Nurse-led Cardiovascular Diseases Risk Assessment and Communication using WHO/ISH Risk Prediction Chart in a Tertiary care Hospital of North India

Cardiovascular diseases (CVDs) contribute to most of the potentially preventable burden through early risk assessment. Nurse-led CVD risk assessment is an effective strategy to address the human resource crisis for CVD prevention. An interventional study was conducted in medicine wards of a tertiary care hospital in North India to train nurses in CVD risk assessment and its communication. All bedside nurses (n = 30) of selected wards were enrolled and trained in CVD risk assessment and communication using WHO/ISH risk prediction charts. Once fully trained, each nurse enrolled patients (>40 years of age) from their respective wards to assess and communicate CVD risk. To calculate the reliability of risk assessment, investigator simultaneously assessed CVD risk with nurses. The mean age of nurses was 32.07 ± 6.31 years. The results revealed that training significantly increased the knowledge of nursing personnel (P < 0.001). There was perfect inter?rater reliability agreement (Cohen’s k = 0.929) between nurses and investigators while assessing CVD risk. Nurses demonstrated good communication skills. The study concluded that nurses can be trained successfully in CVD risk assessment and communication. The study recommends the task shifting of CVD risk assessment to nurses after providing proper training

Punjabi version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-OES 18 and Quality of Life Questionnaire-OG25 modules for quality of life assessment

Context: Health-related quality of life (HRQOL) assessment plays an important role in the decision-making process in oncology. Aims: The aim of the study was to translate European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ) OES18 and OG25 in Punjabi language for HRQOL assessment of patients diagnosed with esophagus and esophagogastric malignancies. Subjects and Methods: The EORTC translation guidelines were duly followed to translate QLQ-OES18 and OG25 into Punjabi language. Each set of questionnaire was independently translated by two forward translators, followed by backward translation of the reconciled version by two independent translators. The final version was submitted to the EORTC Translation Team and served to the patients for the pilot testing. Results: The questionnaire was administered to ten patients each of esophagus and esophagogastric malignancies who were evaluated and treated at our hospital. Every patient underwent an interview to check if any of the questions was difficult, uncomfortable, or upsetting to answer. Their concerns were recorded as per the template provided by the EORTC team and due changes done if required. Conclusions: The EORTC QLQ-OES18 and OG25 questionnaire has been translated to Punjabi language and subsequently approved for usage.

Serum levels of bone sialoprotein, osteopontin, and β2-microglobulin in stage I of multiple myeloma

Context: The fluctuations of proteins in multiple myeloma (MM) are well-known markers for checking the status of the patients. Aims: The objective of this study was to examine three proteins that have an important role in disease progression. Subjects and Methods: The study was performed with two groups: 30 MM stage I patients' (14 females/16 males; aged 60.83 ± 12.38 years) as case group and 40 healthy individuals (18 females/22 males; aged 57.65 ± 6.43 years) as control group. Both groups have been matched in gender and age. Bone sialoprotein (BSP), osteopontin (OPN), and β2-microglobulin (β2M) were measured with an enzyme-linked immunosorbent assay. Results: Serum BSP levels of MM-I patients was significantly higher than that of healthy controls (29.24 ± 5.57 vs. 20.89 ± 3.67, P = 0.001). OPN levels of MM-I patients were significantly lower than that of healthy individuals (12.03 ± 3.45 vs. 19.35 ± 4.67, P = 0.001). β2M levels of patients and controls were similar (1.49 ± 0.67 vs. 1.29 ± 0.55, P = 0.193). Conclusions: The results suggested that myeloma cells may affect the production of BSP and OPN, which possibly contributes to osteoclastic bone resorption in MM-I patients. Their levels may be a useful biomarker for assessing bone destruction in MM-I patients and distinguishing MM-I from healthy individuals

Endoscopic Repair of Spontaneous Cerebrospinal Fluid Rhinorrhoea Via Paraseptal Approach.

CSF rhinorrhoea poses a significant challenge even to most astute and experienced surgeons in its accurate localization and management. The diagnosis of CSF leak is ascertained on proper history, neurologic and otorhinolaryngologic examination, laboratory tests and endoscopic findings supplanted by appropriate radiologic studies. The exact visualization and atraumatic surgical technique using endoscope provides better lighting with magnified view, even in lateral recesses giving an edge over other techniques, thus enhancing the surgical outcome.

Pilomyxoid astrocytoma.

Pilomyxoid astrocytoma (PMA) is a recently described brain tumor. PMA shares similar features with pilocytic astrocytoma (PA), the most common central nervous system (CNS) tumor in the pediatric population, yet displays subtle histologic differences. We describe a case of PMA in a six-year-old male involving sellar and suprasellar region presenting with failure to thrive and delayed developmental milestones. The histological findings revealed a tumor composed of a monotonous population of loosely arranged cells with delicate piloid like processes, within a prominent myxoid background. The tumor lacked biphasic appearance, Rosenthal fibers, eosinophilic granular bodies and calcification that are commonly observed in classical PA. Previous studies have shown PMA to behave more aggressively than PA, with shorter progression-free survival as well as a higher rate of recurrence and CNS dissemination. Thus, recognition of PMA and its distinction from classical PA is very important.

Factors influencing the outcome in symptomatic Chiari I malformation.

BACKGROUND: To study the clinico-radiological determinants of outcome in patients with Chiari I malformation (CIM). MATERIALS AND METHODS: The disability assessment of 48 patients with C I M who underwent posterior decompression was done by modified Klekamp and Samii scoring system. The outcome was regarded as good when the patient was ambulant without any aid with an improvement in the disability score; and, poor when (a) there was postoperative deterioration or lack of improvement; (b) the patient was non-ambulant without aid, irrespective of the improvement in the clinical score; or, (c) there was a perioperative mortality. Patients with hydrocephalus; those who underwent syringo-subarachnoid or syringo-peritoneal shunt as the primary procedure; and, patients with atlanto-axial dislocation were excluded from the study. STATISTICAL METHODS USED: Categorical data were expressed in proportions and analyzed with Chi square test. Analysis of factors predicting clinical outcome at 6 months was done utilizing logistic regression analysis. RESULTS: The outcome assessed at six months showed that 30 patients (62.5%) had good outcome while 18 patients (37.5%; including two perioperative mortalities) had a poor outcome. CONCLUSIONS: Significant predictors of outcome in patients with CIM include the duration of symptoms (P value=0.006), respiratory distress (P value=0.001), and basilar invagination (P value=0.048). The effect of syringomyelia in predicting the clinical outcome could not be determined due to the differences in the number of patients in the groups with or without syringomyelia.