Glycogen Phosphorylase BB: A more Sensitive and Specific Marker than Other Cardiac Markers for Early Diagnosis of Acute Myocardial Infarction

Cardiac markers are used to evaluate functions of heart. However, there are no satisfactory cardiac biomarkers for the diagnosis of acute myocardial infarction (AMI) within 4 h of onset of chest pain. Among novel cardiac markers, glycogen phosphorylase BB (GPBB) is of particular interest as it is increased in the early hours after AMI. The present study was conducted with the objective to find out the sensitivity and specificity of GPBB over other cardiac markers i.e. myoglobin and CKMB in patients of AMI within 4 h after the onset of chest pain. The study includes 100 AMI patients and 100 normal healthy individuals as controls. In all the cases and controls, serum GPBB and myoglobin concentrations were measured by ELISA where as CK-MB was measured by diagnostic kit supplied by ERBA. The sensitivity and specificity of glycogen phosphorylase BB (GPBB) were greater than CK-MB and myoglobin in patients of AMI within 4 h after the onset of chest pain. Hence, glycogen phosphorylase BB (GPBB) can be used as additional biomarker for the early diagnosis of AMI.     

Quality early childhood education for disadvantaged children: an investigation in the MCD schools

Schools run by Municipal Corporation of Delhi (MCD) play a pivotal role in providing early childhood education to young children belonging to marginalized sections of Delhi. However, literature review reveals that low learning outcomes are common among children attending these schools. Low levels of learning are often associated with poor quality educational programmes. The present study was therefore undertaken in nursery, grade I and grade II of 36 randomly selected MCD schools to investigate their structural and process quality. Structural quality included infrastructure facilities like availability of drinking water and toilets, safety and cleanliness of the physical setting among others. Process quality included the experiences of the children in the school. Findings revealed that while many MCD schools had an average score on components related to structural quality, the process quality scores of the schools were below average. Significant differences were also observed in overall quality scores of grade II, grade I and nursery, with nursery scores being the highest. The decline in quality scores from nursery to grade II is a sign of decreasing quality and prevents a smooth transition of children from pre-primary to primary.     

Incorporating the views of obstetric clinicians in implementing evidence-supported labour and delivery suite ward rounds: a case study

Objectives: To implement evidence‐supported delivery suite ward rounds using strategies to overcome barriers. Design: Qualitative case study to identify barriers and a quantitative assessment of outcomes on ward rounds. Method: After an introduction to the proposed evidence‐supported delivery suite ward round reactions were elicited from 15 clinicians. Responses were categorized into barriers related to knowledge, skills, attitudes and behaviour. Using strategies to overcome these barriers, a weekly evidence‐supported ward round was established. During patient‐centred discussions, clinical questions were formulated. Following literature searches, evidence was acquired and appraised. Results: Clinicians had limited awareness about the potential benefits of a clinical librarian's support during ward rounds. They were unsure of their skills in evidence‐based practice. There was scepticism, fear of loss of autonomy, poor motivation and resistance to change. Clinicians identified several factors that could impinge on their practice. Using appropriate strategies when evidence‐supported ward rounds were conducted, 67 questions were raised. However only seven articles were appraised in time to affect decisions on that ward round. Conclusions: Knowledge of barriers was helpful in developing plans for implementation of evidence‐supported ward rounds. The pilot study indicates the feasibility of this approach.