scholarly journals Opiophobia: A Barrier to Pain Management

2016 ◽  
Vol 23 (3) ◽  
pp. 1-7
Author(s):  
Ibtihal M. Alattas
Keyword(s):  
Developing Countries ◽  
Pain Management ◽  
Literature Review ◽  
Respiratory Depression ◽  
Severe Pain ◽  
Google Scholar ◽  
Review Articles ◽  
Legal Consequences ◽  
Young Physicians ◽  
Lack Of Knowledge

Opiophobia is the physicians’ irrational fear of prescribing opioids for patients with severe pain. It’s one of the major reasons for many patients to not receive adequate analgesia (oligoanalgesia). It’s an old phenomenon that still persists in both developed and developing countries with diff erent rates. This is an unsystematic literature review of studies that have been written about opiophobia since 1960 using Google Scholar, PubMed and EBSCO to search for the following terms: opiophobia, oligoanalgesia and necrophobia. Studies included were review articles and surveys studies. We found that the three main reasons for opiophobia are concern over addiction, concern over serious side eff ects (mainly respiratory depression) and concern over legal consequences. These consequences, such as being sued, result from serious side eff ects masking or delaying the diagnosis. Lack of knowledge about pain management was another factor among young physicians and interns. As a result, many patients are not adequately treated for severe pain. Physicians prescribe lesser dosages than required and nurses administer even lesser dosages than the physicians prescribed. To tackle such problems, it’s important to know the causes. Education, clarifi cation of the myths and increasingthe physicians’ and nurses’ awareness about pain management is a critically important step especially for new physicians and interns.

scholarly journals Evaluation of unhealthy cervix by Pap smear and colposcopy guided biopsy

2020 ◽  
Vol 9 (6) ◽  
pp. 2663
Author(s):  
Meenakshi Venkatesh ◽  
Ushadevi .
Keyword(s):  
Developing Countries ◽  
Literature Review ◽  
Search Engines ◽  
Pap Smear ◽  
Google Scholar ◽  
Global Burden ◽  
Carcinoma Cervix ◽  
The Third ◽  
Guided Biopsy ◽  
Common Malignancy

Cancer of cervix ranks as the third common malignancy in females worldwide. In developing countries like India, carcinoma cervix is the second commonest malignancy affecting females. India accounts for 18% of the global burden of carcinoma cervix. To address the above problem a literature review was done using search engines like PubMed, Google scholar etc to evaluate the unhealthy cervix by comparison of Pap smear and colposcopy guided biopsy.

Evaluation of Acute Postoperative Pain Management During an Injectable Opioid Shortage

2020 ◽  
pp. 106002802096203
Author(s):  
Kenneth K. Tran ◽  
Madeline A. VanDaele ◽  
Sylvia Tran ◽  
Shelley A. Stevens ◽  
Nicole Maltese Dietrich ◽  
...  
Keyword(s):  
Pain Management ◽  
Length Of Stay ◽  
Respiratory Depression ◽  
Severe Pain ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Pain Scores ◽  
The Impact ◽  
Analgesic Use ◽  
Nonopioid Analgesic

Background: Drug product shortages, including injectable opioids, are common and have the potential to adversely affect patient care. Objective: To evaluate the impact of an injectable opioid shortage for hospitalized adult patients in the acute postoperative setting. Methods: A single-center, retrospective cohort study of noncritically ill hospitalized, postoperative patients requiring opioids for acute pain management was conducted. Patient cohorts were compared preshortage and postshortage for proportion of total intravenous (IV) opioids used, proportions of specific pain medications used, subjective pain scores, 30-day mortality, respiratory depression, need for opioid reversal, hospital length of stay, and opioid equivalent doses. Results: A total of 275 patients were included, 130 patients in the preshortage cohort and 145 in the postshortage cohort. The proportion of total IV opioid doses was lower in the postshortage cohort versus the preshortage cohort (16.6% vs 20.5%; P < 0.01). Specific medications used were significantly different between the cohorts. The proportion of severe pain scores was lower in the postshortage cohort versus the preshortage cohort (55.6% vs 58.5%; P = 0.04). No significant differences were seen in the overall proportion of nonopioid analgesic use, 30-day mortality, respiratory depression, need for emergent opioid reversal, hospital length of stay, or opioid equivalent doses between cohorts. Conclusion and Relevance: In hospitalized, postoperative adults, an injectable opioid shortage was associated with significant decreases in IV opioid use and severe pain scores but no significant differences in nonopioid analgesic use, safety outcomes, or opioid equivalent doses. These results may assist clinicians in developing strategies for injectable opioid shortages and generating hypotheses for future studies.

