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Publisher: Medknow Publishers   (Total: 355 journals)

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Showing 1 - 200 of 355 Journals sorted alphabetically
Advanced Arab Academy of Audio-Vestibulogy J.     Open Access  
Advances in Human Biology     Open Access   (Followers: 1)
African J. for Infertility and Assisted Conception     Open Access  
African J. of Business Ethics     Open Access   (Followers: 6)
African J. of Medical and Health Sciences     Open Access   (Followers: 1)
African J. of Paediatric Surgery     Open Access   (Followers: 7, SJR: 0.269, h-index: 10)
African J. of Trauma     Open Access  
Ain-Shams J. of Anaesthesiology     Open Access   (Followers: 3)
Al-Azhar Assiut Medical J.     Open Access  
Al-Basar Intl. J. of Ophthalmology     Open Access   (Followers: 1)
Ancient Science of Life     Open Access   (Followers: 6)
Anesthesia : Essays and Researches     Open Access   (Followers: 7)
Annals of African Medicine     Open Access   (Followers: 1, SJR: 0.331, h-index: 15)
Annals of Bioanthropology     Open Access   (Followers: 3)
Annals of Cardiac Anaesthesia     Open Access   (Followers: 12, SJR: 0.408, h-index: 15)
Annals of Indian Academy of Neurology     Open Access   (Followers: 3, SJR: 0.308, h-index: 14)
Annals of Maxillofacial Surgery     Open Access   (Followers: 6)
Annals of Medical and Health Sciences Research     Open Access   (Followers: 7)
Annals of Nigerian Medicine     Open Access   (Followers: 1)
Annals of Pediatric Cardiology     Open Access   (Followers: 7, SJR: 0.441, h-index: 10)
Annals of Saudi Medicine     Open Access   (SJR: 0.24, h-index: 29)
Annals of Thoracic Medicine     Open Access   (Followers: 4, SJR: 0.388, h-index: 19)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 15, SJR: 0.148, h-index: 5)
APOS Trends in Orthodontics     Open Access   (Followers: 1)
Arab J. of Interventional Radiology     Open Access  
Archives of Intl. Surgery     Open Access   (Followers: 9)
Archives of Medicine and Health Sciences     Open Access   (Followers: 3)
Archives of Pharmacy Practice     Open Access   (Followers: 5)
Asia Pacific J. of Clinical Trials : Nervous System Diseases     Open Access  
Asia-Pacific J. of Oncology Nursing     Open Access   (Followers: 3)
Asian J. of Andrology     Open Access   (Followers: 1, SJR: 0.879, h-index: 49)
Asian J. of Neurosurgery     Open Access   (Followers: 2)
Asian J. of Oncology     Open Access   (Followers: 1)
Asian J. of Transfusion Science     Open Access   (Followers: 2, SJR: 0.362, h-index: 10)
Astrocyte     Open Access  
Avicenna J. of Medicine     Open Access   (Followers: 1)
AYU : An international quarterly journal of research in Ayurveda     Open Access   (Followers: 6)
Benha Medical J.     Open Access  
BLDE University J. of Health Sciences     Open Access  
Brain Circulation     Open Access  
Bulletin of Faculty of Physical Therapy     Open Access   (Followers: 1)
Cancer Translational Medicine     Open Access   (Followers: 1)
CHRISMED J. of Health and Research     Open Access  
Clinical Dermatology Review     Open Access   (Followers: 1)
Clinical Trials in Degenerative Diseases     Open Access  
Clinical Trials in Orthopedic Disorders     Open Access   (Followers: 1)
Community Acquired Infection     Open Access  
Conservation and Society     Open Access   (Followers: 12, SJR: 0.82, h-index: 12)
Contemporary Clinical Dentistry     Open Access   (Followers: 4)
Current Medical Issues     Open Access   (Followers: 1)
CytoJ.     Open Access   (Followers: 2, SJR: 0.339, h-index: 19)
Delta J. of Ophthalmology     Open Access  
Dental Hypotheses     Open Access   (Followers: 3, SJR: 0.131, h-index: 4)
Dental Research J.     Open Access   (Followers: 9)
Dentistry and Medical Research     Open Access  
Digital Medicine     Open Access  
Drug Development and Therapeutics     Open Access  
Education for Health     Open Access   (Followers: 5, SJR: 0.205, h-index: 22)
Egyptian J. of Bronchology     Open Access  
Egyptian J. of Cardiothoracic Anesthesia     Open Access  
Egyptian J. of Cataract and Refractive Surgery     Open Access   (Followers: 1)
Egyptian J. of Dermatology and Venerology     Open Access   (Followers: 1)
Egyptian J. of Haematology     Open Access  
Egyptian J. of Internal Medicine     Open Access   (Followers: 1)
Egyptian J. of Neurology, Psychiatry and Neurosurgery     Open Access   (Followers: 1, SJR: 0.121, h-index: 3)
Egyptian J. of Obesity, Diabetes and Endocrinology     Open Access  
Egyptian J. of Otolaryngology     Open Access  
Egyptian J. of Psychiatry     Open Access   (Followers: 2)
Egyptian J. of Surgery     Open Access   (Followers: 1)
Egyptian Orthopaedic J.     Open Access  
Egyptian Pharmaceutical J.     Open Access  
Egyptian Retina J.     Open Access  
Egyptian Rheumatology and Rehabilitation     Open Access  
Endodontology     Open Access  
Endoscopic Ultrasound     Open Access   (SJR: 0.473, h-index: 8)
Environmental Disease     Open Access  
European J. of Dentistry     Open Access   (Followers: 2, SJR: 0.496, h-index: 11)
European J. of General Dentistry     Open Access   (Followers: 1)
European J. of Prosthodontics     Open Access   (Followers: 2)
European J. of Psychology and Educational Studies     Open Access   (Followers: 7)
Fertility Science and Research     Open Access  
Formosan J. of Surgery     Open Access   (SJR: 0.107, h-index: 5)
Genome Integrity     Open Access   (Followers: 4, SJR: 1.227, h-index: 12)
Global J. of Transfusion Medicine     Open Access   (Followers: 1)
Heart India     Open Access   (Followers: 1)
Heart Views     Open Access   (Followers: 2)
Hepatitis B Annual     Open Access   (Followers: 3)
IJS Short Reports     Open Access  
Indian Anaesthetists Forum     Open Access  
Indian Dermatology Online J.     Open Access   (Followers: 3)
Indian J. of Allergy, Asthma and Immunology     Open Access   (Followers: 1)
Indian J. of Anaesthesia     Open Access   (Followers: 8, SJR: 0.302, h-index: 13)
Indian J. of Burns     Open Access   (Followers: 1)
Indian J. of Cancer     Open Access   (SJR: 0.318, h-index: 26)
Indian J. of Cerebral Palsy     Open Access   (Followers: 1)
Indian J. of Community Medicine     Open Access   (Followers: 2, SJR: 0.618, h-index: 16)
Indian J. of Critical Care Medicine     Open Access   (Followers: 2, SJR: 0.307, h-index: 16)
Indian J. of Dental Research     Open Access   (Followers: 4, SJR: 0.243, h-index: 24)
Indian J. of Dental Sciences     Open Access  
Indian J. of Dentistry     Open Access   (Followers: 1)
Indian J. of Dermatology     Open Access   (Followers: 2, SJR: 0.448, h-index: 16)
Indian J. of Dermatology, Venereology and Leprology     Open Access   (Followers: 3, SJR: 0.563, h-index: 29)
Indian J. of Dermatopathology and Diagnostic Dermatology     Open Access  
Indian J. of Drugs in Dermatology     Open Access   (Followers: 1)
Indian J. of Endocrinology and Metabolism     Open Access   (Followers: 4)
Indian J. of Health Sciences     Open Access   (Followers: 2)
