Palliative surgery in gastrointestinal malignancy: experience from a regional cancer centre

Background: With so much burden of advanced incurable disease, the role of palliative surgery is paramount for gastrointestinal malignancies improving quality of life. Aim of the study was to study the indications, risks and outcome of palliative surgeries in gastrointestinal malignancies, the burden of disease requiring palliative surgery, and to describe strategies to improve end of life care.Methods: All the patients diagnosed with gastrointestinal malignancy and who underwent palliative surgery between January 2017 and December 2017 were analysed.Results: A total of 186 cases underwent palliative surgery. The most common age group affected was between 50-60 years and the mean age was 54.55 years. Stomach was the most common primary consisting of 58.60% followed by colorectal (23.66%), small intestine (9.68%), hepato-pacreatico-billiary (4.30%), and oesophageal (3.76%) primary. Major complications were seen in 4.84% of cases. Average symptomatic relief was observed for 5.5 months in cases of stomach and 7 months in case of colorectal malignancies. 35.48% cases were alive at the end of one year.Conclusions: Present study concludes that palliative surgery improves quality of life of the patient, provides them with time to accept death and live rest of the life in a dignified manner.

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Prospective cohort study of surgical outcome for spinal metastases in patients aged 70 years or older

The Bone & Joint Journal ◽

10.1302/0301-620x.102b12.bjj-2020-0566.r1 ◽

2020 ◽

Vol 102-B (12) ◽

pp. 1709-1716

Author(s):

Yutaro Kanda ◽

Kenichiro Kakutani ◽

Yoshitada Sakai ◽

Takashi Yurube ◽

Shingo Miyazaki ◽

...

Keyword(s):

Quality Of Life ◽

Performance Status ◽

Eastern Cooperative Oncology Group ◽

Spinal Metastases ◽

Palliative Surgery ◽

Advanced Age ◽

Health State ◽

Survival Times ◽

The Mean

Aims With recent progress in cancer treatment, the number of advanced-age patients with spinal metastases has been increasing. It is important to clarify the influence of advanced age on outcomes following surgery for spinal metastases, especially with a focus on subjective health state values. Methods We prospectively analyzed 101 patients with spinal metastases who underwent palliative surgery from 2013 to 2016. These patients were divided into two groups based on age (< 70 years and ≥ 70 years). The Eastern Cooperative Oncology Group (ECOG) performance status (PS), Barthel index (BI), and EuroQol-5 dimension (EQ-5D) score were assessed at study enrolment and at one, three, and six months after surgery. The survival times and complications were also collected. Results In total, 65 patients were aged < 70 years (mean 59.6 years; 32 to 69) and 36 patients were aged ≥ 70 years (mean 75.9 years; 70 to 90). In both groups, the PS improved from PS3 to PS1 by spine surgery, the mean BI improved from < 60 to > 80 points, and the mean EQ-5D score improved from 0.0 to > 0.7 points. However, no significant differences were found in the improvement rates and values of the PS, BI, and EQ-5D score at any time points between the two groups. The PS, BI, and EQ-5D score improved throughout the follow-up period in approximately 90% of patients in each group. However, the improved PS, BI, and EQ-5D scores subsequently deteriorated in some patients, and the redeterioration rate of the EQ-5D was significantly higher in patients aged ≥ 70 than < 70 years (p = 0.027). Conclusion Palliative surgery for spinal metastases improved the PS, activities of daily living, and quality of life, regardless of age. However, clinicians should be aware of the higher risk of redeterioration of the quality of life in advanced-age patients. Cite this article: Bone Joint J 2020;102-B(12):1709–1716.

