An internal medicine residents & #39; perspective on end-of-life discussions
Pradhum Ram, Benjamin Horn, Arthur SiegelIndian Journal of Palliative Care 2018 24(3):388-389 (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - July 16, 2018 Category: Palliative Care Authors: Pradhum Ram Benjamin Horn Arthur Siegel Source Type: research

Could art therapy reduce the death anxiety of patients with advanced cancer ? An interesting question that deserves to be investigated
Hamed MortazaviIndian Journal of Palliative Care 2018 24(3):387-388 (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - July 16, 2018 Category: Palliative Care Authors: Hamed Mortazavi Source Type: research

Palliative dermatology
NA Bishurul Hafi, NA UvaisIndian Journal of Palliative Care 2018 24(3):385-386 (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - July 16, 2018 Category: Palliative Care Authors: NA Bishurul Hafi NA Uvais Source Type: research

Tanezumab: Finally a monoclonal antibody for pain relief
Abhijit S NairIndian Journal of Palliative Care 2018 24(3):384-385 (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - July 16, 2018 Category: Palliative Care Authors: Abhijit S Nair Source Type: research

Are we missing out on something ?
Astha Koolwal Kapoor, Sushma BhatnagarIndian Journal of Palliative Care 2018 24(3):381-383Suicide risk is very high in the patients suffering from advanced cancer. Around 60% of patients with advanced cancer suffer from cancer related pain and this further accentuates the risk of psychiatric disorders as well as suicide. A fifty year old male who was a known case of carcinoma of floor of mouth, post chemotherapy and post radiotherapy came in the outpatient clinic with complains of throat pain which increased on swallowing. On further probing, it was revealed, that he consumed poison in the recent past while being agita...
Source: Indian Journal of Palliative Care - July 16, 2018 Category: Palliative Care Authors: Astha Koolwal Kapoor Sushma Bhatnagar Source Type: research

Massive lymphedema necessitating disarticulation of shoulder joint following treatment for carcinoma breast
We report a case of massive upper-limb edema necessitating disarticulation, in a cancer survivor who tended to ignore instructions regarding preventive exercises since 2002 after completion of her treatment for breast cancer. However, she was in a family situation where she was constrained to physically involve in daily chores. Consequently, she presented 14 years later with a lymphedematous arm which weighed over 31 kg, necessitating disarticulation. We highlight the role of preventive exercises in postmastectomy patients and also the efficacy of continuous nerve block techniques in preventing the development of phantom l...
Source: Indian Journal of Palliative Care - July 16, 2018 Category: Palliative Care Authors: B Manju Cherian Koshy Sibi M Ismail O Rajasree Rachel C Koshy Source Type: research

Bradycardia with syncope in carotid sinus syndrome: A rare case report in palliative care
Arunangshu Ghoshal, Shamali Poojary, Anuja Damani, Naveen S Salins, Jayita K Deodhar, Maryann MuckadenIndian Journal of Palliative Care 2018 24(3):375-377Emergencies in palliative care need to be defined by the potential distress that a clinical issue raises for a person. A 58-year-old male with carcinoma vallecula referred for palliative care presented with recurrent syncopal attacks. On examination, a swelling at the left angle of mandible pressing on the carotid sinus was detected. A clinical diagnosis of carotid sinus syndrome was made, which is an exaggerated response to carotid sinus baroreceptor stimulation and resu...
Source: Indian Journal of Palliative Care - July 16, 2018 Category: Palliative Care Authors: Arunangshu Ghoshal Shamali Poojary Anuja Damani Naveen S Salins Jayita K Deodhar Maryann Muckaden Source Type: research

Olanzapine in the treatment of refractory nausea and vomiting in palliative care settings
We report a case of gallbladder carcinoma who presented to us with intractable vomiting which was not relieved with a combination of traditional antiemetics but showed marked improvement with olanzapine. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - July 16, 2018 Category: Palliative Care Authors: Nishkarsh Gupta Sidharth Puri Vinod Kumar Rakesh Garg Sachidanand Jee Bharati Seema Mishra Sushma Bhatnagar Source Type: research

Radiation-Induced neuropsychiatric manifestations in a patient with brain metastasis: A diagnostic and therapeutic challenges for consultation-liaison psychiatrist
We report the case of a 61-year-old man presented with neurological and psychiatric manifestations following the radiation therapy for non-small cell lung carcinoma with brain metastasis. We have briefly reviewed and discussed the risk factors, clinical features, diagnostic, therapeutic, and preventive aspect of radiation-induced neuropsychiatric manifestations. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - July 16, 2018 Category: Palliative Care Authors: Kumari Padma Sagar Nanaware Nikhil Pande Ramdas Ransing Krishnaji Kulkarni Source Type: research

