Clinical Processes and Symptom Management

This section describes condition-based clinical processes and symptom management. Shortness of breath, chest tightness, and air hunger (dyspnea) are often associated with findings of anxiety, panic, desperation, or impending doom. These symptoms are often more distressing than pain. As such, it is suggested to never delay palliative treatment for any reason. The section then explores the management of anorexia and cachexia; belching and burping (eructation); bleeding, draining, and malodorous lesions; confusion/delirium; constipation; coughing; depression; diarrhea and anorectal problems; dysphagia and oropharyngeal problems; and edema. It also looks at fatigue and weakness (aesthenia); fever and diaphoresis; hiccups; imminent death; insomnia and nocturnal restlessness; nausea and vomiting; pain; pruritus; seizures; skeletal muscle and bladder spasms; skin breakdown; urinary problems; and xerostomia (dry mouth).

Sensory Stimulation for Nursing-Home Residents: Systematic Review and Meta-Analysis of Its Effects on Sleep Quality and Rest-Activity Rhythm in Dementia

<b><i>Introduction:</i></b> Disrupted sleep-wake cycles might be associated with an exacerbation of behavioural disturbances and accelerate disease progression in dementia. The effect of sensory stimulation for improving sleep quality is unclear. <b><i>Methods:</i></b> A systematic literature search was performed and all studies examining the effects of a sensory stimulation intervention (i.e. bright light, massage, acupuncture, animal-assisted interventions) on rest-activity rhythm (RAR) and/or nocturnal restlessness in nursing-home residents with dementia were included. <b><i>Results:</i></b> Sensory stimulation was shown to improve nocturnal behavioural restlessness as well as sleep duration and continuation, but the effect on the number of awakenings, RAR, and daytime sleep was negligible. Notable was the high heterogeneity between studies regarding treatments and patients’ characteristics and sleep parameters. <b><i>Conclusion:</i></b> Sleep quality and nocturnal restlessness in nursing-home residents with dementia may benefit from sensory stimulation. An environment with sensory stimulation may prevent or improve sleep disturbances in nursing homes, and thereby contribute to a better quality of life for their patients.

Hymenolepis diminuta Infection in a Child from a Rural Area: A Rare Case Report

ABSTRACTIn humans, infection with Hymenolepis diminuta is usually uncommon but has been reported from various areas of the world. Parasitization rates ranging between 0.001% and 5.5% have been reported according to different surveys. We report a rare case of H. diminuta infection in a 10-year-old female from the rural area of Kendrapada district of Odisha. The patient came to our pediatrics outpatient department with the chief complain of intermittent abdominal pain, anal pruritus and nocturnal restlessness. She responded well to praziquantel therapy.