This document summarizes the results of a survey of 115 Japanese medical facilities that treat gynecologic cancers, regarding their palliative care practices. The survey found that about 30% of facilities had a dedicated palliative care ward. Most facilities had a palliative care team but about half of physicians on the team had other duties as well. End-of-life care was typically managed in the gynecology department. The median time between a patient's last chemotherapy treatment and death was 85 days. Over 15% of patients received chemotherapy within 30 days of death and over 7% within 14 days of death. The survey identified some gaps in palliative care coordination and opportunities to improve symptom management at the end of life.
1. The study analyzed treatment patterns over time in patients receiving first-line chemotherapy for advanced or metastatic esophageal or gastric cancer based on data from 2,808 patients documented in Therapiemonitor from 2006-2013.
2. Treatment intensity increased over time, with 49.3% of patients receiving triplet chemotherapy in 2013 compared to just 10.1% in 2006. HER2 testing rates increased from 49.1% in earlier studies to 79.1% in 2012-2013, though testing was still not always performed according to guidelines.
3. Usage of fluoropyrimidine/cisplatin combinations with trastuzumab declined from 67% in 2010-2011 to 50% in 2012-2013
A Study on Patient Satisfaction towards Cancer Hospitalijtsrd
A cancer diagnosis places considerable stress on patients and their families. They find themselves discomfort with the strange health system making serious decisions with long term consequences living with uncertainness about the nature, cause and indefinite progress of the disease living with a disrupted family, work, social life and facing the possibility of becoming increasingly dependent on others. Dhivya. S | Harshath. S "A Study on Patient Satisfaction towards Cancer Hospital" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-6 , October 2019, URL: https://www.ijtsrd.com/papers/ijtsrd29274.pdf Paper URL: https://www.ijtsrd.com/management/consumer-behaviour/29274/a-study-on-patient-satisfaction-towards-cancer-hospital/dhivya-s
This study assessed the use of complementary and alternative medicine (CAM) among patients in India with four chronic diseases: epilepsy, HIV, rheumatoid arthritis, and diabetes. The researchers surveyed over 4,600 patients and found that 34.7% used CAM. CAM use was highest among diabetes patients (63%) and lowest among epilepsy patients (7.7%). Ayurveda was the most commonly used CAM therapy. The study also assessed patient satisfaction with CAM and found the highest satisfaction for effectiveness and overall among HIV patients, and the lowest among rheumatoid arthritis patients. A large proportion of patients with chronic diseases in India are using CAM and are satisfied with it.
Use of complementary and alternative medicine by cancer patients at the Unive...home
CAM use is common among cancer patients in Nigeria. Most users do not obtain the
expected benefits, and adverse events are not uncommon. Every clinician in the field of oncology
should ask his/her patients about the use of CAM; this knowledge will enable them to better
counsel the patients
This document discusses the debate between randomized clinical trials (RCTs) and observational studies using big data. While RCTs are better for minimizing bias, observational studies can include more patients and answer questions RCTs cannot. The document outlines several large cancer databases that can help learn from every patient, including SEER and NCDB registries. It describes how these databases are being enriched with additional data sources like EHRs, genomic data, and mobile devices. This evolving use of big data from numerous sources can improve outcomes by better understanding toxicity, costs, and quality of cancer care.
Factors Predicting Sexual Dysfunction in Thai Cancer Patients after TreatmentCrimsonpublishersTTEH
Aim: Purpose of this research was to study what factors that can predict sexual dysfunction in Thai patients with cancer after treatment.Methods: This study was a predictive correlational research. Participants were 110 Thai patients with cancer of breast, prostate, bladder, and colon who were completed treatments from 6 months - 2 years from a university hospital, and 2 cancer specialize hospitals in 2013. The instruments were (1) the personal information and disease related treatment questionnaires (2) Dyadic Adjustment Scale developed by Spanier [1] and were translated into Thai by Kasemkitawatana (1993); and (3) the Sexual Health Dysfunction questionnaires developed by Kumdaeng [2]. Alpha Cronbach’s coefficients were .89 both Dyadic Adjustment Scale and Sexual Health Dysfunction questionnaires. Data were analyzed by descriptive and multiple regression. Result: Results found that gender, dyadic consensus, and affectional expression in the dyadic adjustment could predict the sexual dysfunction at .05 level, whereas age, duration of marriage, and other two subscales of dyadic adjustment could not predict the sexual dysfunction in patients with cancer after treatment.Conclusion: Results confirmed that Thai cancer patients generally had to deal with sexual dysfunction. Female with low degree of dyadic consensus and less affectional expression predictively had more sexual dysfunction. These results can be used as evidence-based to provide and improve sexual health in patients with cancer after treatment.
The document describes a study on the prevalence of overweight and obesity in Parkinson's disease (PD) patients in Mexico City. The study found:
1) 134 PD patients and 134 healthy controls were recruited and had their weight, height and BMI measured.
2) PD patients had a statistically significant lower mean BMI than controls, but there was no significant difference in overweight, obesity or underweight prevalence between the groups.
3) In PD patients, lower BMI correlated with higher Hoehn & Yahr stage (indicating more advanced disease) and worse motor function scores. BMI did not correlate with disease duration or levodopa dose.
4) 70% of PD patients were found to have overweight or
This document summarizes the results of a survey of 115 Japanese medical facilities that treat gynecologic cancers, regarding their palliative care practices. The survey found that about 30% of facilities had a dedicated palliative care ward. Most facilities had a palliative care team but about half of physicians on the team had other duties as well. End-of-life care was typically managed in the gynecology department. The median time between a patient's last chemotherapy treatment and death was 85 days. Over 15% of patients received chemotherapy within 30 days of death and over 7% within 14 days of death. The survey identified some gaps in palliative care coordination and opportunities to improve symptom management at the end of life.
1. The study analyzed treatment patterns over time in patients receiving first-line chemotherapy for advanced or metastatic esophageal or gastric cancer based on data from 2,808 patients documented in Therapiemonitor from 2006-2013.
2. Treatment intensity increased over time, with 49.3% of patients receiving triplet chemotherapy in 2013 compared to just 10.1% in 2006. HER2 testing rates increased from 49.1% in earlier studies to 79.1% in 2012-2013, though testing was still not always performed according to guidelines.
3. Usage of fluoropyrimidine/cisplatin combinations with trastuzumab declined from 67% in 2010-2011 to 50% in 2012-2013
A Study on Patient Satisfaction towards Cancer Hospitalijtsrd
A cancer diagnosis places considerable stress on patients and their families. They find themselves discomfort with the strange health system making serious decisions with long term consequences living with uncertainness about the nature, cause and indefinite progress of the disease living with a disrupted family, work, social life and facing the possibility of becoming increasingly dependent on others. Dhivya. S | Harshath. S "A Study on Patient Satisfaction towards Cancer Hospital" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-6 , October 2019, URL: https://www.ijtsrd.com/papers/ijtsrd29274.pdf Paper URL: https://www.ijtsrd.com/management/consumer-behaviour/29274/a-study-on-patient-satisfaction-towards-cancer-hospital/dhivya-s
This study assessed the use of complementary and alternative medicine (CAM) among patients in India with four chronic diseases: epilepsy, HIV, rheumatoid arthritis, and diabetes. The researchers surveyed over 4,600 patients and found that 34.7% used CAM. CAM use was highest among diabetes patients (63%) and lowest among epilepsy patients (7.7%). Ayurveda was the most commonly used CAM therapy. The study also assessed patient satisfaction with CAM and found the highest satisfaction for effectiveness and overall among HIV patients, and the lowest among rheumatoid arthritis patients. A large proportion of patients with chronic diseases in India are using CAM and are satisfied with it.
Use of complementary and alternative medicine by cancer patients at the Unive...home
CAM use is common among cancer patients in Nigeria. Most users do not obtain the
expected benefits, and adverse events are not uncommon. Every clinician in the field of oncology
should ask his/her patients about the use of CAM; this knowledge will enable them to better
counsel the patients
This document discusses the debate between randomized clinical trials (RCTs) and observational studies using big data. While RCTs are better for minimizing bias, observational studies can include more patients and answer questions RCTs cannot. The document outlines several large cancer databases that can help learn from every patient, including SEER and NCDB registries. It describes how these databases are being enriched with additional data sources like EHRs, genomic data, and mobile devices. This evolving use of big data from numerous sources can improve outcomes by better understanding toxicity, costs, and quality of cancer care.
Factors Predicting Sexual Dysfunction in Thai Cancer Patients after TreatmentCrimsonpublishersTTEH
Aim: Purpose of this research was to study what factors that can predict sexual dysfunction in Thai patients with cancer after treatment.Methods: This study was a predictive correlational research. Participants were 110 Thai patients with cancer of breast, prostate, bladder, and colon who were completed treatments from 6 months - 2 years from a university hospital, and 2 cancer specialize hospitals in 2013. The instruments were (1) the personal information and disease related treatment questionnaires (2) Dyadic Adjustment Scale developed by Spanier [1] and were translated into Thai by Kasemkitawatana (1993); and (3) the Sexual Health Dysfunction questionnaires developed by Kumdaeng [2]. Alpha Cronbach’s coefficients were .89 both Dyadic Adjustment Scale and Sexual Health Dysfunction questionnaires. Data were analyzed by descriptive and multiple regression. Result: Results found that gender, dyadic consensus, and affectional expression in the dyadic adjustment could predict the sexual dysfunction at .05 level, whereas age, duration of marriage, and other two subscales of dyadic adjustment could not predict the sexual dysfunction in patients with cancer after treatment.Conclusion: Results confirmed that Thai cancer patients generally had to deal with sexual dysfunction. Female with low degree of dyadic consensus and less affectional expression predictively had more sexual dysfunction. These results can be used as evidence-based to provide and improve sexual health in patients with cancer after treatment.
The document describes a study on the prevalence of overweight and obesity in Parkinson's disease (PD) patients in Mexico City. The study found:
1) 134 PD patients and 134 healthy controls were recruited and had their weight, height and BMI measured.
2) PD patients had a statistically significant lower mean BMI than controls, but there was no significant difference in overweight, obesity or underweight prevalence between the groups.
3) In PD patients, lower BMI correlated with higher Hoehn & Yahr stage (indicating more advanced disease) and worse motor function scores. BMI did not correlate with disease duration or levodopa dose.