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The role of trans obturator tape as a surgical procedure for female stress urinary incontinence and its impact on quality of life in Jammu region

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20195355 ◽

2019 ◽

Vol 8 (12) ◽

pp. 4975

Author(s):

Sapna Puri ◽

Manisha Kohli

Keyword(s):

Quality Of Life ◽

Stress Incontinence ◽

Symptomatic Relief ◽

Female Stress Urinary Incontinence ◽

Medical Sciences ◽

King’S Health Questionnaire ◽

Promising Treatment ◽

Pre Treatment

Background: Stress incontinence is one of the most common but debilitating health issue among women. It has a detrimental effect on overall health and quality of life of women. Trans obturator tape (TOT) has emerged as a promising treatment modality. The aim of present study was to assess the usefulness of TOT in terms of change in quality of life of stress incontinence patients.Methods: The study was performed at Department of Obstetrics and Gynecology, Acharya Shri Chandler of Medical Sciences (ASCOMS), Jammu. A total of 50 symptomatic women were enrolled in the study and underwent TOT procedure using outside-in technique. The quality of life of women was assessed at enrolment and 12 months after the procedure using King’s Health Questionnaire (KHQ). Change in QOL was assessed using paired ‘t’-test.Results: After 12 months follow-up, a total of 27 (54%) patients were entirely symptom free. As compared to pre-treatment QOL assessment on KHQ for general health/incontinence impact, quality of life and symptom scores a % decline of 73.2%, 79.8% and 78.4% was observed. For all the three parts, the change in scores was significant statistically. No other complications and side effects were reported.Conclusions: TOT is a useful procedure which provided symptomatic relief as well as QOL enhancement.

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Orofacial complaints and complications of chemotherapy

Archive of oncology ◽

10.2298/aoo1701009n ◽

2017 ◽

Vol 23 (1) ◽

pp. 9-14

Author(s):

Cristina Novaes ◽

e Tristão ◽

Coelho Mello ◽

Fabri Campos ◽

Maria Chaves

Keyword(s):

Quality Of Life ◽

Oral Health ◽

Health Impact ◽

Plaque Index ◽

Oral Complications ◽

Related Quality ◽

Health Related ◽

The Mean

Background: Oral complications of chemotherapy are sometimes unnoticed and if not treated, they can compromise patients? health and quality of life. Methods: This study aimed to assess and characterize orofacial complaints and complications, and their impact on the oral-health-related quality of life in patients undergoing cancer chemotherapy. Results: We evaluated 28 patients with solid tumors undergoing chemotherapy, through a systematic orofacial evaluation. Eighteen patients (64.2%) developed oral complications during chemotherapy and xerostomia scored the highest incidence n = 14 (50%). About oral health data, gingival index revealed greater part of patients classified with moderate or severe gingival inflammation. The mean plaque index was 25.6%. The mean CPOD index was 15.48 and was worse in patients without oral complications. The patients presented higher plaque index and the oral health impact profile showed higher mean index in the patients group that developed oral complications. Conclusion: These data reinforce the crucial role of the dentist in the multidisciplinary team, with crucial suport in the diagnosis of oral complications. Thus, a specific assistance and relieve of patient?s complaints could impact positively on quality of life.

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Tratamiento del síndrome de intestino irritable por gastroenterólogos: resultados de un estudio de corte transversal a partir de una encuesta elaborada por expertos

Acta gastroenterológica latinoamericana ◽

10.52787/kksx5531 ◽

2021 ◽

Vol 51 (3) ◽

Author(s):

Luis Soifer ◽

José Tawil ◽

Alejandro Rey ◽

Laura Solé ◽

Silvia Bernstein

Keyword(s):