Asymptomatic cardiac metastasis in a diagnosed case of squamous cell carcinoma of the middle third of esophagus
HS Sachin, Preethi Shetty, CS Pramesh, Sarbani Ghosh LaskarIndian Journal of Palliative Care 2018 24(3):365-368A lady walks in with complaints of dysphagia mostly to solids to begin with and gradually progressive to liquids requiring naso-gastric tube feeding ,with history of vomiting after taking food and weight loss of 20kilograms over 2months. Upper gastrointestinal endoscopy showed an ulceroproliferative growth starting at 28cms from the central incisor and extending upto 36 cms with luminal compromise. Biopsy from the lesion was found to be moderately differentiated squamous cell carcinoma. As part of metastatic work-...
Source: Indian Journal of Palliative Care - July 16, 2018 Category: Palliative Care Authors: HS Sachin Preethi Shetty CS Pramesh Sarbani Ghosh Laskar Source Type: research

Organ donation in pediatric patients with severe anoxic brain injury
Ratna Basak, Shirley Louis, Nan Shin, Michael Sherman, Ilana Harwayne-GidanskyIndian Journal of Palliative Care 2018 24(3):362-364Anoxic brain injury in children is a rare and devastating occurrence. Families are shocked by the unexpected nature of their child's neurologic injury, which may be the result of a sudden and prolonged cardiac arrest. Organ donation in these children is subject to much discussion and controversy. Recently, we encountered three pediatric patients with anoxic brain damage who progressed to brain death within a few days of admission. Pediatric palliative care was involved from the time of arriv...
Source: Indian Journal of Palliative Care - July 16, 2018 Category: Palliative Care Authors: Ratna Basak Shirley Louis Nan Shin Michael Sherman Ilana Harwayne-Gidansky Source Type: research

Palliative mastectomy revisited
Digpal V Dharkar, Sonia MosesIndian Journal of Palliative Care 2018 24(3):359-361Couple of decades ago, Palliative Mastectomy for locally advanced breast cancers was common, if not frequent surgical procedure in the surgical armamentarium. The advent of better understanding of tumor biology and better multidisciplinary management has certainly narrowed down its role. However there are situations where it is still a potent option. In the subset of patients where palliative mastectomy is to be performed, it is important to aim for clear surgical margins, with good clearance at the third dimension, i.e. the tumor base. Surgeo...
Source: Indian Journal of Palliative Care - July 16, 2018 Category: Palliative Care Authors: Digpal V Dharkar Sonia Moses Source Type: research

Utilizing Yoga in oncologic patients treated with radiotherapy: Review
Conclusions: This systematic review of randomized controlled trials showed that yoga has strong beneficial effects on oncologic patients' quality of life. Results of the current review must be interpreted with caution due to the relative small sample sizes of most of the included studies, while a prospective randomized study stands in need for the confirmation of our results. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - July 16, 2018 Category: Palliative Care Authors: Maria Tolia Nikolaos Tsoukalas Michail Nikolaou Eftychia Mosa Ioannis Nazos Antigoni Poultsidi Jiannis Hajiioannou Konstantinos Tsanadis Despoina Spyropoulou Nikolaos Charalampakis Dimitrios Kardamakis Vasileios Kouloulias Kyriaki Pistevou-Gombaki George Source Type: research

The PEP project - Synergistic community based action in prevention, early detection and palliative care, to impact the cancer burden in India
This article describes the scope for reducing the cancer burden in the community, through capacity building of community based PC healthcare functionaries in the domains of Prevention, and Early detection of common cancers along with Palliative care – the PEP domains. It suggests aligning and enhancing the workforce already active within the community for PC, for screening, and if feasible, for early detection of common cancers. The article describes possibilities of initiating PEP activities and offers a set of screening questionnaire that may be used when engaged with family/ community setting. The aim is to integr...
Source: Indian Journal of Palliative Care - July 16, 2018 Category: Palliative Care Authors: Roopa Hariprasad Gayatri Palat Ravi Mehrotra Nandini Vallath Source Type: research

