Natl Med J India
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Background Autologous stem cell transplantation (ASCT) is potentially beneficial for patients with myeloma-related renal impairment but is associated with high rates of complications in dialysis-dependent patients and requires specific precautions. Methods Patients diagnosed with myeloma and concomitant dialysis-dependent renal dysfunction were admitted for ASCT after achieving at least partial response with bortezomib-based induction therapy. For both patients, mobilization consisted of granulocyte colony stimulating factor for 5 days and CD34 directed Plerixafor on Day 1. ⋯ Conclusions ASCT in dialysis-dependent patients is associated with a higher risk of drug toxicity, infections and transplant-related mortality. Use of reduced dose melphalan, pre-emptive dialysis after 24 hours and monitoring for acidosis and symptoms of uraemia to identify acidosis at an early stage allows safe administration of high dose chemotherapy. A major proportion of patients can potentially achieve reduction or freedom from dialysis support post-transplant.
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Background We initiated a conversation regarding the concept of professional identity formation (PIF) with faculty of Institute of Nursing at our university through a participatory workshop. We report the planning and conduct of the workshop, as well as lessons learnt from the discussions in the workshop. Methods We designed and implemented a day-long workshop for 28 nursing faculty at Institute of Nursing, Bhaikaka University, Gujarat. ⋯ Key themes identified from the participants' reflections were: (i) their different views about professional identity, (ii) experiences and reactions and (iii) their future action plan. Conclusions The workshop was well received by the participants. Our approach to the workshop might help other institutions design and implement similar activities as a part of their faculty development programme.
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Continuing medical education (CME) credits has been mandated by the National Medical Commission for registered medical practitioners in India as a part of continuing professional development and a minimum of 30 credits in 5 years is required for the renewal of the medical license. Undoubtedly, credit hours for CME attendance is an essential yardstick for professional and career growth, the modus operandi adopted to grant these credit hours needs a serious look. Targeted learning with adequate feedback either with a post CME examination or questionnaire should become the norm and every publication in high impact indexed journal deserve a higher credit point than the rest of the publications.