Translation and Validation of an Arabic Version of the Voice Disability Coping Questionnaire.

OBJECTIVES/HYPOTHESES: Voice disorders can significantly affect the quality of life. This study aimed to translate, culturally adapt, and validate an Arabic version of the voice disability coping questionnaire (A-VDCQ) for use in Arabic-speaking populations with dysphonia. STUDY DESIGN: This was a cross-sectional study involving the translation and cultural adaptation of the VDCQ into Arabic. The validation process included reliability and validity assessments. Participants were categorized into cases (individuals with dysphonia) and controls (individuals without dysphonia) to compare coping strategies between the two groups. METHODS: ccccccccThe 15-item VDCQ was translated from English into Arabic using the forward and backward translation methods. The questionnaire's reliability was assessed using Cronbach's alpha and test-retest reliability (intraclass correlation coefficient, ICC). Validity was evaluated by comparing cases and controls using the Mann-Whitney test. Differences in coping strategies across different diagnoses were examined using the Kruskal-Wallis test. RESULTS: The A-VDCQ demonstrated satisfactory internal consistency (Cronbach's alpha = 0.769) and excellent test-retest reliability (ICC = 0.993). Significant differences in coping strategies between the cases and controls were also observed (P < 0.001), supporting the instrument's validity. Notably, item 4, which is related to information seeking, had the highest impact score among the cases. However, no statistically significant differences were found in coping strategies across different diagnoses (P = 0.249). CONCLUSIONS: The A-VDCQ demonstrated robust psychometric properties for assessing coping strategies in individuals with voice disorders and such strategies' potential implications for clinical practice and research.

Role of Otolaryngologists in the Treatment of Patients With Riboflavin Transporter Deficiency: A Case Report.

Riboflavin transporter deficiency (RTD) is a rare genetic disorder that can have detrimental effects on the nervous system, causing progressive neurodegeneration. Here, we report the second case of RTD in Saudi Arabia. An 18-month-old boy presented to the otolaryngology clinic with six weeks history of progressive noisy breathing associated with drooling, choking, and difficulty in swallowing. Progressive regression of the child's motor and communicative abilities was reported as well. Upon examination, the child had biphasic stridor, chest retractions, bilateral facial palsy, and hypotonia. The presence of an aerodigestive foreign body or congenital anomalies was excluded using bronchoscopy and esophagoscopy. Empirical high-dose riboflavin replacement therapy was initiated upon anticipation of diagnosis. Whole exome sequencing revealed a SLC52A3 gene mutation, which confirmed the diagnosis of RTD. After a period of intensive care unit (ICU) admission with endotracheal intubation, the child's general condition improved, and he was weaned off of respiratory support. Tracheostomy was avoided in this patient, as he responded to riboflavin replacement therapy. During the disease course, an audiological assessment revealed severe bilateral sensorineural hearing loss. He was discharged home on gastrostomy feeding owing to the risk of frequent aspiration, and he was regularly followed up by the swallowing team. The early initiation of high-dose riboflavin replacement appears to be of great value. The benefits of cochlear implants in RTD have been reported, but not fully established. This case report will increase awareness in the otolaryngology community about patients with this rare disease who might initially present to the clinic with an otolaryngology-related complaint.

The Reliability of the Arabic Version of the Dyspnea Index Questionnaire for Upper Airway-Related Dyspnea.

Objectives This study aimed to translate the Dyspnea Index (DI) questionnaire into the Arabic language and determine whether this version is valid and reliable for Arabic-speaking patients with upper airway-related dyspnea. Methods A cross-sectional study was conducted at the King Saud University Medical City otolaryngology clinics in Riyadh, Saudi Arabia. The DI questionnaire was translated into Arabic and then back-translated into the English language. Inclusion criteria were preoperative patients presenting to the otolaryngology clinic with upper airway-related dyspnea between November and December 2020. The results of internal consistency and factor analysis among the items were compared to the original DI development results to assess the reliability of the questionnaire. Results Among a total of 57 recruited patients, 50 questionnaires were completed with an 88% response rate. The mean age of the included patients was 38 ±14 years. Women constituted 58% of the patients. The most common diagnosis was subglottic stenosis (72%). Principle component extraction in factor analysis revealed a single underlying factor for all the questions. Factor loading ranged from 0.69 to 0.85. Reliability statistics showed a high value of internal consistency among the items. The mean inter-item correlation was 0.58. Conclusion Based on our findings, the Arabic version of the DI questionnaire is a reliable instrument for evaluating upper airway dyspnea.

