scholarly journals Treatment delay of cancer patients in Indonesia: a reflection from a national referral hospital

2021 ◽  
Vol 30 (2) ◽  
pp. 129-37
Author(s):  
Soehartati Gondhowiardjo ◽  
Sugandi Hartanto ◽  
Sigit Wirawan ◽  
Vito Filbert Jayalie ◽  
Ida Ayu Putri Astiti ◽  
...  

BACKGROUND Cancer is a complex disease requiring a multidisciplinary approach in establishing prompt diagnosis and treatment. Treatment in a timely manner is crucial for the outcomes. Hence, this study aimed to provide information on treatment delay including patient and provider delays and its associated factors. METHODS Cancer patients were recruited conveniently in the outpatient clinic of Department of Radiation Oncology, Cipto Mangunkusumo Hospital, Indonesia between May and August 2015. All patients were asked to fill a questionnaire and interviewed in this cross-sectional study. Treatment delay was explored and categorized into patient delay and provider delay. Patient delay could be happened before (patient-delay-1) or after (patient-delay-2) the patient was diagnosed with cancer. Provider delay could be due to physician, system-diagnosis, and system-treatment delays. RESULTS Among 294 patients, 86% patient had treatment delay. Patient delay was observed in 153 patients, and 43% of them had a history of alternative treatment. An older age (p = 0.047), lower educational level (p = 0.047), and history of alternative treatment (p<0.001) were associated with patient delay. Meanwhile, 214 patients had provider delay, and 9%, 36%, and 80% of them experienced physician, system-diagnosis, and system-treatment delays, respectively. All types of provider delay were associated with patient delay (p<0.001). CONCLUSIONS Most of the patient had treatment delay caused by either patient or provider.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 1525-1525
Author(s):  
John Panzone ◽  
Christopher Welch ◽  
Ruben Pinkhasov ◽  
Joseph M Jacob ◽  
Oleg Shapiro ◽  
...  

1525 Background: Studies show that cancer patients and survivors are likely to endure financial toxicity long after being diagnosed. Methods: To examine the influence of race on financial toxicity among individuals with a history of cancer, a US based cross sectional study was conducted using data on 1,328 cancer patients collected from the Health Information National Trends Survey. Multivariable logistic regression analyses were used to analyze the relationship between race and financial toxicity, adjusting for known confounders. Results: Blacks, Hispanics and other races were shown to have a lower rate of insurance compared to Whites. Whites were also more likely to receive cancer treatment than other races (6.1% received no treatment vs 15.0% of Blacks, 17.8% of Hispanics, and 9.7% of other races, p<0.001). Considerably more Whites underwent surgical treatment of their cancer (77%) vs. 60% of Blacks, 55% of Hispanics and 74.2% of other races, p<0.001. Blacks were found to be over 5 times more likely to be denied insurance (OR 5.003, 95% CI 2.451-10.213, p<0.001) and more than twice as likely to be hurt financially than Whites (OR 2.448, 95% CI 1.520-3.941, p<0.001). Other racial minorities were also more than twice as likely to be hurt financially than Whites (OR 2.421, 95% CI 1.248-4.698, p=0.009) (Table). Conclusions: These data suggest that race is significantly associated with increased rates of being hurt financially and being denied insurance due to cancer. Awareness of race inequality should be raised so that equal cancer treatment can be provided, irrespective of race, gender or socioeconomic status.[Table: see text]


2021 ◽  
Vol 11 (11) ◽  
pp. 15-22
Author(s):  
Hetanshi Raikundlia ◽  
Siddhi Ghodge

Cancer is a debilitating and complex disease that affects millions of people around the world, it has been identified that cancer rehabilitation including physiotherapy can be important factor in management of cancer patients and survivors. There are disquisitions that showcase and prove the presence of certain problems with respect to referral and delivery of the physiotherapy treatment given to oncology patients. It is noticed that in spite of available facilities a large number of our population including the cancer patients are unaware of the presence of onco-physiotherapy and its potential benefits. This cross sectional study conducted among cancer patients aims to identify these barriers to help gain a complete understanding of them and the benefits of rehabilitation will help us gain valuable insight to optimise the beneficial services and its deliverance at these centres. It showed that only half of the samples were aware of onco-physiotherapy. There are multiple barriers faced especially with respect to the referral system present in our country. Though they do not lack motivation, family and community support, ability to follow exercise regime and home programme, this study showed that in spite of this being conducted in an urban setting most were unaware of such services. This tells us that there is a dire need of awareness among patients, doctors and general population. There is also a need for more awareness about NGOs, government schemes and specialised branch of onco-physiotherapy to aid the rehabilitation process. Key words: Oncology, cancer rehabilitation, onco-physiotherpy, barriers, awareness.


