Public Knowledge and Belief Regarding Antibiotic Use and Antimicrobial Resistance in Qatar

Background: Antibiotics act as a therapeutic weapon in eradicating pathogens. Antibiotics are the most common group of drugs misused for self-medication. This is a global public health concern and is one of the major contributing factors to antibiotic resistance (ABR). This study aimed to assess the knowledge and beliefs of the public in Qatar regarding appropriate antibiotic use and antimicrobial resistance. Methods: A cross-sectional research design was used to collect the information from the participants based on an adapted questionnaire from the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) between September – November 2018. The study enrolled 1000 par-ticipants who visited two large emergency departments (ED) of public hospitals in Qatar. Results: The mean knowledge and belief scores were 55.07±15.87 and 66.57±23.13 respectively. 42% of the participants had moderate knowledge regarding antibiotic and antimicrobial resistance. The majori-ty of the participants (64.8%) believed that antibiotics fight against bacteria and viruses. The educational level significantly influences the belief of the participants. Graduates possess a higher belief score of 11.75±12.5 (P=0.001) compared to others. Conclusion: The key findings of this study highlighted the existing gap in knowledge among the public. A community-based health education program should be launched to promote judicious of use antibiotics

An R Function for Cronbach’s Alpha Analysis: A Case-Based Approach

Cronbach’s alpha is a very commonly used method in biomedical research. Cronbach’s alpha Indicates the extent to which the items in your questionnaire are related to each other, a useful coefficient for assessing the internal consistency of the items. Although this method is commonly used in medical research, the statistical software packages do not have the direct menu-driven operation for Cronbach’s alpha. Hence this paper intends to provide an R function (Cronbach. Alpha) for Cronbach’s alpha analysis.

Association Of Non-Specific Low Back Pain And Disability Index With Lower Extremity Alignment Factors

Background: An array of risk factors contributes to non-specific low back pain. Apart from age, female gender, low educational status, obesity, occupation, and psychological factors, postural variations (including variations in the lower extremity) play a significant role in predisposing an individual to low back pain. Hence, while evaluating/examining a patient with back pain, the alignment of the lower extremity should be taken into consideration rather than restricting the evaluation to the lumbosacral region. Methods: 36 subjects (12 Males, 24 Females) with non-specific low back pain were assessed for pain and disability using the Oswestry Disability Index (ODI). The measurements for lower extremity alignment factors (Pelvic angle, Angle of torsion of the femur, Quadriceps angle, Tibial torsion, and Navicular drop) were recorded bilaterally Results: There was a positive correlation of non-specific low back pain and disability index with the right pelvic angle (p=0.0012, r=0.51, and p=0.0003, r=0.56 respectively). Non-specific low back pain and disability index had no correlation with left pelvic angle (p=0.9101, r=0.01 and p=0.9794, r=0.00 respectively). Non-specific low back pain and disability index had a positive correlation with angle of torsion (AOT) of femur (Rt: p=0.0027, r=0.48, Lt: p=0.0084, r=0.43 and Rt: p=0.0039, r=0.46, Lt: p=0.0023, r=0.49 respectively), quadriceps angle (Q-angle) (Rt: p=0.0020, r=0.49, Lt: p=0.0014, r=0.51 and Rt: p=0.0019, r=0.49, Lt: p=0.0024, r=0.49 respectively) and navicular drop (Rt: p=<0.0001, r=0.61, Lt: p=0.0053, r=0.45 and Rt: p=0.0002, r=0.58, Lt: p=0.0048, r=0.46 respectively) bilaterally. Non-specific low back pain had no correlation with right tibial torsion (p=0.9269, r=0.01). Disability index had a positive correlation (not significant) with right tibial torsion (p=0.2427, r=0.19). There was a positive correlation (not significant) of non-specific low back pain and disability with left tibial torsion (p=0.1757, r=0.23 and p=0.0703, r=0.30 respectively). Conclusion: There was an association of non-specific low back pain and disability index with lower extremity alignment factors.

Do the length-based (Broselow) Tape, APLS, Argall and Nelson's formulae accurately estimate weight of Indian children?

