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Volumen 6, Ausgabe 3 (2020)

Kurze Kommunikation

Validity and Reliability of Pain Assessment Tool for Bangladeshi Children

Rowsan Ara

Background: Pain is one of the most common and feared symptoms of children with cancer and their family caregivers or parents. The Faces Pain Scale- Revised (FPS-R) is a self- report measure of pain intensity scale to assess pain in children.

Objectives: To assess the validity and reliability of FPS-R for Bangladeshi children.

Methodology: A methodological study design was conducted among 84 child with cancer and 84 family caregivers recruited conveniently from Dhaka Medical College Hospital (DMCH) and Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh. A self-report tool, FPS-R was used by children to measure their pain and Numeric Rating Scale (NRS) was used by the parents to measure their child’s pain. Face to face interview was conducted to collect data through semi-structured questionnaire. Descriptive statistics, t-test, ANOVA, Pearson‘s correlation coefficient, were used for data analysis.

Results: The mean age of children was 5.73 years with SD ± 1.60. Majority 64.3% of the child’s current diagnosis was Acute Lymphoblastic Leukemia. FPS-R scores correlated with parent scores using NRS (r= 0.77, p<0.001) suggested good validity. Test-retest reliability of FPS-R was supported by strong correlations (r=.93, p=<0.001) suggested excellent reliability.

Conclusion: We can conclude, FPS-R as a valid and reliable tool for the child with cancer to assess pain. Dissemination and broader application of the FPS-R tool in Bangladesh could improve pediatric pain evaluation and in relieving their pain suffering.

Kurze Kommunikation

The condition of Peoples and their education in Backward Areas of PAK

Saqib Ullah

The situation and mentality of the peoples in Pakistan’s backward areas are miserable, due to gun culture killing human being is their favorite game. Shortly in that areas we started our campaign on to work over the youth for as they are the future. It was in fact very difficult to start work as an organization at the area where peoples consider the NGOs as the agent of the western ideology, people usually told their children to keep away from organizations etc so to handle these hatred situations and to create soft image in the eyes of people I talked to many social welfare organizations and different Charity trusts to help the needy and poor peoples of that area as because the main reason of their conservative mentality is that they are below line of poverty and they are living like slaves of the landlords and politicians due to lack of awareness. So after that session of helping people financially and to make their very small needs full which they were expecting from their politicians yearly we started plantation campaign in different schools, streets and even in the houses of that area after that we started next session of seminars in different schools and colleges of that area to aware our youth the importance of education and awareness regarding their rights and duties towards the society. As there is very less tolerance in that area so through these seminars we also worked to promote tolerance for this we requested members of another organization “Together for tolerance”. Now a days many students that were trained by have sent their sisters to schools and they have become model for their society. The students are going increase day by day even girls are taking admissions in the newly established university of that area.

Kurze Kommunikation

Breast cancer among young girls: a KAP study conducted in Lahore

Shamaila Hassnain

Background: Breast cancer is the second most frequently occurring malignant tumour. It is a progressive disease hence gradually developing into more fatal form from very small lesion. Knowledge and awareness about risk factors, symptoms and screening methods reduces the mortality and morbidity. Methods: A cross-sectional study was conducted in Lahore. Data was collected anonymously on self- administrated questionnaire regarding awareness and knowledge about risk factors, presentations of breast cancer and screening practices about breast self-examination (BSE), clinical breast examination (CBE) and mammography. Results: A total of 400 females participated in this study. 34% had heard of BSE, 30% of CBE and 29.5% of the mammography. Only 21.8% had ever performed BSE and 14% had ever received CBE. On enquiring the reasons for not performing BSE 29% did not know how to do it and 14.3% indicated embarrassment as the cause of not performing CBE. Regarding the source of information internet was identified as the most popular one (64.8%) followed by breast cancer campaigns (58.5%). Participants had inadequate knowledge about risk factors and its presentations. There is much lack of information about mammography but participants were aware of the age (35-40years) to start this screening procedure. Conclusions: Our studies revealed lack of awareness and knowledge with regard to breast cancer and it screening methods. There is utmost need to enhance the awareness and encouraging the performance of BSE, CBE and mammography among females from very young age to reduce its incidence.

Kurze Kommunikation

Does a Single Dose of Adenosine in Epidural Space Reduce Cancerrelated Neuropathic Pain? A randomized clinical trial