2021 ◽  
Vol 21 (2) ◽  
pp. e221-230
Author(s):  
Mohammed Al-Azri ◽  
Fahad Al-Hattali ◽  
Humaid Al-Ghafri ◽  
Sathiya M Panchatcharam

Objectives: Many cancer patients experience social difficulties and feelings of isolation. This study aimed to evaluate patients’ and attendees’ attitudes towards cancer patients. Methods: A cross-sectional study was conducted of patients and attendees attending Sultan Qaboos University Hospital (SQUH), Muscat, Oman, from December 2018 to March 2019. Results: A total of 1,190 people participated (response rate: 91.5%). The majority (90.7%) did not express reluctance to help cancer patients. Most agreed that cancer patients were productive (76.2%) and are respected by the public (75.0%). However, many participants (63.1%) felt that cancer patients might face difficulties getting married. Multivariate analysis showed that participants who had a family history of cancer or had previously been a caregiver for cancer patients were more likely to believe that cancer patients could be productive (odds ratio [OR] = 1.92, 95% confidence interval [CI]: 1.31–2.82; P <0.05). Less-educated participants were more likely to believe that cancer patients feared not being productive (OR = 1.49, 95% CI: 1.01–2.19; P <0.05). Male and single participants were more likely to perceive that cancer patients faced difficulties getting married (OR = 1.56, 95% CI: 1.20–2.02 and OR = 1.68, 95% CI: 1.22–2.32, respectively; P <0.05 each). Conclusion: Patients and attendees attending SQUH in Oman appeared to have positive and supportive attitudes towards cancer patients, although some felt that cancer patients might encounter social obstacles. Healthcare professionals should consider reassuring cancer patients of such positive sentiments. Governmental and non-governmental organisations should act to promote a supportive environment for cancer patients in Oman. Keywords: Cancer; Attitudes; Patients; Surveys and Questionnaires; Oman.


Crisis ◽  
2020 ◽  
pp. 1-6
Author(s):  
Mohammed Madadin ◽  
Ritesh G. Menezes ◽  
Maha A. Alassaf ◽  
Abdulaziz M. Almulhim ◽  
Mahdi S. Abumadini ◽  
...  

Abstract. Background: Medical students are at high risk of suicidal ideation. Aim: We aimed to obtain information on suicidal ideation among medical students in Dammam located in the Eastern Province of Saudi Arabia. Method: This cross-sectional study was conducted at the College of Medicine affiliated with Imam Abdulrahman Bin Faisal University in the Eastern Province of Saudi Arabia. Suicidal ideation in the past 12 months was assessed based on responses to four questions in the depression subscale of the General Health Questionnaire 28 (GHQ-28). In addition, data were collected to examine the association of suicidal ideation with various factors. Results: We found that 1 in 3 medical students in the study had suicidal ideation in the past 12 months, while around 40% had lifetime suicidal ideation. Suicidal ideation was associated with feelings of parental neglect, history of physical abuse, and dissatisfaction with academic performance. Limitations: The cross-sectional nature of this study limits its ability to determine causality regarding suicidal ideation. Conclusion: These rates are considerably high when compared with rates from studies in other countries around the world. This study provides a reference in the field of suicidology for this region of Saudi Arabia.


Author(s):  
Kashish Narula ◽  
Narendra Kumar Dara ◽  
Shyam Lal Meena

Background: Thyroid hormones influence nearly all major metabolic pathways. Their most obvious and well-known action is the increase in basal energy expenditure obtained by acting on protein, carbohydrate and lipid metabolism. The lipid metabolism is more influenced by the thyroid hormone. Methods: A cross-sectional study was conducted on 100 patients with suspicion of thyroid disorders were taken as cases. One hundred patients with normal thyroid profile and no history of other chronic diseases were taken as control group. Results: The serum TC, TG and LDL levels in hypothyroid individuals (both overt and subclinical) were significantly higher than euthyroid subjects but the levels were comparable between hyperthyroid and euthyroid group. Conclusion: Dyslipidemias are associated with thyroid disorders, so biochemical screening for thyroid dysfunction in all dyslipidemic patients. Therefore, patients presenting with dyslipidemia are recommended for investigation to explore thyroid dysfunction. Keywords: Thyroid profile, Total cholesterol, Triglycerides and LDL


2020 ◽  
Vol 18 (6) ◽  
pp. 388-395
Author(s):  
Daniel Vargas-Pacherrez ◽  
Helma P. Cotrim ◽  
Leonardo Pires ◽  
Vitor Cunha ◽  
Vitor Coelho ◽  
...  