This study was aimed at validating the usefulness of a length based pediatric emergency tape (Broselow) in an Indian population. The secondary objective was to validate age based weight estimation formulae (Nelson, Argalls, APLS) for emergency needs (doses, sizes). This cross sectional study was done at a tertiary teaching hospital on a sample of 500 children attending outpatient clinic. Inclusion criteria was age between 1 month to 12 years. Children who were unstable, uncooperative or critically ill requiring emergency care and those measuring more than 145 cm in length or weighing more than 35 kg weight were excluded from the study. Measurement of actual weights, calculation of weight, adrenaline dose, fluid bolus and endotracheal tube size was done by all four methods. Results indicated good positive correlation between actual measured weights and weights estimated using Broselow Tape (r = 0.974), APLS (r = 0.902), Argalls modification (r = 0.902), and combined Nelson formulae (0.935). However, specific Nelson formulas for 7-12 yr and 3-12 mo were especially poor in correlation. Bland-Altman Plots comparing actual weight showed least mean bias for Broselow Tape estimations in < 15 kg group (0.080 +/- 0.96 kg) and maximum bias with Nelsons formula for 7 to12 yr (5.204 +/- 4.272 kg). For adrenaline doses and fluid bolus calculations, Broselow estimations were valid estimates. Broselow tape did underestimate endotracheal tube size (mean bias -0.53 +/- 0.18). To conclude, length based pediatric emergency tape (Broselow) correlates well with overall emergency decision making process in our setting. This is especially validated in the age group 0.1 to 6.7 yr weighing less than 15 kg.

Validation of EORTC quality-of-life questionnaire in Indian women with operable breast cancer.

BACKGROUND: The European Organization for Research and Treatment of Cancer (EORTC) module QLQ-C30 and the breast cancer-specific module BR-23 have been validated worldwide to assess the quality of life (QOL) in women with breast cancer. No such study has been published on Indian women using EORTC questionnaires. METHODS: QOL was assessed in relation to surgery, adjuvant chemotherapy, radiation therapy and hormone therapy in 299 Indian women with operable breast cancer (OBC) at the Breast Unit of Tata Memorial Hospital (TMH), Mumbai, from October 1998 to September 2001. The QLQ-C30 module was used to assess physical health, emotional, cognitive and social functioning, and the BR-23 module to assess breast cancer treatment-related symptoms. Assessment was done at 3 visits: visit 1 (after surgery); visit 2 (during adjuvant therapy) and visit 3 (on completion of adjuvant therapy). RESULTS: Of the 299 women at first visit, 274 (91.6%) completed the visit 2 questionnaire and 239 (80%) completed the visit 3 questionnaire. Only those women who filled the questionnaires at all 3 visits were included as 'valid visits' for analysis (193 of 299; 64.5%). The reliability and validity of the English and translated versions of the questionnaires were tested by Cronbach alpha (0.61-0.96) and item-scale correlation (0.63-0.93). Women with breast conservation treatment had a superior body image as compared to those with mastectomy (p <0.001). Physical, emotional and cognitive functions were not related to the type of surgery. Global QOL, physical, sexual and role functioning were found to deteriorate with chemotherapy (p < or = 0.01). Radiotherapy had only local adverse effects (p < 0.001 ), while hormone therapy had no adverse impact on QOL. CONCLUSION: QLQ-C30 and BR-23 questionnaires can be used reliably to assess QOL in Indian patients. The translated versions were found to be valid for further use in clinical trials on Indian women with breast cancer.

Protective action of aspirin in experimental myocardial infarction induced by isoproterenol in rats and its effect on lipid peroxidation.

The protective action of aspirin in experimental myocardial infraction induced by isoproterenol was studied in rats. Aspirin treated rats showed lower mortality rate and smaller changes in the myocardium on histopathological examination when compared to corresponding animals given isoproterenol alone. Changes were also observed in the different lipid fractions studied. The ratio of cholesterol to phospholipids decreased in the heart in aspirin treated animals when compared to control rats given isoproterenol alone. The levels of lipid peroxide also showed a decrease while the activity of superoxide dismutase (SOD) and catalase registered an increase in the aspirin treated animals given isoproterenol when compared to corresponding animals given isoproterenol alone.

Effect of vitamin E on the severity of myocardial infarction induced by isoproterenol.

The effect of vitamin E administration on the severity of myocardial infarction induced by isoproterenol on rats was studied. Judging from serum enzyme activity (CPK 714 micromoles; GOT 291.7 micromoles; and GPT 155.5 micromoles), mortality rate (60 to 65% survived) and histopathological observation, vitamin E has been observed to offer very little protection to the myocardium during experimental myocardial infarction when compared to control animals given isoproterenol alone (CPK 775.8 micromoles; GOT 336.2 micromoles; and GPT 168 micromoles), mortality rate (60 to 65% survived) and histopathological observation (more or less similar). The level of lipid peroxides namely hydroperoxides (control 3.15; vitamin E + iso. 14.8); conjugated diene (4.45 and 6.85) and malondialdehyde (1.22 and 2.55) in the heart were higher in the vitamin E treated animals given isoproterenol when compared to control animals given vitamin E alone. The level of cholesterol and phospholipid was more or less similar in the control animals given vitamin E alone (183.6 and 3.12) and vitamin E treated animals given isoproterenol (170.25 and 2.49), but the ratio of cholesterol to phospholipid was higher in the vitamin E treated animals given isoproterenol when compared to control animals given vitamin E alone.