4) 70% of PD patients were found to have overweight or
The effect of long-term traditional Chinese medicine treatment on disease-fre...LucyPi1
Abstract Objective: Traditional Chinese medicine (TCM) has been extensively used as one of popular alternative therapies for several cancers. However, it remains unclear whether TCM treatment is associated with longer survival in lung cancer patients. In this study, we explored the effect of long-term TCM treatment on patients with different stages of lung cancer. Methods: All information of lung cancer patients with stage I-III disease from January 2007 to September 2015 was collected for this retrospective cohort study. Those who were treated with TCM after surgery were divided into TCM group and the others were into the non-TCM group (control group). All patients were regularly followed up by clinic appointment or phone, and all survival data were collected from databases after the last follow-up in October 2017. Results: A total of 575 patients were included in this study, with 299 patients in the TCM group and 276 in the control group. For all patients, 5-year disease-free survival (DFS) was 62.2% in TCM group and 42.1% in the control group, and 6-year DFSs were 51.8% and 35.4%, respectively (HR = 0.51, 95% CI: 0.40 to 0.66, log-rank P ≤ 0.001). For patients with stage I, 5-year DFSs were 83.7% (TCM group) and 57.5% (control group) and 6-year DFSs were 73.7% and 51.9%, respectively (HR = 0.30, 95% CI: 0.18 to 0.50, log-rank P ≤ 0.001). For patients with stage II in the TCM group and the control group, 5-year DFSs were 59.4% and 17.6% and 6-year DFSs were 44.7% and 17.6%, respectively (HR = 0.31, 95% CI: 0.19 to 0.52, log-rank P ≤ 0.001), and for patients with stage III, 5-year and 6-year DFSs in the TCM group were 18.7% and 12.5% compared with 28.4% and 20.3% in the control group (HR = 1.06, 95% CI: 0.72 to 1.56, log-rank P = 0.76). Conclusions: This study demonstrated that long-term TCM treatment as an adjuvant therapy is able to improve the DFS of postoperative stage I-III lung cancer patients, especially in patients with stage I and II disease. However, these observational findings need being validated by large sample randomized controlled trials.
Knowledge and attitudes towards complementary and alternative medicine among ...home
The document summarizes a study that examined medical students' knowledge and attitudes toward complementary and alternative medicine (CAM) in Turkey. The study found that the majority of the 943 medical students surveyed were familiar with common CAM methods like herbal treatment, acupuncture, and massage. Most students had positive attitudes toward CAM and expressed willingness to receive training in it. Attitudes declined as students progressed in their medical education. Overall, there was support for integrating CAM into the medical curriculum in Turkey.
Integrative Health Care Shift Benefits and Challenges among Health Care Profe...ijtsrd
Nurses play an important role in supporting patients with any illness who often seek information regarding alternative therapy. Within their scope of practice, it is expected that nurses have sufficient knowledge about the safety and effective use of alternative therapies, and positive attitudes toward supporting patients who wish to use such therapies. An alternative therapy refers to the health treatments which go along with the medical care, and it is based on natural and traditional methods. It includes natural therapies, herbal medicines yoga, aromatherapy, batch flower medicines, spiritual therapies etc. They offer people the chance to try therapies outside of their standard medical care. These treatment methods are totally different from allopathic medical practices. An evaluative approach with one group pre test, post test design was used for this study. The study was conducted in selected rural areas of Tamilnadu. The samples comprised of 600 health professionals. Convenient sampling technique was used to select the samples. Data was collected using structured knowledge questionnaire before and after administering the structured health education program. The study proved their knowledge improved remarkably after administering the education. The findings of the study support the need for providing information to improve the knowledge of the health professionals regarding complementary therapies in the perspectives of integrating health care shift towards alternative therapies. So the findings have also proved that the information booklet was effective in terms of gain in knowledge scores. Dr. Pushpamala Ramaiah | Dr. Sahar Mohammed Aly | Dr. Afnan Abdulltif Albokhary ""Integrative Health Care Shift- Benefits and Challenges among Health Care Professionals"" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-2 , February 2020,
URL: https://www.ijtsrd.com/papers/ijtsrd30044.pdf
Paper Url : https://www.ijtsrd.com/medicine/nursing/30044/integrative-health-care-shift--benefits-and-challenges-among-health-care-professionals/dr-pushpamala-ramaiah
- The median delay from first consultation to radiation simulation for cervical cancer patients was 55 days. Longer delays did not correlate with increased tumor progression. However, one in four patients received blood transfusions or were hospitalized while waiting, and some required emergency brachytherapy due to bleeding. Though delays did not definitively increase progression in this study, the long wait times highlighted issues in access to timely radiation treatment for cervical cancer patients.
Chapter 15 precision medicine in oncologyNilesh Kucha
This document discusses precision medicine in oncology and molecular monitoring of cancer patients. It describes how molecular characterization of tumors can guide treatment decisions and help develop targeted therapies. Next-generation DNA sequencing is allowing large amounts of tumor DNA to be analyzed to identify molecular targets and guide clinical trials matching treatments to tumor mutations. Challenges include limiting sequencing to known targets, accounting for germline variants, incidental findings, and integrating sequencing results into clinical decision making. Repeated biopsies during treatment can provide insights into drug sensitivity and resistance mechanisms in individual patients.
Discuss the role of precision medicine in breast cancerAbdullahi Sanusi
Precision medicine plays an important role in contemporary breast cancer therapy by tailoring treatment to individual patients based on their specific genetic, biomarker, and other characteristics. This allows for more accurate predictions about treatment effectiveness and side effects. Key aspects of precision medicine in breast cancer include molecular subtyping of tumors to determine optimal surgical, radiation, chemotherapy, and targeted therapy approaches. Challenges remain in fully implementing precision approaches due to limitations in diagnostic facilities, accounting for tumor heterogeneity, and developing targeted therapies.
Current Status and Prospective Of Cancer Disease in Bangladesh: A Cross-Secti...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
This document discusses the need for geriatric assessments (GAs) in older cancer patients undergoing treatment. GAs evaluate patients' functional status, medical conditions, cognition, nutrition, social support and medications. The document aims to analyze evidence on how GAs impact treatment decisions and patient outcomes. It describes how GAs may alter treatments in up to 49% of patients by identifying age-related vulnerabilities. Studies show GAs correlate with survival rates, quality of life and toxicity risks. While GAs provide useful information, more research is still needed on their optimal use in oncology.
This document summarizes the results of a study that evaluated the health care resource utilization and costs of patients with symptomatic multiple myeloma in the United Kingdom. The study found that the average total cost per treatment line was £34,296, with most costs attributed to anti-tumor drugs. The average cost per month of active treatment was £5,168. For patients receiving best supportive care after discontinuing active treatment, the average total cost was £1,444 if they progressed or £2,480 if they did not progress before death.
Who seeks primary care for musculoskeletal disorders (MSDs) with physicians p...home
MSD patients consulting primary care physicians who prescribed homeopathy and CAMs differed
from those seen in conventional medicine. Chronic MSD patients represented a greater proportion of the clientele
in physicians offering alternatives to conventional medicine. In addition, these physicians treated chronic patients
as consulting rather than regular treating physicians, with potentially important impacts upon professional health
care practices and organisation.
1. Chemotherapy medication errors pose significant risks to patient safety, ranging from 0.4% to 31.9% of incidents according to literature, with around 11% causing patient harm.
2. Common chemotherapy medication errors involve administering the wrong dose or wrong drug, as well as failures during the prescribing, preparation, and administration phases.
3. Numerous guidelines and standards have been introduced over time to improve chemotherapy medication safety, including checklists, error reporting systems, education, and standardized processes.
Objective: To evaluate the utility of a targeted lecture in improving FP awareness amongst clinicians.
Design: This is a dual institution, prospective survey-based study assessing if an educational lecture can increase the likelihood of FP consideration, discussion, and referral.
Three studies found that direct access to physical therapists significantly reduced waiting times for treatment compared to referral through consultants. Direct access also reduced pressure on consultant outpatient clinics by decreasing unnecessary referrals in two studies. One randomized controlled trial found slightly better patient recovery times and higher patient assessments of progress with direct access. However, most studies found no significant differences in the number of treatment sessions, recovery time, or return to work between direct access models and consultant referral models of physical therapy.
Study of the distribution and determinants of
health-related states or events in specified populations and the application of this study to control health problems.
John M. Last, Dictionary of Epidemiology
Laproscopic management of huge ovarian cystArsla Memon
This document summarizes a study on the laparoscopic management of huge ovarian cysts. Five patients with ovarian cysts ranging from 18 to 42 cm in diameter were treated laparoscopically. The cysts were drained of 1-12 liters of fluid under laparoscopic guidance before performing laparoscopic oophorectomy or cystectomy. There were no complications and the cysts were found to be benign. The study concludes that with proper patient selection and surgical expertise, it is possible to remove large ovarian cysts laparoscopically.
This document summarizes a study on drug utilization patterns in patients with burns over 15% of their total body surface area admitted to a tertiary hospital burn ward in Nashik, India. A total of 50 patients were included in the study, with an average burn percentage of 61.96%. The mortality rate was found to be 20% for burns under 40% TBSA, 33% for 40-60% TBSA, and 95% for over 60% TBSA. The most commonly prescribed drugs were Ringer's Lactate, gentamicin, ranitidine, metronidazole, cefoperazone + sulbactam, and ciprofloxacin. The drug utilization 90% included
This document outlines a study on the influence of pharmacogenomics on drug therapy and personalized medicine. The study focused on analyzing gene polymorphisms related to thyroid function in the Saudi population and their association with thyroid cancer risk and thyroxine drug dose requirements. The study found several novel and common single nucleotide polymorphisms in genes like DIO1, DIO3, PAX8, TSHB, and NIS. Some of these gene variants were associated with increased thyroid cancer risk. Additionally, polymorphisms in DIO1, PAX8 and TSHB were found to predict differences in required thyroxine drug doses for patients.
This study investigated the quality and safety of discharge prescriptions from mental health hospitals in the UK. The researchers found that:
1) 20.8% of discharge prescriptions contained at least one prescribing error, with an overall error rate of 5.08% of prescribed items. Nearly three-quarters of errors were considered clinically relevant.
2) Increasing numbers of medications prescribed (polypharmacy) and prescriptions written by GP Trainees and Core/Specialist Trainees were associated with higher rates of prescribing errors.