Indian J. of Medical and Paediatric Oncology     Open Access   (SJR: 0.292, h-index: 9)
Indian J. of Medical Microbiology     Open Access   (Followers: 1, SJR: 0.53, h-index: 34)
Indian J. of Medical Research     Open Access   (Followers: 4, SJR: 0.716, h-index: 60)
Indian J. of Medical Sciences     Open Access   (Followers: 2, SJR: 0.207, h-index: 31)
Indian J. of Multidisciplinary Dentistry     Open Access   (Followers: 1)
Indian J. of Nephrology     Open Access   (Followers: 1, SJR: 0.233, h-index: 12)
Indian J. of Nuclear Medicine     Open Access   (Followers: 2, SJR: 0.213, h-index: 5)
Indian J. of Occupational and Environmental Medicine     Open Access   (Followers: 4, SJR: 0.203, h-index: 13)
Indian J. of Ophthalmology     Open Access   (Followers: 5, SJR: 0.536, h-index: 34)
Indian J. of Oral Health and Research     Open Access  
Indian J. of Oral Sciences     Open Access   (Followers: 1)
Indian J. of Orthopaedics     Open Access   (Followers: 9, SJR: 0.393, h-index: 15)
Indian J. of Otology     Open Access   (Followers: 1, SJR: 0.218, h-index: 5)
Indian J. of Paediatric Dermatology     Open Access   (Followers: 2)
Indian J. of Pain     Open Access   (Followers: 1)
Indian J. of Palliative Care     Open Access   (Followers: 5, SJR: 0.35, h-index: 12)
Indian J. of Pathology and Microbiology     Open Access   (Followers: 1, SJR: 0.285, h-index: 22)
Indian J. of Pharmacology     Open Access   (SJR: 0.347, h-index: 44)
Indian J. of Plastic Surgery     Open Access   (Followers: 12, SJR: 0.303, h-index: 13)
Indian J. of Psychiatry     Open Access   (Followers: 3, SJR: 0.496, h-index: 15)
Indian J. of Psychological Medicine     Open Access   (Followers: 1, SJR: 0.344, h-index: 9)
Indian J. of Public Health     Open Access   (Followers: 1, SJR: 0.444, h-index: 17)
Indian J. of Radiology and Imaging     Open Access   (Followers: 4, SJR: 0.253, h-index: 14)
Indian J. of Research in Homoeopathy     Open Access  
Indian J. of Rheumatology     Open Access   (SJR: 0.169, h-index: 7)
Indian J. of Sexually Transmitted Diseases and AIDS     Open Access   (Followers: 2, SJR: 0.313, h-index: 9)
Indian J. of Social Psychiatry     Open Access   (Followers: 2)
Indian J. of Urology     Open Access   (Followers: 3, SJR: 0.366, h-index: 16)
Indian J. of Vascular and Endovascular Surgery     Open Access   (Followers: 2)
Industrial Psychiatry J.     Open Access   (Followers: 2)
Intl. J. of Academic Medicine     Open Access  
Intl. J. of Advanced Medical and Health Research     Open Access  
Intl. J. of Applied and Basic Medical Research     Open Access  
Intl. J. of Clinical and Experimental Physiology     Open Access   (Followers: 1)
Intl. J. of Critical Illness and Injury Science     Open Access   (Followers: 1)
Intl. J. of Educational and Psychological Researches     Open Access   (Followers: 3)
Intl. J. of Environmental Health Engineering     Open Access   (Followers: 1)
Intl. J. of Forensic Odontology     Open Access   (Followers: 1)
Intl. J. of Green Pharmacy     Open Access   (Followers: 4, SJR: 0.229, h-index: 13)
Intl. J. of Health & Allied Sciences     Open Access   (Followers: 3)
Intl. J. of Health System and Disaster Management     Open Access   (Followers: 2)
Intl. J. of Heart Rhythm     Open Access  
Intl. J. of Medicine and Public Health     Open Access   (Followers: 7)
Intl. J. of Mycobacteriology     Open Access   (SJR: 0.239, h-index: 4)
Intl. J. of Noncommunicable Diseases     Open Access  
Intl. J. of Nutrition, Pharmacology, Neurological Diseases     Open Access   (Followers: 4)
Intl. J. of Oral Health Sciences     Open Access   (Followers: 1)
Intl. J. of Orthodontic Rehabilitation     Open Access  
Intl. J. of Pedodontic Rehabilitation     Open Access  
Intl. J. of Pharmaceutical Investigation     Open Access   (Followers: 1)
Intl. J. of Preventive Medicine     Open Access   (Followers: 1, SJR: 0.523, h-index: 15)
Intl. J. of Shoulder Surgery     Open Access   (Followers: 7, SJR: 0.611, h-index: 9)
Intl. J. of Trichology     Open Access   (SJR: 0.37, h-index: 10)
Intl. J. of Yoga     Open Access   (Followers: 15)
Intl. J. of Yoga : Philosophy, Psychology and Parapsychology     Open Access   (Followers: 6)
Iranian J. of Nursing and Midwifery Research     Open Access   (Followers: 2)
Iraqi J. of Hematology     Open Access  
J. of Academy of Medical Sciences     Open Access  
J. of Advanced Pharmaceutical Technology & Research     Open Access   (Followers: 4, SJR: 0.427, h-index: 15)
J. of Anaesthesiology Clinical Pharmacology     Open Access   (Followers: 8, SJR: 0.416, h-index: 14)
J. of Applied Hematology     Open Access  
J. of Association of Chest Physicians     Open Access   (Followers: 2)
J. of Basic and Clinical Reproductive Sciences     Open Access   (Followers: 1)
J. of Cancer Research and Therapeutics     Open Access   (Followers: 4, SJR: 0.359, h-index: 21)
J. of Carcinogenesis     Open Access   (Followers: 1, SJR: 1.152, h-index: 26)
J. of Cardiothoracic Trauma     Open Access  
J. of Cardiovascular Disease Research     Open Access   (Followers: 3, SJR: 0.351, h-index: 13)
J. of Cardiovascular Echography     Open Access   (SJR: 0.134, h-index: 2)
J. of Cleft Lip Palate and Craniofacial Anomalies     Open Access   (Followers: 2)
J. of Clinical and Preventive Cardiology     Open Access   (Followers: 1)
J. of Clinical Imaging Science     Open Access   (Followers: 1, SJR: 0.277, h-index: 8)
J. of Clinical Neonatology     Open Access   (Followers: 1)
J. of Clinical Ophthalmology and Research     Open Access   (Followers: 2)
J. of Clinical Sciences     Open Access  
J. of Conservative Dentistry     Open Access   (Followers: 4, SJR: 0.532, h-index: 10)
J. of Craniovertebral Junction and Spine     Open Access   (Followers: 4, SJR: 0.199, h-index: 9)
J. of Current Medical Research and Practice     Open Access  
J. of Current Research in Scientific Medicine     Open Access  
J. of Cutaneous and Aesthetic Surgery     Open Access   (Followers: 1)
J. of Cytology     Open Access   (Followers: 1, SJR: 0.274, h-index: 9)
J. of Dental and Allied Sciences     Open Access   (Followers: 1)
J. of Dental Implants     Open Access   (Followers: 7)
J. of Dental Lasers     Open Access   (Followers: 2)
J. of Dental Research and Review     Open Access   (Followers: 1)
J. of Digestive Endoscopy     Open Access   (Followers: 3)
J. of Dr. NTR University of Health Sciences     Open Access  
J. of Earth, Environment and Health Sciences     Open Access   (Followers: 1)
J. of Education and Ethics in Dentistry     Open Access   (Followers: 5)
J. of Education and Health Promotion     Open Access   (Followers: 5)
J. of Emergencies, Trauma and Shock     Open Access   (Followers: 9, SJR: 0.353, h-index: 14)
J. of Engineering and Technology     Open Access   (Followers: 6)
J. of Experimental and Clinical Anatomy     Open Access   (Followers: 2)
J. of Family and Community Medicine     Open Access   (Followers: 2)
J. of Family Medicine and Primary Care     Open Access   (Followers: 9)

