Journal articles on the topic 'Palliative treatment Malaysia'

The community's stigma towards advanced cancer patients at the final stages of cancer ending up with this death, has deny their need and right to receive the best service and treatment at the end of their lives. Although there was abundant research on cancer patient issues, but there was still lack of research that focusing on final stage of cancer patients in Malaysia. This cross-sectional study is done to gives overall picture of quality of life (QOL) among final stage of cancer patient and to identify the factor that differentiate the score of QOL for the final stage of cancer patients that receiving palliative treatment at the one medical centres in Kuala Lumpur. The cross-sectional study that has been done with 120 of cancer patients that receiving palliative treatment using convenience sampling. The SF-36 questionnaire has been used to measures Quality of Life (QOL) across eight domains based on physically and emotionally component summary. Results showed that the highest score of QOL were observed in the Mental Component Summary (44.93±6.84) compared with Physical Component Summary at (42.24± 7.91). There is a difference in QOL based on mental and physical component especially from patient social demography. Mental component score have difference in term of age (t = - 0.38; p <0.001), type of cancer (F = 5.522: p <0.001), duration of treatment (t = 5.15; p < 0.001), type of treatment (F = 3.11; p = 0.029) and amount of financial support (F = 7.16; p <0.001). Meanwhile, score for physical component composite has shown difference of score based on level of education (F = 6.21; p <0.001), type of cancer (F = 5.96; p <0.001) and also amount of financial support (F = 3.00; p = 0.033). Further study should be conducted in social work perspective to identify other factors that contribute to the patient QoL and identify problems that prevent them from getting social service, so that the service given by social worker can be improved.

Abstract Background Esophageal cancer is one of the deadliest cancer in Malaysia. However, neither the incidence nor prevalence has been recorded nationally. We report our experience in dealing with esophageal cancer in Penang Hospital (PH) and Universiti Kebangsaan Malaysia Medical Center (UKMMC), two tertiary hospitals in Northern and Central region of Malaysia, respectively. Methods A review of 143 esophageal cancer that were diagnosed in PH and UKMMC in year 2014–2017. Results Among the 143 esophageal cancers, 60 cases were from HPP and 83 from UKMMC. The mean age at diagnosis was 62.5 ± 14.2. 67.4% were male patients. Esophageal cancer was commonest in Chinese ethnicity (41%), followed by Malay (29.9%), Indian (17.4%) and others (11.8%). Dysphagia was the commonest presenting symptom (84.6%) and the mean duration of symptoms were 14 weeks. Majority of the cancers were located at the cardioesophageal junction (38.6%), followed by lower third of esophagus (32.1%), mid esophagus (23%), upper third of esophagus (11.5%) and cervical esophagus (5.7%). More than 90% of patients presented with advanced disease, 35% and 55% of patients with stage 3 and stage 4 disease, respectively. Squamous cell carcinoma (45.8%) was the commonest histology type, slightly more than adenocarcinoma (45.1%). The rest were neuroendocrine tumour, gastrointestinal tumour and lymphoma. To date, surgery with curative intend were done in 44.1% of patients while the rest were managed with palliative treatment. Conclusion It is striking that majority of patients presented with late disease. Disease awareness campaign, early detection and multimodality treatment are crucial to improve outcomes of patients. Disclosure All authors have declared no conflicts of interest.

Fatal familial insomnia (FFI) is an extremely rare autosomal dominant prion disease. The chief clinical features include an organic sleep disorder associated with sympathetic overdrive, motor and bulbar compromise as well as progressive cognitive decline. Death ensures in 100% of cases with a mean survival duration of 18 months from time of symptom onset. Treatment strategies in the management of FFI remains largely symptomatic with greater emphasis placed on palliative care services. We report a case of a 31-year old gentleman (Mr G) who presented with insomnia, sleep behavior disturbances, diplopia, myoclonus and transient global amnesia. A family history of a paternal aunt with similar presentation who passed away raised the suspicion of probable FFI, which was subsequently confirmed by genetic testing. Mr G is the first reported definitive FFI case of Malaysian Chinese descent. Standard MRI imaging and CSF analyses are insufficient in the workup of an individual with probable FFI. PET scan, polysomnogram and genetic studies are required for cases with high index of suspicion. In view of the rapid progression of the disease with significant cognitive impairment within months of symptom onset, we advocate for early diagnosis and a biopsychosocial patient-centered treatment approach.