3) Over 70% of prescriptions contained clerical errors, most commonly related to specifying who should continue prescribing medications. Over 67% of prescriptions requiring communication
Utilization of complementary and alternative medicine (CAM) among children fr...home
A homeopathy user utilized on average homeopathic remedies worth EUR 15.28. The corresponding figure for herbal
drug users was EUR 16.02, and EUR 18.72 for overall medicinal CAM users.
CAM use among 15-year-old children in the GINIplus cohort is popular, but decreased noticeably compared
with children from the same cohort at the age of 10 years. This is possibly mainly because German health legislation
normally covers CAM for children younger than 12 years only.
This document provides a summary of the current state of the oil and gas industry in Africa. It notes that while Africa's share of global oil production has declined slightly in recent years to 9.6% currently, its proven oil reserves remain at around 8% of the global total. Natural gas production and reserves have also declined slightly. The political instability in North Africa has negatively impacted production levels there. While industry activity has slowed due to lower oil prices, countries in East Africa continue developing major gas projects, and some companies are looking to South Africa as it works to pass new legislation. Overall the report finds that while the industry currently faces challenges, many companies are using the downturn to develop new strategies and plans to position themselves for future
A presentation by Chris Bredenhann, southern African energy leader, PWC South Africa. Delivered during African Ports Evolution 2015 in Durban, South Africa.
More like this on www.transportworldafrica.co.za
The effect of long-term traditional Chinese medicine treatment on disease-fre...LucyPi1
Abstract Objective: Traditional Chinese medicine (TCM) has been extensively used as one of popular alternative therapies for several cancers. However, it remains unclear whether TCM treatment is associated with longer survival in lung cancer patients. In this study, we explored the effect of long-term TCM treatment on patients with different stages of lung cancer. Methods: All information of lung cancer patients with stage I-III disease from January 2007 to September 2015 was collected for this retrospective cohort study. Those who were treated with TCM after surgery were divided into TCM group and the others were into the non-TCM group (control group). All patients were regularly followed up by clinic appointment or phone, and all survival data were collected from databases after the last follow-up in October 2017. Results: A total of 575 patients were included in this study, with 299 patients in the TCM group and 276 in the control group. For all patients, 5-year disease-free survival (DFS) was 62.2% in TCM group and 42.1% in the control group, and 6-year DFSs were 51.8% and 35.4%, respectively (HR = 0.51, 95% CI: 0.40 to 0.66, log-rank P ≤ 0.001). For patients with stage I, 5-year DFSs were 83.7% (TCM group) and 57.5% (control group) and 6-year DFSs were 73.7% and 51.9%, respectively (HR = 0.30, 95% CI: 0.18 to 0.50, log-rank P ≤ 0.001). For patients with stage II in the TCM group and the control group, 5-year DFSs were 59.4% and 17.6% and 6-year DFSs were 44.7% and 17.6%, respectively (HR = 0.31, 95% CI: 0.19 to 0.52, log-rank P ≤ 0.001), and for patients with stage III, 5-year and 6-year DFSs in the TCM group were 18.7% and 12.5% compared with 28.4% and 20.3% in the control group (HR = 1.06, 95% CI: 0.72 to 1.56, log-rank P = 0.76). Conclusions: This study demonstrated that long-term TCM treatment as an adjuvant therapy is able to improve the DFS of postoperative stage I-III lung cancer patients, especially in patients with stage I and II disease. However, these observational findings need being validated by large sample randomized controlled trials.
Knowledge and attitudes towards complementary and alternative medicine among ...home
The document summarizes a study that examined medical students' knowledge and attitudes toward complementary and alternative medicine (CAM) in Turkey. The study found that the majority of the 943 medical students surveyed were familiar with common CAM methods like herbal treatment, acupuncture, and massage. Most students had positive attitudes toward CAM and expressed willingness to receive training in it. Attitudes declined as students progressed in their medical education. Overall, there was support for integrating CAM into the medical curriculum in Turkey.
Integrative Health Care Shift Benefits and Challenges among Health Care Profe...ijtsrd
Nurses play an important role in supporting patients with any illness who often seek information regarding alternative therapy. Within their scope of practice, it is expected that nurses have sufficient knowledge about the safety and effective use of alternative therapies, and positive attitudes toward supporting patients who wish to use such therapies. An alternative therapy refers to the health treatments which go along with the medical care, and it is based on natural and traditional methods. It includes natural therapies, herbal medicines yoga, aromatherapy, batch flower medicines, spiritual therapies etc. They offer people the chance to try therapies outside of their standard medical care. These treatment methods are totally different from allopathic medical practices. An evaluative approach with one group pre test, post test design was used for this study. The study was conducted in selected rural areas of Tamilnadu. The samples comprised of 600 health professionals. Convenient sampling technique was used to select the samples. Data was collected using structured knowledge questionnaire before and after administering the structured health education program. The study proved their knowledge improved remarkably after administering the education. The findings of the study support the need for providing information to improve the knowledge of the health professionals regarding complementary therapies in the perspectives of integrating health care shift towards alternative therapies. So the findings have also proved that the information booklet was effective in terms of gain in knowledge scores. Dr. Pushpamala Ramaiah | Dr. Sahar Mohammed Aly | Dr. Afnan Abdulltif Albokhary ""Integrative Health Care Shift- Benefits and Challenges among Health Care Professionals"" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-2 , February 2020,
URL: https://www.ijtsrd.com/papers/ijtsrd30044.pdf
Paper Url : https://www.ijtsrd.com/medicine/nursing/30044/integrative-health-care-shift--benefits-and-challenges-among-health-care-professionals/dr-pushpamala-ramaiah
- The median delay from first consultation to radiation simulation for cervical cancer patients was 55 days. Longer delays did not correlate with increased tumor progression. However, one in four patients received blood transfusions or were hospitalized while waiting, and some required emergency brachytherapy due to bleeding. Though delays did not definitively increase progression in this study, the long wait times highlighted issues in access to timely radiation treatment for cervical cancer patients.
Chapter 15 precision medicine in oncologyNilesh Kucha
This document discusses precision medicine in oncology and molecular monitoring of cancer patients. It describes how molecular characterization of tumors can guide treatment decisions and help develop targeted therapies. Next-generation DNA sequencing is allowing large amounts of tumor DNA to be analyzed to identify molecular targets and guide clinical trials matching treatments to tumor mutations. Challenges include limiting sequencing to known targets, accounting for germline variants, incidental findings, and integrating sequencing results into clinical decision making. Repeated biopsies during treatment can provide insights into drug sensitivity and resistance mechanisms in individual patients.
Discuss the role of precision medicine in breast cancerAbdullahi Sanusi
Precision medicine plays an important role in contemporary breast cancer therapy by tailoring treatment to individual patients based on their specific genetic, biomarker, and other characteristics. This allows for more accurate predictions about treatment effectiveness and side effects. Key aspects of precision medicine in breast cancer include molecular subtyping of tumors to determine optimal surgical, radiation, chemotherapy, and targeted therapy approaches. Challenges remain in fully implementing precision approaches due to limitations in diagnostic facilities, accounting for tumor heterogeneity, and developing targeted therapies.
Current Status and Prospective Of Cancer Disease in Bangladesh: A Cross-Secti...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
This document discusses the need for geriatric assessments (GAs) in older cancer patients undergoing treatment. GAs evaluate patients' functional status, medical conditions, cognition, nutrition, social support and medications. The document aims to analyze evidence on how GAs impact treatment decisions and patient outcomes. It describes how GAs may alter treatments in up to 49% of patients by identifying age-related vulnerabilities. Studies show GAs correlate with survival rates, quality of life and toxicity risks. While GAs provide useful information, more research is still needed on their optimal use in oncology.
This document summarizes the results of a study that evaluated the health care resource utilization and costs of patients with symptomatic multiple myeloma in the United Kingdom. The study found that the average total cost per treatment line was £34,296, with most costs attributed to anti-tumor drugs. The average cost per month of active treatment was £5,168. For patients receiving best supportive care after discontinuing active treatment, the average total cost was £1,444 if they progressed or £2,480 if they did not progress before death.
Who seeks primary care for musculoskeletal disorders (MSDs) with physicians p...home
MSD patients consulting primary care physicians who prescribed homeopathy and CAMs differed
from those seen in conventional medicine. Chronic MSD patients represented a greater proportion of the clientele
in physicians offering alternatives to conventional medicine. In addition, these physicians treated chronic patients
as consulting rather than regular treating physicians, with potentially important impacts upon professional health
care practices and organisation.
1. Chemotherapy medication errors pose significant risks to patient safety, ranging from 0.4% to 31.9% of incidents according to literature, with around 11% causing patient harm.
2. Common chemotherapy medication errors involve administering the wrong dose or wrong drug, as well as failures during the prescribing, preparation, and administration phases.
3. Numerous guidelines and standards have been introduced over time to improve chemotherapy medication safety, including checklists, error reporting systems, education, and standardized processes.
Objective: To evaluate the utility of a targeted lecture in improving FP awareness amongst clinicians.
Design: This is a dual institution, prospective survey-based study assessing if an educational lecture can increase the likelihood of FP consideration, discussion, and referral.
Three studies found that direct access to physical therapists significantly reduced waiting times for treatment compared to referral through consultants. Direct access also reduced pressure on consultant outpatient clinics by decreasing unnecessary referrals in two studies. One randomized controlled trial found slightly better patient recovery times and higher patient assessments of progress with direct access. However, most studies found no significant differences in the number of treatment sessions, recovery time, or return to work between direct access models and consultant referral models of physical therapy.
Study of the distribution and determinants of
health-related states or events in specified populations and the application of this study to control health problems.
John M. Last, Dictionary of Epidemiology
Laproscopic management of huge ovarian cystArsla Memon
This document summarizes a study on the laparoscopic management of huge ovarian cysts. Five patients with ovarian cysts ranging from 18 to 42 cm in diameter were treated laparoscopically. The cysts were drained of 1-12 liters of fluid under laparoscopic guidance before performing laparoscopic oophorectomy or cystectomy. There were no complications and the cysts were found to be benign. The study concludes that with proper patient selection and surgical expertise, it is possible to remove large ovarian cysts laparoscopically.
