Comparative Analysis of Stereotactic Radiation Therapy and Conventional Radiation Therapy in Cancer Pain Control: A Systematic Review and Meta-Analysis.

AIMS: Approximately 55% of patients diagnosed with primary or metastatic cancer endure pain directly attributable to the disease. Consequently, it becomes imperative to address pain management through a comparative analysis of stereotactic radiotherapy (SRT) and conventional radiation therapy (CRT), especially in light of the less efficacious improvement achieved solely through pharmacological interventions. MATERIALS AND METHODS: A systematic exploration was undertaken on PubMed, the Cochrane Library, and Elsevier's ScienceDirect databases to identify studies that compare Stereotactic Radiotherapy to Conventional radiation therapy for pain management in individuals with metastatic bone cancer. The analyses were executed utilizing the random-effects model. RESULTS: A cohort of 1152 participants with metastatic bone cancer was analyzed, demonstrating significantly higher complete pain relief in the Stereotactic Radiotherapy group during both early and late follow-up (RR: 1.61; 95% CI: 1.17, 2.23, p-value: 0.004; I2: 0%). Stereotactic Radiotherapy also showed a non-significant increase in the incidence of partial pain relief (RR: 1.07; 95% CI: 0.85, 1.34, p-value: 0.56; I2: 18%). Furthermore, Stereotactic Radiotherapy was associated with a significantly reduced risk of stationary pain throughout follow-up (RR: 0.61; 95%CI: 0.48, 0.76, p-value: <0.0001; I2: 0. The incidence of progressive pain was non-significantly reduced with Stereotactic Radiotherapy during both early and late follow-up (RR: 0.77; 95% CI: 0.50, 1.17, p-value: 0.22; I2: 0%). Secondary outcomes exhibited a non-significant trend favoring Stereotactic Radiotherapy for dysphagia, esophagitis, pain, and radiodermatitis, while a non-significant increase was observed for nausea, fatigue, and vertebral compression fracture. CONCLUSION: In summary, stereotactic radiation therapy (SRT) has improved in achieving complete pain relief while exhibiting a decreased probability of delivering stationary pain compared to conventional radiation therapy (CRT). Nevertheless, it is crucial in future research to address a noteworthy limitation, specifically, the risk of vertebral compression fracture.

Physical illnesses among elderly psychiatric out-patients with depression.

Forty elderly psychiatric out-patients with an ICD-9 diagnosis of depression and twenty matched controls were studied for the presence of physical illnesses, using a pre-defined battery of investigative techniques. While the prevalence of physical illness diagnosis was not significantly different between the two groups, the number of subjects with undiagnosed illnesses and those with multiple illnesses was significantly higher among the depressives. Among specific illnesses, hypertension, osteoarthritis and cataract were significantly more common among depressives. Significance of the findings is discussed.

Neuropsychiatric and psychological aspects related to human immuno deficincy virus (hiv) infection.

The prevalence of HIV infection in India is likely to increase dramatically in coming years. Neuropsychiatric and psychosocial problems are common among HIV infected individuals. Therapeutic measures employing biological, psychological and social approaches are necessary for managing these problems. Strategies for reducing high-risk behavioural patterns need to be developed for preventing the spread of infection. To cope with these tasks, neurology and psychiatric personnel should possess an adequate knowledge of the various aspects of HIV infection. Reports indicate a high prevalence of misconceptions among hospital staff. The paper provides a brief review of the biological, europsychiatric, psychosocial and management aspects of HIV infection relevant to neurology and psychiatry.

Interepisodic morbidity in Kleine-Levin syndrome.

Three patients with Kleine-Levin syndrome had evidence of interepisodic organic brain dysfunction. This is counter to earlier views that the disorder is benign.

Elderly depressives : use of medicines with a potenital to cause depression.

The prevalence of use of medicines with a known potential to cause depression among 40 elderly depressives and 20 matched controls was studied. Results showed that the prevalence was not significantly different between the two groups. Within the patient group, the prevalence was independent of the variables of sex, nature and severity of depression, and history of previous episodes of affective illness. While the results indicate that depressive illnesses secondary to the use of medicines are not common, the possibility of a medicine rarely inducing depression cannot be ruled out.

Lithium in pregnancy and still birth: a case report.

Although initially considered safe for the foetus, lithium has been shown to have teratogenic effects if used during the first trimester of pregnancy. Its use is also associated with a higher than expected frequency of still births and perinatal deaths. Our patient, in whom lithium prophylaxis was considered essential for clinical and social reasons, continued to take lithium without medical supervision throughout her pregnancy and had a still birth. We suggest avoiding the use of lithium at least during the first trimester of pregnancy.