The Impact of Educational Package on Nursing Students' Knowledge towards Fertility Preservation, a Quasi-Experimental Study

Background: Recent advances in diagnosis and treatment of cancers have resulted in survival improvement in young patients with cancer. Given the side effects of cancer treatments on the function of the reproductive system, health care providers need to be educated about the side effects of cancer treatment and fertility preservation. The aim of this study was to explore the effect of education on nursing students' knowledge towards fertility preservation methods in patients with cancer. Methodology: This was a quasi-experimental one-group pre-test post-test research study that was carried out by the nursing faculty at Islamic Azad University of Tonekabon in 2018. Data was collected through a two-part questionnaire, including demographic characteristics and 32 questions about the knowledge of fertility preservation in patients with cancer. The study intervention was an educational package which includes 8 sessions of small group education, planning questions, and a booklet. Students were asked to complete the questionnaire before starting an educational session and again two weeks after the last session. Results: The difference in the mean score of the nursing students’ knowledge before and after the educational package intervention was significant (P= 0.0001). Also, the knowledge rank of nursing students after the intervention was significantly better than before (P = 0.0001).  There was a significant difference between the mean score of knowledge based on gender (0.0001), marital status (0.0001) and residency (0.0001). Conclusion: In conclusion, educational intervention towards fertility preservation had a positive effect on nursing students’ knowledge. Therefore, the importance of considering this new approach to fertility preservation in patients with cancer should be considered in the nursing curriculum as they consider as the main resource of the medical information to the patient

The global burden of adolescent and young adult cancer in 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. Findings There were 1.19 million (95% UI 1.11-1.28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59.6 [54.5-65.7] per 100 000 person-years) and high-middle SDI countries (53.2 [48.8-57.9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14.2 [12.9-15.6] per 100 000 person-years) and middle SDI (13.6 [12.6-14.8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23.5 million (21.9-25.2) DALYs to the global burden of disease, of which 2.7% (1.9-3.6) came from YLDs and 97.3% (96.4-98.1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

Central nervous system nocardiosis in Queensland: a report of 20 cases and review of the literature

Nocardia infection of the central nervous system (CNS) is an uncommon but clinically important disease, often occurring in immunocompromised individuals and carrying a high mortality rate. We present 20 cases of microbiologically proven CNS nocardiosis diagnosed in Queensland from 1997 to 2015 and review the literature from 1997 to 2016.Over 50% of cases occurred in immunocompromised individuals, with corticosteroid use posing a particularly significant risk factor. Nine (45%) patients were immunocompetent and 3 had no comorbidities at time of diagnosis. Nocardia farcinica was the most frequently isolated species (8/20) and resistance to trimethoprim-sulfamethoxazole (TMP-SMX) was found in 2 isolates. Overall, 35% of our patients died within 1 year, with the majority of deaths occurring in the first month following diagnosis. Interestingly, of the 7 deaths occurring at 1 year, 6 were attributed to N farcinica with the seventh isolate being unspeciated, suggesting the virulence of the N farcinica strain

A Case of Tuberculosis-related Leukocytoclastic Vasculitis Presenting With Peripheral Neuropathy.

Tuberculous granulomatous vasculitis is commonly associated with meningitis and retinitis. We describe a 39-year-old male, with a history of pulmonary tuberculosis (TB) who presented with progressive weakness, pain, tingling and numbness in the bilateral lower extremities. Significant atrophy and weakness of the lower extremities were evident along with absent reflexes. Nerve conduction studies and electromyography showed severe axonal polyneuropathy and denervation on the lower extremities. Nerve biopsy demonstrated small vessel leukocytoclastic vasculitis without any granuloma formation. Muscle biopsy was consistent with denervation and atrophy with target fiber changes. Tuberculosis-related vasculitis causing peripheral neuropathy is extremely rare and our case is unique in manifesting this presentation

Characteristics and outcomes of choroidal neovascularization occurring after macular hole surgery

To study the characteristics and outcomes of choroidal neovascularization (CNV) developing after surgery for idiopathic macular holes. Retrospective, noncomparative case series. Search of diagnostic and procedure databases of four participating institutes identified nine eyes of eight patients with CNV after surgery for idiopathic macular hole. Demographic, clinical, and fundus fluorescein angiographic data were abstracted from patients' medical records. Choroidal neovascularization developed 6 weeks to 30 months after macular hole surgery. The macular hole was closed in all cases. The CNV complex involved the foveal region in 9 (100%) eyes, was predominantly classic in 8 (89%) eyes, and was associated with moderate to severe leakage of fluorescein in 8 (89%) eyes. The CNV was crescent-shaped and spared the central area of retinal pigment epithelial mottling that corresponded to the site of the macular hole in 6 (67%) cases. Other fluorescein angiographic features included retinal pigment epitheliopathy in 6 (67%) eyes and presence of drusen in 7 (78%) eyes. The final visual acuity after a mean follow-up period of 11.2 months (range, 3-16 months) was 20/50 to 20/80 in 2 (22%) eyes, 20/100 to 20/200 in 1 (11%) eye, and less than 20/200 in 6 (67%) eyes. Choroidal neovascular complexes occurring after macular hole surgery tend to share certain characteristics, including foveal involvement, frequent sparing of the central area corresponding to the site of the closed macular hole, and generally poor visual outcomes. Therapeutic modalities including photodynamic therapy and surgical options may be considered in these patients