The Role of a 'Tracheostomy Care Training Module' in Improving the Knowledge, Attitude and Practices Among Nurses in High Dependency Units.

Background: The occurrence of life-threatening events in hospitalized patients with tracheostomies are often preventable. Nurses have a vital role in providing consistent tracheostomy care to patients, thereby avoiding complications. This study was conducted to assess the knowledge of nurses in high dependency areas at a tertiary care hospital with regards to tracheostomy care, to train them and to assess the impact of a tracheostomy care teaching module. Methods: Purposive sampling techniques were used to recruit 65 nurses from high dependency areas in Father Muller Medical College Hospital. With appropriate informed, a detailed evaluation was conducted with a pre-validated questionnaire that assesses the knowledge, attitude and practices with regards to tracheostomy care. The nurses then underwent a tracheostomy training programme with a teaching module that emphasizes on tracheostomy care, a demonstration and hands on experience in the simulation lab, followed by an OSCE and a post-test. Statistical analysis was done using SPSS version 28 for paired T test and crosstabulation. Results: There was a mean increase in test scores, from 7.74 in pretest to 10.66 in post-test which was statistically significant. The comfort and confidence level of nurses after the module, increased by 80% and the OSCE scores were averaged around 73% giving a satisfactory outcome. Conclusion: This module significantly increased the quality of tracheostomy tube care provided by nurses thereby improving patient outcome. Small modifications to existing training programs can have a significant impact on overall health care as demonstrated by our study. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-024-04489-y.

Rhodamine 6G derivative for the selective copper detection and remediation using nanoporous diatomaceous earth-engineered functional receptor.

A rhodamine-derived receptor was synthesized and comprehensively characterized for structural confirmation. The receptor was able to distinguish the copper ions (Cu2+) from other competing cations. The yellow color of the receptor changed to pink upon adding Cu2+ ions, however, other competing cations ions were impotent towards any color variation. The UV-visible titration studies revealed the binding stoichiometry of a 1:1 ratio with a detection limit of 9.663 × 10-8 M. Additionally, a novel idea of the work resides in the use of diatom for the practical application, where the receptor has been tethered on nanoporous diatomaceous earth microparticles (P2D) to remove Cu2+ ions. The results confirmed that 50 mg receptor functionalized DE could adsorb 10 mL of 1 ppm Cu2+ ions from water. Furthermore, a proof-of-concept device that is inexpensive, simple to operate, and continuously removes Cu2+ ions from water has been developed. The efficiency of the device in Cu2+ ion removal could be realized through the naked eye by observing the color change of P2D particles, which has excellent potential for application in remote locations where water contamination is a significant issue.

Acoustic Analysis of Voice in Laryngopharyngeal Cancers Pre and Post Radiotherapy.

Laryngopharyngeal cancers are one of the most commonly diagnosed head and neck malignancies frequently presenting primarily with change in voice. Radiotherapy being the main modality of treatment for early cancers continues to affect voice. Hence, acoustic analysis of the voice offers quantifiable values of several parameters delineating the obvious effect of the therapy. A total number of 60 patients, diagnosed with laryngopharyngeal cancers undergoing radiotherapy underwent acoustic voice assessment using Dr. speech software pre-treatment and at 1 and 3 months post radiotherapy. Data analysis was done using Mann-Whitney test and Wilcoxon signed rank test and a significant p value was obtained. The results of the study showed fundamental frequency (F0) and noise to harmonic ratio (NHR) to be the most affected in comparison to Jitter and Shimmer. The F0 and NHR values across baseline evaluation, first month and third month follow up showed a steady deterioration which was significant. The deterioration noted from the first to third month was not statistically significant. Across genders both F0 and NHR deterioration is more in males than in females. Radiotherapy causes definitive alterations in some acoustic measures of voice, which make the voice disharmonic and hoarse with contribution of harshness and breathiness. The effect is more pronounced on vocal parameters that are structure and projection based as evidenced by deterioration in values noted in F0 and NHR. Persistent deteriorated acoustic parameters for a longer duration of time are more likely which emphasizes the need for early voice rehabilitation.