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Journal Cover Indian Journal of Palliative Care
  [SJR: 0.35]   [H-I: 12]   [5 followers]  Follow
    
  This is an Open Access Journal Open Access journal
   ISSN (Print) 0973-1075
   Published by Medknow Publishers Homepage  [355 journals]
  • Integrating AYUSH into palliative care

    • Authors: Naveen Salins
      Pages: 219 - 220
      Abstract: Naveen Salins
      Indian Journal of Palliative Care 2017 23(3):219-220

      Citation: Indian Journal of Palliative Care 2017 23(3):219-220
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_101_17
      Issue No: Vol. 23, No. 3 (2017)
       
  • Balancing improved opioid supply and safe use of opioids for cancer pain
           by using “Circle of safety”

    • Authors: Sushma Bhatnagar, Wasimul Hoda
      Pages: 221 - 222
      Abstract: Sushma Bhatnagar, Wasimul Hoda
      Indian Journal of Palliative Care 2017 23(3):221-222

      Citation: Indian Journal of Palliative Care 2017 23(3):221-222
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_94_17
      Issue No: Vol. 23, No. 3 (2017)
       
  • Integrating yoga in cancer care: Scope and challenges

    • Authors: HR Nagendra
      Pages: 223 - 224
      Abstract: HR Nagendra
      Indian Journal of Palliative Care 2017 23(3):223-224

      Citation: Indian Journal of Palliative Care 2017 23(3):223-224
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_103_17
      Issue No: Vol. 23, No. 3 (2017)
       
  • Role of yoga in cancer patients: Expectations, benefits, and risks: A
           review

    • Authors: Raghavendra Mohan Rao, Ram Amritanshu, HT Vinutha, Shanmugaraj Vaishnaruby, Shashidhara Deepashree, Murthy Megha, Rajendra Geetha, BS Ajaikumar
      Pages: 225 - 230
      Abstract: Raghavendra Mohan Rao, Ram Amritanshu, HT Vinutha, Shanmugaraj Vaishnaruby, Shashidhara Deepashree, Murthy Megha, Rajendra Geetha, BS Ajaikumar
      Indian Journal of Palliative Care 2017 23(3):225-230
      Background: The diagnosis and treatment of cancer poses severe psychologic distress that impacts functional quality of life. While cancer directed treatments are directed purely against tumor killing, interventions that reduce treatment related distress and improve quality of life are the need of the hour. Yoga is one such mind body intervention that is gaining popularity among cancer patients. Method: Several research studies in the last two decades unravel the benefits of yoga in terms of improved mood states, symptom reduction, stress reduction and improved quality of life apart from improving host factors that are known to affect survival in cancer patients. However, several metaanalysis and reviews show equivocal benefits for yoga. In this review, we will study the Yoga interventions in cancer patients with respect to expectations, benefits and risks and analyse the principles behind tailoring yoga interventions in cancer patients. Results: The studies on Yoga show heterogeneity with varied types of Yoga Interventions, duration, exposure, practices and indications. It also elucidates the situational context for reaping benefits and cautions against its use in several others. However, there are several reviews and bibliometric analysis of effects of yoga; most of them have not enlarged the scope of their review to cover the basic principles behind use of these practices in cancer patients. Conclusion: This review offers insight into the principles and practice of yoga in cancer patients.
      Citation: Indian Journal of Palliative Care 2017 23(3):225-230
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_107_17
      Issue No: Vol. 23, No. 3 (2017)
       
  • Effect of long-term yoga practice on psychological outcomes in breast
           cancer survivors

    • Authors: Ram R Amritanshu, Raghavendra Mohan Rao, Raghuram Nagaratna, Vidya Harini Veldore, MR Usha Rani, Kodaganur S Gopinath, BS Ajaikumar
      Pages: 231 - 236
      Abstract: Ram R Amritanshu, Raghavendra Mohan Rao, Raghuram Nagaratna, Vidya Harini Veldore, MR Usha Rani, Kodaganur S Gopinath, BS Ajaikumar
      Indian Journal of Palliative Care 2017 23(3):231-236
      Aim: Breast cancer has become a pandemic with an ever-increasing incidence. Although better diagnostics and treatment modalities have reduced mortality, a large number of survivors face cancer and treatment-related long-term symptoms. Many survivors are taking up yoga for improving the quality of life (QoL). The present study attempts to evaluate predictors of psychological states in breast cancer survivors with long-term yoga experience. Materials and Methods: A case–control study recruited early breast cancer survivors, 30–65 years, completing treatment > 6 months before recruitment, and grouped them based on prior yoga experience (BCY, n = 27) or naïve (BCN, n = 25). Demography, cancer history, diet, exercise habits, and yoga schedule were collected and tools to assess stress, anxiety, depression, general health, and QoL were administered. Multivariate linear regression was done to identify predictors of psychological variables. Results: BCY had significantly lower stress, anxiety, depression, better general health, and QoL (P < 0.001). Global QoL and trait anxiety were significantly predicted by Yoga practice; depression was predicted by yoga practice, annual income, and sleep quality; state anxiety was predicted by Yoga practice and income; and stress was predicted by Yoga practice and sleep quality. Conclusion: Results indicate that breast cancer survivors, doing yoga, have better psychological profiles and are able to deal with demanding situations better. The psycho-oncogenic model of cancer etiology suggests that a better psychological state in survival has the potential to improve prognosis and survival outcomes and Yoga may be a suitable practice for staying cancer-free for a longer time.
      Citation: Indian Journal of Palliative Care 2017 23(3):231-236
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_93_17
      Issue No: Vol. 23, No. 3 (2017)
       
  • Effects of a yoga program on mood states, quality of life, and toxicity in
           breast cancer patients receiving conventional treatment: A randomized
           controlled trial