Background The technical aspects of ductal stenting have beenreported, but little is known about the fate of the duct after stentimplantation.Objectives To determine the effects of PDA stenting on the degreeof cyanosis, blood oxygen saturation, long-term patency of PDA,and the growth of pulmonary artery and its branches, in patientswith duct-dependent pulmonary circulation.Methods This was a case series study conducted at the Depart-ment of Pediatric Cardiology, Institut Jantung Negara (National HeartInstitute), Kuala Lumpur, Malaysia from November 1996 to Septem-ber 2001 on patients with duct-dependent pulmonary circulation whounderwent stent implantation. All patients were followed-up until oc-clusion or block occurred or until the end of follow-up time. The evalu-ation consisted of clinical manifestations, electrocardiography, chestx-ray, echocardiography, and cardiac catheterization.Results Stent was successfully implanted in 60 patients (84%),failed in 7 patients (10%) and contra indicated in 4 patients (6%).There was significant improvement on the degree of cyanosis afterstent implantation (p<0.0001). The blood oxygen saturation signifi-cantly increased from 74% (ranged 42-93; SD 12) before proce-dure, to 90% (ranged 62-100; SD 8) afterward (p<0.0001). The meanduration of follow-up time was 14.2 months (ranged 2.5-50.8; SD13) and the minimal patency of PDA was 11.2 months (ranged 1.1-47.7; SD 10.7) after implantation. At the end of follow-up, the stentswere widely patent in 33 patients (55%), stenotic in 15 patients (25%)and spontaneously occluded in 12 patients (20%). There was in-creased growth of pulmonary artery as measured by McGoon ratiofrom 1.23 (ranged 0.4-2.3; SD 0.4) to 1.81 (ranged 0.7-0.9; SD 0.57),and no distortion of pulmonary artery and its branches found.Conclusion Stent implantation into ductus arteriosus decreasedthe degree of cyanosis, increased blood oxygen saturation, main-tained long-term patency of ductus arteriosus, and promoted theincreased growth of pulmonary artery without distortion of pulmo-nary artery and its branches

Lack of local and national transgender-led organisations necessitates an informatory response of researchers striving to develop standards of medical and dental care for transgender communities of developing countries. Here in the Universiti Sains Malaysia in Kelantan, Malaysia, we have made efforts to conduct research and develop a better understanding of health care needs for local Bangladeshi transgender community. Currently, we are outreaching transgender community leaders for data collection with prior permissions to facilitate at least palliative treatment provision. We aim to assess the differences in dental and craniofacial morphometry of transgenders. We also focus on identifying the associations of Body Mass Index (BMI) and ABO Blood grouping with the craniofacial morphometrics. So for our knowledge goes, there is no existing database for the dental and craniofacial morphometric norms of transgenders. Our study outcomes will primarily serve orthodontists, maxillofacial surgeons and on a larger scale will facilitate forensic specialists, radiologists and other health care personnel to better understand the inherent differences and plan the desired treatments according to their specific norms. This will also encourage and empower transgenders to seek health advices and enjoy a healthy social life. The fears of violence and discrimination that transgenders face in our society have suppressed their basic health care needs for long. We need to work in globalised collaboration to address the complex array of challenges that the transgender community faces. Gender equity and indiscrimination is their birth right and we hold this responsibility to defend and fight for their rights to ensure their prosperous future.International Journal of Human and Health Sciences Vol. 04 No. 03 July’20 Page : 155

Abstract INTRODUCTION Medulloblastoma is the most common malignant brain tumour in children. The overall outcome has improved however, this was not translated to developing nations. METHOD This was a retrospective review of patients from January 2000 to December 2017. Treatment was given using modified SIOP PNET 4 protocol: cranio spinal irradiation (CSI), a total of 54G with vincristine followed by 8 cycles of adjuvant chemotherapy. Prior to year 2007, patients had CSI with or without adjuvant chemotherapy. Those &lt;3 years old received modified UKCCSG/SIOP CNS protocol with 2 weekly chemotherapy for a duration of 392 days followed by CSI when required. All patients had MRI brain and spine, and tissue histopathological examination but without molecular subtype. RESULTS Medulloblastoma comprised of 30% (n=31) out of total 103 brain tumour cases. Mean age at presentation was 7.6 years old (SD 4.4) with male to female ratio of 2:1. Average time of symptoms was 4.8 weeks. Majority, 77.4% was high risk and 19.4% was standard risk. There was high treatment abandonment rate (35.5%, n=11). Three patients returned and completed treatment after multiple surgeries in an average of 9 months. Three years OS and EF were 69.6% and 74.8%, respectively. Six patients aged &lt; 3years; half had advance disease on palliative care post surgery. Other survivors had severe learning difficulty and two had second malignancy (meningioma and thyroid carcinoma) at average 15.5 years after diagnosis. CONCLUSION Strategy to reduce treatment abandonment is crucial. Moreover, multidisciplinary management and molecular stratification are important in improving the outcome.

