AK Dam, Nivedita Datta, Usha Rani MohantyIndian Journal of Palliative Care 2010 16(1):23-25Background: Inavailability of morphine continues to plague most parts of India. Good palliative care must, however, focus on resources that are locally available, culturally acceptable, financially affordable, and easily applicable. These factors were all integral to the development of the "Kosish cocktail" for use in severe pain. This cocktail is a mixture of ketamine, midazolam, pentazocine lactate, and other adjuvants for use in the domiciliary set-up as intermittent subcutaneous injections in a morphine-naοve community. Our aims and objectives were: (1) To assess the efficacy of the "Kosish cocktail" in treating severe pain in terminally...

Dam A K, Datta Nivedita, Mohanty Usha RaniIndian Journal of Palliative Care 2010 16(1):23-25Background: Inavailability of morphine continues to plague most parts of India. Good palliative care must, however, focus on resources that are locally available, culturally acceptable, financially affordable, and easily applicable. These factors were all integral to the development of the "Kosish cocktail" for use in severe pain. This cocktail is a mixture of ketamine, midazolam, pentazocine lactate, and other adjuvants for use in the domiciliary set-up as intermittent subcutaneous injections in a morphine-naοve community. Our aims and objectives were: (1) To assess the efficacy of the "Kosish cocktail" in treating severe pain in t...

Vallath NandiniIndian Journal of Palliative Care 2010 16(1):1-7Chronic pain is multi-dimensional. At the physical level itself, beyond the nociceptive pathway, there is hyper arousal state of the components of the nervous system, which negatively influences tension component of the muscles, patterns of breathing, energy levels and mindset, all of which exacerbate the distress and affect the quality of life of the individual and family. Beginning with the physical body, Yoga eventually influences all aspects of the person: vital, mental, emotional, intellectual and spiritual. It offers various levels and approaches to relax, energize, remodel and strengthen body and psyche. The asanas and pranayama harmonize the physiological system and initiate a "relaxation response&#x0026...

Saroja G, Devi P Saraswathi, Namrata RIndian Journal of Palliative Care 2010 16(1):54-55 (Source: Indian Journal of Palliative Care)

Wiwanitkit VirojIndian Journal of Palliative Care 2010 16(1):54-54 (Source: Indian Journal of Palliative Care)

Janaki M G, Mukesh S, Arul Ponni T R, Nirmala SIndian Journal of Palliative Care 2010 16(1):52-53Carcinoma of cervix is the most common cancer in developing countries. Majority of them present in locally advanced stages. A 36-year-old lady presented with bleeding and white discharge per vagina since four months, vomiting and reduced urine output since two weeks. Patient had an exophytic cervical growth. Investigation revealed elevated serum creatinine. Patient received single fraction radiation and underwent percutaneous nephrostomy. At one month follow-up, serum creatinine returned to almost normal level. Patient underwent bilateral ante grade stenting and completed concurrent chemoradiotherapy. In selected subsets of patients, aggressive management offered longer palliation and good qual...

Yadav Naveen, Philip Frenny Ann, Gogia Vikas, Choudhary Prakash, Rana Shiv Pratap Singh, Mishra Seema, Bhatnagar SushmaIndian Journal of Palliative Care 2010 16(1):48-51Chemotherapy-induced peripheral neuropathy (CIPN) is a frequently encountered complication. It can result from a host of agents. Various modalities of treatment have been advocated, of which a novel method is radio frequency ablation. A 63-year-old male, a case of carcinoma prostrate with bone metastases, presented with tingling and numbness in right upper limb. He was given morphine, gabapentin and later switched to pregabalin, but medications provided only minor relief. Initially he was given stellate ganglion block, then radiofrequency ablation of dorsal root ganglion was done, but it failed to provide complete relief. P...