Quality Of Life ◽

Irritable Bowel Syndrome ◽

Polyethylene Glycol ◽

Symptomatic Relief ◽

Colonic Transit ◽

Significant Deterioration ◽

Medical Associations ◽

The Mean ◽

Irritable Bowel

Introduction. Irritable bowel syndrome (IBS) accounts for a significant deterioration in the quality of life of patients who suffer from it and is a common reason for consultation in gastroenterology. The treatment of this syndrome includes a wide variety of medications and recommendations based on different factors of its physiopathology. However, the results are usually variable and sometimes unsatisfactory for either the patient or the treating physician. The main objective of the present work is to describe the different treatments used by gastroenterologists in the management of IBS in Argentina. Materials and methods. Questionnaire of forty-seven questions, prepared by experts, distributed by medical associations of gastroenterology in Argentina and answered by specialists via Google Forms. Results. 304 responses, 157 from women (51.6%) and 147 from men (48.4%). The mean age was 44 and 49.9 years, respectively. 87.5% consider improvement of quality of life as the main goal of treatment. Regarding physiopathology of diarrhea variant irritable bowel syndrome (IBS-D), 49.5% considered emotional stress, while for constipation variant irritable bowel syndrome (IBS-C), 42.8% considered it multifactorial, with a predominance of slow colonic transit. No treatment option was rated as very effective by more than 50% of the respondents. Rifaximin was considered the most effective treatment in IBS-D, while polyethylene glycol was for IBS-C. Statistical significant differences were observed among gastroenterology subspecialties in the treatment of IBS-D with respect to the efficacy of diet, amitriptyline and antibiotics other than rifaximin, and regarding the effectiveness for bisacodyl/picosulfate and antibiotics in the treatment of IBS-C. Conclusion. The most common pathophysiological mechanismin IBS-D is stress. The vast majority of respondents consider that the main goal of treatment is the improvement of the quality of life, over symptomatic relief. None of the drugs is considered very effective in the treatment of the different IBS variants by at least 50% of those surveyed. Statistically significant differences were observed in the proportion of monthly consultations for IBS regarding to age and in the effectiveness considered for some treatments in relation to the subspecialty of physicians. The therapeutic approach to IBS by Argentine gastroenterologists is varied and somewhat heterogeneous, resulting in a still inappropriate management of this condition.

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Effectiveness and Quality of Life with Montelukast in Asthma – A double-blind randomized control trial

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.3.42 ◽

2019 ◽

Vol 35 (3) ◽

Author(s):

Mirza Saif Ullah Baig ◽

Rashid Ahmed Khan ◽

Kamran Khan ◽

Nadeem Rizvi

Keyword(s):

Quality Of Life ◽

Placebo Group ◽

Asthma Control ◽

Persistent Asthma ◽

Double Blind ◽

Once Daily ◽

The Mean ◽

Moderate Persistent Asthma

Objective: To determine the role of montelukast – a leukotriene receptor antagonist (LTRA) – in improving the quality of life (QOL) and asthma control of adult patients with mild to moderate persistent asthma. Methods: Randomized, double-blind, placebo-controlled, non-crossover trial was conducted from March 2017 till November 2018 in three hospitals of Karachi and Hyderabad. Adults of age 15 years or more with mild to moderate persistent asthma. Treatment group was administered tablet montelukast 10mg once daily; the other group was given a similar looking placebo; as an adjuvant to the current medication. QOL was assessed with Asthma Quality of Life Questionnaire – Standard (AQLQ-S) before and after the treatment. Asthma control was monitored via Asthma Control Test (ACT). Results: After 4 weeks, the mean ± SD of overall QOL on AQLQ-S improved from 3.74±0.88 to 5.06±0.89 for montelukast group and from 3.58±0.92 to 4.71±0.97 for placebo group (p=0.02). The improvement in sub-domains of symptoms, activity, and emotional functions was not significant; however, the sub-domain “environmental stimuli” significantly improved with 5.06±0.89 for montelukast group and 4.71±0.97 for placebo group (p=0.02). The mean ± SD of ACT, after four weeks, for montelukast group was 18.19±2.91 and for placebo group 17.28±3.36. Only on ACT, Montelukast did not show any statistically insignificant results. Conclusion: The role of montelukast in improving QOL of adult patients with mild to moderate persistent asthma is quite beneficial. It improves patient quality of life. It has the ease of once daily oral administration and also eradicates side effects associated with long-term adherence to steroids. doi: https://doi.org/10.12669/pjms.35.3.42 How to cite this:Baig S, Khan RA, Khan K, Rizvi N. Effectiveness and Quality of Life with Montelukast in Asthma – A double-blind randomized control trial. Pak J Med Sci. 2019;35(3):---------. doi: https://doi.org/10.12669/pjms.35.3.42 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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