    • Authors: Raghavendra Mohan Rao, Nagaratna Raghuram, Hongasandra Ramarao Nagendra, Gopinath S Kodaganur, Ramesh S Bilimagga, HP Shashidhara, Ravi B Diwakar, Shekhar Patil, Nalini Rao
      Pages: 237 - 246
      Abstract: Raghavendra Mohan Rao, Nagaratna Raghuram, Hongasandra Ramarao Nagendra, Gopinath S Kodaganur, Ramesh S Bilimagga, HP Shashidhara, Ravi B Diwakar, Shekhar Patil, Nalini Rao
      Indian Journal of Palliative Care 2017 23(3):237-246
      Aims: The aim of this study is to compare the effects of yoga program with supportive therapy counseling on mood states, treatment-related symptoms, toxicity, and quality of life in Stage II and III breast cancer patients on conventional treatment. Methods: Ninety-eight Stage II and III breast cancer patients underwent surgery followed by adjuvant radiotherapy (RT) or chemotherapy (CT) or both at a cancer center were randomly assigned to receive yoga (n = 45) and supportive therapy counseling (n = 53) over a 24-week period. Intervention consisted of 60-min yoga sessions, daily while the control group was imparted supportive therapy during their hospital visits. Assessments included state-trait anxiety inventory, Beck's depression inventory, symptom checklist, common toxicity criteria, and functional living index-cancer. Assessments were done at baseline, after surgery, before, during, and after RT and six cycles of CT. Results: Both groups had similar baseline scores. There were 29 dropouts 12 (yoga) and 17 (controls) following surgery. Sixty-nine participants contributed data to the current analysis (33 in yoga, and 36 in controls). An ANCOVA, adjusting for baseline differences, showed a significant decrease for the yoga intervention as compared to the control group during RT ( first result) and CT (second result), in (i) anxiety state by 4.72 and 7.7 points, (ii) depression by 5.74 and 7.25 points, (iii) treatment-related symptoms by 2.34 and 2.97 points, (iv) severity of symptoms by 6.43 and 8.83 points, (v) distress by 7.19 and 13.11 points, and (vi) and improved overall quality of life by 23.9 and 31.2 points as compared to controls. Toxicity was significantly less in the yoga group (P = 0.01) during CT. Conclusion: The results suggest a possible use for yoga as a psychotherapeutic intervention in breast cancer patients undergoing conventional treatment.
      Citation: Indian Journal of Palliative Care 2017 23(3):237-246
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_92_17
      Issue No: Vol. 23, No. 3 (2017)
       
  • Effects of yoga in managing fatigue in breast cancer patients: A
           randomized controlled trial

    • Authors: HS Vadiraja, Raghavendra Mohan Rao, R Nagarathna, HR Nagendra, Shekhar Patil, Ravi B Diwakar, HP Shashidhara, KS Gopinath, BS Ajaikumar
      Pages: 247 - 252
      Abstract: HS Vadiraja, Raghavendra Mohan Rao, R Nagarathna, HR Nagendra, Shekhar Patil, Ravi B Diwakar, HP Shashidhara, KS Gopinath, BS Ajaikumar
      Indian Journal of Palliative Care 2017 23(3):247-252
      Background: Cancer-related fatigue is widely prevalent in cancer patients and affects quality of life in advanced cancer patients. Fatigue is caused due to both psychologic distress and physiological sequel following cancer progression and its treatment. In this study, we evaluate the effects of yogic intervention in managing fatigue in metastatic breast cancer patients. Methods: Ninety-one patients with metastatic breast cancer were randomized to receive integrated yoga program (n = 46) or supportive therapy and education (n = 45) over a 3-month period. Assessments such as perceived stress, fatigue symptom inventory, diurnal salivary cortisol, and natural killer cell counts were carried out before and after intervention. Analysis was done using an intention-to-treat approach. Postmeasures for the above outcomes were assessed using ANCOVA with respective baseline measure as a covariate. Results: The results suggest that yoga reduces perceived stress (P = 0.001), fatigue frequency (P < 0.001), fatigue severity (P < 0.001), interference (P < 0.001), and diurnal variation (P < 0.001) when compared to supportive therapy. There was a positive correlation of change in fatigue severity with 9 a.m. salivary cortisol levels. Conclusion: The results suggest that yoga reduces fatigue in advanced breast cancer patients.
      Citation: Indian Journal of Palliative Care 2017 23(3):247-252
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_95_17
      Issue No: Vol. 23, No. 3 (2017)
       
  • Effect of yoga on sleep quality and neuroendocrine immune response in
           metastatic breast cancer patients

    • Authors: Raghavendra Mohan Rao, HS Vadiraja, R Nagaratna, KS Gopinath, Shekhar Patil, Ravi B Diwakar, HP Shahsidhara, BS Ajaikumar, HR Nagendra
      Pages: 253 - 260
      Abstract: Raghavendra Mohan Rao, HS Vadiraja, R Nagaratna, KS Gopinath, Shekhar Patil, Ravi B Diwakar, HP Shahsidhara, BS Ajaikumar, HR Nagendra
      Indian Journal of Palliative Care 2017 23(3):253-260
      Background: Studies have shown that distress and accompanying neuroendocrine stress responses as important predictor of survival in advanced breast cancer patients. Some psychotherapeutic intervention studies have shown have modulation of neuroendocrine-immune responses in advanced breast cancer patients. In this study, we evaluate the effects of yoga on perceived stress, sleep, diurnal cortisol, and natural killer (NK) cell counts in patients with metastatic cancer. Methods: In this study, 91 patients with metastatic breast cancer who satisfied selection criteria and consented to participate were recruited and randomized to receive “integrated yoga based stress reduction program” (n = 45) or standard “education and supportive therapy sessions” (n = 46) over a 3 month period. Psychometric assessments for sleep quality were done before and after intervention. Blood draws for NK cell counts were collected before and after the intervention. Saliva samples were collected for three consecutive days before and after intervention. Data were analyzed using the analysis of covariance on postmeasures using respective baseline measure as a covariate. Results: There was a significant decrease in scales of symptom distress (P < 0.001), sleep parameters (P = 0.02), and improvement in quality of sleep (P = 0.001) and Insomnia Rating Scale sleep score (P = 0.001) following intervention. There was a decrease in morning waking cortisol in yoga group (P = 0.003) alone following intervention. There was a significant improvement in NK cell percent (P = 0.03) following intervention in yoga group compared to control group. Conclusion: The results suggest modulation of neuroendocrine responses and improvement in sleep in patients with advanced breast cancer following yoga intervention.
      Citation: Indian Journal of Palliative Care 2017 23(3):253-260
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_102_17
      Issue No: Vol. 23, No. 3 (2017)
       
  • A study to assess the feasibility of introducing early palliative care in
           ambulatory patients with advanced lung cancer

    • Authors: Jayita Kedar Deodhar, Vanita Noronha, Mary Ann Muckaden, Shrikant Atreya, Amit Joshi, Sandeep P Tandon, Arunangshu Ghoshal, Naveen S Salins, Vijay M Patil, Kumar Prabhash
      Pages: 261 - 267
      Abstract: Jayita Kedar Deodhar, Vanita Noronha, Mary Ann Muckaden, Shrikant Atreya, Amit Joshi, Sandeep P Tandon, Arunangshu Ghoshal, Naveen S Salins, Vijay M Patil, Kumar Prabhash
      Indian Journal of Palliative Care 2017 23(3):261-267
      Purpose: Early palliative care is beneficial in advanced lung cancer patients. We aimed to assess the feasibility of introducing early palliative care in ambulatory advanced lung cancer patients in an Indian tertiary cancer center. Methodology: In a longitudinal, single–arm, and single-center study, fifty patients were recruited and followed up every 3–4 weeks for 6 months, measuring the symptom burden using Edmonton Symptom Assessment Scale (ESAS) and quality of life (QoL) with European Organization for Research and Treatment of Cancer-QoL tools. The primary end point of feasibility was that at least 60% of the patients should complete 50% of the planned palliative care visits and over 50% of the patients should complete QoL questionnaires. Analysis was done using Statistical Package for the Social Sciences version 20. Results: Twenty-four of fifty patients (48%) completed the planned follow-up visits. All patients completed the questionnaires at baseline and 31 (62%) at their follow-up visits. The patients' main reasons for not following up in the hospital palliative care clinic were logistics and fatigue. Tiredness, pain, and appetite loss were the highest rated symptoms at baseline (ESAS scores 3, 2.2, and 2.1, respectively). Improvement in pain and anxiety scores at follow-up visits 1 and 2 was significant (P < 0.05). Scores on QoL functioning scales improved during the follow-up period. Conclusions: We did not meet the feasibility criteria for the introduction of early palliative care in our advanced lung cancer patients in a resource-limited country.
      Citation: Indian Journal of Palliative Care 2017 23(3):261-267
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_19_17
      Issue No: Vol. 23, No. 3 (2017)
       
