collaborative Perinatal Network participating hospitals over a three-year period (April 1, 1999 to March 31, 2002). Chi-square tests and logistic regression analyses were applied. RESULTS: Out of 5556 nulliparous mothers, 5.4% had a preterm delivery and 5.2% a low-birthweight infant. In the multivariate analysis, preterm delivery was not significantly affected by old maternal age. Mothers aged 25 years or more remained a high-risk group for low birthweight even after controlling for potentially confounding characteristics. CONCLUSIONS: Maternal age at first childbirth above 25 years is an independent risk factor for low birthweight, but not for preterm delivery, an outcome influenced mainly by obstetric complications.     

Visual estimation versus gravimetric measurement of postpartum blood loss: a prospective cohort study

Purpose  

One of the major problems in international literature is how to measure postpartum blood loss with accuracy. We aimed in this research to assess the accuracy of visual estimation of postpartum blood loss (by each of two main health-care providers) compared with the gravimetric calculation method.     

Preoperative biliary drainage for malignant biliary obstruction: results from a national database

Background

The impact of preoperative biliary drainage (PBD) on postoperative morbidity and mortality in patients with malignant biliary obstruction is still unclear. We examined short‐term surgical outcomes among drained and non‐drained patients.

Methods

Patients who underwent surgical resection for their malignancies with biliary obstruction were identified using the American College of Surgeons National Surgical Quality Improvement Program Participant Use Files from 2014 to 2015. Mortality and morbidity were compared among patients who had PBD to those who did not undergo biliary drainage prior to surgery.

Results

A total of 2,306 patients were included; of these 1,803 (77.8%) had PBD. The postoperative mortality was 3.0% and 2.2% among direct surgery (DS) group and PBD group, respectively (P = 0.3). Postoperative complications were higher in the PBD group compared to the DS group (27.1% vs. 19.5%; P = 0.0005). Patients in the PBD group had higher risk of sepsis (13.5% vs. 7.2%; P = 0.0001), wound infections (16.5% vs. 10.9%; P = 0.002) and pancreatic fistula (17.5% vs. 12.4%; P = 0.006) compared to the DS group.

Conclusion

Preoperative biliary drainage is associated with increased risk of sepsis and wound infections, but does not impact the postoperative mortality of patients undergoing PBD.