Severity, Risk Factors and Quality of Life of Patients associated with Chemotherapy-Induced Peripheral Neuropathy.

Chemotherapy-induced peripheral neuropathy (CIPN) refers to numbness, tingling, and burning sensation caused by chemotherapy that can cause impairment in Quality of Life (QoL) of the patients. Study assesses severity, risk factors, and quality of life of patients associated with CIPN. A cross sectional descriptive study was conducted at day care ward, tertiary care hospital India. Total of 98 patients receiving paclitaxel for ≥4 months were enrolled by convenient sampling. Data regarding demographics and clinical characteristics, CIPN severity, risk factors, and QoL were collected by structured questionnaires. Study revealed that median score of autonomic symptoms was higher than sensory and motor symptoms. Mean score of FACT/GOG-Ntx sub-domain was 99.05 ± 20.87on a scale of 0 to 152. ECOG Performance status, current exercise behavior, and fruit and vegetable intake was found to be significantly (at p < .05) associated with sensory, motor, and autonomic symptom score. Therefore, CIPN was found to have debilitating effect on QoL.

Does an additional virtual interactive session increase the impact of digital educational material given to epilepsy patients? A randomized controlled trial.

PURPOSE: To study if an additional virtual interactive epilepsy education session improves post-test epilepsy knowledge scores more than providing digital educational material alone in persons with epilepsy (PWE) and caregivers. METHODS: In a single centre, open labelled, randomised controlled trial, PWE and caregivers were randomised to receive digital epilepsy educational material alone or an additional virtual interactive epilepsy session along with the digital educational material. Pre-test knowledge scores were compared with post-test knowledge scores. A difference between the post-test scores in the two arms was the primary outcome. This was assessed one week after the epilepsy education had been received. Secondary outcomes were the difference between the two arms in quality of life and breakthrough seizure frequencies at the end of one month. RESULTS: A total of 130 participants (PWE+caregivers) were randomised of which 66 were in the control arm and 64 in the intervention arm. Baseline demographic and epilepsy characteristics were comparable in both arms except for the higher age of PWE in the intervention arm. Post-test knowledge scores improved significantly from the pre-test knowledge scores in both control and intervention arms (p<0.001). Post-test knowledge scores in the intervention arm were significantly better both for patients (p = 0.003) as well as for caregivers (p = 0.007) compared to controls. There was no difference in the quality of life and frequency of breakthrough seizures between the two arms. CONCLUSION: Digital educational material is effective in improving post-test epilepsy knowledge scores in PWE and caregivers. Knowledge scores can be further improved by an additional virtual interactive session.

Impact of Standardized Educational Intervention on Improvement in Analgesic Knowledge and Its Compliance among Patients of Advanced Cancer Patients Attending Palliative Clinic: Prospective Randomized Study.

Patient education is a low-cost intervention that can help in improving the knowledge and compliance regarding analgesics. This study aimed to assess the effectiveness of the standardized educational intervention on knowledge regarding analgesic, its compliance, and barriers to compliance among advanced cancer patients attending palliative care clinic.In this randomized control trial, 100 advanced cancer patients with pain were randomly allocated to two groups. A standardized educational intervention of 10-15 minutes on cancer pain management and analgesics was delivered at clinic visit to the patients in the intervention group at baseline and the control group received usual care. Analgesic knowledge, analgesic compliance, and barriers to compliance were measured for each patient at baseline, 2 and 4 weeks follow up visit. The data was analyzed and p < 0.05 was considered significant.Analgesic knowledge (p = 0.001) and compliance (p = 0.001) improved significantly in the experimental group at 2 weeks and 4 weeks as compared to the control group. There was also a statistically significant decrease in barriers to compliance in the experimental group as compared to the control group. A significant correlation between the knowledge and compliance score at 4 weeks in the experimental group was found with a Karl Pearson correlation coefficient, r = 0.628 (p = 0.001).The standardized educational intervention was found to be effective in improving the analgesic knowledge and analgesic compliance among cancer patients with pain at 2 and 4 weeks follow up as compared to the usual care.

Fatigue and Functional Ability in Patients Undergoing Upfront Surgical Treatment for Solid Malignancies.

Fatigue is an underassessed and underreported aspect of cancer patients undergoing treatment. In patients being treated with surgery, its extent and manifestations may be varied but it affects their functional quality of life. This study was designed to evaluate the level of fatigue in pre- and post-surgery period and its relation with the functional disability in patients undergoing upfront surgery for solid malignancies. A prospective observational study was conducted between 2016 and 2017. A total of 71 patients with malignant solid tumors (up to stage III) undergoing upfront surgery were included. The fatigue and functional disability were assessed in pre- and post-surgery period using Multidimensional Fatigue Inventory-20 (MFI-20) and Functional Assessment of Chronic Illness Therapy (FACIT-F) questionnaires respectively. The mean age was 42.4 years. The post-operative fatigue levels were significantly higher compared with the pre-operative levels (p = 0.001). The maximum levels of fatigue and loss of functional ability were seen at the time of discharge that recovered up to some extent after 30 days of surgery. Operative duration > 8 h, hospital stay > 9 days, and blood loss of > 200 ml were associated with increased fatigue level. Mental fatigue and limitation of physical activity were the most significant domains in pre- and post-surgery period respectively. This study concludes that cancer-related fatigue is present in both pre- and post-surgery period and it correlates with functional disability. Assessment of different dimensions of fatigue is important and patients need to be made aware about them for planning any specific intervention including life style modification to help them cope up with these practical issues.