Introduction: The global prevalence of metabolic syndrome (MS) among people living with HIV/AIDS varies from 20% to 33%. Objective: to estimate the prevalence of metabolic syndrome and associated factors in a group of HIV-infected patients on antiretroviral therapy. Methods: This is a cross-sectional study with HIV-infected patients from a reference center in Bahia, Brazil. We evaluated clinical, socio-demographic and anthropometric data. MS was defined according to the guidelines of International Diabetes Federation. Results: We evaluated 152 patients with mean age of 47.3±11.6 years, 59.2% male. The main comorbidities detected were diabetes (3.3%) hypertriglyceridemia (9.3%) and metabolic syndrome (MS,38.2%). Patients with MS were predominantly women (55.2% vs 31.9%; p=0.005), older [52.1 (10.4) vs 44.3 (11.3); p<0.001], and had overweight (74.1% vs 23.4%; p<0.001). After multivariate analysis MS remained associated with age (OR = 1.076; 95% CI: 1.030 – 1.125), female sex (OR = 2.452; 95% CI: 1.114 – 5.374) and family history of hypertension (OR = 3.678; 95% CI: 1.431 – 9.395). Conclusion: Almost half of the HIV-infected patients in Bahia presents with MS which seems to be driven by classical risk factors.


2020 ◽  
Vol 16 (3) ◽  
pp. 240-244 ◽  
Author(s):  
Nessrine Akasbi ◽  
Siar Nihad ◽  
Zoukal Sofia ◽  
El Kohen Khadija ◽  
Harzy Taoufik

Background: According to the new classification criteria developed by The Assessment of SpondyloArthritis International Society, patients with axial spondyloarthritis (axSpA) can be classified in 2 subgroups: Patients with radiographic axial spondyloarthritis: ankylosing spondylitis patients (AS) and those with non-radiographic axial spondyloarthritis (nr-axSpA). Objective: The aim of the present study is to describe and discuss the differences and similarities between the two subgroups. Patients and Methods: A cross-sectional study was conducted in a single rheumatology hospital in Morocco. These included patients diagnosed as having axial spondyloarthritis according to ASAS criteria 2010, during a period of 6 years. The AS and the nr-axSpA subgroups were compared for the various axSpA-related variables. Results: Of the 277 patients with a diagnosis of axial SpA who were included in this study, 160 had AS and 117 had nr-axSpA. AS and nr-ax-SpA shared a similar age at diagnosis, similar prevalence of low back pain, lumbar stiffness, extra-articular manifestations, BASDAI and BASFI. In the multivariate analysis, AS patients were mainly male with cervical stiffness, enthesitis, coxitis and high level of ESR (erythrocyte sedimentation rate). The females generally had a family history of SpA and arthritis and were associated to the nr-axSpA form in the univariate analysis. Conclusion: This was the first study to characterise patients with AS and nr-axSpA in Morocco. Consistent with other studies published, this study showed that patients with nr-axSpA and patients with AS shared a comparable degree of disease burden.


2020 ◽  
Vol 2 (4) ◽  
Author(s):  
Shweta R Singh ◽  
Bunsoth Mao ◽  
Konstantin Evdokimov ◽  
Pisey Tan ◽  
Phana Leab ◽  
...  

Abstract Background The rising incidence of infections caused by MDR organisms (MDROs) poses a significant public health threat. However, little has been reported regarding community MDRO carriage in low- and middle-income countries. Methods We conducted a cross-sectional study in Siem Reap, Cambodia comparing hospital-associated households, in which an index child (age: 2–14 years) had been hospitalized for at least 48 h in the preceding 2–4 weeks, with matched community households on the same street, in which no other child had a recent history of hospitalization. Participants were interviewed using a survey questionnaire and tested for carriage of MRSA, ESBL-producing Enterobacterales (ESBL-E) and carbapenemase-producing Enterobacterales (CPE) by culture followed by antibiotic susceptibility testing. We used logistic regression analysis to analyse associations between collected variables and MDRO carriage. Results Forty-two pairs of households including 376 participants with 376 nasal swabs and 290 stool specimens were included in final analysis. MRSA was isolated from 26 specimens (6.9%). ESBL-producing Escherichia coli was detected in 269 specimens (92.8%) whereas ESBL-producing Klebsiella pneumoniae was isolated from 128 specimens (44.1%), of which 123 (42.4%) were co-colonized with ESBL-producing E. coli. Six (2.1%) specimens tested positive for CPE (4 E. coli and 2 K. pneumoniae). The prevalence ratios for MRSA, ESBL-producing E. coli and ESBL-producing K. pneumoniae carriage did not differ significantly in hospital-associated households and hospitalized children compared with their counterparts. Conclusions The high prevalence of ESBL-E across both household types suggests that MDRO reservoirs are common in the community. Ongoing genomic analyses will help to understand the epidemiology and course of MDRO spread.


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