Translation, linguistic validation and reliability of FACT-H&N questionnaire in Oral Cancer patients in Sudan.

BACKGROUND: This study aimed to translate and validate an Arabic version of the Functional Assessment of Cancer Therapy Head and Neck Scale (FACT-H&N, v-4) for use among Sudanese oral cancer patients. METHODS: The instrument underwent translation and validation following the standard FACT translation methodology. The translated instrument was pre-tested for face validity and content validity using semi-structured, in-depth interviews with ten oral cancer patients to assess acceptability. The questionnaire was pilot tested with 60 patients; reliability was tested for internal consistency with Cronbach's alpha while construct validity was tested using 'known-group validity'. RESULTS: The pre-test study revealed no major issues, apart from a reluctance to answer questions on sexual satisfaction. The FACT-H&N demonstrated good internal consistency, it considered five particular constructs: PWB, SWB, EWB, FWB and FACT-H&N, their Cronbach's α values were positive and close to 1 with values of 0.85, 0.788, 0.86, 0.895 and 0.703 respectively, indicating that the questionnaire was valid and the responses consistent. Sixty patients were asked the global health-related quality of life item, 36.3% rated their QOL as very good or good (36.3%), while 41.7% rated it as average, and 21.7% as poor or very poor. Then FACT subscale mean scores were tabulated against three categories; patients with very poor/poor recorded significantly lower scores indicating construct validity. Some psychometric properties were consistent with other FACT-H&N translations such as the Chinese, French, Pakistani and Malaysian. CONCLUSIONS: This study validates the Arabic version of the FACT-H&N. It is a reliable tool and, will assist further QoL research in other Arabic-speaking countries.

While survival rates are routinely used to evaluate treatment outcomes in oral cancer, increased understanding of the human cost of this disease highlights the need to also consider the impact of the disease and therapy on patients' quality of life (QoL). Measurement of quality of life outcomes requires a validated QoL questionnaire with proven applicability in that specific context. Little research has been undertaken on the QoL of cancer patients in Sudan and no published research exists to date on the QoL of Sudanese oral cancer patients. While an Arabic version of the FACT-G general questionnaire exists, the FACT-H&N module was not previously available in Arabic. This paper describes the translation of the FACT-H&N from English into Arabic to suit Sudanese patients and other Arabic-speaking patients, with a detailed pre-test review by 10 patients, a pilot study with 60 patients and further validation with 130 patients. This study represents the first QoL research undertaken in oral cancer patients in Sudan and provides some insight into the impact of oral cancer on their lives. Findings from this study indicate that the Arabic version of the FACT-H&N questionnaire is a valid, reliable and acceptable method for assessing health related QoL in Arabic-speaking Sudanese oral cancer patients. This work will benefit future researchers working with Arabic-speaking oral cancer patients.

Discrimination potential of root canal treated tooth in forensic dentistry.

Forensic Odontology is a vital component of forensic science and one branch involves the application of dental science to the identification of unknown human remains. The aim of this study is to investigate the discriminatory potential for identification of the radiographic morphology of obturated single root canals. Thirty periapical radiographs of patients having endodontic treatment of single rooted canals were selected randomly from the data bank of the digital X- ray system present in the restorative department, University of Science and Technology, Sudan. The post-operative radiographs were considered as an ant-mortem data "Set 1". Ten radiographs from the thirty were reprinted, labelled from (A-J) and considered as a post-mortem data "Set 2". This post-mortem group of 10 radiographs "Set 2" would be compared with the ante-mortem group of 30 radiographs comprising "Set 1". These two sets of radiographs would be examined by 40 dentally trained personnel. The thirty radiographs comprising "Set 1" and the 10 radiographs comprising "Set 2" were provided to each of the examiners who were asked to match the individual post-mortem radiographs ("Set 2") with the ante-mortem radiographs ("Set1"). The result demonstrated that 34 examiners achieved a success rate of 100%, 4 examiners achieved a success rate of 97.5% (1 mismatch) and 2 examiners achieved a success rate of 95% (2 mismatches). The radiographic images of obturated single-rooted teeth in this study were shown to have highly- specific morphological features. It is proposed that, in cases where the ante and post-mortem radiographs of a single-rooted obturated canal show similar morphology, this commonality of morphology can be used as a tool in the identification process.

Meckel-Gruber syndrome: Antenatal diagnosis and ethical perspectives.

Meckel-Gruber syndrome (MGS) is an autosomal recessive disorder characterized by occipital encephalocele, polycystic kidneys and variable other congenital malformations. We report on a Sudanese patient with MGS diagnosed by antenatal ultrasound scan. Pregnancy was terminated at 25 weeks of gestation.

Hypothalamohypophyseal response to drugs used in anesthesia.