Recent Advances in Microfluidic Platform for Physical and Immunological Detection and Capture of Circulating Tumor Cells.

CTCs (circulating tumor cells) are well-known for their use in clinical trials for tumor diagnosis. Capturing and isolating these CTCs from whole blood samples has enormous benefits in cancer diagnosis and treatment. In general, various approaches are being used to separate malignant cells, including immunomagnets, macroscale filters, centrifuges, dielectrophoresis, and immunological approaches. These procedures, on the other hand, are time-consuming and necessitate multiple high-level operational protocols. In addition, considering their low efficiency and throughput, the processes of capturing and isolating CTCs face tremendous challenges. Meanwhile, recent advances in microfluidic devices promise unprecedented advantages for capturing and isolating CTCs with greater efficiency, sensitivity, selectivity and accuracy. In this regard, this review article focuses primarily on the various fabrication methodologies involved in microfluidic devices and techniques specifically used to capture and isolate CTCs using various physical and biological methods as well as their conceptual ideas, advantages and disadvantages.

Design and Synthesis of Novel Coumarin Conjugated Acetamides as Promising Anticancer Agents: An In Silico and In Vitro Approach.

BACKGROUND: Coumarin and benzophenone possess a vast sphere of biological activities, whereas thiazoles display various pharmacological properties. Hence, present study focused on the incorporation of coumarin and thiazole core to the benzophenone skeleton to enhance the bioactivity, anticipating their interesting biological properties. OBJECTIVE: The objective of the current work is the synthesis and biological evaluation of a novel series of coumarin fused thiazole derivatives. METHODS: A novel series of coumarin conjugated thiazolyl acetamide hybrid derivatives were synthesized by a multistep reaction sequence and were characterized by the FT-IR, LCMS, and NMR spectral techniques. The newly synthesized compounds were screened for anti-cancer activity by in silico and in vitro methods. The cytotoxicity of the synthesized unique compounds was executed for two different cancer cell lines, MCF-7 (Breast cancer) and KB (Oral cancer), in comparison with standard paclitaxel by MTT assay. RESULTS: The compound 7f is a potent motif with an acceptable range of IC50 values, for anti-cancer activity, i.e., 63.54µg/ml and 55.67µg/ml, against the MCF-7 and KB cell lines, respectively. Molecule docking model revealed that this compound formed three conventional hydrogen bonds with the active sites of the amino acids, MET 769, ARG 817, and LYS 721. CONCLUSION: Compound 7f with two methyl groups on the phenoxy ring and one 4-position methoxy group on the benzoyl ring, showed a significant cytotoxic effect. An advantageous level of low toxicity against normal cell line (L292) by MTT assay was determined.

Paediatric spondylodiscitis: a 10-year single institution experience in management and clinical outcomes.

PURPOSE: Discitis in the paediatric population poses diagnostic challenges due to non-specific presenting symptoms and difficulty with expressing pain in non-communicating children. Discitis remains a relatively rare condition in the paediatric population and previous reports are limited to small cohorts. In this article, we report our experience in management of discitis over a 10-year period and review the literature on this topic. METHODS: We retrospectively reviewed cases of paediatric discitis/spondylodiscitis over a 10-year period between 2008 and 2018 managed in our regional paediatric neurosurgery unit. Relevant demographic information, microbiological data, blood investigation profile, antibiotic treatment duration and clinical outcomes were interrogated from clinical notes and electronic databases and further analysed. RESULTS: Overall, 21 cases of paediatric discitis were identified from year 2008 to 2018 with a female to male ratio of 1.3:1. The mean age at presentation was 4.3 years (range 1 to 15 years). Overall, there were 19 cases of lumbosacral/lumbar, 1 thoracic and 1 cervical discitis. The mean duration of follow-up was 20 months (range 6 to 69 months). The most common presenting features were back pain and refusal to walk/sit or weight bear. Erythrocyte sedimentation rate (ESR) was found to be more sensitive than C-reactive protein (CRP) (sensitivity 78% versus 38%) in our cohort. Computer tomography (CT)-guided biopsy was performed in five cases and only one of these was positive (20%). All patients were treated with intravenous antibiotics with resolution of discitis. CONCLUSIONS: Presentation of discitis in children can be non-specific and requires high index of suspicion. CT-guided biopsy in our cohort revealed a low rate of positive cultures. Despite negative blood cultures and CT-guided biopsy results, empirical intravenous antibiotics were effective in treating discitis successfully. In our cohort, low yield of CT-guided biopsy does not support its use on each case and this may be reserved for cases resistant to antimicrobial therapy or concerns regarding other pathology mimicking infection. Better understanding and awareness of this condition and its pathophysiology can lead to timely imaging, diagnosis and treatment.

