Adherence outcomes in patients with the most severe complications of AIDS, Kaposi''s sarcoma (KS), the commonest AIDS related cancer, is unknown. This books reports on 35 patients prospectively evaluated over 12 months for adherence to highly active antiretroviral therapy (HAART) in a clinical trial of ARVs for management of AIDS KS in KwaZulu- Natal (KZN). Twenty of the initial patients also recieved Chemotherapy (CXT). Adherence was assessed by 7-day self-report. Patients who reported >95% mean adherence were classified as being adherent to HAART. HIV-1 viral load (VL) and CD4+ cell counts were correlated with adherence to HAART. Mean adherence was 86%.This is the first study to show high adherence rates in patients with AIDS KS, receiving HAART, with and without chemotherapy (CTX), specifically in KwaZulu- Natal South Africa. This experience indicates that adherence to generic fixed-dose combination of stavudine, lamivudine and nevirapine is effective and hold much promise.
Epigenetic is one the most important and distinct molecular pathway in colorectal cancer.The epigenetic pathway affect the level of expression of multiple cancer candidate genes essential for cell cycle control, DNA repair, and many others actions within the colon mucosa. Therefore, besides mutations, epigenetic changes including the promoters’ methylation of a set of cancer candidate genes (CAN genes) are associated with the CRC progression. Transcriptional silencing by the hypermethylation of CpG islands is an early event in tumor progression and is considered as a methylator phenotype.
Diabetic patients who require surgery present special challenges in perioperative management. Special attention must be paid to prevention and treatment of metabolic derangements. There is a high frequency of heart failure accompanied by an increased mortality risk for patients with diabetes. The poor prognosis of these patients has been explained by an underlying diabetic cardiomyopathy exacerbated by hypertension and ischemic heart disease. This study was conducted to identify the indicators of cardiac risk among diabetic surgical patients, and the physiological implications for nursing practice.
Prostaglandin is a product of cyclooxygenase-2. Compelling epidemiological and experimental studies over the last few decades have suggested that elevated cyclooxygenase-2 activity has been associated with enhanced development and spread of colorectal cancer, although the exact mechanisms of action are largely unknown or poorly understood. Modulation of adhesion molecules allows colorectal cancer cells to break away from their primary site and invade into the extracellular matrix: the initial process of metastasis. Other molecules such as Metalloproteinases, Cluster differentiation 44 and selectins are also thought to be involved. This short book revisits these various processes of cancer metastasis and reviews possible mechanisms of action with cyclooxygenase on a molecular level. Furthermore, common intrinsic and extrinsic modulators of cyclooxygenase are also discussed. This important biological concept has potential pharmacological implications with regards to chemo-prevention of cancer metastasis - remains to be the leading cause of colorectal cancer deaths.
Attempts to determine the association between the radiographic and clinical findings of knee pathology have produced conflicting results. It is also not yet known how knee radiographs influence the conservative management of patients with knee pain. The objective of the study is to determine the association between the clinical and radiographic diagnoses of knee pain and to record the suspected clinical diagnoses and management of the patients prior to referral for radiographs of the knee. The study will also determine any change in the clinical diagnoses and management following radiographic reporting of the selected radiographs. Degenerative changes were the most common radiographic findings. The majority of the knee radiographs were requested at the initial consultation and as the length of treatment increased, the frequency of radiograph requests decreased. Knee radiographs were over-utilized at the CDC and the findings on radiography did not have much influence on the diagnosis and the management of the patient presenting with knee pain. The majority of the clinical diagnoses were degenerative causes of knee pain.
Lung cancer is one of the most life-threatening cancers worldwide. Treatment for this cancer includes combinations of chemotherapy and radiotherapy. However, side effects of these therapies are limiting their efficacy, so alternative therapies are now emerging. Complementary therapy can be used in addition to conventional treatment and may be used instead of it and so called alternative therapy. Many complementary and/or alternative cancer treatments are based on nutrition and diet, detoxification of the body, emotional well-being and enhanced energy. Examples of such alternative treatments including Vitamin C, lysine, proline, epigallocatechin gallate, zinc and alpha-1-antitrypsin protein have a good protective and therapeutic effects on lung cancer.