This document summarizes a study on drug utilization patterns in patients with burns over 15% of their total body surface area admitted to a tertiary hospital burn ward in Nashik, India. A total of 50 patients were included in the study, with an average burn percentage of 61.96%. The mortality rate was found to be 20% for burns under 40% TBSA, 33% for 40-60% TBSA, and 95% for over 60% TBSA. The most commonly prescribed drugs were Ringer's Lactate, gentamicin, ranitidine, metronidazole, cefoperazone + sulbactam, and ciprofloxacin. The drug utilization 90% included
This document outlines a study on the influence of pharmacogenomics on drug therapy and personalized medicine. The study focused on analyzing gene polymorphisms related to thyroid function in the Saudi population and their association with thyroid cancer risk and thyroxine drug dose requirements. The study found several novel and common single nucleotide polymorphisms in genes like DIO1, DIO3, PAX8, TSHB, and NIS. Some of these gene variants were associated with increased thyroid cancer risk. Additionally, polymorphisms in DIO1, PAX8 and TSHB were found to predict differences in required thyroxine drug doses for patients.
This study investigated the quality and safety of discharge prescriptions from mental health hospitals in the UK. The researchers found that:
1) 20.8% of discharge prescriptions contained at least one prescribing error, with an overall error rate of 5.08% of prescribed items. Nearly three-quarters of errors were considered clinically relevant.
2) Increasing numbers of medications prescribed (polypharmacy) and prescriptions written by GP Trainees and Core/Specialist Trainees were associated with higher rates of prescribing errors.
3) Over 70% of prescriptions contained clerical errors, most commonly related to specifying who should continue prescribing medications. Over 67% of prescriptions requiring communication
Utilization of complementary and alternative medicine (CAM) among children fr...home
A homeopathy user utilized on average homeopathic remedies worth EUR 15.28. The corresponding figure for herbal
drug users was EUR 16.02, and EUR 18.72 for overall medicinal CAM users.
CAM use among 15-year-old children in the GINIplus cohort is popular, but decreased noticeably compared
with children from the same cohort at the age of 10 years. This is possibly mainly because German health legislation
normally covers CAM for children younger than 12 years only.
This document provides a summary of the current state of the oil and gas industry in Africa. It notes that while Africa's share of global oil production has declined slightly in recent years to 9.6% currently, its proven oil reserves remain at around 8% of the global total. Natural gas production and reserves have also declined slightly. The political instability in North Africa has negatively impacted production levels there. While industry activity has slowed due to lower oil prices, countries in East Africa continue developing major gas projects, and some companies are looking to South Africa as it works to pass new legislation. Overall the report finds that while the industry currently faces challenges, many companies are using the downturn to develop new strategies and plans to position themselves for future
A presentation by Chris Bredenhann, southern African energy leader, PWC South Africa. Delivered during African Ports Evolution 2015 in Durban, South Africa.
More like this on www.transportworldafrica.co.za
This document provides an overview of Sub-Saharan Africa. It outlines the political map, geographical conditions, economical conditions, and social issues of the region. The geographical conditions include deserts, mountains, valleys, and rivers. Key economic issues include energy, unemployment, standard of living, trade, and agriculture. The document also discusses political instability in Sub-Saharan Africa since independence, and how this has negatively impacted economic development. Specific topics covered include food crises, Nigeria's oil industry, conflicts between Ethiopia and Eritrea, and AIDS in Africa. The document provides several links for further reference.
ERHC Presentation at the 8th Annual Sub-Saharan Africa Oil & Gas ConferenceDan Keeney
ERHC Energy President and CEO Dr. Peter Ntephe presented during the opening day of the 8th Annual Sub-Saharan Africa Oil & Gas Conference, explaining how the decline in oil prices have impacted small exploration companies.
Presentation Sub Saharan Africa (March 2012) (00167794)Elvis Angyiembe
This document provides an overview of recent developments in the oil and gas industry in Sub-Saharan Africa presented by Elvis Angyiembe of Burleson LLP. It discusses Africa's growing role as a source of oil and gas globally. It outlines the major oil producing countries in Sub-Saharan Africa like Nigeria, Angola, and Equatorial Guinea, as well as new and emerging producers. The document also discusses recent acquisitions, legal cases, and challenges facing the industry such as insecurity, piracy, and corruption. It predicts that Africa will continue to be an important source of oil and gas in the future.
ERHC Energy Inc. Presentation at SeeThruEquity Microcap Investor ConferenceDan Keeney
On Tuesday, November 12, 2013, ERHC Exploration Manager Gertjan van Mechelen presented at the SeeThruEquity Microcap Investor Conference in New York City. The presentation introduced the audience to ERHC, with an overview of its oil and gas exploration assets that stretch from the offshore Gulf of Guinea in West Africa to onshore assets in Chad in Central Africa and Kenya in East Africa. Attending the conference were numerous institutional investors, investment bankers, analysts and representatives from media companies.
This document contains images that depict various landscapes, landmarks, and cities across Africa. It includes photos of the Pyramids of Giza and Great Sphinx in Egypt, Mount Kilimanjaro in Tanzania, Victoria Falls between Zambia and Zimbabwe, Lake Tanganyika, the Sahara Desert, and Serengeti Plain in Tanzania and Kenya. It also contains images of cities like Cairo, Alexandria, Johannesburg, Lagos, and Kinshasa showing their architecture, landscapes, and growing populations.
Dr. Rajagopalan and colleagues conducted a study examining trends in the use of brachytherapy boost for vaginal cancer treatment between 2004 and 2011. They found a significant decrease in the use of brachytherapy boost from 87.7% in 2004 to 68.6% in 2011. Factors associated with lower odds of receiving brachytherapy boost included higher disease stage, advanced patient age, and treatment at smaller, nonacademic facilities. However, brachytherapy boost remained critical for achieving sufficient radiation doses without overexposure of surrounding organs. The authors conclude that further efforts are needed to emphasize brachytherapy's importance and ensure expertise and access for optimal gynecologic cancer treatment.
This randomized controlled trial compared induction chemotherapy with gemcitabine and cisplatin followed by concurrent chemoradiotherapy to concurrent chemoradiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma. At a median follow-up of 42.7 months, recurrence-free survival was significantly improved in the induction chemotherapy group compared to the standard therapy group. Overall survival was also significantly improved. More grade 3-4 adverse events occurred with induction chemotherapy but late toxic effects were similar between groups. Induction chemotherapy provided significant benefits in recurrence-free and overall survival.
Effectiveness of structured education on safe handling and disposal of chemot...SriramNagarajan16
Aim
To evaluate the effectiveness of structured education on safe handling and disposal of chemotherapeutic drugs among nursing
students
Participants and setting
A pre-experimental one group pre-test – post-test design was adopted for this study. The study was conducted in Vandhana
school of Nursing, Kodhad, telugana, India. The investigator selected 40 nursing students who fulfilled the inclusion criteria
were selected by using simple random sampling technique.
Intervention
Data was collected regarding demographic variable, knowledge and attitude of the diploma in nursing students on safe
handling and disposal of chemotherapeutic drugs.The investigator assessed the level of knowledge and attitude of the
diploma in nursing students by using structured questionnaire and modified three point Likert Scale and by using checklist
through one to one teaching by lecture, demonstration, video clippings and verbalization. Structured teaching programme was
conducted on the same day on group wise each group consists of 17members. Data collection was done in English the
questionnaire was distributed to each nursing students. At the end of the teaching the doubts were cleared. Then 10 minutes
was allotted for discussion.
Measurement and findings
The analysis finding indicates clearly that 36% of students had inadequate knowledge and 46% of them had negative attitude
regarding safe handling and disposal of chemotherapeutic drugs. A well planned structured teaching programme given to the
same group. The effectiveness of programme showed high level of significant at p<0.001 level. It showed that structured
teaching programme was an effective method to improve the knowledge and attitude.
Conclusion
The pharmacist-based interventions improved the knowledge of nursing students in cytotoxic drug handling. Further
assessment may help to confirm the sustainability of the improved practices
Patients with carcinoma of the buccal mucosa treated with postoperative ipsilateral radiotherapy at a single institution were analyzed. 116 patients received ipsilateral radiotherapy to a median dose of 60 Gy. With a median follow-up of 24 months, the 2-year local, regional and locoregional control rates were 88.4%, 89.5% and 80.9% respectively. The 2-year disease-free and overall survival rates were 77.4% and 79.5% respectively. Contralateral neck failures occurred in only 3.4% of patients. Ipsilateral radiotherapy achieved good locoregional control for select postoperative buccal mucosa cancer patients.
1) Moffitt Cancer Center provides timely access to a multidisciplinary care team for melanoma patients, allowing diagnosis, staging, and treatment planning to occur in one to two visits. The team reviews pathology reports prior to the first visit to ensure consensus on diagnosis and treatment options.
2) Moffitt streamlines care by having oncologists, dermatologists, surgeons, pathologists, and other providers who are teaching faculty all see patients as part of the comprehensive melanoma care team.
3) Moffitt addresses barriers to care like insurance issues, transportation costs, and travel expenses through dedicated social work support staff to help melanoma patients.
This study examined the impact of the 21-gene breast cancer assay (Oncotype DX) on adjuvant therapy decisions in a Mexican public hospital. 98 early-stage breast cancer patients were tested. Following assay results, treatment decisions changed for 32% of patients (27% of node-negative and 41% of node-positive patients). The proportion recommended chemotherapy decreased from 48% to 34% after testing. 92% of physicians reported being more confident in their recommendations after ordering the assay. The results suggest the 21-gene assay can meaningfully impact adjuvant treatment decisions and potentially reduce chemotherapy use in the Mexican public health system.
ISSN 2347-2251
It appears that you're describing the scope of a scientific journal. This journal covers a wide range of topics related to both Pharmaceutical Sciences and Biological Sciences of the scopus database journal.
Indo-American Journal of Pharma and Bio Sciences is an international, online, English-language journal that publishes articles on pharmaceutical and biological sciences of the ugc carelist journals.
This document summarizes a study that evaluated the knowledge, attitudes, and practices of oncology health professionals in Australia regarding complementary and alternative medicine (CAM). The study surveyed 99 oncology physicians, nurses, and pharmacists. It found that the professionals had moderate knowledge of CAMs but felt unprepared to advise patients due to a lack of expertise. While they acknowledged potential benefits of CAMs, they also expressed safety concerns. Fewer than 40% of patients were open to discussing CAMs with their providers, hindered by a lack of scientific evidence and guidelines. The study reveals a need for more CAM education for oncology clinicians to improve patient-provider discussions and decision-making regarding CAM use.
