validation study comparing the sensitivity and specificity of the new Dr. KSU H1N1 RT-PCR kit with reAl time RT-PCR for diagnosing influenza A [H1N1]

A new test [Dr. KSU H1N1 RT-PCR kit] was recently developed to provide a less expensive alternative to reAl time reverse transcriptase-polymerase chain reaction [RT-PCR]. We report the findings of a validation study designed to assess the diagnostic accuracy, including sensitivity and specificity, of the new kit, as compared to reAl time RT-PCR. Cross-sectional validation study conducted from 18-22 November 2009 at a primary care clinic for H1N1 at a tertiary care teaching hospital in Riyadh. Nasopharyngeal swab samples and data on socio-demographic characteristics and symptoms were collected from 186 patients. Swab samples were sent to the laboratory for testing with both reAl time RT-PCR and the new Dr. KSU H1N1 RT-PCR kit. We measured the sensitivity and specificity of the new test across the entire sample size and investigated how these values were affected by patient socio-demographic characteristics and symptoms. The outcomes of the two tests were highly correlated [kappa=0.85; P<.0001]. The sensitivity and specificity of the new test were 99.11% and 83.78%, respectively. The sensitivity of the new test was affected only minimally [96%-100%] by patient characteristics and number of symptoms. On the other hand, the specificity of the new test varied depending on how soon patients were tested after onset of symptoms [100% specificity when swabs were taken on the first day of the symptoms, decreasing to 75% when swabs were taken on or after the third day]. The specificity of the new test also increased with increasing body temperature. The new test seems to provide a cost-effective alternative to reAl time RT-PCR for diagnosing H1N1 influenza. However, further testing may be needed to verify the efficacy of the test in different settings and communities

Suboptimal use of risk reduction therapy in peripheral arterial disease patients at a major teaching hospital

Current evidence suggests that modification of atherosclerosis risk factors plays an important role in reducing adverse cardiovascular outcomes in patients with peripheral arterial disease [PAD]. This study was undertaken to determine whether patients in this high-risk group were adequately using risk factor modification therapy. Prospective study of consecutive patients with PAD from a teaching hospital. The collected data included information about atherosclerotic risk factors and utilization of risk factor modification therapy. The 391 patients had a mean [standard deviation of 3 [1] atherosclerotic risk factors. Hypertension was identified in 56.8% of patients [222/391], of whom only 37.4% [83/222] had adequate blood pressure control [BP<140/90 mm Hg]. The prevalence of diabetes mellitus [DM] was 35% [137/391]. Among patients with DM, only 49% [67/137] had adequate blood glucose control [glycosylated hemoglobin, HbA1c<7%]. Statins were currently prescribed in 61% of patients [238/391], 38.7% [92/238] of whom continued to have low-density lipoprotein [LDL]>2.5 mmol/L, compared to a rate of 76.5% [117/153] among non-statin users [P<.001]. The majority of patients of patients [72.4%; 283/391] were overweight/obese. Many patients [67.3%; 263/391] were nonsmokers; however, most [73.4%; 193/263] had a history of smoking. Antiplatelets were prescribed for 78.3% of patients [306/391], of whom 70.6% [216/306] were taking aspirin. Angiotensin converting enzyme [ACE] inhibitors were prescribed for 44.8% of patients [175/391]. Among rampril users, only 36.8% of patients [53/144] were on an optimal dose. Although atherosclerotic risk factors were prevalent in patients with PAD, we found that patients received sub-optimal use of risk reduction treatments. Effective strategies to encourage health professionals to use these adjunctive therapies need to be developed

Linguistic validation of the chronic respiratory disease questionnaire in an arabic-speaking population with chronic respiratory diseases

To develop an Arabic version of the Chronic Respiratory Disease Questionnaire [CRQ] to be known as ArabiCRQ. We conducted a linguistic validation of the CRQ in the Arabic language. The validation process involved 4 phases, including forward and backward translations, pilot testing, and revision to produce a final version of the ArabiCRQ. Five native Arabic-speaking patients with chronic obstructive pulmonary disease completed the ArabiCRQ both in initial and follow-up visits. Wording was modified according to feedback the participants provided. Two of the patients' scores changed appreciably, despite ensuring their clinical stability. The ArabiCRQ may be a valuable tool to assess the health-related quality of life in patients with chronic respiratory diseases