  • Prevalence of depression in breast cancer patients and its association
           with their quality of life: A cross-sectional observational study

    • Authors: Debasweta Purkayastha, Chitra Venkateswaran, Kesavankutty Nayar, UG Unnikrishnan
      Pages: 268 - 273
      Abstract: Debasweta Purkayastha, Chitra Venkateswaran, Kesavankutty Nayar, UG Unnikrishnan
      Indian Journal of Palliative Care 2017 23(3):268-273
      Background: Breast cancer is the leading cause of cancer death among women worldwide. In India, the incidence rate of breast cancer is found to be 25.8/10,000 females. The statistics for Kerala, India, is 30.5 in urban areas and 19.8 in rural areas. Cancer and treatment-related symptoms are major stressors in patients with breast cancer undergoing treatment for the disease. Depression is a prevalent psychological symptom perceived by breast cancer patients, and it also impacts the quality of life (QOL) in these patients. We aimed to assess the prevalence of depression and its association with QOL of patients with breast cancer undergoing treatment for breast cancer. Materials and Methods: This cross-sectional study enrolled 270 patients diagnosed with breast cancer (>18 years) and undergoing active treatment in a tertiary care center in Kerala, India. Depression was assessed using the Patient Health Questionnaire 9 and International Classification of Diseases, Tenth Edition Research guidelines. We measured the QOL and its domains using the WHOQOL-BREF. Results: The average age of women in research was 53.56 years. Of the 270 patients, 21.5% had depression. Among patients with depression, 22% had moderately severe to severe depression. Patients with depression experienced overall a poor QOL. Twenty-two patients reported their overall QOL was “poor” and 34 patients reported to be dissatisfied with their health. There was an association between depression and domains of QOL. Patients with depression had lower scores in all domains when compared to those without depression. Conclusion: Depression and poor QOL is common among breast cancer patients.
      Citation: Indian Journal of Palliative Care 2017 23(3):268-273
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_6_17
      Issue No: Vol. 23, No. 3 (2017)
       
  • Fluoroscopy-guided neurolytic splanchnic nerve block for intractable pain
           from upper abdominal malignancies in patients with distorted celiac axis
           anatomy: An effective alternative to celiac plexus neurolysis - A
           retrospective study

    • Authors: Arif Ahmed, Divesh Arora
      Pages: 274 - 281
      Abstract: Arif Ahmed, Divesh Arora
      Indian Journal of Palliative Care 2017 23(3):274-281
      Introduction: The pain from upper gastrointestinal malignancy leads to considerable morbidity. The celiac plexus and splanchnic nerve neurolysis are good therapeutic options. Although splanchnic nerve neurolysis less frequently performed, but it has an edge over celiac plexus as it can be performed in patients with altered celiac plexus anatomy by enlarged lymph nodes. Methods: The fluoroscopy-guided splanchnic nerve neurolysis was done in about 21 patients with intractable upper abdominal pain with pain intensity of ≥7 in numerical rating scale (NRS) from upper gastrointestinal cancers with distorted celiac plexus anatomy from enlarged celiac lymph nodes as seen by computed tomography scan after positive diagnostic splanchnic nerve neurolysis. The demographic features, pain intensity, daily opioid dose, functional status and quality of life was measured at baseline and 1 week, 1 and 3 months after the procedure. Results: There was a significant improvement in pain intensity, opioid requirement, functional status, and physical components quality of life after the neurolysis (P < 0.05) and this improvement had continued till 3 months. There were also more than 50% reduction in pain intensity and significant decrease in opioid requirement in all the patients after neurolysis. Conclusion: The fluoroscopy-guided splanchnic nerve neurolysis results significant pain relief, decrease in opioid intake, improvement in functional status, and quality of life for up to 3 months in upper abdominal pain from gastrointestinal cancers in patients with distorted celiac lymph node anatomy not amenable to celiac plexus neurolysis.
      Citation: Indian Journal of Palliative Care 2017 23(3):274-281
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_28_17
      Issue No: Vol. 23, No. 3 (2017)
       
  • Home-based application of sphenopalatine ganglion block for head and neck
           cancer pain management

    • Authors: Priti R Sanghavi, Bhavna C Shah, Geeta M Joshi
      Pages: 282 - 286
      Abstract: Priti R Sanghavi, Bhavna C Shah, Geeta M Joshi
      Indian Journal of Palliative Care 2017 23(3):282-286
      Background: Head and neck cancer pain is intractable and difficult to manage. Many a times it is difficult to treat with oral opioids and adjuvants. Aim: This study aims to study the effects of transnasal sphenopalatine ganglion block (SPGB), administered using cotton swab/ear bud by patients' caretaker, at home, for pain management. Study Design: This is a prospective, single-arm observational study conducted on 100 head and neck cancer patients, from January 2014 to December 2015. Patients and caretaker were given a demonstration of the procedure using sterile cotton swab/ear buds. They were advised to repeat the procedure when their visual analog score (VAS) was more than 5. They continued with the oral analgesics. They kept the records of pre- and post-procedure pain score (VAS), the frequency of repetition, ease of performance of procedure, and morphine requirement. A paired t-test (SPSS software) was used for statistical analysis. Results: A significant reduction in pain was noted by a decrease in mean VAS from 8.57 ± 1.31 to 2.46 ± 1.23 (P < 0.0001), immediately on first administration. The mean duration of analgesia was 4.95 ± 3.43 days. Pre- and post-procedure mean morphine requirement were 128.2 ± 84.64 and 133.8 ± 81.93 (P > 0.05) mg per day, at the end of 2 months. Ease of performance was observed in 88 patients. Conclusion: The home-based application of SPGB is an easy, safe, and cost-effective method to manage cancer pain. It provides excellent immediate pain relief with a minimum side effect. It can be performed bilaterally, repeatedly and even with a feeding tube in place.
      Citation: Indian Journal of Palliative Care 2017 23(3):282-286
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_39_17
      Issue No: Vol. 23, No. 3 (2017)
       
  • Comparison of Neonatal Pain, Agitation, and Sedation Scale with Premature
           Infant Pain Profile for the assessment of acute prolonged pain in neonates
           on assisted ventilation: A prospective observational study