ISSN 2347-2251
Manuscripts should be carefully checked for grammatical and punctuation errors. All papers undergo peer review. Please note that all articles published in this journal represent the opinions of the authors and do not necessarily reflect the official policy of the Journal of Indo-American Journal of Pharma and Bio Sciences of the journals to publish paper.
Scientific development is an ever-evolving journey, driven by the exchange of data and ideas among researchers across the globe.One such remarkable publication dedicated to facilitating this exchange within the fields of Pharmacy and Bio Sciences is the Indo-American Journal of Pharma and Bio Sciences of the published research.
Cancer and Internist - Koronadal Internist Society.pdfLanceCatedral
General internists can participate in cancer care in several ways:
1) They can conduct cancer screening tests for breast, cervical, colorectal, liver, and prostate cancers to detect cancers early.
2) They can educate patients on cancer prevention strategies like maintaining a healthy weight, being physically active, not smoking, limiting alcohol, and following dietary recommendations.
3) They can manage cancer patients in a multidisciplinary setting to provide comprehensive care involving screening, prevention, treatment, palliative care, and survivorship support.
Cancer and the General Internist discusses how general internists can participate in cancer care. Key points include:
1. Cancer is a leading cause of death in the Philippines and costs of treatment are high, often leading to financial catastrophe for patients.
2. General internists can play roles in cancer screening, prevention through lifestyle counseling, and multidisciplinary care throughout the cancer continuum.
3. Filipinos actively search online for information about cancer signs, symptoms, and treatments. General internists are well-positioned to provide guidance and education to the public.
Optimal Treatment for Clinically Node Positive Prostate Cancer -A Brief Analy...Kanhu Charan
1. The document discusses the optimal treatment for clinically node positive prostate cancer, which is a controversial issue due to lack of randomized trial data.
2. It analyzes guidelines from the NCCN, results from the RTOG 85-31 trial, and studies from the national cancer database which all suggest that androgen deprivation therapy (ADT) plus radiation therapy provides better survival outcomes than ADT alone.
3. While most evidence comes from retrospective studies, the findings indicate that ADT plus radiation should be the standard treatment, and a randomized controlled trial is still needed to confirm potential survival benefits seen in previous analyses.
Designed this online educational booklet for Association of Community Cancer ...Vickie Spindler
This document summarizes the findings from a focus group and survey conducted by the Association of Community Cancer Centers (ACCC) regarding venous thromboembolism (VTE) risk assessment, prevention, and management for cancer patients in outpatient settings. The focus group and survey found significant variability in VTE risk assessment and documentation. Few oncology practices have formal protocols for VTE risk assessment or use tools to calculate risk. Additionally, VTE prevention and education for patients is not standardized. The document provides opportunities for improvement, including developing formal VTE assessment and order protocols, incorporating risk assessment into electronic health records, and improving patient education about VTE risk and prevention.
This study analyzed 54 breast carcinoma cases to correlate histopathological findings with estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status and prognostic importance. Ductal carcinoma was the most common type observed in 92.6% of cases. Lymph node metastasis was found in 66% of cases. Most cases (54%) were histological grade II. A positive correlation was found between histological grade and ER, PR, HER2 status. Higher grades were more likely to be ER and PR negative. The study concluded that immunohistochemical markers can help predict prognosis and guide treatment for breast cancer patients.
Evidence TableEvidence TablePICOT Question
[Insert here]APA Source Reference
(Include the DOI or URL. Use the source URL, not the library link.) Indicate: Peer Reviewed,
Clinical Guideline, or
Best Practice GuidelineAim, Hypothesis,
or Research QuestionConceptual or
Theoretical FrameworkResearch Design/MethodologyMeasurement
MethodSample Population
or SettingResearch Variables Data AnalysisFindingsGaps in ResearchSignificant Findings from a Critical Appraisal of the Evidence
(level, quality of the evidence)Good QuotesAdditional NotesEnd of Worksheet
Role of Clinical Trial Participation in Cancer Research: Barriers,
Evidence, and Strategies
Joseph M. Unger, Ph.D.1, Elise Cook, M.D.2, Eric Tai, M.D.3, and Archie Bleyer, M.D.4
1Fred Hutchinson Cancer Research Center, Seattle, Washington
2The University of Texas MD Anderson Cancer Center, Houston, Texas
3Centers for Disease Control and Prevention, Atlanta, Georgia
4St Charles Health System, Quality Department, Bend, Oregon
OVERVIEW
Fewer than 1 in 20 adult cancer patients enroll in cancer clinical trials. But although barriers to
trial participation have been the subject of frequent study, the rate of trial participation has not
changed substantially over time. Barriers to trial participation are structural, clinical, and
attitudinal, and differ according to demographic and socioeconomic factors. In this paper, we
characterize the nature of cancer clinical trial barriers, and we consider global and local strategies
for reducing barriers. We also consider the specific case of adolescents with cancer, and show that
the low rate of trial enrollment in this age group strongly correlates with limited improvements in
cancer population outcomes compared to other age groups. Our analysis suggests that a clinical
trial system that enrolls patients at higher rates produces treatment advances at a faster rate and
corresponding improvements in cancer population outcomes. Viewed in this light, the issue of
clinical trial enrollment is foundational, lying at the heart of the cancer clinical trial endeavor.
Fewer barriers to trial participation would allow trials to be completed more quickly and would
improve the generalizability of trial results. Moreover, increased accrual to trials is important to
patients, since trials provide patients the opportunity to receive the newest treatments. In an era of
increasing emphasis on a treatment decision-making process that incorporates the patient
perspective, the opportunity for patients to choose trial participation for their care is vital.
INTRODUCTION
The path from initial development of a new cancer drug to diffusion of the new therapy into
the cancer treatment community relies, crucially, on clinical trials, which represent the final
step in evaluating the efficacy of new therapeutic approaches for malignancy. It has been
repeatedly estimated that <5% of adult cancer patients enroll in cancer clinical trials.1,2
...
This document summarizes a study on multimodal treatment for gastric cancer. The study analyzed 163 gastric cancer patients treated between 2018-2020 at a hospital in Romania. Key findings include:
- The most common tumor locations were the antrum (55% of cases) and stomach (32%).
- Most tumors were classified as proliferative (61.2%) or ulcerated (24.3%) according to the Borman classification.
- The majority of cases (80%) presented at medium or advanced stages, most commonly stage IIIa.
- Postoperative complications like anastomotic fistula (9.2% of cases) correlated with increased re-interventions.
- The most frequent
This document summarizes a study on multimodal treatment for gastric cancer. The study analyzed 163 gastric cancer patients treated between 2018-2020 at a hospital in Romania. Key findings include:
- The most common tumor locations were the antrum (55% of cases) and stomach (32% of cases).
- Most tumors were classified as proliferative (61.2%) or ulcerated (24.3%) according to the Borman classification.
- 80% of cases were at medium or advanced stages (IIb-IVb), with stage IIIa being most common.
- 75.4% of surgeries achieved an R0 resection with no remaining tumor at margins.
-
Secondary Malignancy after Treatment of Prostate Cancer. Radical Prostatectom...asclepiuspdfs
Background: This study aims to determine whether the treatment of locally confined prostate cancer (PCa) with external radiotherapy (EBRT) increases the risk to develop secondary malignancies (SM) compared to radical prostatectomy (RPE). Materials and Methods: Data from patients who were treated curatively with RPE or EBRT from 2010 to 2018 and who did not have distant metastases, previous malignancy, or previous treatment with radiotherapy or chemotherapy at the time of diagnosis were reviewed to determine the incidence of SM over a median follow-up period of 47 months (range 12–96 months). Regression models were used to correlate the clinicopathological factors with the incidence of SM.
Similar to A study on traditional, complementary and alternative medicine (tcam) usage among malaysian cancer patients (20)
Patient compliance: Challenges in management of cardiac diseases in Kuala Lum...pharmaindexing
Background
The objective of this study was to investigate the degree of compliance among cardiac patients who attend the health facilities in Kuala Lumpur and Perak, Malaysia. The reasons for non-compliance and recommendations from healthcare professionals were also evaluated.
Method
A cross-sectional study of 400 patients and 100 healthcare professionals was carried out. This study utilizes variables on external factors and internal factors as the measurement tools. The questionnaire which consists of Morisky self-reported medication adherence questions was administered to patients and causes for non-compliance sought. Questionnaire for healthcare professionals was used to determine strategies that can improve compliance rate.
Results
The study revealed a 15.8% of high adherence rate, 54.3% of moderate adherence rate and 30% of poor adherence to cardiovascular disease medications. The chi-square tests showed the strong association between dependent and independent variables. The model chosen for testing the patient compliance through external and internal factors gives an R2 value of 85.0% with an adjusted R2 of 84.7%. The F value (317.187) was also significant (p=0.000) which means that the variables have better fit in the multivariate model. The major reasons determined for non-adherence were attitudes and beliefs, lifestyle, side effects and cost of medications. The study recommends that pharmacists and dispensing technicians should be adequately qualified to provide proper counselling to cardiac patients on their medicines and disease conditions.
Conclusion
The result of this study is of value to health care providers. Compliance to cardiovascular medications will avoid treatment failures encountered in therapy.
Overview on Recurrence Pregnancy Loss etiology and risk factorspharmaindexing
Recurrent pregnancy loss (RPL) can be defined as more than two to three consecutive miscarriages before 20 weeks’ gestation; it affects approximately 1% to 2% of women. RPL is a multifactorial disease. It is very important to study the etiology and risk factors of RPL to find the best diagnostic tests and suitable therapeutic intervention. This article will discuss the current understanding etiologies and risk factors of RPL.
Novel treatments for asthma: Corticosteroids and other anti-inflammatory agents.pharmaindexing
Asthma management is a challenge due to the prevalence of disease in the world. Based on the immunological and inflammatory mechanisms of asthma, corticosteroids and anti-inflammatory participate greatly in the treatment plan. Due to different reasons, there is still an unmet need to develop new agents in this field. A lot of compounds with anti-inflammatory effect are investigated in both pre-clinical and clinical studies.
