RESUMEN
Pediatric cancers are relatively rare diseases when considering all types of cancer. Platinum-based chemotherapeutic agents are potent agents against a variety of pediatric malignancies. An important adverse effect of platinum-based agents is the occurrence of hearing loss. This hearing loss can pose a challenge to detect especially if the child is in his early of life. It will also significantly affect the child development of social, pedagogical, and personal dimensions. It is integral to identify incidence of platinum-based ototoxicity and risk factors that increase the likelihood of developing hearing loss in cancer children. We performed a retrospective chart review of 123 pediatric patients who had completed cisplatin and carboplatin therapy for a variety of malignancies. Patients were diagnosed at Princess Nourah Oncology Centre between January 2011 and December 2016, were less than 14 years old at diagnosis. Audiograms were scored using the International Society of Pediatric Oncology (SIOP) Boston Scale (0-4), a validated grading system for cisplatin-related hearing loss. Ototoxicity was reported in 16 patients out of 123 with a rate of 13%. The incidence of ototoxicity was highest in CNS tumors such as medulloblastoma (37.5%) and optic glioma (25%). Males were at greater risk for developing hearing loss than females. Cumulative cisplatin dose and addition radiation therapy were also identified as risk factors for development of ototoxicity (P = 0.008). Nature and location of cancer, gender, cumulative dose, and addition of radiation therapy are important clinical biomarkers of cisplatin ototoxicity.
RESUMEN
INTRODUCTION: Instant Messaging Applications are known for their potential to enhance learning. However, to date, there has been little investigation into the implications of the 'Telegram' application for online medical education and training. AIM: This study explores the potential benefits and disadvantages of integrating Telegram into undergraduate medical education during the COVID-19 pandemic. METHODS: An exploratory study was conducted between March and May 2020, with 203 undergraduate medical students recruited through purposive sampling. Data was collected through seven open-ended questions, followed by thematic analysis using Atlas.ti. RESULTS: Most students participating in this study reported multiple utilities of the application, including easy access to educational resources and the ability to add unlimited members, as well as files in all formats and sizes. Additionally, the application assisted students to engage with collaborative learning, maintain their wellbeing, and ensure their security. However, they also reported some drawbacks, i.e., a complex interface, information overload, and a tendency to distract them, causing time wastage. CONCLUSION: This study concludes that Telegram provides an effective mobile learning platform for medical students during the current crisis, in particular. Moreover, it offers considerably more functionalities and fewer potential drawbacks than alternative applications.
RESUMEN
Acute respiratory distress syndrome (ARDS) is a life threatening complication of H1N1 pneumonia. According to the Berlin conference guidelines, severe ARDS requires management with early invasive mechanical ventilation. Whether noninvasive positive pressure ventilation (NIPPV) should be attempted in patients with H1N1 pneumonia is still a matter of debate. We report the case of one patient with severe ARDS without other organ failure. The patient was managed successfully using NIPPV. Endotracheal intubation was avoided and the patient was discharged from the intensive care unit (ICU) after 10 days with a successful outcome. NIPPV can be useful in patients with isolated severe H1N1 ARDS provided early improvement of the oxygenation parameters is achieved. Patients with multiple organ failure or with persistent severe hypoxemia under noninvasive ventilation should be electively intubated and started on invasive mechanical ventilation.