Prevalence and Risk Factors of Discordance Between Hip and Spinal Bone Mineral Density Among Saudi Subjects.

Background Discordance between hip and spine on dual-energy x-ray absorptiometry is a well-known problem in diagnosing osteoporosis. The prevalence and risk factors of this problem have not been studied in the Saudi population. The objective of this study was to document this discordance in our population and its possible risk factors. Materials and methods We analyzed data obtained from subjects who had dual x-ray absorptiometry (DXA) between January 2021 and December 2021 at King Khalid University Hospital, Riyadh, Saudi Arabia. Subjects with the following conditions were excluded: secondary osteoporosis, patients taking anti-osteoporotic agents, patients on steroids or hormonal replacement therapy, hyperparathyroidism, hypoparathyroidism, and chronic renal disease. A total of 1388 patients satisfied our inclusion criteria. World Health Organization (WHO) criteria for diagnosis were implemented. Major discordance was defined as osteoporosis in one site and normal in the other. Minor discordance was defined as a difference of no more than one World Health Organization diagnostic class between two sites. Bivariate statistical analysis was achieved using appropriate statistical tests (chi-square, student's t-test, one-way analysis of variance, and Pearson's correlation), based on the type of study and outcome variables. A p-value of < 0.05 and 95% CI were used to report the statistical significance and precision of results. Results A total of 1388 subjects were analyzed, of which, 1196 (86%) were females with a mean age of 58.8 (13.8 SD) and 192 were males with a mean age of 58 (18.0 SD). Lumbar osteoporosis was found in 312 (22.5%) participants while hip osteoporosis was reported in 73 (5.3%) of the participants. Major discordance was documented in 85 (6.1%) of all participants (6.3% of the male and 6.1% of the female patients). All of these subjects had lumbar spine osteoporosis with normal hip bone mineral density (BMD). Minor discordance was found in 591 patients (42.6%). Obesity (BMI > 30) was found to be a risk factor for both major (2.10-11.6, 95% CI) and minor (2.5-11.4, 95% CI) discordance. Conclusion Discordance between hip and spine BMD is common among Saudi subjects. Lumbar spine osteoporosis with normal hip BMD caused this discordance in our subjects. Obesity could be responsible for the occurrence of this discordance. Mechanisms may include higher rate of turnover in spine, technical artifacts in the measurements of lumbar spine BMD, or due to the effects of weight loading. Caution should be exercised when interpreting DXA results, especially in obese subjects.

Predictors of recurrent arteriovenous fistula stenosis in Saudi patients undergoing hemodialysis.

OBJECTIVES: To identify predictors of recurrent arteriovenous fistula (AVF) stenosis. It also seeks to calculate the average primary patency duration in Saudi patients undergoing hemodialysis. METHODS: A retrospective case-control study was conducted at a tertiary care hospital in Riyadh. Data from 180 patients who had undergone angioplasty between May 2009 and May 2020 were analyzed. Following the inclusion/exclusion criteria, 99 patients were included. Based on the presence or absence of recurrent AVF stenosis, the patients were divided into cases and controls, respectively. Recurrence was defined as an occurrence of stenosis within <12 months of a previous stenotic event, or patients who had >3 total stenotic events. Clinical, radiological, and laboratory variables were collected and subjected to multivariate binary regression analysis to assess the odds of a recurrence of fistula stenosis. RESULTS: A total of 29 patients were categorized as cases, while 70 patients were categorized as controls. The median primary patency duration was found to be seven months. Multivariate binary regression analysis revealed higher levels of serum calcium (p=0.012) and BMI (p=0.007) in patients with recurrent stenosis. A positive association was also observed between the use of antiplatelets (0.039) and recurrent stenosis. CONCLUSION: Higher levels of corrected calcium, BMI, and the application of antiplatelet therapy were found to be predictors of recurrent AVF stenosis. No other traditional variables were found to be significant.