Perspectives of Glioblastoma Patients on Death and Dying: A Qualitative Study.

BACKGROUND: Glioblastoma (GBM) is a terminal illness and associated with poor prognosis. Brain cancer creates significant traumatic effects including death and dying fears not only on patients but also in Asia's tightly knitted families. Very few studies made attempt to elicit the death and dying issues among brain cancer patients. Therefore, the study aimed to explore the patient's perspectives on death and dying among GBM patients during hospitalization. METHODOLOGY: The study used qualitative approach. Purposive sampling was used to enroll 31 consented patients for in depth interviews. The in-depth interviews were guided by pre-designed open ended guidelines and took 45 min to 1 h. All interviews were conducted in the private room in the hospital. Interviews were manually documented soon after the interview. Thematic analysis was used to generate themes. R (QOL) software was used for data analysis. RESULTS: Four themes were emerged from the analysis; (i). Understanding about illness (ii). Personal views and feelings on death and dying (iii). Coping with fear of death and dying (iv). Need for early preparation to face death and dying fears. CONCLUSION: Psychosocial interventions on early death preparation programs are recommended for GBM patients in the in-patient care. Yet, it should be handled carefully and sensitively, otherwise, it creates more psychological and emotional harm than the illness per se.

Real world experience with an indigenously manufactured stent Cobal C--a retrospective study.

BACKGROUND: Second generation bare metal stents made of cobalt chromium alloy are superior to first generation stain less steel stents. The thin struts are shown to reduce clinical and angiographic adverse outcomes. OBJECTIVE: To study the long term clinical and angiographic outcomes in patients who underwent coronary angioplasty with an indigenously made cobalt chromium bare metal stents with thin strut Cobal+C™ (Relisys). METHODS: A total of 268 consecutive patients who underwent coronary angioplasty with Cobal+C stents were studied retrospectively. Clinical follow up was done after a minimum period of nine months through telephonic interview and angiographic follow up was done in 80 patients chosen randomly. The end points analyzed included major adverse cardiac events (MACE) at nine months and the rate of binary restenosis at follow up angiogram done between 9 and 15 months post angioplasty. RESULTS: Thirty four percent were diabetic and 33% had acute myocardial infarction. Females constituted 17%. Mean stent diameter was 2.88 ± 0.28 and mean stent length 18.8 ± 4.2. MACE at nine months was 4.5% with TLR 0.3%. The rate of binary restenosis was 21%. Patients with longer stent lengths and non-compliance with medications had significantly higher rates of binary restenosis. CONCLUSIONS: The use of Relisys Cobal+C stents was associated with good long term clinical and angiographic outcomes as evidenced by low incidence of MACE and binary restenosis rates for a bare metal stent.