Salins Naveen S, Crawford Gregory BIndian Journal of Palliative Care 2010 16(1):44-47Intrathecal analgesia is an interventional form of pain relief with definite advantages and multiple complications. Administration of intrathecal analgesia needs a good resource setting and expertise. Early complications of intrathecal analgesia can be very distressing and managing these complications will need a high degree of knowledge, technical expertise and level of experience. Pain control alone cannot be the marker of quality in palliative care. A holistic approach may need to be employed that is more person and family oriented. (Source: Indian Journal of Palliative Care)

Conclusions: Increasing QOL and KPS showed a positive correlation whereas increasing pain and better QOL show negative correlation, as do better performance status and increasing pain score. (Source: Indian Journal of Palliative Care)

Kangethe SimonIndian Journal of Palliative Care 2010 16(1):30-35Background/Aim: To explore and assess the magnitude of stigma and its impact to palliative care giving. Objective: To involve the palliative caregivers in exploring the impact of stigma in their care giving. Materials and Methods: The study was exploratory in nature and used attracted qualitative design and interviewed 82 palliative caregivers in 10 focus groups using an interview guide as a data collection instrument, and five CHBC nurses on one-to-one in-depth interviews, still guided by an interview guide that differed only slightly with the one for the caregivers. Results: The study findings revealed that stigma and discrimination was immensely perfidious due to: (1) Discrimination against caregivers by the service...

Conclusion: Training programs in communication skills should teach doctors how to elicit patients' preferences for information. Systematic training programs with feedback can decrease physicians stress and burnout. More research for understanding a culturally appropriate communication framework is needed. (Source: Indian Journal of Palliative Care)

Dam A K, Datta Nivedita, Mohanty Usha RaniIndian Journal of Palliative Care 2010 16(1):23-25Background: Inavailability of morphine continues to plague most parts of India. Good palliative care must, however, focus on resources that are locally available, culturally acceptable, financially affordable, and easily applicable. These factors were all integral to the development of the "Kosish cocktail" for use in severe pain. This cocktail is a mixture of ketamine, midazolam, pentazocine lactate, and other adjuvants for use in the domiciliary set-up as intermittent subcutaneous injections in a morphine-naοve community. Our aims and objectives were: (1) To assess the efficacy of the "Kosish cocktail" in treating seve...

Kangethe SimonIndian Journal of Palliative Care 2010 16(1):16-22Aim: The study aims to explore the attitudes and perceptions of family and community palliative care givers pertaining to volunteerism. Objective: The main objective is to involve palliative caregivers and their supervisors in assessing their contribution to care and evaluate their state of volunteerism. Materials and Methods: The study attracted qualitative design and involved 82 palliative caregivers in 10 focus group discussions; one-to-one interviews with the nurses supervising them. Two slightly different interview guides were used as research instruments. Results: Findings indicate that palliative care giving volunteerism is motivated and sustained by: (1) Principles of love emanating from blood and kinship relatio...

Selman Lucy, Harding RichardIndian Journal of Palliative Care 2010 16(1):8-15Palliative care in India has made enormous advances in providing better care for patients and families living with progressive disease, and many clinical services are well placed to begin quality improvement initiatives, including clinical audit. Clinical audit is recognized globally to be essential in all healthcare, as a way of monitoring and improving quality of care. However, it is not common in developing country settings, including India. Clinical audit is a cyclical activity involving: identification of areas of care in need of improvement, through data collection and analysis utilizing an appropriate questionnaire; setting measurable quality of care targets in specific areas; designing and implementing ser...

Vallath NandiniIndian Journal of Palliative Care 2010 16(1):1-7Chronic pain is multi-dimensional. At the physical level itself, beyond the nociceptive pathway, there is hyper arousal state of the components of the nervous system, which negatively influences tension component of the muscles, patterns of breathing, energy levels and mindset, all of which exacerbate the distress and affect the quality of life of the individual and family. Beginning with the physical body, Yoga eventually influences all aspects of the person: vital, mental, emotional, intellectual and spiritual. It offers various levels and approaches to relax, energize, remodel and strengthen body and psyche. The asanas and pranayama harmonize the physiological system and initiate a "relaxation response&#x0026...