ABSTRACT To report a case of anaplastic thyroid carcinoma (ATC) with huge ulcer and to review our experience with these aggressive tumors in our hospital. We retrospectively reviewed the presentation, treatment and survival of all the patients who were diagnosed with ATC at Hospital Raja Perempuan Zainab II (HRPZ II), Kota Bharu, Malaysia from 2004 to 2010. A 63-year-old woman presented to outpatient clinic with history of anterior neck swelling for more than 10 years. She complained of rapid increase in size with huge ulcer and associated with hoarseness of voice and shortness of breath over 1 month period. She was investigated and the diagnosis of ATC was established. However, she refused for any surgical intervention and eventually succumbed during the palliative treatment 5 months later. ATC is a very rare thyroid cancer and usually presents at a very late stage with significant morbidity and mortality. Early detection, new therapeutic strategies and more studies especially based on molecular approaches may probably more helpful for better survival results in the future. How to cite this article Sze-How NG, Imisairi AH. The Aggressive Anaplastic Thyroid Carcinoma: A Case Report and Institutional Review. World J Endocr Surg 2012;4(1):20-22.

Withholding and withdrawal of life-sustaining treatments is one of the hot topics discussing in intensive care unit as most of the death occurs as a result of it. This point of transition from active intervention to the palliation process required a crucial decision-making process. The decision conveys information to families to be well prepared beforehand especially during the process of withdrawing life-sustaining treatment. Once the final decision to withdraw the treatment has been made, procedure of cessation of care, treatment withdrawal and nature of follow-up support will be informed to the family members. This article aims to explore the relationship between decision in withholding and withdrawal of life-sustaining treatment based on Malaysian intensive care unit protocol and the related fatwa in Malaysia. The methodology chosen for this study is content analysis of the relevant published literatures. This study reveals the decision for withholding and withdrawal life sustaining treatment in intensive care unit has correlation between the protocol and related fatwa in Malaysia.

Anaemia is a crucial issue among cancer patients and need to be treated properly. High incidence of anaemia in patients with cancer have been associated with several physiological manifestations, leading to decreased quality of life (QOL). The current study aimed to assess the severity of anaemia, evaluate the current treatment guideline of anaemia, and to determine the association between the level of anaemia and its treatment on quality of life of breast cancer patients in Malaysia. This prospective study conducted among breast cancer patients in multicancer centers in Malaysia including three follow ups after receiving their chemotherapy. Clinical data were collected from their medical records and at each follow up, they asked to fill up a functional assessment chronic therapy (FACT-An) questionnaire. Descriptive and inferential statistical analysis were done using SPSS. The mean age of participants was 52 ± 11 years old, and out of 120 participants, 32% received anti-anaemic treatments including 87% of them were prescribed with iron supplementation and only 13% received combination of blood transfusion and iron therapy. Surprisingly, none of the participants received erythropoietin stimulating agents (ESAs). Statistical tests also indicated a significant association between anti-anaemic treatments with haemoglobin level and QOL scores. However, this association was insufficient to significantly improve QOL or palliate anaemia severity among participants. This study showed a great evidence that, the current practice of anaemia treatment (iron therapy) among breast cancer patients in Malaysia’s healthcare setting, was not sufficient to palliate anaemia severity or to improve patients’ QOL. There is still a lot of gaps to improve in the management of anaemia among breast cancer patients to show a significant improvement in haemoglobin level. Therefore, respective organisations and oncologists are required to raise awareness about the optimal treatment of anaemia among breast cancer patients, as a result, improve their general wellbeing