scholarly journals Gambaran Perbaikan Kondisi Fungsi Kognitif Pada Lanjut Usia (Lansia) Sebelum Dan Setelah Pemberian Brain Gym : Literature Review

2021 ◽  
Vol 1 ◽  
pp. 2105-2112
Author(s):  
Widya Amalia Chrismonika ◽  
Lia Dwi Prafitri
Keyword(s):  
Developing Countries ◽  
Cognitive Function ◽  
Literature Review ◽  
Mental State ◽  
The Elderly ◽  
Google Scholar ◽  
Brain Gym ◽  
Gender And Age ◽  
Result Show ◽  
The Brain

AbstractThe number of elderly in developing countries increases every year. It was predicted by 2050 the number of elderly wiil be 10 million from 22 developing countries. The common health problem facing by elderly is decline in cognitive function due to nervous damage. By giving brain gym, cognitive function in the elderly can be stimulate. The study aimed to describe the improvement of cognitive function in elderly after giving brain gym. The study used a literature review with PICO method. The arcticles were searched trouhgh Google Scholar. The articles should use Mini Mental State Examitation (MMSE) intrusment to measure cognitive function. The result show there was an improvement in the cognitive function in elderly after the brain gym intervention. Gender and age are determinant factors related to cognitive decline in the elderly. There is an improvement in the cognitive function in eldery after the brain gym intervention.Brain gym can be used as a physiotherapy intervention, especially to improve the cognitive fuynction in elderly.Keywords: Brain gym; Cognitive function; Elderly AbstrakJumlah penduduk lansia dinegara berkembang mengalami peningkatan setiap tahun, diprediksi pada tahun 2050 jumlah lansia mencapai 10 juta jiwa dari 22 negara berkembang, salah satu permasalahn kesehatan pada lansia adalah gangguan pada sistem saraf yaitu penurunan kondisi fungsi kognitif, pendekatan fisioterapi untuk perbaikan kondisi fungsi kognitif dilakukan dengan pemberian aktifitas fisik berupa brain gym untuk mempertahankan kemampuan fungsi kognitif yang ada pada lansia dengan memberikan stimulasi pada otak. Penelitian ini bertujuan untuk mengetahui gambaran perbaikan kondisi fungsi kognitif pada lansia setelah pemberian brain gym. Desain penelitian ini menggunakanan analisis literature review dengan metode PICO, pencarian artikel melalui Google Scholar diperoleh 5 artikel yang direview dan menggunakan instrument alat ukur Mini Mental State Examination (MMSE) untuk mengukur fungsi kognitif pada lansia dengan intervensi brain gym. Hasil analisa dari berbagai literature didapatkan bahwa adanya perbaikan kondisi fungsi kognitif pada lansia sebelun dan setelah dilakukan intervensi brain gym. Jenis kelamin perempuan dan rentang usia 55-75 tahun merupakan faktor yang menyebabkan penurunan fungsi kognitif pada lansia. Adanya perbaikan kondisi fungsi kognitif pada lansia sebelum dan setelah dilakukan intervensi brain gym. Brain gym dapat digunakan sebagai intervensi fisioterapi khususunya pasein lansia pada perbaikan kondisi fungsi kognitif.Kata kunci: Brain gym; Fungsi kognitif; Lansia

scholarly journals Prospects of Electric Vehicles in the Developing Countries: A Literature Review

2020 ◽  
Vol 12 (5) ◽  
pp. 1906 ◽  
Author(s):  
Sarmad Zaman Rajper ◽  
Johan Albrecht
Keyword(s):  
Developing Countries ◽  
Literature Review ◽  
Electric Vehicles ◽  
Web Of Science ◽  
Low Cost ◽  
Meta Analysis ◽  
Google Scholar ◽  
Purchase Price ◽  
Feasible Option ◽  
Barriers And Opportunities