A review on liver disorders and screening models of hepatoprotective agentspharmaindexing
The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of bio chemicals necessary for digestion. The liver is necessary for survival; there is currently no way to compensate for the absence of liver function long term, although liver dialysis can be used short term.
Carbamazepine induced Steven Johnson syndrome: A case reportpharmaindexing
Drugs are the most common cause that induces Steven Johnson syndrome (SJS) and includes antiepileptic drugs, antiretroviral drugs, anti-tuberculosis drugs, Sulphonamides, fluoroquinolones, penicillins, non-Steroidal anti-inflammatory drugs, Multivitamins. The genetic markers are also the cause for carbamazepine induced Steven Johnson Syndrome. In our study, the antiepileptic drug (Carbamazepine) is the cause for Steven Johnson Syndrome. A female patient aged 25 years came to the hospital with the complaints of bubbling over the skin and all over the body with papillary vesicles associated with pain and irritation, fever, myalgia, and nausea. The patient is known case of Phenytoin induced Steven Johnson Syndrome. In this case the patient developed the Steven Johnson Syndrome approximately after one month after starting the carbamazepine.By the withdrawal of the drug, the condition of the patient was improved.
Monoherbal formulation development for laxative activitypharmaindexing
The Ayurvedic Pharmacopoeia specifically approves flaxseed as a poultice for boils externally and demulcent or laxative internally. In this study monoherbal formulation development for laxative activity of flaxseed was undertaken. The plantLinumusitatissimumhasshowed higher percentage of total ash as well as alcohol soluble extractive values. The aqueous extract of Linumusitatissimumwas prepared by using pilot scale extraction plant and spray drying unit. The qualitative phytochemical studies reveal the presence of amino acids, carbohydrates, vitamins and proteins. From the available literatures it was found that Linumusitatissimum contains more number of amino acids. The formulated tablets showed acceptable pharmacopoeial limits and complies with specifications for thickness, hardness, friability and weight variation. The formulation has showed better laxative activity indicating additive property of the combined phytoconstituents of the plant.
Monoherbal formulation development for laxative activitypharmaindexing
The Ayurvedic Pharmacopoeia specifically approves flaxseed as a poultice for boils externally and demulcent or laxative internally. In this study monoherbal formulation development for laxative activity of flaxseed was undertaken. The plantLinumusitatissimumhasshowed higher percentage of total ash as well as alcohol soluble extractive values. The aqueous extract of Linumusitatissimumwas prepared by using pilot scale extraction plant and spray drying unit. The qualitative phytochemical studies reveal the presence of amino acids, carbohydrates, vitamins and proteins. From the available literatures it was found that Linumusitatissimum contains more number of amino acids. The formulated tablets showed acceptable pharmacopoeial limits and complies with specifications for thickness, hardness, friability and weight variation. The formulation has showed better laxative activity indicating additive property of the combined phytoconstituents of the plant.
Pneumonia and respiratory failure from swine origin influenza H1n1pharmaindexing
Swine influenza (swine flu) became alarming health concern when World Health Organization declared as “public health emergency of international concern” on April 25, 2009. After documentation of human-to-human transmission of the virus in at least three countries of two WHO regions, the WHO raised the pandemic level to 6.1 During the 1918, flu pandemic infected one-third of the world's population (an estimated 500 million people) and caused approximately 50 million deaths.2 In 1976, an outbreak of swine influenza occurred in New Jersey, USA, which involved more than 200 cases, some of them severe, resulting in one death.3 In 1988, another fatality was reported as a complication of swine influenza.
A descriptive study on newborn care among postnatal mothers in selected mater...pharmaindexing
The newborn health challenge faced by India is more formidable than that experienced by any other country in the world. The newborn health is inevitably affected by the traditional care practices of the mothers causing high infant morbidity and mortality.The aim of the study were determine the knowledge, attitude and practice of postnatal mothers regarding new born care and find out the association between knowledge, attitude and practice of postnatal mothers regarding new born care and to determine the association between these as well as with the selected demographic variables. A descriptive study was conducted to assess the knowledge, attitude and practice of postnatal mothers regarding new born care in selected maternity centres in Madurai. Survey approach was employed to select sample and it consisted of 100 postnatal mothers. Data was collected using structured interview schedule. Findings of the study showed that 65% of postnatal mothers had moderate knowledge; 61% had favourable attitude and 57% of them had high practice of new born care. There was a significant association between knowledge and attitude (r=+0.567), knowledge and practice (r=+0.388), attitude and practice (r=+0.321) .There was a significant association between knowledge and education, monthly family income and obstetrical score at p<0.05. Findings of the study indicated the need to conduct frequent assessment of knowledge, attitude and practice of postnatal mothers regarding new born care. Awareness and attitude of the mothers towards new born care still has lots of lacunae especially in those who belong to the lower socio economic statusand poorly educated postnatal mothers. So it is imperative to provide comprehensive training in the field of new born care for mothers during pregnancy
Late 19th century was evident of intelligent biomaterial; which has changed researcher’s perspective towards science and technology. This intelligent biomaterial are envisioned to have huge impact on Healthcare from sequential signalling of biomedical molecule, mimicking natural gene, an effective drug carrier, to high resolution diagnostic tool.From drug discovery aspect many of NCE fail to reach therapeutic potential due to PK/ PD profile. Nanotechnology has changed the face of drug discovery form chemical evaluation to structure of proteins in signalling pathways and development of chemical antibody. Nanotechnology from lab to market approval is long process due to regulatory evaluation. Though it seems to be bright future market it has to go through a long process from being innovation to complete market product. This makes whole process expensive making investor reluctant to invest in big projects.Western world is aware of dramatic potential of nano-projects; which has its limitation in financial investments; with major challenge of transforming nano science to commercial pharmaceutical product.
The Flaws in health practice in post-operative management of a patient in ter...pharmaindexing
This case study summarizes the treatment of a 4-year old child with congenital urinary tract obstruction who presented with constipation, fever, and cough. Laboratory tests found low electrolyte levels, high blood acids, and kidney damage. The child's treatment included surgery, dialysis to correct electrolyte imbalances, and antibiotics for chest infection. However, the case study notes discrepancies in the post-operative treatment, including questionable antibiotic selection and prescribing of calcium channel blockers not recommended for children. The study concludes there is a need for clinical pharmacists on the healthcare team to improve rational medication use.
Corticosteroid induced disorders – An overviewpharmaindexing
Glucocorticoids are important in the treatment of many inflammatory, allergic, immunologic, and malignant disorders, and the toxicity of glucocorticoids is one of the commonest causes of iatrogenic illness associated with chronic inflammatory disease.Glucocorticoid-induced muscle atrophy is characterized by fast-twitch or type II muscle fiber atrophy. Corticosteroid (CS) therapy is widely used in the treatment of rheumatic diseases.Osteoporosis remains one of its major complications.Steroid induced glaucoma is a form of open angle glaucoma occurring as an adverse effect of corticosteroid therapy. Glucocorticoids induce hepatic and extrahepatic insulin resistance.Glucocorticoid treatment impairs both glucose transport in fat and muscle cells. Corticosteroid-induced psychosis represents a spectrum of psychological changes that can occur at any time during treatment. Cushing’s syndrome describes the signs and symptoms associated with prolonged exposure to inappropriately high levels of the hormone cortisol. Physicians must be aware of these adverse effects and be equipped to manage them.
Anti-inflammatory activity of pupalia lappacea L. Jusspharmaindexing
Pupalia lappacea (L) Juss is an erect shrub used in folklore medicine to treat bone fractures and in inflammatory conditions. Methanolic extract of aerial parts shown is claimed in traditional medicine that the leaves of the plant are used in the treatment of inflammation. In the present study, the methanolic extract of Pupalia lappacea was screened for its anti-inflammatory activity using carageenan induced rat paw edema egg white induced paw oedema models. The methanolic extract at the dose of 200 mg/kg p.o exhibited significant anti-inflammatory activity in carrageenan induced paw edema model (p<0.01). In egg white induced model, methanolic extract at the dose of 200 mg/kg inhibited paw oedema significantly (p<0.01) indicating that both test samples inhibit the increase in number of fibroblasts and synthesis of collagen and mucopolysaccharides during prostaglandin formation during the inflammation. These experimental results have established a pharmacological evidence for the folklore claim of the drug to be used as an anti inflammatory agent. HPTLC analysis of the extract shows the presence of gallic acid 1.24mg/ml, ferulic acid 2.00mg/ml, chlorogenic acid 46.25mg/ml and rutin 7.02mg/ml of the extract which were responsible for the claimed anti-inflammatory action in the animal models studied.
Lucinactant: A new solution in treating neonatal respiratory distress syndrom...pharmaindexing
This document summarizes research on Lucinactant, a novel synthetic surfactant approved by the FDA in 2012 for treatment of neonatal respiratory distress syndrome (RDS). It contains a peptide called sinapultide that mimics the function of human surfactant protein B. Studies found Lucinactant was as effective as or more effective than previous animal-derived surfactants in reducing mortality from RDS, but its pharmacokinetics are not fully understood. The document reviews clinical trials and mechanisms of Lucinactant and discusses its efficacy, safety profile, and potential cost benefits compared to other surfactants.
Bioactivity screening of Soil bacteria against human pathogenspharmaindexing
This study aimed to isolate soil bacteria with potential bioactive properties against human pathogens. 36 bacterial strains were isolated from 3 soil samples and screened against common pathogens. 14 isolates showed antibacterial activity, including against Staphylococcus aureus, Streptococcus faecalis, E. coli, Klebsiella aerogenes, Proteus vulgaris, Pseudomonas aureginosa and Salmonella typhi. The 3 most active bacterial isolates were selected for further production and isolation of their bioactive metabolites. Testing found the metabolites had prominent antibacterial effects against the clinical pathogens studied, indicating their potential as a source of new antimicrobials given the rise in drug resistance.