Unmet needs for palliation in fibrotic interstitial lung disease
Sumeet Vimal Kishore Singhania, Shriram Sudhakar ShenoyIndian Journal of Palliative Care 2018 24(3):345-348Chronic fibrotic interstitial lung disease (ILD) forms a substantial proportion of disabling lung diseases and leads to significant morbidity and mortality. The mortality of these patients when admitted to the Intensive Care Unit with acute respiratory worsening requiring mechanical ventilation can reach up to 90%. Indian law does not allow the physician to make the final decision about mechanical ventilation, we are forced to follow the wishes of the family despite knowing the extremely poor outcome of aggressive...
Source: Indian Journal of Palliative Care - July 16, 2018 Category: Palliative Care Authors: Sumeet Vimal Kishore Singhania Shriram Sudhakar Shenoy Source Type: research

End-of-life decision-making for people in a minimally conscious state: A review of the application of the mental capacity act 2005
This article provides an overview of key MCA sections applied in such end-of-life MCS cases and reviews seminal cases elucidating how the Act has been applied. It further describes the evolution of how courts have interpreted the doctrine of best interests when considering withholding or withdrawing CANH and other life-sustaining treatments. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - July 16, 2018 Category: Palliative Care Authors: Martin Curtice Jessica Two Jonathan Packer Source Type: research

Quality of life and neuropathic pain in hospitalized cancer patients: A comparative analysis of patients in palliative care wards versus those in general wards
Conclusions: Since there was a homogeneous distribution among the groups in terms of both cancer treatment and pain management, we directly related the deterioration of the patients' quality of life to NP. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - July 16, 2018 Category: Palliative Care Authors: Sungur Ulas Sibel Eyigor Ismail Caramat Source Type: research

Perspectives of glioblastoma patients on death and dying: A qualitative study
Conclusion: Psychosocial interventions on early death preparation programs are recommended for GBM patients in the in-patient care. Yet, it should be handled carefully and sensitively, otherwise, it creates more psychological and emotional harm than the illness per se. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - July 16, 2018 Category: Palliative Care Authors: Birudu Raju N Krishna Reddy Source Type: research

Stress, coping, and lived experiences among caregivers of cancer patients on palliative care: A mixed method research
Conclusion: Palliative caregiving is stressfull, challenging and can impact the caregiver's physical, emotional, psychological, and social well-being. Understanding lived experiences of caregivers of cancer patients on palliative care is important for the health professionals to improve the support, guidance, and education given to the caregivers of cancer patients on palliative care. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - July 16, 2018 Category: Palliative Care Authors: Lovely Antony Linu Sara George Tessy Treesa Jose Source Type: research

Palliation of brain metastases: Analysis of prognostic factors affecting overall survival
Conclusions: WBRT remains the cornerstone of the management of brain metastases. The present study concludes that the survival of patients with brain metastases is significantly improved with female gender, good PS, primary breast cancer, time lag of>6 months between diagnosis of the primary tumor and development of brain metastases, solitary lesion, and controlled primary tumor. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - July 16, 2018 Category: Palliative Care Authors: Kartick Rastogi Sandeep Bhaskar Shivani Gupta Sandeep Jain Daleep Singh Pawan Kumar Source Type: research

Caregivers & #39; difficulty rating scale: Development and initial validation of a tool to identify the unmet needs of Indian caregivers
Conclusion: CDRS had fifty items under four dimensions – physical, emotional, social, and financial. The scale requires further work on convergent and divergent validity and sensitivity to change which are underway. The study has implications for respite care. Community engagements and caregivers' support group may work as sources of emotional and social support. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - July 16, 2018 Category: Palliative Care Authors: Tushti Bhardwaj Source Type: research

Specialized palliative care and the quality of life for hospitalized cancer patients at a low-resource hospital in India
Conclusion: Consultation with a specialized PCU at this tertiary referral center did not alter the QoL of patients with an ECOG performance of 3–4 nor did it affect the psychological well-being of their caregivers. We argue that monitoring prescribed treatment and follow-up is a necessary component of PC. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - July 16, 2018 Category: Palliative Care Authors: Gayatri Palat Caroline Stenlander Jean Jacob Sudha Sinha Vineela Rapelli Thomas Wiebe Eva Brun Mikael Segerlantz Source Type: research

Hippocratic: The Columbus who dared to voyage the & #8220;el fin del mundo & #8221;
Naveen SalinsIndian Journal of Palliative Care 2018 24(3):287-288 (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - July 16, 2018 Category: Palliative Care Authors: Naveen Salins Source Type: research

