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2005| July-December | Volume 11 | Issue 2
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COVERAGE
Community participation in palliative care
Jan Stjernsward
July-December 2005, 11(2):111-117
DOI
:10.4103/0973-1075.19190
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PSYCHOSOCIAL ISSUES
Psychosocial issues faced by women with incurable cervical cancer in India - how can we help?
Mary Ann Muckaden, Mrunal Marathe, Rupali Tulshan, Maria Carvalho, Mario Pinto
July-December 2005, 11(2):94-96
DOI
:10.4103/0973-1075.19185
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PAIN
Cancer and treatment related pains in patients with cervical carcinoma
Saikat Das, Jenifer Jeba, Reena George
July-December 2005, 11(2):74-81
DOI
:10.4103/0973-1075.19183
Pain in carcinoma cervix is a multidimensional experience with sensory, affective and cognitive-evaluative components. Many patients do not receive adequate pain management because of a lack of proper assessment, misconceptions regarding the pharmacologic and non pharmacologic methods of pain management and failure to distinguish between different types of pain. In our audit pelvic and nodal recurrence were the commonest cause of pain presenting as as pelvic pain, [42%], lumbosacral plexopathy [40%] and abdominal pain [34%] [n = 30]. Pain on defaecation caused by rectal obstruction, and suprapubic pain due to pyometra can be relieved by colostomy and drainage. Very little literature is available on the pain syndromes associated with carcinoma cervix. The present article is a review of cancer and treatment related pains in carcinoma cervix.
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LETTERS
Improving opioid availability
David E Joranson, Aaron M Gilson, Martha A Maurer
July-December 2005, 11(2):119-120
DOI
:10.4103/0973-1075.19192
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NURSING
Nursing measures for lymphoedema in gynaecologic cancers
Ghayathri Ananthi
July-December 2005, 11(2):101-104
DOI
:10.4103/0973-1075.19187
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Wound care in resource poor settings
Sister Casilda, Manjula Krishnaswamy
July-December 2005, 11(2):105-107
DOI
:10.4103/0973-1075.19188
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ONCOLOGY
The oncologic management of carcinoma cervix after primary treatment failure
Lee Hsueh Ni, Firuza Patel, Santam Chakraborty, Suresh Sharma
July-December 2005, 11(2):82-93
DOI
:10.4103/0973-1075.19184
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PAIN
Pain management in cancer cervix
Gayatri Palat, MS Biji, MR Rajagopal
July-December 2005, 11(2):64-73
DOI
:10.4103/0973-1075.19182
Cancer of the cervix uteri is a common cause of pain among women. On the physical realm, the cancer may cause somatic [soft tissue and bone], visceral and neuropathic pain [lumbosacral plexopathy]. Radiotherapy and chemotherapy may cause neuropathy too. Psychological, social and cultural factors modify the pain. Evaluation of the individual type of pain and a patient-centred approach are fundamental requirements for rational management. Disease modifying treatment like radiotherapy and chemotherapy must be considered when applicable. Pain control is usually achieved by the use of WHO three-step ladder, remembering that possible association of renal dysfunction would necessitate caution in the use of NSAIDs and opioids. Side effects must be anticipated, prevented when possible, and aggressively treated; nausea and vomiting may already be present, and constipation can worsen pain when there is a pelvic mass. Pain emergencies can be treated by quick titration with intravenous morphine bolus doses. Neuropathic pain may warrant the use of usual adjuvants, with particular reference to cortico-steroids and the NMDA antagonist, ketamine. In intractable pain, many neurolytic procedures are tried, but a solid evidence base to justify their use is lacking. Continuous epidural analgesia with local anaesthetic and opioid may be needed when drug therapy fails, and desperate situations may warrant interventions such as neurolysis. Such physical measures for pain relief must be combined with psychosocial support and adequate explanations to the patient and the family.
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BRIEF REPORT
Are our patients getting palliative care too late? An audit
Biju Raghavan, Gayatri Palat, MR Rajagopal
July-December 2005, 11(2):108-110
DOI
:10.4103/0973-1075.19189
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EDITORIAL
Doubly disadvantaged - dying of cervical cancer
Reena George
July-December 2005, 11(2):62-63
DOI
:10.4103/0973-1075.19181
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5,704
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LETTERS
Staff support in palliative care
Latha Vikraman, Prabha Chandra
July-December 2005, 11(2):118-118
DOI
:10.4103/0973-1075.19191
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4,053
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SPIRITUALITY
Spirituality and terminal illness
Robert Twycross
July-December 2005, 11(2):98-100
DOI
:10.4103/0973-1075.19186
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