RESUMEN
Patients with Voice problems are frequently encountered in clinics. There is no tool available in Punjabi language for evaluation of impact of voice disorder on patient's life. The aim of this study was to adapt Voice Handicap Index in Punjabi language and to obtain validity, reliability and consistency of the developed tool. The study also aims to compare the scores of VHI-Punjabi between patients with voice problems and asymptomatic age-matched controls. The study follows qualitative research design with purposive sampling. The study was conducted at the Audiology and SLP unit of ENT, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab. A total of 200 subjects in the age group of 20-50 years were included, 100 each in study and control group. Combination of reverse translation, committee, and bilingual models were used for development of VHI-Punjabi. The construct validity was very good (r = 0.91). A statistically significant difference (p < 0.001) was obtained between the study group and control group in all the subtest scores and on the total scores of VHI-Punjabi. Statistical significant correlation is found in two administrations of VHI-Punjabi after a gap of 2 weeks in both study group and control group (p < 0.001). To find the internal consistency of VHI-Punjabi, Chronbach alpha was calculated, which came to be 0.97. The internal consistency was high. The results of the present study indicate that VHI-Punjabi is a valid and reliable tool that can be used for evaluation of patients with different types of voice problems.
RESUMEN
The continuation of bone-modifying agents (BMAs) in patients with established medication-related osteonecrosis of the jaw (MRONJ) is a common concern among dentists and oncologists. There is little evidence supporting or refuting the continued use of BMAs or drug holidays and their impact on established MRONJ. This paper evaluates the outcome of continued BMAs use on the patient's MRONJ status. A retrospective review of 29 oncology patients undergoing active cancer care for either metastatic disease or multiple myeloma was conducted. Data on demographics, oncological status, BMA history and MRONJ status were collected. In total, 90% of patients were judged to have healed or stable MRONJ while continuing BMAs. Most patients (69%) continued the same BMA regime (three- or four-weekly) that they were on before developing MRONJ. The average number of BMAs doses received after an MRONJ diagnosis was 12 (range 1-48). Three patients (10.3%) were found to have MRONJ progression, with two patients developing new sites of necrosis. This real-world dataset suggests that the majority of MRONJ cases remain stable and will not worsen with the continuation of BMAs.