Abstract 23 Background: Breast cancer incidence is rapidly increasing in Asia as a result of changes in life expectancy and lifestyle factors. In Malaysia, incidence is expected to double in the next decade and survival is poor (50% to 75%) because of late presentation and poor adherence to treatment. This burden is greater for women in underserved communities, but few studies have examined systematic approaches to reduce late presentation and poor treatment adherence. We sought to determine whether a patient navigation program (PNP) could be a community-based solution to improve outcomes of patients with breast cancer, particularly in a resource-constrained setting. Methods: PNP was implemented in a secondary hospital that serves a suburban area near Kuala Lumpur. A decision aid, which incorporated local key messages, was developed. Nurses and community workers in the program received skills training in navigation, communications, patient management, and resource identification and utilization. Data were retrieved from baseline questionnaires and a patient tracking system and was analyzed by using descriptive statistics. Results: In the first year of the program, 225 women were served, of whom 137 were patients with breast cancer. Compared with the prior year, more patients in the PNP received diagnoses within 14 days of their first visit (67.7% v 62.4%; P = .516) and had surgery within 28 days from diagnosis (68.4% v 61.3%; P = .487). There were also fewer reported patients who experienced default in the PNP (4.4% v 6.6%; P = .797). Conclusion: This 1-year evaluation showed that patient navigation is feasible in a resource-constrained setting, but longer follow-up is required to determine the impact on outcomes. Moving forward, we seek to increase the efficiency of patient navigation by increasing access to palliative care and improving interdepartment coordination and patient tracking systems. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST Maheswari Jaganathan No relationship to disclose Dhiauddin Hai No relationship to disclose Nur Hidayati Zainal No relationship to disclose Nadia Rajaram No relationship to disclose Mohamed Yusof No relationship to disclose Soo-Hwang Teo Honoraria: AstraZeneca Consulting or Advisory Role: AstraZeneca Speakers' Bureau: AstraZeneca Research Funding: AstraZeneca Travel, Accommodations, Expenses: AstraZeneca

Background: Pain Management is a medical approach that draws on science and alternative healing disciplines to study the prevention, diagnosis, and treatment of pain. Operating theatre nurses play the leading role in pain management and require thorough knowledge and skill in managing pain. Significant: Nurses, especially those working in a palliative setting, are considered to demonstrate a high level of knowledge regarding pain management principles with adequate understanding on matters such as a vital sign of patients in response to pain and type of analgesic drugs available. Aim: This study aims to determine the knowledge and attitude regarding pain management among operating theatre nurses in Hospital Melaka. Objective To determine the knowledge and attitude towards pain management among operating theater nurses in Hospital Melaka. Methods: A descriptive, cross-sectional survey was employed to determine operating theatre nurses' knowledge and attitude towards pain management in Hospital Melaka. The total sampling method was used to draw the respondents. An adapted version of The Nurses' Knowledge and Attitudes Survey Regarding Pain (NKASRP) tool was used to test the knowledge and attitude of operating theatre nurses in Hospital Melaka. Normality tests were used to determine the normality of data distribution, and descriptive statistics were used to analyze the data to present quantitative descriptions of variables in this study. Limitations: Although this study was carefully prepared, there were some unavoidable limitations. There is a lack of time for this study because during this study was performed, and it is a pandemic COVID-19, most of the nurses do not have enough time to answer the questionnaire because of their workload. Findings: This study showed that 77.9% of operating theatre nurses in Hospital Melaka had a high level of knowledge, and 88.4% had a high attitude regarding pain management. Nurses specializing in the perioperative course have a slightly higher level of knowledge (78.2%) and attitude (87.3%) than respondents who specialized in the perioperative course. In general, all operating theatre nurses in Hospital Melaka had adequate knowledge and attitude toward pain management. Pain management is effectively managed by operating theatre nurses in the hospital. Implications: However, all nurses need to adhere to best practices in pain management by increasing their theoretical and practical knowledge to improve pain management procedures in the future. Keywords: Knowledge, Attitude, Pain Management, Nurses. eISBN 978-1-913576-05-9 © 2022. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., U.K. This is an open access publication under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.