Art Poster Presentation
Indian Journal of Palliative Care 2018 24(2):285-286 (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - April 13, 2018 Category: Palliative Care Source Type: research

Slogan Presentations
Indian Journal of Palliative Care 2018 24(2):283-284 (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - April 13, 2018 Category: Palliative Care Source Type: research

Poster Presentation Abstracts
Indian Journal of Palliative Care 2018 24(2):228-282 (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - April 13, 2018 Category: Palliative Care Source Type: research

Oral Presentaton Abstracts
Indian Journal of Palliative Care 2018 24(2):207-227 (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - April 13, 2018 Category: Palliative Care Source Type: research

Perceived barriers to symptoms management among family caregivers of cancer patients
Conclusion: FCGs take the major responsibilities both at the hospital and at home in caring for the cancer patients. Since FCGs had lack of knowledge on caring of cancer patients, there is a need for awareness program on the assessment and management of symptoms among cancer patients. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - April 13, 2018 Category: Palliative Care Authors: Malathi G Nayak Anice George MS Vidyasagar Source Type: research

Spirituality-focused palliative care to improve indonesian breast cancer patient comfort
Conclusion: Spirituality-focused palliative care is fundamentally importance for breast cancer patients. Nurses play an essential role in providing spirituality-focused palliative care to promote comfort in breast cancer patients in Indonesia. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - April 13, 2018 Category: Palliative Care Authors: Tuti Nuraini Andrijono Andrijono Dewi Irawaty Jahja Umar Dewi Gayatri Source Type: research

Burden experience of caregivers of acute lymphoblastic leukemia: Impact of coping and spirituality
Conclusion: Cancer in the child impacts the parent's burden but providing sufficient support and implementing effective coping strategies, will help in mitigating the intensity of caregiver burden. It is essential that the hospital authorities and policymakers understand that a professional health psychologist could be a liaison between the doctor, patient, and the caregiver in bringing down the levels of burden and psychological distress in caregivers as well as patients. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - April 13, 2018 Category: Palliative Care Authors: Usha Chivukula Sirisha Kota Durgesh Nandinee Source Type: research

Prognostic factors of malignant pleural effusion among palliative care outpatients: A retrospective study
Conclusion: ECOG performance status, bilateral effusion, and no oncological treatment after diagnosis of MPE were associated with poor ST. Lung primary was associated with shorter OS and ST. Small numbers precluded any definitive conclusion on the prognostic value of LENT in our group of patients, and hence larger studies are recommended. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - April 13, 2018 Category: Palliative Care Authors: Jenifer Jeba Renitha M Cherian Balamugesh Thangakunam Reena George J Visalakshi Source Type: research

Evaluation of supportive care management outcomes in cancer chemotherapy: A prospective observational study in a tertiary care teaching hospital in South India
Conclusions: Pharmacists can provide better patient care by identifying and preventing DRPs and reducing drug-related morbidity and mortality. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - April 13, 2018 Category: Palliative Care Authors: Reshma Susan Reji Binit Kumar N Sreedharan Girish Thunga K Vijayanarayana Mahadev Rao Karthik S Udupa MK Unnikrishnan Source Type: research

Analgesic and opioid use in pain associated with head-and-neck radiation therapy
Conclusion: More than 90% of all head and neck cancer patient undergoing radiation therapy experience therapy related pain for more than 6 weeks. 53% of the patients require opioids and 15% require strong opioids. The use of concurrent chemotherapy was significantly associated with severe pain. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - April 13, 2018 Category: Palliative Care Authors: Sandeep Muzumder S Nirmala HU Avinash M G John Sebastian Prashanth Bhat Kainthaje Source Type: research

Symptoms in Bangladeshi patients with incurable cancers: Implications for interventions
Conclusions: While the types and direct effects of the cancers, the young age distribution, and the true symptomatic status of this Bangladeshi population studied may explain the described characteristics, the observations deserve exploration of other causes with specific therapeutic implications. These patients appear to have been partially treated for pain, and in particular, environmental factors such as extreme heat and its consequences appear more likely causes of moderate levels of multiple symptoms, which collectively magnified patients' suffering. Greater attention to gastrointestinal symptoms and sleep disturb...
Source: Indian Journal of Palliative Care - April 13, 2018 Category: Palliative Care Authors: Richard R Love GM Tanimul Ahsan Tahmina Ferdousy Shamsun Nahar Sheikh Iqbal Ahamed Source Type: research