Prevalence of hearing impairment amongst school going children in the rural field practice area of the institution.

Worldwide, over 275 million people are estimated to have moderate to profound hearing loss in both ears. Children with hearing impairment often experience delayed development of speech and cognitive skills, which may result in slower learning and difficulty in progressing at school. Adequate hearing is one of the main factors for good psychosocial development, by which individuals may express their thoughts, feelings, and wishes, and acquire life experience and knowledge. Therefore, hearing impairment needs to be diagnosed early for prompt therapy. Primary objectives of this study was to know prevalence of hearing impairment amongst primary school children and secondary objective was to identify the common causes of hearing impairment amongst primary school children. The cross sectional study was conducted in the government and private schools of our rural field practice area in 2013-2014 for the duration of 4 months from November 2013 to February 2014. Prevalence of Hearing loss was 8.8%. Most common cause of Hearing loss was Impacted wax and Retracted Tympanic membrane. Otological conditions-Wax followed by otitis media with effusion and chronic suppurative otitis media were the common ear problems found in our study.

Role of concomitant chemoradiation in locally advanced head and neck cancers.

Standard therapy for advanced head and neck cancer consists of a combination of surgery and radiation. However, survival of this patient population has not improved during the past 20 years. Many different multimodality treatment schedules have been proposed, and chemotherapy is often used with the intent of organ preservation. The present study was intended to establish the efficacy of concomitant chemoradiation with a single agent carboplatin in advanced head and neck cancers.The objectives were to investigate the feasibility of concomitant administration of carboplatin, monitor acute toxicity during radiotherapy, and determine subacute side effects, such as wound healing following surgery after chemoradiotherapy. A prospective study was conducted wherein a total of 40 patients with stage III and IV squamous cell carcinomas of oral cavity, oropharynx, hypopharynx and larynx were enrolled. All patients were treated with external beam radiotherapy and weekly carboplatin area under curve (AUC of 5). Radiotherapy was given in single daily fractions of 1.8-2 grays (Gy) to a total dose of 66-72 Gy. Salvage surgery was performed for any residual or recurrent locoregional disease. Neck dissection was recommended for all patients with neck disease showing less than a complete response after chemoradiation. A total of 40 patients were enrolled of whom 32 were males and 8 were females. Highest incidence of cancer was seen in the 5th-6th decades of life with a median age of 47.7 years. Oropharyngeal tumours constituted a maximum of 21 patients followed by hypopharynx in 10, larynx in 7 and oral cavity in 2. 80% of the patients had a neck node on presentation of which 40% had N2-N3 nodal status. TNM staging revealed that 58% of patients were in stage III and 43% in stage IV. Evaluation of acute toxicity revealed that 50% had grade II mucositis, 25% grade III mucositis, 2.5% grade IV mucositis. 50% of patients had grade I skin reactions, 65% of patients had grade I thrombocytopenia, and 24% of patients had grade I anaemia. After completion of treatment 65% of patients had complete response at the primary and regional sites, and 35% of patients had a partial response of whom 23% underwent neck dissection and 5% of them underwent salvage surgery at the primary site. At the end of one year there were six deaths and four recurrences and 70% were free of disease. Concurrent chemoradiation with carboplatin provided good locoregional control for locally advanced head and neck cancers. This regimen, although toxic, is tolerable with appropriate supportive intervention. Primary site conservation is possible in many patients. Chemoradiotherapy appears to have an emerging role in the primary management of head and neck cancers.