Cervical cancer incidences are on the rise in Africa and notably in Kenya. Lack of awareness among child bearing aged women has been the major contributor of the increase in the incidences in Kenya. The book explores the awareness levels of women of child bearing age about cervical cancer in urban slums in Kenya. This was a case study of Mathare slums Nairobi, Kenya. Cervical cancer awareness among women is the key to curbing the new incidences of this debilitating disease among women and ensure that they live abundant, and healthy lives.
Post-mastectomy pain syndrome is common among breast cancer patients. There are many different causes and different ways to relief as well. It is different from other types of pain as it is a neuropathic pain which makes it difficult to respond to simple routine analgesia. In this book, we will touch some of the causes, mechanism, and different treatments to relief this pain. pharmacological as well as surgical interventions are described.
The allocation of nursing resources in hospitals is a major policy issue and there are controversies about whether a system based on equity ratios or one based on measurement of patient dependency is more accurate. This is the first empirical analysis of nurse patient ratios and patient dependency data on the same patient and staff cohort. The analysis was of 103,269 valid shifts of care, representing 1,998,902 nursing hours. It is expected to be of interest to all stakeholders, notably funding agencies that have established nursing policy using either of these two systems to measure and allocate nursing workloads. A statistical analysis of nursing hours and patient types was undertaken through retrospective analysis of existing administrative data provided by 22 acute care public and private hospitals in Australia, New Zealand and Thailand.The results showed that both ratios and the dependency based TrendCare system can predict a fair allocation of nursing resources to patients, however TrendCare predicts actual direct care requirements with greater accuracy than ratios for the full range of hospital and patient types and this facilitates better allocation of nursing resources.
Myocardial Infarction is a huge global burden and is the single most common cause of death. Nurse plays the vital role for the assessment, care and management, prevention from complication and effective health education to the patient with Myocardial Infarction. The purpose of this study is to find out the nurses knowledge regarding the care of patient with myocardial infarction. A descriptive research design was used for the study. A total of 50 nurses working in CMSTH, Bharatpur-10, Chitwan and willing to participate in the study were selected by using non- probability purposive sampling technique and a self administered questionnaire (SAQ) was used to collect the data. Reliability and validity was maintained. Data were analyzed and interpreted on the basis of graphical tools using simple table.Based on the study finding, it is concluded that Majority of respondent had poor knowledge regarding pain assessment, ECG, Cardiac enzyme and blood test. Therefore, hospital management should provide in-service education programme and training related to care of patient with myocardial infarction to the nurses.
A patient who is self managing a chronic condition is actively involved in the prevention, understanding and regulation of his symptoms by means of his behavior and choices. The most diffused self management theories and strategies are presented, with an accent on those that can be relevant for supporting solutions in Healthcare HCI. The user centered design process is explained by making the example of a project for the development of tools supporting the self management of stroke, congestive heart failure and chronic pain. Paper prototypes are illustrated throughout the work.
According to the International Association for the Study of Pain (IASP) Pain is an unpleasant sensory and emotional experience associated with either actual or potential tissue damage, or described in terms of such damage. The aim of this study was to assess the comparative efficacy of different NSAIDs in patients diagnosed with low back pain. Our objective of the study was to improve quality of life for the patient, to compare analgesic effect and complication of non-steroidal anti-inflammatory drugs(NSAIDs) in painful conditions, To reduce the incidence and severity of pain and, in some cases, help minimize further health problems, to reduce morbidity, to provide professional staff with standard of practice that will assist them in the effective assessment, monitoring and management of the resident’s pain.
Fatigue is a common and potentially debilitating symptom of neuromuscular disease. It has a major impact on people's quality of life. To date no treatment has proven to be truly effective through evidence based medicine. Thus the therapist must use a multimodality approach in treating fatigue in patient with neuromuscular disease. Therapist managing the patient with neuromuscular fatigue should focus on finding ways for managing their life and to lessens the impact of fatigue. Key to the effective management of fatigue is accurate understanding of the physiological mechanisms responsible for it, identification of factors which may be contributing to it, and the central involvement of the individual and their family experiencing it.Exercises, activity pacing and assistive aids plays an important role in managing the patient with fatigue.