A study on sigmoid Volvulus presentation and managementpharmaindexing
A study on sigmoid volvulus presentation and management was a 2yr retrospective study done at RMMCH.The diagnosis of sigmoid volvulus was made from a history of large bowel obstruction (constipation, abdominal distension, and abdominal pain), which were often recurrent and plain abdominal radiographs.The morbidity associated isSuperficial wound infection occurred in four patients. All the infected wounds eventually healed with conservative measures. Clinical anastomotic dehiscence was noted in 1 patient for which during relaparotomy proximal colostomy and mucous fistula was done. The mortality associated is shown is there were 9 deaths of which 7 were due to sepsis and 2 were due to comorbid illness. Two out of eight patients for whom a colopexy was done had a recurrent attack of sigmoid volvulus. The duration of hospital stay ranged between 10 and 21 days. Use of sigmoidoscopic detorsion for viable colon should be encouraged. Sigmoidopexy, which is associated with a recurrence rate of 20% in our series of patients, should be used selectively.Hartmann’s procedure is a safe option in sigmoid volvulus with gangrenous bowel. Primary anastomosis in emergency situation can be carried out with morbidity and mortality in patients with viable colon
Evaluation of Preliminary phytochemical on various some medicinal plantspharmaindexing
The present study was carried out to evaluate the physical status and percentage yield of methanolic extract and its fractions of whole plant of Leucas cephalotes, leaves of Hiptage benghalensis and leaves of Kydia calycina were recorded for future references and Preliminary phytochemical screening of MLC, MHB and MKC revealed the presence of carbohydrates, glycosides, saponins, flavonoids, steroidal and phenolic compounds. MLC revealed the presence of all the above mentioned phytoconstituents except saponins and also MKC steroidal compounds. The fractions of MLC, MHB and MKC revealed the presence of glycosides, phenolic compounds, steroids and flavonoids.
Comparision of in vitro antibacterial activity of cefoperazone and levofloxac...pharmaindexing
This study compared the in vitro antibacterial activity of cefoperazone and levofloxacin against various clinical isolates. 120 bacterial isolates from patient samples were tested for susceptibility to cefoperazone and levofloxacin using disc diffusion. Results showed levofloxacin had lower resistance than cefoperazone for E. coli and P. aeruginosa, while cefoperazone was more effective against S. aureus. However, resistance to both antibiotics was gradually increasing, highlighting the need for regular surveillance of antibiotic susceptibility.
Concept of srotas from ayurvedic perspective with special reference to neurologypharmaindexing
Ayurveda is a life science. The researchers of ayurveda could rule out the presence of srotas (channels) spreading throughout the human body. These srotas (channels) are governed by vayu which is using all the srotas (channels) of the body to carry out the functional and physiological activities of the human body without which the human society will not exist. Several synonymous words have been described by the ayurvedicacharyas for srotas. Some are micro and some are macro in structures and they adopt the same colour of the particular dhatus of the body to which it belongs. The aim of the study is to justify that srotas are nothing but innurmerable channels or pathways of the nervous system governed by electric current without which no functional and physiological activities of the human body will develope.
Health promotion survey in overweight and obese students of universities in n...pharmaindexing
Introduction
Overweight and obesity is one of the major health problems in the UK and worldwide. Approximately two-thirds of the population in the UK is either overweight or obese. Overweight and obesity is an important issue that causes distress to most women. Health promotion is the best method to educate overweight and obese women. It is defined as the process enabling people to increase control over and to improve their health by Ottawa Charter for Health Promotion. It is aimed to enhance the well-being of the individuals and their positive attitudes towards prevention of various diseases. In order to make any improvement to the health promotion for overweight and obesity, the risk factors and the opinions from the public should first be identified and addressed.
Methods
Cross-sectional survey design was selected with a questionnaire that consisted of 20 open and close ended questions. A sample size of 196 was determined. The data thus gathered was analyzed using SPSS V20 (Statistical Package for Social Science version 20). Descriptive statistics (fx) and (SD) were used and Chi-square X2 test for association was employed.
Results
Out of the total 196 responses, only (40%) of the students had normal weight (SD 1.1), (25%) students had a good understanding of health promotion (SD 1.6), half (50%) appeared concerned about their weight (SD 0.5), (60%) had an obese family member (0.5). The BMI of students was associated with the presence of an obese member in their family and their weight as a concern for them. (P-value <0.05).
Conclusion
The health promotion service is beneficial as it was found to have raised concerns in the mind of the students regarding over weight and obesity. However it was observed that the understanding of health promotion service was different among students and this is the root of the problem.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
A study on traditional, complementary and alternative medicine (tcam) usage among malaysian cancer patients
1. Nagarajan Srinivasan et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-2(3) 2014 [216-221]
*Corresponding author: Nagarajan Srinivasan
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IJAMSCR |Volume 2 | Issue 3 | July-Sep - 2014
www.ijamscr.com
Research article
A study on traditional, complementary and alternative medicine
(TCAM) usage among malaysian cancer patients
*,1
Nagarajan Srinivasan, 2
Lim Li Ann, 1
Molugulu Nagashekhara, 1
Suresh Kumar M.
1
Asia Metropolitan University,G-8,Jalan Kemacahaya, Batu 9, 43200, Cheras,
Selangor, Malaysia.
2
Department of pharmaceutical science, La Trobe University, Bendigo, Australia.
ABSTRACT
Background
Usage of traditional, complementary and alternative medicine (TCAM) has gained popularity over the past few
years. However, very little is known about TCAM utilization among Malaysian cancer patients.
Aim
This study aims to identify the determinants of TCAM usage.
Objectives
This study intends to determine the relationship between the cancer patients’ demographic factors, patient’s
satisfaction with conventional treatment, knowledge on TCAM and healthcare professional’s influence on
TCAM usage. Patient’s perceptions towards TCAM will also be determined.
Methodology
Simple random and convenient sampling method was used to recruit 354 patients from Hospital Kuala Lumpur
between February to April 2013. All patients were directly interviewed with a structured questionnaire.
Results
In this study, 172 respondents were TCAM users. There were no significant differences between demographic
background of respondents in the use of TCAM using ANOVA. Minimal correlation was found between
patient’s satisfaction with the conventional treatment and usage of TCAM (r = 0.091). Poor correlation was
found between healthcare professional’s influence and TCAM usage (r = -0.213) indicating an increase in
healthcare professional’s influence will cause TCAM usage by cancer patients to decrease. Patient’s TCAM
knowledge correlated negatively with the TCAM usage (r = -0.555) indicated that cancer patients are less likely
to use TCAM when they have more TCAM knowledge.
Conclusion
Healthcare professionals should be fully equipped with the necessary TCAM knowledge while maintaining
patient’s satisfaction with the conventional treatment. They should also intervene patients’ TCAM usage where
a potential drug interaction or a harmful adverse event can occur.
Keywords: TCAM; cancer; satisfaction; knowledge; healthcare professionals
INTRODUCTION
Traditional, complementary and alternative
medicine (TCAM) has gained popularity for cancer
treatment over the past few years. According to
WHO, 7.6 million deaths worldwide in 2008 are
caused by cancer, where abnormal cells divide
without control and are able to metastasize through
the blood or lymph nodes involving malfunctioning
genes that control cell growth and division 1,2
. In
2007, 18,219 new cancer cases were diagnosed and
registered at the National Cancer Registry (NCR)
International Journal of Allied Medical Sciences
and Clinical Research (IJAMSCR)
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of Malaysia comprising of 8,123 (44.6%) males
and 10,096 (55.4%) females3
.
Traditional Chinese medicine, traditional Malay
medicine (Jamu), Ayurveda, dietary supplements,
meditations and spiritual therapies are examples of
TCAM used among Malaysian cancer patients4
. A
nationwide study conducted in 2004 showed that
the prevalence of TCAM usage among Malaysians
in their lifetime was 55.6% in the last 12-month
period of the study5
. However, not all TCAM are
free from side effects. Pharmacodynamic
interactions may occur when active constituents of
herbal compounds act in an additive, synergistic or
antagonistic manner with a therapeutic agent6
.
Even patients who received acupuncture may
experience needle pain, bleeding and syncope
although it is infrequent7
.
TCAM has not been well received by the world of
western medicine and healthcare providers as most
are not taught about TCAM in medical school
training. Thus, they are not properly educated in
this field to offer these services to the patients who
may benefit from them. The lack of TCAM
knowledge has caused a disconnection between
patients and their healthcare providers8
. Thus, it has
been hypothesized in this study that there is a
significant relationship between the healthcare
professional’s influence with patient’s TCAM use.
Shin J.Y. et al. reported that the overall degree of
satisfaction with conventional medicine was a
predictor of TCAM use9
. Hence, it was
hypothesized that there was a relationship between
patient’s satisfaction with the conventional
treatment and TCAM use.
However, there were no studies reporting possible
predictors of TCAM use such as patient’s TCAM
knowledge in cancer treatment. Cancer patients
mainly obtain their knowledge about TCAM
through family and friends, other cancer patients
and the Internet. Other sources included electronic
media and printed materials10
. Only a few cancer
patients are able to obtain some TCAM knowledge
through healthcare professionals11
. Hence, a
significant relationship between patient’s TCAM
knowledge and usage of TCAM was hypothesized.
Next, patients with cancer generally face a situation
that is subjectively more frightening and less
controllable compared to other chronic or life-
threatening diseases. Thus, it is important for the
medical community to understand the factors
motivating them to use TCAM13,14
. Besides that,
very little is known about TCAM utilization among
Malaysians who are diagnosed with cancer.
METHODOLOGY
Simple random and convenient sampling method
was used to select 354 cancer patients from the
outpatient Department of Radiotherapy and
Oncology in Hospital Kuala Lumpur between
February to April 2013. All patients were directly
interviewed with a structured questionnaire. All
participants taking part in this study gave full
informed consent. Patients completed the
questionnaire while they were waiting at the
outpatient clinic to be seen by their physician. On
completion, patients handed the questionnaire to
the researcher.
The inclusion criteria for this study were cancer
patients above 18 years old and were suffering
from any type of cancer and stages with or without
co-morbidities. The exclusion criteria were cancer
patients below 18 years old, patients who did not
give their consent for this study and subjects who
have life-threatening or any conditions that
compromised their ability to give informed consent
are excluded.
Statistical analysis was performed using SPSS
version 18.0 software. Differences of TCAM use
within patient categories of selected demographic
and clinical variables were assessed by χ² test. The
factors predicting TCAM use was analyzed by
univariate analysis and then multiple logistic
regression analysis was performed using all
significant predictor variables. Statistical
significance was set at P<0.05.
RESULTS
In this study, 354 respondents were interviewed
whereby 171 (48.3%) were males and 183 (51.7%)
were females. Most of the respondents were
between ages 40 to 65 are suffering from cancer.