Electric mobility offers a low cost of travel along with energy and harmful emissions savings. Nevertheless, a comprehensive literature review is missing for the prospects of electric vehicles in developing countries. Such an overview would be instrumental for policymakers to understand the barriers and opportunities related to different types of electric vehicles (EVs). Considering the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, a systematic review was performed of the electronic databases Google Scholar and Web of Science for the years 2010–2020. The electric four-wheelers, hybrid electric vehicles and electric two-wheeler constituted the electric vehicles searched in the databases. Initially, 35 studies identified in the Web of Science that matched the criteria were studied. Later, 105 other relevant reports and articles related to barriers and opportunities were found by using Google Scholar and studied. Results reveal that electric four-wheelers are not a feasible option in developing countries due to their high purchase price. On the contrary, electric two-wheelers may be beneficial as they come with a lower purchase price.

GREEN OPEN ACCESS IN KENYA: A REVIEW OF THE CONTENT, POLICIES AND USAGE OF INSTITUTIONAL REPOSITORIES

Mousaion ◽  
2016 ◽  
Vol 33 (3) ◽  
pp. 25-54
Author(s):  
Wanyenda Leonard Chilimo
Keyword(s):  
Developing Countries ◽  
Open Access ◽  
Descriptive Study ◽  
Google Scholar ◽  
Research Institutions ◽  
Journal Articles ◽  
Content Type ◽  
Institutional Repositories ◽  
Current State ◽  
Theses And Dissertations

 There is scant research-based evidence on the development and adoption of open access (OA) and institutional repositories (IRs) in Africa, and in Kenya in particular. This article reports on a study that attempted to fill that gap and provide feedback on the various OA projects and advocacy work currently underway in universities and research institutions in Kenya and in other developing countries. The article presents the findings of a descriptive study that set out to evaluate the current state of IRs in Kenya. Webometric approaches and interviews with IR managers were used to collect the data for the study. The findings showed that Kenya has made some progress in adopting OA with a total of 12 IRs currently listed in the Directory of Open Access Repositories (OpenDOAR) and five mandatory self-archiving policies listed in the Registry of Open Access Repositories Mandatory Archiving Policies (ROARMAP). Most of the IRs are owned by universities where theses and dissertations constitute the majority of the content type followed by journal articles. The results on the usage and impact of materials deposited in Kenyan IRs indicated that the most viewed publications in the repositories also received citations in Google Scholar, thereby signifying their impact and importance. The results also showed that there was a considerable interest in Swahili language publications among users of the repositories in Kenya.

scholarly journals Pain management after lung surgery

2014 ◽  
Vol 4 (1) ◽  
Author(s):  
Maria Frödin ◽  
Margareta Warrén Stomberg
Keyword(s):  
Quality Of Care ◽  
Pain Management ◽  
Postoperative Pain ◽  
Severe Pain ◽  
Postoperative Pain Management ◽  
Lung Surgery ◽  
Moderate Pain ◽  
Number Of Patients ◽  
Severe Postoperative Pain

Pain management is an integral challenge in nursing and includes the responsibility of managing patients’ pain, evaluating pain therapy and ensuring the quality of care. The aims of this study were to explore patients’ experiences of pain after lung surgery and evaluate their satisfaction with the postoperative pain management. A descriptive design was used which studied 51 participants undergoing lung surgery. The incidence of moderate postoperative pain varied from 36- 58% among the participants and severe pain from 11-26%, during their hospital stay. Thirty-nine percent had more pain than expected. After three months, 20% experienced moderate pain and 4% experienced severe pain, while after six months, 16% experienced moderate pain. The desired quality of care goal was not fully achieved. We conclude that a large number of patients experienced moderate and severe postoperative pain and more than one third had more pain than expected. However, 88% were satisfied with the pain management. The findings confirm the severity of pain experienced after lung surgery and facilitate the apparent need for the continued improvement of postoperative pain management following this procedure.

scholarly journals Prevalence of Polypharmacy and Risks of Potentially Inappropriate Medication Use in the Older Population in a Developing Country: A Systematic Review and Meta-Analysis

