Assessing validity of the adapted Arabic Paediatric Asthma Quality of Life Questionnaire among Egyptian children with asthma

The recent focus in asthma management is rendering children a better quality of life [QOL]. Validity and reliability of an adapted Arabic translation of the Paediatric Asthma Quality of Life Questionnaire [PAQLQ-A] among Egyptians was assessed in a cohort of 103 asthmatic children aged 8-16 years. Discriminative validity of mean scores was significantly higher among mild asthmatics than those with moderate/severe asthma. Construct validity of domains was significantly negatively correlated with clinical severity score. Reliability and internal consistency were assessed using Cronbach alpha coefficient [alpha = 0.84]. Reproducibility and responsiveness were high among both stable and unstable asthma patients. PAQLQ-A is valid and reliable for assessing QOL among Egyptian asthmatic children

Sonographic and bacteriological evaluation of cases likely to progress to preterm labor

The aim of the work is evaluation of bacteriological and sonographic role in the assessment of cases likely to progress to preterm labour and setting the management plan. This study included 30 pregnant ladies selected from the Shatby Maternity University Hospital between 20-30 years, primigravida or multigravida, and pregnant between 26 to 34. Presenting with threatening preterm labor, with intact membrane, with two or more of the following criteria: persistent menstrual like cramps and low dull backache, persistent heaviness, abdominal cramping, increase or change in vaginal discharge. All cases were subjected] 1-Complete history taking 2-Complete physical and obstetrical examination included a] inspection of the vulva, urethra, and perineum to detect the presence of any discharge or local inflammatory signs b] Speculum examination: for the presence of any pathological lesion and the type and character of any discharge [amount, color, and odor] c] Digital vaginal examination is performed with sterile glove if established preterm labour is suspected.3-Investigations:-1] Vaginal specimens: Sterile cotton-tipped swabs were used, inserted into the upper part of the vagina and rotated there before withdrawing it. For each case, two swabs were collected: one was placed in a transport medium for culture of aerobes and anaerobes; the other was rolled into a clean glass slide to make a smear.2] Specimens of urine were collected to detect and treat urinary tract infection if present.3] Detailed abdominal ultrasonography.4] Trans-vaginal ultrasound to determine: i] Cervical length. ii] Cervical width iii] The presence of funneling iv] Condition of the membranes. Cases were followeA up till either labor or complete 34 weeks was reached. The study -started with 54 cases, 24 cases dropped out, while 30 cases completed the study till the end-point. Initial pregnancy duration of the selected cases ranged between 26 - 33 weeks with a mean of 28.8 +/- 2.1. Culturing vaginal swabs recovered pathogens in a total of 18 of the studied 30 cases [60%]. Gardnerella virginals was found in 9 cases [30%], Klebsiella spp.5 cases [16.6%] and anaerobic streptococci spp. in 3 cases [10%] and pseudomonas spp.1 case [3.3%]. In the remaining 12 cases [40%], the recovered organisms were encountered as vaginal flora. Six cases with positive vaginal swabs showed clinical manifestations of vaginal infection mainly itching and vaginal discharge, while the remaining 12 cases are asymptomatic. Urine culture showed 3 cases of the study to have urinary tract infection [UTI], one of t em had Escherichia Coli [E.coli], and the other 2 cases had asymptomatic bacteriuria. All cases with viable singleton pregnancy between 26 -33 weeks, with adequate amount of liquor, placenta was fundal anterior in 25 cases and fundal posterior in the remaining 5 cases. Cephalic presentation in [16] cases, breech in [6] cases, and the remaining [8] cases with unstable lie. Ten cases out of 30 [33.3%] showed positive cervical changes on ultrasonography [cervical length<27 mm and diameter >17 mm], while 20 cases [66.7%] showed no changes.18 cases out of 30 showed positive vaginal infection, the cases with mean gestational age 27.09 +/- 1.30 weeks at the beginning of the study [11 cases], they continued their pregnancy till the end-point of the study[completed 34 weeks,] while cases with mean gestational age of 29.71 +/- 2.14 weeks at the beginning of the study [7 cases], they progressed to preterm labour, in spite of the same management plan. This difference showed a statistical significance [X[2] 6.744, P>0.05]. Positive correlation was found between the presence of vaginal infection and the occurrence of cervical changes and between cervical changes as detected by ultrasonography [decreased cervical length less than 27 mm and dilatation of the internal os more than 17 mm] and the occurrence of preterm labor