<p>The second ESMO Asia 2016 Congress, led by an international committee to promote the sharing of expertise and interaction between regional and international experts in oncology, returned for a second appearance at the Suntec Convention and Exhibition Centre in Singapore recently. Organized by the European Society for Medical Oncology (ESMO), the Asian leg of the annual scientific and educational congress was held from December 16–19th, 2016 and attended by over 2,000 healthcare professionals and exhibitors, including representatives from AMOR who were also present to cover the event. <br /> <br />ESMO Asia 2016 brought together oncologists from the Asian region and beyond to discuss important discoveries in oncology and to update delegates on the latest standards of care, the organizer noted in its media release. More specifically, delegates attending the meeting took the opportunity to exchange thoughts and ideas on current clinical challenges and novel treatment strategies for a variety of tumor subtypes, as well as to highlight emerging cancer therapeutics that are rapidly gaining attention in clinical settings. In addition to highlighting the latest in cancer research, the congress also sought to underscore bioethical, economic, and social challenges posed by cancer by addressing crucial issues such as the rising costs of treatments, the need for psychological support for patients, the need for better palliative care, and the vital importance of improving access to innovative drugs. <br /> <br />In this edition of the ESMO Asia congress, the keynote lectures consisted of two topics: how the differences between tumors can impact the design of effective treatments, and the link between common Epstein-Barr virus and nasopharyngeal cancer. With these two keynote lectures setting the tone for the congress, delegates saw a wide range of key discussions pertaining to the clinical relevance of molecular advances and innovative treatment approaches. Moreover, sessions that focus on improving current clinical understanding of various tumor types and novel treatment strategies for different tumor subtypes were also prominently featured. <br /> <br />In his opening remarks, ESMO President Prof. Fortunato Ciardiello said, “We are glad to be returning to Singapore for the second ESMO Asia Congress. Consolidating activities in Asia underlines the importance ESMO places on collaboration with partners in this region. The program this year will have a strong emphasis on state-of-the-art education and on the current standard of care across all major tumor types.” He continued, “In addition to practical seminars and wide-ranging discussions about how oncologists and other stakeholders can best collaborate for greater treatment results for cancer patients, delegates can look forward to opportunities for interaction with both local experts and key opinion leaders from the international oncology community.” <br /> <br />The opening ceremony was graced by the Guest-of-Honor – Dr. Amy Khor, Singapore’s Senior Minister of State for Health. In her speech, Dr. Khor laid emphasis on how events such as the ESMO Asia Congress are essential in providing an open platform to facilitate research collaboration. “To address the challenges presented by the complexity of cancer, the development of regional and international research networks is increasingly important to catalyze scientific communication and collaboration,” she said. To this end, Dr. Khor lauded the partnership between ESMO and the Singapore Society of Oncology in setting up a new office for cancer research aimed at facilitating collaborations between researchers in Europe and Asia — ESMO’s first footprint in Asia. “By building capabilities and strengthening our partnerships, we can do much more to improve patient care and treatment, especially for the Asian population,” she said. <br /> <br />Dr. Ravindran Kanesvaran, President of the host organization – Singapore Society of Oncology, echoed the sentiment. “Oncology is a rapidly evolving field that requires a multi-disciplinary approach between various healthcare professionals from different backgrounds and experience extending across all areas of cancer care trying their best to bring an end to this growing scourge. This collaborative endeavor is key to improve access, raise the quality of treatment delivery, and standard of cancer care in Singapore and Asia in general,” he stated. The cancer research office, which is yet to be officially named and launched, will open in the first quarter of 2017 at the National Cancer Centre Singapore and will administer educational grants, workshops, and conferences between Europe and Asia, Dr. Ravindran added. <br /> <br />The ESMO Asia 2016 Congress was supported by 20 of the most important and influential oncology associations in the region, including the Singapore Society of Oncology and the oncology societies from Australia, Bangladesh, China, Hong Kong, India, Indonesia, Iran, Japan, Malaysia, Myanmar, New Zealand, Pakistan, the Philippines, South Korea, Taiwan, Thailand and Uzbekistan. <br /> <br />During the congress, AMOR spoke to Dr. Susanna Hilda Hutajulu, a representative of the Indonesian Society of Hematology and Medical Oncology (ISHMO). Dr. Hutajulu is a practising medical oncologist in Indonesia who is actively involved in clinical research work and she is a regular participant of ESMO meetings, having recently attended ESMO 2016 in Copenhagen, Denmark. Dr. Susanna had also attended the inaugural ESMO Asia congress in 2015 and is an avid supporter of the congress’s multi-faceted agenda. On the development of cancer research in South East Asia, she told AMOR, “I agree that there should be a dedicated platform to showcase and promote the research work of oncology specialists and organizations in South East Asia.” <br /> <br />Dr. Hutajulu added, “Researchers in Indonesia place great importance in Scopus indexing when it comes to choosing the right journals to publish their research work in.” Meanwhile, the Myanmar Oncology Society (MOS) was represented by Dr. Shu Mon, who is based at the Thurein Mon Clinic in Yangon, Myanmar. During the congress, she gave a presentation on breast cancer management that is specific to the Myanmar experience. According to Dr. Shu Mon, there are only 30 qualified medical oncologists serving the whole of Myanmar, a country with a population of about 51 million people. On establishing collaborations with an academic journal, she said, “MOS is willing to work with a journal such as AMOR to promote the oncology research in Myanmar provided that there are suitable opportunities that both sides could agree on.”</p><p> </p><p>During the congress, Assoc. Prof. Dr. Ho Gwo Fuang, the guest managing editor for AMOR’s upcoming special issue and a representative of the Malaysian Oncological Society (MOS) at ESMO Asia 2016, was featured as one of the panelists of the ESMO-COS-MOS-NZSO Joint Symposium on ‘New insights into gastrointestinal cancers’. Dr. Ho, who is a medical oncologist at Malaysia’s University Malaya Medical Centre, delivered a talk entitled ‘Adjuvant aspirin for colorectal cancer? A cross-Asia collaborative effort’, a multi-nation initiative involving Singapore, Malaysia, and other Asia Pacific countries. His presentation offered strong scientific and observational data to support the adjuvant use of aspirin in reducing the formation of polyps and metastases after colorectal cancer diagnosis. Towards the end of his presentation, Dr. Ho highlighted the ongoing curation of AMOR’s Special Issue and invited his peers to submit papers to the journal for consideration.</p>