Gerontology ◽  
2021 ◽  
pp. 1-10
Author(s):  
Akshaya Srikanth Bhagavathula ◽  
Eyob Alemayehu Gebreyohannes ◽  
Daniela Fialova
Keyword(s):  
Risk Factors ◽  
Developing Countries ◽  
Literature Review ◽  
Developing Country ◽  
Systematic Literature Review ◽  
Meta Analysis ◽  
Inappropriate Medication ◽  
Older Age ◽  
Potentially Inappropriate Medication ◽  
Older Population

<b><i>Background and Aim:</i></b> Polypharmacy and potentially inappropriate medication (PIM) use in older populations (65+ years) have not yet been investigated by meta-analyses in developing countries. This systematic literature review and meta-analysis aimed to investigate the prevalence of polypharmacy and PIM use and major risk factors associated with PIM prescribing in older adults in Ethiopia. <b><i>Methods:</i></b> We searched PubMed/MEDLINE, Scopus, Embase, and Google Scholar databases to identify relevant studies published between January 1990 and October 2020. Observational studies reporting the prevalence and association of risk factors with polypharmacy and PIM use in the older population were meta-analyzed. A multilevel meta-analysis was conducted to pool the prevalence estimates, and the risk of PIM use was reported as a relative risk (RR) with a 95% confidence interval (CI). <b><i>Results:</i></b> We identified by systematic literature review 404 articles. Of those, 8 studies fulfilled inclusion criteria, comprising a total sample of 2,608 participants. The overall prevalence of polypharmacy and PIM use pooled by meta-analysis in the Ethiopian older population was 33 and 37%, respectively. The risk factors of PIM use were analyzed in the meta-analysis (particularly polymorbidity, polypharmacy, gender, and older age), and only older age of 65+ (RR: 1.71, 95% CI: 1.16–2.51) was significantly associated with PIM use. <b><i>Conclusion:</i></b> This first meta-analysis from a developing country revealed a high prevalence of polypharmacy and PIM use in the Ethiopian older population. There was no awareness about the risk of PIMs in patients with polypharmacy and polymorbidity, and older age significantly predicted PIM use. Interventions ensuring rational geriatric pharmacotherapy are essential in developing countries in order to reduce the expected burden of PIM-related geriatric morbidity, higher costs, and mortality.

An Audit of Pain Control Pathways following Video-Assisted Thoracoscopic Surgery

2011 ◽  
Vol 6 (4) ◽  
pp. 248-252 ◽  
Author(s):  
Espeed Khoshbin ◽  
Ali N. Al-Jilaihawi ◽  
Nicholas B. Scott ◽  
Dhruva Prakash ◽  
Alan J. B. Kirk
Keyword(s):  
Pain Management ◽  
Pain Relief ◽  
Visual Analog Scale ◽  
Severe Pain ◽  
Thoracoscopic Surgery ◽  
Analog Scale ◽  
Pain Scores ◽  
Audit Commission ◽  
Video Assisted Thoracoscopic Surgery ◽  
Daily Pain

Objective To compare different modes of pain management following video-assisted thoracoscopic surgery (VATS) to our national standard. Methods This is an audit based on patient's experiences. One hundred consecutive patients who underwent VATS with or without pleurodesis were managed by one of the following pain relief pathways: (A) thoracic paravertebral block + morphine patient-controlled analgesia (PCA), (B) percutaneous thoracic paravertebral catheter +/– morphine PCA, (C) thoracic epidural +/– morphine PCA, (D) morphine PCA alone, and (E) intravenous or subcutaneous morphine as required. Pain score was documented up to four times per day for each patient. The incidence of severe pain was defined as visual analog scale ≥7. The results were compared with the standard set by the audit commission for postoperative pain relief in the UK. The mean daily pain scores were calculated retrospectively for all patients. Results There were no statistically significant differences in mean daily pain scores irrespective of having a pleurodesis. The percentage of patients experiencing severe pain was 34% [mean visual analog scale = 8 (standard deviation = 1.0)]. This was almost seven times the standard. Among these pathways, B had the least percentage incidence of severe pain (16.7%) followed by A (25.0%) D (33.3%), C (35.7%), and E (52.4%). Conclusions We are not compliant with the standards set by the audit commission. Pain management in theater recovery needs to be targeted. In the light of these results, we recommend the use of percutaneous thoracic paravertebral catheter +/– morphine PCA for postoperative VATS pain relief.

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