    • Authors: Saumil Ashvin Desai, Ruchi Nimish Nanavati, Bonny Bipin Jasani, Nandkishor Kabra
      Pages: 287 - 292
      Abstract: Saumil Ashvin Desai, Ruchi Nimish Nanavati, Bonny Bipin Jasani, Nandkishor Kabra
      Indian Journal of Palliative Care 2017 23(3):287-292
      Aim: This study aimed to compare Neonatal Pain, Agitation, and Sedation Scale (N-PASS) with Premature Infant Pain Profile (PIPP) for the assessment of acute prolonged pain in ventilated neonates. Methods: This study was conducted in two phases. In phase 1 of the study, we assessed whether neonates on assisted ventilation experienced acute prolonged pain. In phase 2, the aim was to compare N-PASS with PIPP for the assessment of acute prolonged pain in neonates on assisted ventilation.. Design: This is a prospective observational study. Study Setting and Duration: This study was conducted at a tertiary care neonatal intensive care unit for 6 months. Inclusion Criteria: Neonates on assisted ventilation for >48 h were selected for this study. Exclusion Criteria: Neonates with lethal congenital anomalies and severe encephalopathy were excluded from the study. N-PASS and PIPP tools were used to assess acute prolonged pain in ventilated neonates. Taking PIPP as gold standard and N-PASS as a new test, the correlation coefficient was calculated. The sensitivity, specificity, positive predictive value, and negative predictive value were also computed. The time taken to administer the tools was also computed. Results: The average PIPP score for ventilated neonates was 8.33. The correlation coefficient of N-PASS when compared to PIPP was 0.62. The average time taken to apply the N-PASS scale was 4.42 min as compared to 8.20 min for PIPP scale. In term neonates, the sensitivity, specificity, positive predictive value, and negative predictive value of N-PASS were 75%, 100%, 100%, and 60%, respectively. The corresponding values in preterm neonates were lesser. Conclusions: The study proves that neonates on assisted ventilation experience acute prolonged pain. N-PASS is clinically reliable and valid to assess acute prolonged pain in ventilated term neonates. The N-PASS is quicker than PIPP in assessing acute prolonged pain in ventilated neonates. Future Directions: The modified N-PASS tool (including the gestational age) should be developed.
      Citation: Indian Journal of Palliative Care 2017 23(3):287-292
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_42_17
      Issue No: Vol. 23, No. 3 (2017)
       
  • Validation of the Malayalam version of Leeds assessment of neuropathic
           symptoms and signs pain scale in cancer patients in the Regional Cancer
           Centre, Thiruvananthapuram, Kerala, India

    • Authors: Shoukkathali Anzar, Cherian Koshy, Kurian Mathew Abraham
      Pages: 293 - 299
      Abstract: Shoukkathali Anzar, Cherian Koshy, Kurian Mathew Abraham
      Indian Journal of Palliative Care 2017 23(3):293-299
      Objective: The Self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) is a 7-item self-report scale developed to identify pain which is of predominantly neuropathic origin. The aim of this study was to develop a Malayalam version of the LANSS and to test its validity and reliability in chronic pain patients. Methodology: We enrolled 101 Malayalam-speaking chronic pain patients who visited the Division of Palliative Medicine, Regional Cancer Centre, Thiruvananthapuram, Kerala, India. The translated version of S- LANSS was constructed by standard means. Fifty-one neuropathic pain and fifty nociceptive pain patients were identified by an independent pain physician and were subjected to the new pain scale by a palliative care nurse who was blinded to the diagnosis. The “gold standard diagnosis” is what the physician makes after clinical examination. Its validation, sensitivity, specificity, and positive and negative predictive values were determined. Results: Fifty-one neuropathic pain and fifty nociceptive pain patients were subjected to the Malayalam version of S-LANSS pain scale for validity testing. The agreement by Cohen's Kappa 0.743, Chi-square test P < 0.001, sensitivity 89.58, specificity 84.91, positive predictive value 84.31, negative predictive value 90.00, accuracy by 87.13, and likelihood ratio 5.94. Conclusion: The Malayalam version of S-LANSS pain scale is a validated screening tool for identifying neuropathic pain in chronic pain patients in Malayalam-speaking regions.
      Citation: Indian Journal of Palliative Care 2017 23(3):293-299
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_119_16
      Issue No: Vol. 23, No. 3 (2017)
       
  • The process of translation and linguistic validation of the Functional
           Assessment of Cancer Therapy-Brain quality of life instrument from English
           to Malayalam: The challenges faced

    • Authors: Durgapoorna Menon, Chitra Venkateswaran
      Pages: 300 - 305
      Abstract: Durgapoorna Menon, Chitra Venkateswaran
      Indian Journal of Palliative Care 2017 23(3):300-305
      Aim: Both brain tumors and their treatments have a major negative impact on the quality of life (QoL). EORTC BN20 and Functional Assessment of Cancer Therapy-Brain (FACT-BR) are the most commonly used tools to assess QoL. The FACT-BR is a 23-item questionnaire, especially about the psychosocial aspects of QoL. This paper describes the challenges we faced during the process of translation and validation of the FACT-BR into Malayalam. Methods: We first screened the patients to ensure their mental status was satisfactory and that they could communicate well in both languages. According to the Functional Assessment of Chronic Illness Therapy methodology, there were two forward translations from English to Malayalam by two independent translators, a reconciliation of the two forward translations, a back-translation into English, a review/finalization by a fifth translator, proofreading, and then testing on a small cohort of patients. Results: The whole process of translation was fraught with small and large hurdles – from small technical issues to the gaps in sociocultural norms. The sub item BR 7, due to the lack of an exact equivalent word, had issues that persisted up to the validation phase. The postquestionnaire debriefing interviews confirmed that the translations were well understood and conceptually equivalent to the original English one. Conclusions: Translation of the FACT-BR into Malayalam nearly completely reproduced the concepts of the original English questionnaire, as proved in the subsequent validation process.
      Citation: Indian Journal of Palliative Care 2017 23(3):300-305
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_36_17
      Issue No: Vol. 23, No. 3 (2017)
       
  • Signs of spiritual distress and its implications for practice in Indian
           Palliative Care

    • Authors: Sushma Bhatnagar, Joris Gielen, Aanchal Satija, Suraj Pal Singh, Simon Noble, Santosh K Chaturvedi
      Pages: 306 - 311
      Abstract: Sushma Bhatnagar, Joris Gielen, Aanchal Satija, Suraj Pal Singh, Simon Noble, Santosh K Chaturvedi
      Indian Journal of Palliative Care 2017 23(3):306-311
      Introduction: Given the particularity of spirituality in the Indian context, models and tools for spiritual care that have been developed in Western countries may not be applicable to Indian palliative care patients. Therefore, we intended to describe the most common signs of spiritual distress in Indian palliative care patients, assess differences between male and female participants, and formulate contextually appropriate recommendations for spiritual care based on this data. Methods: Data from 300 adult cancer patients who had completed a questionnaire with 36 spirituality items were analyzed. We calculated frequencies and percentages, and we compared responses of male and female participants using Chi-squared tests. Results: Most participants believed in God or a higher power who somehow supports them. Signs of potential spiritual distress were evident in the participants' strong agreement with existential explanations of suffering that directly or indirectly put the blame for the illness on the patient, the persistence of the “Why meY” question, and feelings of unfairness and anger. Women were more likely to consider illness their fate, be worried about the future of their children or spouse and be angry about what was happening to them. They were less likely than men to blame themselves for their illness. The observations on spirituality enabled us to formulate recommendations for spiritual history taking in Indian palliative care. Conclusion: Our recommendations may help clinicians to provide appropriate spiritual care based on the latest evidence on spirituality in Indian palliative care. Unfortunately, this evidence is limited and more research is required.
      Citation: Indian Journal of Palliative Care 2017 23(3):306-311
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_24_17
      Issue No: Vol. 23, No. 3 (2017)
       
  • Commentary

    • Authors: Jayita Kedar Deodhar
      Pages: 311 - 312
      Abstract: Jayita Kedar Deodhar
      Indian Journal of Palliative Care 2017 23(3):311-312