<div>As an ardent cancer researcher, Dr. Smita Asthana has a vision to create wider awareness on cancer and its prevention, and aims to work on translational research to benefit the general public through the implementation of evidence-based research. “I have been associated with the National Institute of Cancer Prevention and Research (NICPR) and Institute of Cytology and Preventive Oncology (ICPO) since November 2004 and have progressed over a period of time from being a staff scientist to the current role of a senior scientist,” says Dr. Asthana, who is presently with NICPR’s Biostatistics and Epidemiology division.</div><p> </p><p>“I have been working in various positions that deal with the design, execution, and evaluation of medical projects. Recently, we have concluded two major cervical cancer screening projects and conducted a screening of 10,000 women in rural areas,” she tells AMOR. One project, funded by the Indian Council of Medical Research, was carried out 100 km west of New Delhi in the rural town of Dadri “as part of an operational research to see the implementation of VIA (visual inspection with acetic acid) and VILI (visual inspection with Lugol's iodine) screenings with the help of existing healthcare infrastructure,” she explains.</p><p> </p><p>As a leading researcher in cervical cancer screening, she completed an Indo-US collaborative project on the clinical performance of a human papillomavirus (HPV) test, used as a strategy for screening cervical cancer in rural communities, with funding from the Bill and Melinda Gates Foundation via the international non-profit global health organization PATH. “The primary objective of the project was to observe the performance of careHPV, a new diagnostic kit, in a rural setup,” she says.</p><p> </p><p>CareHPV is a highly sensitive DNA test, which detects 14 different types of the human papillomavirus that cause cervical cancer, providing results more rapidly than other DNA tests and is designed especially for use in clinics that lack reliable clean water or electricity. It is an incredibly cost-effective option for low-resource countries seeking to develop national cervical cancer screening and treatment programs according to PATH.</p><p> </p><p>“Both projects were completed successfully and brought out research conclusions in the form of national and international publications,” Dr. Asthana says. In addition to the projects, she had also developed health education materials to create cervical cancer awareness among the women of rural Indian community, while providing training to auxiliary nurses and midwives for cervical cancer screening.</p><p> </p><p>Dr. Asthana graduated with a degree in Bachelor of Medicine and Bachelor of Surgery from King George Medical College (KGMC), Lucknow, Uttar Pradesh, India, before pursuing her Doctor of Medicine (MD) in Community Medicine from Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College, Kanpur, India. Throughout her career, she has published over 40 articles in national and international journals. As a result of her hard work and dedication toward the medical field, she has been awarded first prizes for oral presentation in international conferences such as Indian Cancer Congress (ICC 2014) and Asia Oceania Research Organisation on Genital Infections and Neoplasia (AOGIN 2012).</p><p> </p><p>She is an active member of various scientific associations and societies such as the Indian Association for Cancer Research (IACR), Indian Society for Medical Statistics (ISMS), Indian Association of Preventive and Social Medicine (IAPSM), and International Epidemiological Association (IEA). In her effort to provide impactful messages via research publications, she is currently working on remodeling the cancer registry data, which includes a diversified field for incidence of childhood cancer, breast and cervical cancer, trends of major cancer, cancer burden in Northeast of India, among other things.</p><p> </p><p>According to Dr. Asthana, her vision is the utilization of voluminous cancer registry data to produce comprehensive reports in the form of research communication to give a clearer picture of different cancer burden in various Indian registries. “I have also proposed a project for establishing cancer registry at NICPR, which was approved by the Indian Council of Medical Research (ICMR) in principle, but we are currently still waiting for funding,” says the medical scientist.