Various agents used in the practice of anesthesia were applied in fifty five healthy postmenopausal female volunteers in order to investigate their hypothalamo hypophyseal response to these drugs, by measuring PRL and TSH levels in peripheral blood. Selection of volunteers, separation of blood specimens and RIA techniques were performed according to international standards. Our results show that thiopental, ketamine and dehydrobenzperidine increase PRL levels significantly (p less than 0.05-0.0025) while fentanyl and diazepam do not alter basal PRL values (p greater than 0.10). It is assumed that thiopental and ketamine may affect the hypothalamo hypophyseal axis through a cholinergic mechanism, whereas dehydrobenzperidine through a dopaminergic one. Atropine reduces the increase in PRL levels caused by thiopental and ketamine, while it does not affect PRL high levels induced by dehydrobenzperidine. TSH levels remain unaffected by all drugs, though ketamine shows a statistically indicative mild tendency to increase PRL levels (p less than 0.10). The fact that TSH values remain the same may be due either to the slower release of TSH stores, or to the involvement of a somatostatin-related mechanism in addition to the one described herein.

Characterization of toxicity involving haemorrhage and cardiovascular failure, caused by parenteral administration of a soluble polyacrylate in the rat.

Adverse effects, involving a combination of hypotension and widespread haemorrhages, as well as evidence of vascullar and other tissue dissociation, associated with various systemic malfunctions (cyanosis, cardiac arrhythmias, neuromuscular disorder and death) were observed in the rat, from parenteral administration of a high-molecular-weight soluble polymer, sodium polyacrylate (EN21). Experiments to elucidate the mechanism of this effect involved comparisons with a low-molecular-weight sodium polyacrylate (EN5), either drug being given to groups of 5-8 rats, male or female, in doses of 5-100 mg/kg i.v., i.p. or s.c., or up to 1000 mg/kg p.o. Effects were observed visually up to the death of the animals, and these plus survivors killed after 10 h were prosected for macroscopic and histopathological examination of internal organs. Characteristic EN21 effects were only observed in animals treated by the i.p. and i.v. routes, death occurring in 4-10 h or rapidly (1 h) after i.v. dosage. No such effects were observed from EN5 by any dose or route. There were no differences between effects in male and female animals. In rats anaesthetized with sodium pentobarbitone and cannulated for blood pressure recording (arterial and venous), no hypertensive effects were observed to explain haemorrhagic effects. Instead, i.v. and i.p. injections gave depressor effects, insidious in the latter case, with a precipitous fall only in the delayed terminal stage. Effects were accompanied by cardiac arrhythmias. Depressor effects were prevented by prior treatment of the animals with calcium chloride solution. These effects could not be evoked by EN5, nor by injection of methylcellulose solutions of equivalent high viscosity.(ABSTRACT TRUNCATED AT 250 WORDS)

Furazolidone concentrations in plasma, milk and some tissues of Nubian goats.

The concentrations of furazolidone (FZ) in plasma and milk were measured in goats treated orally with the drug at a dose of 10 mg kg-1 daily for 5 days. The maximum plasma concentrations obtained were 1.57 +/- 0.52 micrograms ml-1 (n = 5) 8 h after the first dose, and 2.13 +/- 0.11 micrograms ml-1 (n = 4) 6 h after the fifth dose. The maximum milk concentration was 0.88 +/- 0.32 micrograms ml-1 (n = 4) 8 h following the administration of a single dose. Using a colorimetric method, FZ was not detectable in goats' liver or muscle after the recommended therapeutic dose (10 mg kg-1, 5 days). However, using an HPLC method, the drug was detected 24 h after the treatment in the gluteal muscle and liver at concentrations of 0.26 +/- 0.01 microgram g-1 (n = 5) and 0.10 +/- 0.02 microgram g-1 (n = 5), respectively. The drug concentrations decreased significantly (P less than 0.05-0.01) at 3, 5 and 7 days after treatment, and no measurable concentrations were found after 10 days.

HPLC analysis of furazolidone in goats given the therapeutic dose.

Furazolidone (FZ) was given to Nubian goats at the recommended therapeutic dose of 10 mg/kg body wt, for 5 days. The animals were slaughtered 24 hr after the last dose, and their livers, gluteal muscles, kidneys and hearts analysed for FZ residues by an HPLC method with a detection limit of 0.05 micrograms g-1. The drug was detected in the muscle and liver at concentrations of 0.256 +/- 0.009, 0.101 +/- 0.016 micrograms g-1 tissue, respectively. No detectable concentrations of the drug were found in the kidney and heart.

Congo-Crimean haemorrhagic fever in Dubai: histopathological studies.

Necropsies were carried out on two patients who died of Congo-Crimean haemorrhagic fever (C-CHF) in Dubai. The diagnosis was confirmed by isolation of C-CHF virus from the liver. Histopathological changes included extensive cellular necrosis and haemorrhage in the liver, necrosis and lymphoid depletion in the spleen, congestion and oedema formation in the lungs, and haemorrhage in a number of other organs.

Congo/Crimean haemorrhagic fever in Dubai. An outbreak at the Rashid Hospital.

A hospital outbreak of haemorrhagic fever took place in Dubai in November, 1979. The index case died in the casualty department shortly after admission. There were five secondary cases among hospital staff, two of whom died. When, 3 months after this outbreak, a patient with symptoms characteristic of haemorrhagic fever was admitted, immediate barrier nursing prevented further secondary cases.