      Citation: Indian Journal of Palliative Care 2017 23(3):311-312
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_86_17
      Issue No: Vol. 23, No. 3 (2017)
       
  • Hypofractionated radiotherapy for palliation in locally advanced head and
           neck cancer

    • Authors: RK Spartacus, Rohitashwa Dana, Kartick Rastogi, Aseem Rai Bhatnagar, Dhiraj Daga, Kampra Gupta
      Pages: 313 - 316
      Abstract: RK Spartacus, Rohitashwa Dana, Kartick Rastogi, Aseem Rai Bhatnagar, Dhiraj Daga, Kampra Gupta
      Indian Journal of Palliative Care 2017 23(3):313-316
      Context: In India, a considerable proportion of patients with head and neck cancer present with locoregionally advanced disease. Symptom palliation becomes a major objective in these cases when they could not be considered for a curative approach. Aims: The aim of this study is to assess the role of palliative radiotherapy for symptom control in patients with locally advanced head and neck cancer. Settings and Design: This was a retrospective study. Subjects and Methods: Between July 2015 and June 2016, 98 patients with stage IV head and neck cancer were treated with palliative radiotherapy 25 Gray (Gy)/4 fractions (fr)/1 fraction (6.25 Gy)/week. Presenting symptoms were noted. The primary end point was relief of symptoms in the 4th week after radiotherapy. Percentage symptom relief was quantified by the patient using a rupee scale. Treatment response was noted using the WHO criteria. Acute toxicity was graded as per the Radiation Therapy Oncology Group (RTOG) criteria. Results: The most common presenting symptom was pain. At 4 weeks after radiotherapy completion, all patients had >50% pain relief. Dysphagia was improved in 82% of patients. Respiratory distress was improved in all the symptomatic patients. Tumor complete response (CR) was seen in 2 patients, partial response in 89, stable disease in 3, and progressive disease in 4. RTOG Grade 2 and 3 acute skin and mucosal toxicities were seen in 29% and 27% cases, respectively. No patient had Grade 4 adverse effect. Conclusions: Hypofractionated radiation could provide effective symptom palliation in advanced head and neck cancers. The weekly schedule was well tolerated and found convenient by the patients.
      Citation: Indian Journal of Palliative Care 2017 23(3):313-316
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_9_17
      Issue No: Vol. 23, No. 3 (2017)
       
  • The effect of honey on radiation-induced oral mucositis in head and neck
           cancer patients

    • Authors: Amna Amanat, Asrar Ahmed, Abbas Kazmi, Bushra Aziz
      Pages: 317 - 320
      Abstract: Amna Amanat, Asrar Ahmed, Abbas Kazmi, Bushra Aziz
      Indian Journal of Palliative Care 2017 23(3):317-320
      Aim: The aim of this study is to evaluate the effect of honey on clinically scoring grades of oral mucositis. Materials and Methods: This interventional study was carried out in Radiation Oncology Department of Mayo Hospital, Lahore. In this study, 82 patients of both genders, of head and neck cancer, planned for radiotherapy, were divided into two groups by random sampling numbers. Patients in both groups were treated with a total dose of 60–78 Grays in 4–6 weeks. In treatment group, patients were instructed to take 20 mL of honey. In control group, they were advised to rinse with 0.9% of saline. Patients were evaluated every week to assess the grades of oral mucositis up to 6 weeks. The assessment tool was Radiation Therapy Oncology Group Grading System. The statistical analysis was done by Chi-square test. Results: In honey-treated group, the proportion of mucositis (Grades 3 and 4) was lower and statistically significant as compared to control group at the end of 6 weeks of radiation. Conclusion: This study showed that oral intake of honey during radiotherapy is valuable in the reduction of severity of oral mucositis.
      Citation: Indian Journal of Palliative Care 2017 23(3):317-320
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_146_16
      Issue No: Vol. 23, No. 3 (2017)
       
  • Prognostic factors of 30-day survival of patients with malignant pleural
           effusion

    • Authors: Zulkifli Amin, Stephen Diah Iskandar, Sibli
      Pages: 321 - 324
      Abstract: Zulkifli Amin, Stephen Diah Iskandar, Sibli
      Indian Journal of Palliative Care 2017 23(3):321-324
      Background: Treatment of malignant pleural effusion (MPE) depends on the 1 month prognosis of patients. Until now, there is no study evaluate factors affecting 1 month survival. Aims: This study aims to determine the predictors of survival within 1 month. Methods: Prospective study of 102 patients with MPE. Biochemistry data of pleural fluid, characteristics of tumor, and massiveness of the effusion were analyzed to determine their effect on 30-day survival of the patients. Univariate analysis was performed using Chi-square. All prognostic factors that had P < 0.25 were included in multivariate analysis using Cox regression. Results: Median age of patients was 51 years, most of them were female (56%). Common primary sites of tumor were lung (31%), breast (19%), and lymphatic tissue (11%). In univariate analysis, factors that have P < 0.25 were low glucose concentration in pleural fluid (P = 0.01), high lactate dehydrogenase concentration in pleural fluid (P = 0.25), and high risk tumor (P = 0.24). In multivariate analysis, only low glucose concentration was significantly related to poor survival within 1 month (hazard ratio 2.85 [1.10–7.61], P = 0.03). Conclusions: Low level of glucose in pleural fluid is an important factor related to 30-day survival in patients with MPE. It can be used to determine prognosis-based treatment objectively.
      Citation: Indian Journal of Palliative Care 2017 23(3):321-324
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_2_17
      Issue No: Vol. 23, No. 3 (2017)
       
  • Assessment of private homes as spaces for the dying elderly

    • Authors: Tulika Bhattacharyya, Suhita Chopra Chatterjee, Dipannita Chand, Debolina Chatterjee, Jaydeep Sengupta
      Pages: 325 - 330
      Abstract: Tulika Bhattacharyya, Suhita Chopra Chatterjee, Dipannita Chand, Debolina Chatterjee, Jaydeep Sengupta
      Indian Journal of Palliative Care 2017 23(3):325-330
      Aim: This study makes an assessment of end-of-life care of the elderly in private homes in Kolkata, West Bengal, India. Participants and Methods: Primary data were collected from private homes which supported elder care through observation and semi-structured interviews with primary family caregivers of the elderly. Results: The study finds that the major factors preventing private homes from providing adequate care to the elderly were architecturally inadequate housing conditions, paucity of financial support, and scarcity of skilled caregivers. Besides, considerable neglect and domestic abuse of the elderly was also found in some private homes. In addition, the peripheral location of private homes within public health framework and inadequate state palliative policy, including stringent narcotic regulations, accentuated the problems of home care. Conclusion: The study concludes by questioning the rhetoric of private homes as spaces for the dying elderly in Kolkata and suggests remedial measures to improve their capacity to deliver care.
      Citation: Indian Journal of Palliative Care 2017 23(3):325-330
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_148_16
      Issue No: Vol. 23, No. 3 (2017)
       
  • Analytical study of short- and long-term results of home-based palliative
           care services to cancer patients