Ehsan Shahverdi

Background: Systemic and intrathecal adenosine reduce chronic neuropathic and nociceptive pain; however, the effect of adenosine epidural injection in the treatment of neuropathic cancer- related pains remains unclear. Objectives: The objective of this study was to evaluate the efficacy of a single epidural administration of adenosine in alleviating chronic neuropathic pain in patients with primitive neuroectodermal tumors. Methods: In this single-blind randomized clinical trial with the unique ID of IRCT2017031428878N1, 88 patients with chronic neuropathic pain were divided into two equivalent groups. Two groups were treated with a single dose epidural administration of ropivacaine, 0.75 mL/kg from 0.2% solution (both groups), plus adenosine, 50 mcgr/kg (adenosine group), or normal saline (control group). Patients were evaluated on the days 1, 2, 3, 5, 7, 10, and 14 after injection. Results: Both groups showed a reduction in pain severity according to verbal rating scale (VRS) (3 ± 0.09-1 ± 0.05 in adenosine, 4 ± 0.08-1 ± 0.00 in the control group) and visual analogue scale (VAS) (7 ± 0.25-1 ± 0.12 in adenosine, 8 ± 0.22-1 ± 0.06 in the controlgroup); however, this reduction was significantly higher in the controlgroup (P&lt; 0.0005). The intensity of neuropathicpain decreased in both groups according to Douleur Neuropathique 4 questions(DN4) scores(from 5±0.23-1±0.04 in adenosine group, and from 5.5 ± 0.24-1 ± 0.00 in the control group) without a significant difference between the groups (P = 0.19). Adenosine group had less nausea and vomiting (P &lt; 0.0005).There was no significant difference in patient satisfaction levels between adenosine and control groups (P = 0.09). Conclusions: Administration of bolus epidural adenosine is not effective in reducing neuropathic pain in patients with primitive neuroectodermal tumors.

Kurze Kommunikation

Cancer Pain Management

Muhammad Raftaz Kayani

Cancer pain is generally a specific pain depending on location, stage and action. Cancer treatments such as chemotherapy, radiation, and also surgery can cause pain that is felt by cancer patients. Symptoms of cancer pain differ for each cancer patient, depending on the sensitivity of the patient’s pain and the type of cancer that is experienced, the stage and extent of the spread of cancer. Cancer pain can be categorized as mild, moderate, and severe, so cancer treatment can vary according to the category of pain that is felt. Cancer pain can be treated and about ninety out of 100 patients who experience cancer pain will feel relieved after using a combination drug. Cancer pain can be reduced by administering drugs such as analgesic and injection and non-drug tablets such as physical therapy, rehabilitation, and relaxation techniques. Treatment with subcutaneous injection (the drug is placed just below the skin using a small needle). Dermal and intramuscular sub (injections placed deeper into the skin or muscle; not recommended for the treatment of long-term cancer pain). Intravenous drugs are placed directly into the vein through a needle left in the vein, allowing the patient to adjust how much medicine they receive. Epidural or intrathecal (the drug is placed directly into the spine using a small tube, this can provide assistance for several hours). Other methods for reducing cancer pain are: anal suppositories & trans skin patches.

Kurze Kommunikation

Chronic inflammation and mucus hyper secretion are the factors responsible for various respiratory diseases including throat and lung cancers Prevention and management through exercise interventions

Manikonda Prakash Rao

Background: The objective of the paper is to create awareness among people about alternative and complimentary methods to protect themselves from various respiratory diseases including Throat and Lung cancers. The diseases cause the following changes in Airways. 1. Inflammation: Acute inflammation is a defense process whereas chronic inflammation is a disease process. 2. Hyper secretion of mucus: It is the result of goblet cell hyperplasia in respiratory mucosa and is a prominent future of inflammation. They go together. Chronic mucus hyper secretion is a potential risk factor for an accelerated loss of lung function. The thick viscous mucus in the lungs will be conducive to pathogens. Continued inflammation and mucus hyper secretion may significantly contribute to transformation of normal cells into pre-cancerous cells and later into cancerous cells i.e. the scope for series of mutations on Genes may get increased. 3. Bronchospasm: It is an additional factor in asthma patients.
Methods: Exercise is a potent medication in history. It can be used as a tool to manage various respiratory diseases including throat and lung cancers. a) Cleaning Upper airway passages, mouth, nose and pharynx, the primary sites of colonization of pathogens and the sinuses, the way stations to the brain. These exercises should be practiced with hypertonic solution i.e., a solution having greater osmotic pressure than that of cells or body fluids and draws water out of cells thus inducing plasmolysis. b) Physical, aerobic and yogic exercises: help in strengthening the Inspiratory and Expiratory muscles.
Conclusions: Any mucus related respiratory health problem commences from upper airway passages and spread to trachea bronchial tree as they constitute only one pathway. The mucociliary clearance mechanism becomes defunct when excess and sticky mucus forms. Once the upper airway passages are cleaned of it, the defunct cilia become active and ciliate mucus towards mouth, and it can be pushed out easily. The upper airway passages and the bronchial airways get cleaned from excess and sticky mucus. The diseases originating from its pathway come under control. The exercises are based on the concept “Once the offending factor, excess mucus is removed, the origin of it, Inflammation gets resolved “As a result of management of the above two factors, the gene damaging effect may get reduced i.e., the scope for series of mutations on genes may get reduced.

Leitartikel

Anuual Congress on Cancer Nursing and Oncology

Giulio Tarro

The post report of Annual Congress on Cancer Nursing and Oncology captures a programme of keynote presentations, oral talks, panel discussions and shared dialogue at the conference on leading the way in Medical and Health Science, which took place from 30th of July 2020. Cancer Nursing Webinar brought together doctors, physicians, nurses, oncologists, professors, chief officials, entrepreneurs, researchers and also provided a treasurable networking opportunity and set the stage for more cooperation among doctors from countries at different stages of development. The webinar began with opening remarks of the conference host and continued with a set of keynote presentations of real world cases describing new and remarkable initiatives by the distinguished keynote speakers.

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