Professional quality of life among professional care providers at cancer palliative care centers in Bengaluru, India
Conclusion: The overall results strongly suggest that a short intervention targeting STS and BO can help the study population and further enhance their CS and patient care. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - April 13, 2018 Category: Palliative Care Authors: Amanpreet Kaur Mahendra P Sharma Santosh K Chaturvedi Source Type: research

Phenomenology study on nurses & #39; experiences in understanding the comfort of children at the end-of-life
Conclusion: Nurses should provide information regarding children's end of life conditions to the family, to achieve family acceptances. Eventhough it was hard situation and rose internal conflict to nurses. It was found that children also felt comfortable at the end-of-life when they did not experience any suffering, and their wishes were granted. Subsequently, the nurses did not have mixed feelings when the children died. Therefore, evaluation of the training effectiveness that has been given to the nurses should be done to fulfill the need of the child's comfort at the end-of-life. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - April 13, 2018 Category: Palliative Care Authors: Roro Lintang Suryani Allenidekania Allenidekania Imami Nur Rachmawati Source Type: research

Parents & #39; voice in managing the pain of children with cancer during palliative care
Conclusion: It can be concluded that the child's pain is the main cause of mothers' stress and pressure and also affects the daily lives of mothers and children. Along with the most effective intervention, nurses need to provide mothers and children with adequate information about cancer pain. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - April 13, 2018 Category: Palliative Care Authors: Rina Mariyana Allenidekania Allenidekania Nani Nurhaeni Source Type: research

Providing palliative care in rural Nepal: Perceptions of mid-level health workers
Conclusion: MHWs practicing in rural areas reported the suffering of patients inflicted with life-limiting illness and their family due to poverty, poor access, lack of resources, social discrimination, and lack of knowledge and skills of the health workers. While there are clear frustrations with the limited resources, there is a willingness to learn among the health workers and provide care in the community. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - April 13, 2018 Category: Palliative Care Authors: Rajesh N Gongal Shambhu Kumar Upadhyay Kedar Prasad Baral Max Watson George W Kernohan Source Type: research

Developing a training course for spiritual counselors in health care: Evidence from Iran
Conclusion: According to the results of the study, it is suggested that a strategic committee be established at the MOH level for establishment of these training courses as well as another strategic committee for evaluation, review, and service package promotion, and its training courses should be formed. In addition, a set of skills for spiritual assessment of patients and the related interventions should be designed for clinical skill centers of the country in the form of skill training packages. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - April 13, 2018 Category: Palliative Care Authors: Behzad Damari Ahmad Hajebi Jafar Bolhari Alireza Heidari Source Type: research

Exploring education and training needs in palliative care among family physicians in Mumbai: A qualitative study
Conclusions: FPs perceive PC as symptom control and psychological support helpful in managing patients with advanced life-limiting illnesses. Further training would help them in PC provision. Such training programs should preferably focus on symptom management and communication skills. There is a need for further research in designing a training module for FPs to get better understanding of the principles of PC. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - April 13, 2018 Category: Palliative Care Authors: Anuja Damani Arunangshu Ghoshal Manjiri Dighe Sunil Dhiliwal Maryann Muckaden Source Type: research

Getting out or remaining in the cage of inauthentic self: The meaning of existential challenges in patients & #39; with cancer
Conclusions: According to the results of this qualitative study, it is possible to form discussion groups with peers or have self-reflective practice teaching groups to reflect patients' questions and existential challenges. In this way, participants can express themselves, share their experiences, challenges, learn, and find the answers. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - April 13, 2018 Category: Palliative Care Authors: Zohreh Khoshnood Sedigheh Iranmanesh Masoud Rayyani Mahlegha Dehghan Source Type: research

Still hoping for a miracle: Parents & #39; experiences in caring for their child with cancer under palliative care
Conclusion: This study shows that during palliative care, parents cannot be separated from their relationship with God. Therefore, nurses are vital to the continuous assessment of parents' spiritual needs and to the facilitation of need fulfillment involving family and religious figures. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - April 13, 2018 Category: Palliative Care Authors: Mercy Nafratilova Allenidekania Allenidekania Dessie Wanda Source Type: research

Silver jubilee conference of Indian Association of Palliative Care-A reflection
Sushma BhatnagarIndian Journal of Palliative Care 2018 24(2):125-126 (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - April 13, 2018 Category: Palliative Care Authors: Sushma Bhatnagar Source Type: research