    • Authors: Dhritiman Datta, Gautam Majumdar, Shiromani Debbarma, Badan Janapati, Amit Kumar Datta
      Pages: 331 - 334
      Abstract: Dhritiman Datta, Gautam Majumdar, Shiromani Debbarma, Badan Janapati, Amit Kumar Datta
      Indian Journal of Palliative Care 2017 23(3):331-334
      Aims and Object: Identification and selection of patients suffering from terminal stage in bed ridden condition upto village level and to determine the type of palliative care need. Also to asses the effectiveness of the palliative care provided at the bed side. Materials: All registered patients under palliative care of Regional Cancer Centre, Agartala from 2014 April to 2016 March. Methods: A retrospective study. Ten teams comprising of doctors, nurses, pharmacists & Social Workers were trained and engaged in this study for symptom assessment and pain relief of palliative patients. Results: It is highly beneficial for the bed ridden & home bound cancer patients with improved quality of life due to regular home visits and medicine distribution by trained medical personnel. Short term benefits in symptom like pain, nausea & vomiting, retention of urine, constipation, bloating, fever etc. was dramatic after medication by palliative team. Patients also get relief as a result of repeated visit of palliative care team. Conclusion: Home based palliative care is beneficial for the bed ridden and home bound chronically ill patients including cancer patients. Bed ridden patients should be cared by palliative care team at least in every week.
      Citation: Indian Journal of Palliative Care 2017 23(3):331-334
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_46_17
      Issue No: Vol. 23, No. 3 (2017)
       
  • Effect of mirtazapine on gastric emptying in patients with
           cancer-associated anorexia

    • Authors: N Kumar, Sukanta Barai, S Gambhir, N Rastogi
      Pages: 335 - 337
      Abstract: N Kumar, Sukanta Barai, S Gambhir, N Rastogi
      Indian Journal of Palliative Care 2017 23(3):335-337
      Background/Aims: The tetracyclic antidepressant mirtazapine is widely used in cancer patients suffering from anorexia. Although it is known to restore appetite, the exact mechanism remains unknown. The aim of the study was to evaluate if mirtazapine has any effect on gastric emptying in patients suffering from cancer-related anorexia. Materials and Methods: Solid-meal gastric-emptying study using radiolabeled meal was performed in 28 patients suffering from cancer anorexia once at baseline and repeated after 15 days of mirtazapine therapy. Results: At baseline, only 7 (25%) patients had normal gastric motility (emptying >70% at 3 h postingestion) whereas after treatment, 18 (64.2%) patients achieved this limit. Mean % gastric emptying increased from 55.2% ±21.0% to 68.9% ±21.3% (P < 0.001). Mean gastric emptying time (t1/2) before intervention was 314.7 ± 421.0 min which decreased to 116.0 ± 106.7 min after intervention. Results were further analyzed by dividing the patients into two groups based on baseline gastric-emptying study. Group A (normal gastric emptying) consisted of seven patients, mean % gastric emptying at baseline and postintervention was 75.0% ±5.25% and 87.57% ±5.94%, respectively (P < 0.018). Group B (delayed gastric emptying) consisted of 21 patients, mean % gastric emptying at baseline and postintervention was 48.71% ±18.82% and 62.76% ±16.86%, respectively (P < 0.001). Conclusion: Mirtazapine significantly improves gastric emptying in patients of prostate and breast cancer suffering from cancer-associated anorexia.
      Citation: Indian Journal of Palliative Care 2017 23(3):335-337
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_17_17
      Issue No: Vol. 23, No. 3 (2017)
       
  • The philosophical and cultural situatedness of spirituality at the end of
           life in India

    • Authors: Hamilton Inbadas
      Pages: 338 - 340
      Abstract: Hamilton Inbadas
      Indian Journal of Palliative Care 2017 23(3):338-340
      The sustained interest in exploring the spiritual domain at end of life in the Indian context reflects the recognition of its significance as an integral part of palliative care. A key aspect of findings from studies so far is the identification of challenges, inadequacies, limitations and ethical dilemmas in relation to spirituality at the end of life. India is known for its rich spiritual heritage and has unique ways of understanding, experiencing and expressing spirituality. The philosophical and cultural frames of reference, with which communities in India make sense of life, death and dying, determine the characteristics of Indian spirituality at the end of life. Exploring the concepts of the human person, the purpose of human life, the meaning of death and caring for the dying using Indian philosophical and cultural resources can help address some of the identified limitations and challenges in the Indian context. A cross-disciplinary approach, drawing together expertise from clinical palliative care, philosophy, theology and sociology, will enrich the understanding of spirituality at the end of life and can contribute to effective spiritual care in palliative care in specific contexts around the world.
      Citation: Indian Journal of Palliative Care 2017 23(3):338-340
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_61_17
      Issue No: Vol. 23, No. 3 (2017)
       
  • Palliative care for patients with nonmalignant respiratory disease

    • Authors: Nishkarsh Gupta, Rakesh Garg, Vinod Kumar, Sachidanand Jee Bharati, Seema Mishra, Sushma Bhatnagar
      Pages: 341 - 346
      Abstract: Nishkarsh Gupta, Rakesh Garg, Vinod Kumar, Sachidanand Jee Bharati, Seema Mishra, Sushma Bhatnagar
      Indian Journal of Palliative Care 2017 23(3):341-346
      Nonmalignant respiratory diseases are chronic and life-limiting conditions that need holistic palliative care. Such patients not only have a variety of physical symptoms such as dyspnea, pain, cough, depression, and anxiety, but also have a number of psychosocial and spiritual issues, which are not addressed to by us. This leads to a poor quality of life. Hence, these patients require supportive palliative care to relieve their sufferings, but unfortunately such care is not available to them in our country. In this article, we have tried to discuss the barriers to the provision of palliative care to such patients and suggested some measures to overcome them.
      Citation: Indian Journal of Palliative Care 2017 23(3):341-346
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_14_17
      Issue No: Vol. 23, No. 3 (2017)
       
  • Narrative: The fear of disfigurement in cancer patients

    • Authors: Aruna Deshpande, Ravindra Ghooi
      Pages: 347 - 349
      Abstract: Aruna Deshpande, Ravindra Ghooi
      Indian Journal of Palliative Care 2017 23(3):347-349
      Fear of disfigurement affects patients with cancer, in whom the disease or its treatment leaves them permanently marked. Contrary to our thought, disfigurement is equally distressing to male patients, and it causes severe dislocation in their lives. We describe two cases in which disfigurement caused tremendous change in our patients; these cases underline the need for psychotherapy in patients suffering from cancer.
      Citation: Indian Journal of Palliative Care 2017 23(3):347-349
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_33_17
      Issue No: Vol. 23, No. 3 (2017)
       
  • Topical menthol for treatment of chemotherapy-induced peripheral
           neuropathy

    • Authors: Alessio Cortellini, Lucilla Verna, Katia Cannita, Luca Napoleoni, Alessandro Parisi, Corrado Ficorella, Giampiero Porzio
      Pages: 350 - 352
      Abstract: Alessio Cortellini, Lucilla Verna, Katia Cannita, Luca Napoleoni, Alessandro Parisi, Corrado Ficorella, Giampiero Porzio
      Indian Journal of Palliative Care 2017 23(3):350-352
      Chemotherapy-induced peripheral neuropathy is a frequent treatment-limiting factor that significantly impairs patients' everyday life, also because of a lack of valid palliative options. Here, we report a case of a male patient with a history of metastatic colon cancer and previous chemotherapies. He came to our attention with a peripheral neuropathy that impaired his quality of life and could limit the further line of chemotherapy. We treated the neuropathy with menthol aqueous cream with benefit.
      Citation: Indian Journal of Palliative Care 2017 23(3):350-352
      PubDate: Mon,17 Jul 2017
      DOI: 10.4103/IJPC.IJPC_23_17
      Issue No: Vol. 23, No. 3 (2017)
       
 
 
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