Among the female respondents, 102 (55.7%) were
found to be suffering from breast cancer. More than
90% of the cancer patients are currently receiving
or have received treatment for their disease. Nearly
half of the total respondents (48.6%) in this study
are using TCAM to treat cancer.
Association testing has been measured between the
patient’s satisfactions with the conventional
treatment, patient’s TCAM knowledge and
healthcare professional’s influence with the usage
of TCAM using Chi-square test. A Chi-square test
was performed and a significant relationship was
found between patient’s satisfaction with the
conventional treatment and usage of TCAM. χ² (27,
N = 354) = 41.220, p =0.039. The variables
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patient’s TCAM knowledge and usage of TCAM
have a significant relationship, χ² (24, N = 354) =
143.774, p =0.000. The Chi-Square test also
showed that there was a significant relationship
between healthcare professional’s influence and
usage of TCAM χ² (15, N = 354) = 40.462, p
=0.000.
A Pearson correlation coefficient was computed to
assess the correlation between patient satisfaction
with the conventional treatment and usage of
TCAM. There was a minimal positive correlation
between the two variables, r = 0.091, n = 354, p =
0.088. Increases in patient satisfaction were
correlated with increases in usage of TCAM.
Hence, the alternate hypothesis (H4) on patient’s
satisfaction with the conventional treatment and
usage of TCAM is accepted. However, patient
TCAM knowledge had a strong correlation with the
usage of TCAM for cancer treatment r = -0.555, n=
354, p = 0.000. Increases in cancer patient’s TCAM
knowledge was correlated are less likely to use
TCAM for their cancer treatment. Thus, the null
hypothesis (H0) on patient’s TCAM knowledge and
usage of TCAM is rejected. The Pearson
correlation coefficient showed that there was a poor
negative correlation between healthcare
professional’s influence and usage of TCAM, r = -
0.213, n= 354, p = 0.000. Increases in patient
satisfaction were correlated with decreases in usage
of TCAM. Hence, the alternate hypothesis (H6) on
healthcare professional’s influence and usage of
TCAM was accepted.
The R of independent variables (patient’s
satisfaction, patient’s TCAM knowledge and
healthcare professional’s influence) on the
dependent variable (usage of TCAM for cancer
treatment) is 0.563 showed that cancer patients had
positive and strong relationship with the three
independent variables. The R2
is 0.319 suggesting
that there is 31.9% relationship between the usage
of TCAM for cancer treatment and the 3 variables.
The equation for the patient’s usage of TCAM for
cancer treatment was expressed in the following
equation: Usage of TCAM = 2.114 (Constant) –
0.005 (Healthcare professional's influence) + 0.123
(Patient’s satisfaction) – 0.386 (Patient's TCAM
knowledge).
An independent group t -test revealed a non-
significant difference between the mean for females
(M = 1.52, SD = 0.501) and mean for males (M
=1.58, SD = 0.501), with the usage of TCAM for
cancer treatment. This shows that there is no
difference in opinion between genders with the
usage of TCAM, t(352) = 0.018, p = 0.986. An one
way analysis of variance (ANOVA) revealed that
the demographic and clinical background were
non-significant (p>0.05).
Most of the TCAM users agreed and strongly
agreed that they used TCAM to cure cancer,
suppress the progression of cancer, prevent cancer
from reoccurring, improve physical and emotional
well-being, counter symptoms from cancer, reduce
side-effects from medical treatment and
complement the effects of the present medication.
On the other hand, majority of the respondents who
did not use TCAM agreed and strongly agreed that
they did not use TCAM because they were satisfied
with the conventional treatment, never thought of
using TCAM, do not believe in TCAM efficacy,
discouragement from family, friends and doctors,
as well as lack of information about TCAM.
In line with their reasons to use TCAM, it was
found that TCAM users believe that TCAM are
able to cure cancer, suppress the progression of
cancer, and prevent cancer from reoccurring.
Improvement of physical and emotional with
TCAM usage was also a belief among TCAM
users. Many of the respondents also believed that
using TCAM may help in reducing side-effects
from medical treatment besides complementing the
effect of the present medication.
DISCUSSION
In this study, 354 respondents were interviewed
where 171 (48.3%) were males and 183 (51.7%)
were females. Most of the respondents are between
ages 40 to 65 are suffering from cancer. This is
mostly due to the fact that they have been exposed
to more carcinogens compared to the younger
respondents thus increasing the chance of DNA
mutation in their cells causing cancer12
. 102 out of
183 (55.7%) female respondents were found to be
suffering from breast cancer. Although at a lower
percentage, breast cancer was the most common
among the females3
. More than 90% of the cancer
patients are currently receiving or have received
treatment for their disease.
The prevalence of TCAM use was surveyed and
the determinants of TCAM use by cancer patients
were investigated. It is important to note that nearly
half of the total respondents (48.6%) are using
TCAM to treat cancer. This reflects a high rate of
TCAM use and shows that TCAM has become
more acceptable among cancer patients. This can
be explained by the fact that cancer is more
frightening and less controllable compared to other
chronic or life-threatening diseases9
.
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A relationship was found between patient’s TCAM
knowledge and TCAM usage whereby a patient
who is more knowledgeable about TCAM is less
likely to utilize it as their cancer treatment.
However, this result cannot be compared as there
are no previous literatures that analyzed this
predictor. It was also interesting to note that there
was no relationship between patient’s satisfaction
and TCAM usage, which is consistent with the
previous studies 13,14
. It was also discovered that
there was no relationship between TCAM usage
and healthcare professional’s influence. Previous
studies conducted only determined the responses
by healthcare professionals regarding patient’s
usage of TCAM15
.
The characteristics of a CAM user found in this
study were different from that reported in other
studies. In the previous literatures, CAM use
among cancer patients has revealed a common
trend that TCAM users tend to be female11,16,17
,
younger11,16,17
, higher earners11,17
, and better
educated11,16,17
. However, another study conducted
by Soraya SH et al. reported that there were no
significant differences in sociodemographic
background and cancer clinical treatment history
between CAM users and nonusers but this study is
only restricted to breast cancer survivors18
. A study
conducted in Thailand also showed there were no
significant among CAM users by gender, age,
education level or cancer type15
. This study
revealed that there is only a significant difference
in opinion between patients who are satisfied and
unsatisfied with their conventional treatment. This
may be due to the fact that the previous research
were conducted in other countries thus, the
demographics and culture of the patients may differ
which leads to different results.
Cancer patient’s decision to whether to use TCAM
or not as cancer treatment was also analyzed.
Similar to other studies, nearly half of the total
respondents in this study used TCAM to cure,
suppress the progression and prevent the cancer
from reoccurring19
. Majority of TCAM users also
agreed that TCAM is able to improve emotional
and physical well being, similar to previous studies
11,15
. Other reasons of using TCAM are to counter
symptoms of cancer and reduce side-effects from
the medical treatment besides complementing the
effects of the present medication. Previous
literatures have also supported these reasons15,19
.
Considering there is a high prevalence of TCAM
use among Malaysian cancer patients, issues
related to TCAM must be urgently addressed and
should not be ignored or avoided. It should be
proposed that an attempt should be made necessary
to improve collaboration between registered and
licensed TCAM practitioners and conventional
healthcare providers. Not only is that, as there is a
relationship between patients knowledge of TCAM
with the use TCAM for cancer treatment,
healthcare professionals should also be
knowledgeable in this field. This study shows the
need of easily accessible educational materials for
both patients and healthcare professionals in order
to establish the kinds of information patients would
find useful. In addition to thfat, it should be
ensured that these kind of information is easily
accessible and reliable. Future studies should focus
on specific groups of patients, for example patients
with a particular cancer type or conducted in
another rural location where the prevalence of
TCAM could be different.
Table 1 Demographic background of respondents
Parameters Frequency Percent (%)
Gender Male 171 48.3
Female 183 51.7
Total 354 100.0
Age Less than 20 years 6 1.7
Between 20 to 40 years 60 16.9
Between 40 to - 65 years 199 56.2
Above 65 years 89 25.1
Total 354 100.0
Race Malay 183 51.7
Chinese 97 27.4
Indian 70 19.8
Eurasian 4 1.1
Total 354 100.0
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Level of Education None 27 7.6
Primary 37 10.5
Secondary 163 46.0
Tertiary 124 35.0
Missing 3 0.8
Total 354 100.0
Monthly Household Income <RM 1500 124 35.0
RM 1500 - RM 10000 191 54.0
> RM10000 30 8.5
Missing 9 2.5
Total 354 100.0
Table 2 Clinical background of the respondents
Parameters Frequency Percent (%)
Cancer diagnosis Less than 1 year 84 23.7
Between 1 to 5 years 177 50.0
Between 5 to 10 years 73 20.6
More than 10 years 20 5.6
Total 354 100.0
Type of cancer Breast 102 28.8
Gastrointestinal 85 24.0
Respiratory 54 15.3
Genitourinary 75 21.2
Hematologic 6 1.7
Skin 3 0.8
Bone 8 2.3
Others 21 5.9
Total 354 100.0
Cancer Treatment Received/ Receiving 331 93.5
Not receiving 23 6.5
Total 354 100.0
Satisfaction with conventional treatment Satisfied 302 85.3
Unsatisfied 52 14.7
Total 354 100.0
TCAM usage Yes 172 48.6
No 182 51.4
Total 354 100.0
Table 3 Type of conventional treatments received by the respondents
Parameter Frequency Percent (%)
Type of
treatment received
Surgery 26 7.9
Chemotherapy 33 10.0
Hormonal therapy 3 0.90
Radiation 2 0.60
Surgery & chemotherapy 104 31.5
Surgery & hormonal therapy 15 4.5
Surgery & radiation 21 6.3
Chemotherapy & hormonal therapy 2 0.6
Chemotherapy & radiation 31 9.3
Hormonal therapy & radiation 1 0.3
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Surgery, chemotherapy & hormonal therapy 9 2.7
Surgery, chemotherapy & radiation 73 22.1
Surgery, chemotherapy & palliative care 1 0.3
Surgery, hormonal therapy & radiation 1 0.3
Surgery, chemotherapy, hormonal therapy,
radiation
9 2.7
Total 331 100.00
ACKNOWLEDGEMENTS
We wish to thank all the patients who participated in the study and the staffs in Hospital Kuala Lumpur for
providing permission to conduct this study in the Outpatient Department of Radiotherapy and Oncology.
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