Challenges of using methadone in the Indian pain and palliative care practice
This article outlines the challenges of procuring methadone and also discusses the challenges specific to methadone. Balancing the availability and diversion in a setting of opioid phobia, implementing the amended laws to improve availability and accessibility in a country with diverse health-care practices are the major challenges in implementing methadone for relief of pain. The unique pharmacology of the drug requires meticulous patient selection, vigilant monitoring, and excellent communication and collaboration with a multidisciplinary team and caregivers. The psychological acceptance of the patient, the professional ...
Source: Indian Journal of Palliative Care - January 16, 2018 Category: Palliative Care Authors: Vidya Viswanath Gayatri Palat Srini Chary Ann Broderick Source Type: research

Practical guide for using methadone in pain and palliative care practice
Gayatri Palat, Srini CharyIndian Journal of Palliative Care 2018 24(5):21-29Since the 2014 Amendment to the NDPS Act methadone has been released in India for pain management. The methadone is supplied as racemic mixture with R & S methadone with benefit in pain management and associated adverse effects. Physicians need to be aware of adverse effects so that methadone can be administered safely. Similarly, patients and families need to store and use methadone carefully and experience the benefits and not increase the risk of further morbidity. Considerable amount of literature on methadone is available and sometimes con...
Source: Indian Journal of Palliative Care - January 16, 2018 Category: Palliative Care Authors: Gayatri Palat Srini Chary Source Type: research

When to use methadone for pain: A case-based approach
Gayatri Palat, Nandini Vallath, Srini Chary, Ann BroderickIndian Journal of Palliative Care 2018 24(5):15-20The case studies are written in this article to illustrate how methadone might be used for pain in the Indian context. These cases might be used for discussion in a multidisciplinary team, or for individual study. It is important to understand that pain requires a multidisciplinary approach as opioids will assist only with physical, i.e. neuropathic and nociceptive pain, but not emotional, spiritual, or relational pain or the pain of immobility. The social determinants of pain were included to demonstrate how emotion...
Source: Indian Journal of Palliative Care - January 16, 2018 Category: Palliative Care Authors: Gayatri Palat Nandini Vallath Srini Chary Ann Broderick Source Type: research

Practical pharmacology of methadone: A long-acting opioid
MM Sunilkumar, Kashelle LockmanIndian Journal of Palliative Care 2018 24(5):10-14Methadone is a naturally long-acting analgesic with unique pharmacodynamic and pharmacokinetic properties compared to other opioids, available now in India, to treat severe pain. It has the potential to dramatically relieve suffering among patients with serious illness who are living with persistent physical pain. However, clinicians must appreciate its unique pharmacologic properties and its use in clinical practice safely and effectively. The available formulation in India is a racemic mixture of the S- and R-enantiomers, and as such, it wil...
Source: Indian Journal of Palliative Care - January 16, 2018 Category: Palliative Care Authors: MM Sunilkumar Kashelle Lockman Source Type: research

Methadone for pain management: Past, present and future
Srini CharyIndian Journal of Palliative Care 2018 24(5):6-9Methadone for pain management in this article describes briefly pain, methadone as a Level 3 World Health Organization ladder opioid in the context of India and rest of the world, as well as the relationship to past, present, and future possibilities of pain management. Acute pain is proportional to the injury most of the times, and such proportionality may not exist in chronic pain. Pain management over decades has changed because of knowledge and availability of molecules and compounds to reduce chronic pain. Naturally occurring opioids from “poppy” s...
Source: Indian Journal of Palliative Care - January 16, 2018 Category: Palliative Care Authors: Srini Chary Source Type: research

Safe use of methadone for cancer pain using & #8220;Opioid circle of safety & #8221;
Sushma BhatnagarIndian Journal of Palliative Care 2018 24(5):4-5 (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - January 16, 2018 Category: Palliative Care Authors: Sushma Bhatnagar Source Type: research

Methadone is now available in India: Is the long battle over ?
Conclusions: Two steps are suggested. Firstly, the palliative care community in India must launch an educational program on methadone freely available to all potential prescribers of this medicine. Secondly, we must advocate with drug controllers of states and union territories for making methadone available only through recognized medical institutions and for ensuring that indiscriminate sale through pharmacies is avoided. (Source: Indian Journal of Palliative Care)
Source: Indian Journal of Palliative Care - January 16, 2018 Category: Palliative Care Authors: MR Rajagopal Source Type: research