The Female Sexual Function Index (FSFI): Translation, Validation, and Cross-Cultural Adaptation of an Urdu Version "FSFI-U".

INTRODUCTION: Female sexual dysfunction (FSD) is a common problem, and many self-report questionnaires are available for its evaluation. Pakistani women with sexual problems feel shy to consult with their physician. A validated self-report questionnaire, in the local language with modest expressions is required for these women. AIM: The aim of this study was to translate, cross-culturally adapt, and perform a psychometric validation of an Urdu translation of the Female Sexual Function Index (FSFI). METHODS: The FSFI was translated in Urdu, and its precision was ascertained through reverse translation. It was pretested on 22 bilingual women and refined again to reach at a reliable Urdu version of the questionnaire FSFI-U. One hundred sixteen bilingual women, in a stable sexual relationship over the previous 6 months were finally asked to fill out the FSFI and FSFI-U. Their sexual function was then clinically evaluated and responses were compared with the clinical assessment as well as with each other. MAIN OUTCOME MEASURES: The responses were analyzed through descriptive statistics for reliability, face validity, agreement between the responses to the original English version and to the FSFI-U, and also for test-retest consistency. The data were analyzed statistically using Cronbach's alpha analysis, Intraclass correlation coefficients, Pearson correlation, and Student's t-test. RESULTS: FSFI was found to be easily understandable and capable of adequately evaluating and measuring various aspects of female sexual function. A high degree of internal consistency was demonstrated on Cronbach's alpha analysis. Cronbach's α coefficient for various domains was sufficiently high ranging from 0.84 to 0.97. The clinical assessment of the presence and severity of FSD also matched with the self-report questionnaire. Similarly, various domains of FSFI had high degree of correlation in the Urdu version of FSFI (P < 0.001). CONCLUSION: The Urdu translation version of FSFI is valid and reliable for use in the literate population of Pakistan. Rehman KU, Asif Mahmood M, Sheikh SS, Sultan T, Khan MA. The Female Sexual Function Index (FSFI): Translation, Validation, and Cross-Cultural Adaptation of an Urdu Version "FSFI-U". Sex Med 2015;3:244-250.

Growth centile charts (anthropometric measurement) of Pakistani pediatric population.

OBJECTIVE: To measure Anthropometric data (Height and Weight) of Pakistani school children (of different socioeconomic and cultural background) 3-16 year, to develop growth centile charts, based on the above measurement and to document obesity and stunting in Pakistani Paediatric population, based on the above measurement. METHODS: A Cross-sectional study with multistage stratified sampling was done in a Nationwide project of Higher Education Commission (HEC, Ref no: 20-441/R&D/2008) to develop growth centile charts of Pakistani paediatric population. Study was conducted from 2006-2009. Children studying in private and government schools of the four provinces of Pakistan were included. Prior to starting the study permission from the principal of the respective school and parents was taken. A total of 12837 children with normal birth weight, complete immunization, no history of chronic infection from 36-192 months (3-16 year) were included. Heights (cms), weight (kg), for Body Mass Index (BMI) (kg/m2), 24 hour diet recall was obtained. All socioeconomic groups were included. Food records of the children were subjected to USDA food exchange list. RESULTS: The average height (cms) of children was 139.11 +/- 18.44, average weight (kg) was 33.21 +/- 11.25 and average BMI was 16.76 +/- 3.22 kg/m2 (range from 11.3-41.98). The 95th centile according to CDC charts for the age groups 3-16 years were calculated. A total of 664 (5.1%) children were found to be obese. In the age group 3-5 years, > 5-10 year and > 10-16 year; 29 (8.1%), 272 (5.1%) and 363 (5.1%) were found to be obese, respectively. CDC height and weight in the three groups of Pakistani children > 3-5 year, > 5-10 year, > 10-16 year were at the 10-25 centile. CONCLUSION: Overall, the prevalence of stunting was 14%. Height and weight was 10-25 centile of the CDC charts. Obesity was 5%. Pakistani centile charts of healthy children from Pakistan have been made.

Translation, cross-cultural adaptation, and psychometric validation of the 5-item International Index of Erectile Function (IIEF-5) into Urdu.

INTRODUCTION: Patients suffering from erectile dysfunction (ED) feel shy to discuss this issue with their physician. Self-report questionnaires are a key instrument to break this barrier. Most of these questionnaires are in English, and their validated translations in Urdu, the official language of Pakistan, are not available. AIM: The aim of our study is to translate, cross-culturally adapt, and perform psychometric validation of an Urdu translation of the 5-item international index of erectile function (IIEF-5). METHODS: The translation of IIEF-5 was done in Urdu and was refined through reverse translation and expert committee reviews. It was then pretested on 20 bilingual men and reviewed again to develop a final Urdu version of the questionnaire. We selected 47 patients who had been in a stable sexual relationship over the past 6 months and asked them to fill out the IIEF-5 questionnaire in both languages (Urdu and English), followed by evaluation of ED by a clinician, who was blinded to the responses of the patient to the questionnaire. MAIN OUTCOME MEASURES: The self-report to questionnaire and independent clinical assessment were compared. Patients refilled out the questionnaire again at the end of the interview to assess test-retest consistency. These data were now analyzed statistically using descriptive statistics, Cohen's kappa, and Cronbach's alpha analysis. RESULTS: The Cohen's kappa showed a very high degree of agreement between the two versions (P < 0.0001), and a high degree of internal consistency was demonstrated on Cronbach's alpha analysis ([0.882] with 95% confidence interval [0.839-0.916]). The clinical assessment of the presence and severity of ED also matched with the self-report questionnaire. CONCLUSION: We can safely conclude that this Urdu version of IIEF-5 is a valid instrument for use in the literate population of Pakistan.

Outcome of 7-S, TQM technique for healthcare waste management.

OBJECTIVE: To assess the present waste management system of healthcare facilities (HCFs) attached with Shalamar Hospital, Lahore by applying the 7-S technique of Total Quality Management (TQM) and to find out the outcome after imparting training. STUDY DESIGN: Interventional quasi-experimental study. PLACE AND DURATION OF STUDY: The Shalamar Hospital, Lahore, Punjab, Pakistan, November, 2009 to November, 2010. METHODOLOGY: Mckinsey's 7-S, technique of TQM was applied to assess the 220 HCFs from Lahore, Gujranwala and Sheikhupura districts for segregation, collection, transportation and disposal (SCTD) of hospital waste. Direct interview method was applied. Trainings were provided in each institution. After one year action period, the status of four areas of concern was compared before and after training. The parameters studied were segregation, collection, transportation and disposal systems in the 220 HCFs. Each of these were further elaborated by strategy, structure, system, staff, skill, style and stakeholder/shared value factors. Standard error of difference of proportion was applied to assess significance using 95% confidence level. RESULTS: There was marked improvement in all these areas ranging from 20% to 77% following a training program of 3 months. In case of disposal of the waste strategy, structure and system an increase of 60%, 65% and 75% was observed after training. CONCLUSION: The 7-S technique played a vital role in assessing the hospital waste management system. Training for the healthcare workers played a significant role in healthcare facilities.