Quality of life in reflux and dyspepsia [QOLRAD] questionnaire in Iranian patients with GERD: a validation study

Symptoms of gastro-esophageal reflux disease [GERD] affect health-related quality of life [HRQOL]. When a questionnaire is translated into a new language, linguistic validation is necessary, yet insufficient, unless the psychometric characteristics have been verified. The aim of this study is to document the translation and psychometric validation of the Persian translation of the Quality of Life in Reflux and Dyspepsia [QOLRAD] questionnaire. After translation and cultural adaptation of QOLRAD to Persian, fifty patients with clinical GERD from the Prospective Acid Reflux Study of Iran [PARSI] database who had at least one of the symptoms of acid regurgitation, heartburn, non-cardiac chest pain, or dysphagia for at least four weeks over the past three months completed the QOLRAD and Short Form Health Survey-36 [SF-36]. After two weeks, QOLRAD was again completed by the patients. Cronbach alpha and Intra-class Correlation Coefficient [ICC] were used to test reliability and Pearson correlation was used to compare the dimensions of SF-36 and QOLRAD. The translation was approved by MAPI Research Institute. Fifty patients completed the SF-36 and QOLRAD questionnaires at the first visit. Mean [SD] age of the participants was 38.4 [14.6] years and 68% were females. The internal consistency and reliability of QOLRAD ranged from 0.78-0.92. The test-retest reliability of QOLRAD was from 0.87-0.93. Relevant QOLRAD domains significantly correlated with the majority of SF-36 domains, with the exception of sleep disturbance. The psychometric characteristics of the Persian translation of QOLRAD were found to be good, with satisfactory reliability and validity

[Diabetes and diving]

A 35 year old man, who is a diver, comes to your office. He had a hyperglycemia in his last check up. He asks you if he can steel dive in spite of hyperglycemia. We reviewed the recent studies about diabetic persons who dive. Recent studies have shown that well controlled diabetic persons may be permitted to dive, But if they have any problems such as diabetic nephropathy, retinopathy, neurological and cardiac problems, diving is contraindication. So the older persons with type 2 diabetes should be evaluated carefully for diabetic complications. Diabetic persons before diving must be educated about hypoglycemic signs and symptoms and how to manage it under the water. One of the guidelines for management of diabetic divers is Burghan and Vincent protocol for before and after diving, but unfortunately a little research about diabetic divers has been done before. Our data on plasma glucose [PG] response to diving are limited, particularly for adolescents. Our data about type 1 diabetes and diving is very limited