</p><p> </p><p>Focusing on the area of cancer epidemiology and research methodology, Dr. Asthana has faced many challenges commonly encountered by any researcher with a vision to improve medical research. “Gradually, with time and experience, I have overcome these limitations and I now conduct research methodology workshops to help clinicians have a better orientation toward research,” she says. Dr. Asthana is the coordinator of research methodology workshops, which is a series of training courses that started in 2007. Training courses/workshops are being conducted on a regular basis — two to three times a year at ICPO — and on an invitation basis, she has held workshops at other institutions such as her previous visit to Universiti Teknologi PETRONAS in Malaysia to train 30 PhD students.</p><p> </p><p>“The main aim or idea is to educate scientists/researchers and medical faculties about the basics of research methodology, which consist of descriptive statistics, statistical analysis, and clinical trial sampling, as well as research protocol development and scientific reporting/writing,” she elaborates. “The curriculum was formed and executed in such a way that new scientists gain an overall knowledge on how a research project should be planned, executed, and the results communicated,” she adds. The courses, according to her, are targeted for medical faculty members, medical post-graduate students, undergraduate students, and PhD students with a basic science background from various medical institutions.</p><p> </p><p>As a researcher with almost 14 years of experience in medical research, her passion for research does not end there. Dr. Asthana has also ventured into various other new areas that are currently lacking presence in India and other low- and middle-income countries. One such area is palliative care, where she has undergone specialized training in palliative care from the Indian Association of Palliative Care. Additionally, Dr. Asthana is working on a global systematic review project that studies smokeless tobacco attributable risk for oral cancer. She further adds, “As an officer in the district technical support team and in collaboration with World Health Organization, I have devoted quite some time in serving the rural community for leprosy monitoring.”</p><p> </p><p>When asked for her opinion about the future of cancer research, Dr. Asthana believes that targeted therapy is the future of cancer therapy, as it kills only cancer cells and not normal cells, which leads to lesser side effects. “However, the major concern is the cost of it,” she says, “and it doesn’t appear to be affordable in the near future.” Hence, “developing countries like India should focus on the prevention of cancer through the modification of risk factors and adopting healthy lifestyles,” she concludes.</p>

Background and Objective: Despite the increasing treatment options for patients with metastatic breast cancer (MBC), unmet needs remain common, especially in low and middle-income countries where resources are limited and MBC patients face many challenges. They often join support groups to cope with their unmet needs. Currently, many MBC patients connect with each other via online support group in view of the constant availability of support and rapid information exchange. The objective of this study is to determine the unmet needs of women with MBC from an online support group. Material and Methods: Messages in an online support group of twenty-two MBC patients over a period of three years from August 2016 till August 2019 were thematically analyzed. Results: Three themes were generated, (1) unmet information needs (2) unmet financial needs (3) unmet support needs. Women needed information on side effects of treatment, new treatment options and availability of clinical trials. Although Malaysia has universal health care coverage, access to treatment remains a major challenge. When treatment was not available in the public hospitals, or waiting lists were too long, women were forced to seek treatment in private hospitals, incurring financial catastrophe. Insufficient private insurance and inadequate social security payments force many women to consider stopping treatment. Women felt that they were not getting support from their clinicians in the public sector, who were quick to stop active treatment and advise palliation. On the other hand, clinicians in the private sector advise expensive treatment beyond the financial capability of the patients. Women with families also face the challenge of managing their family and household in addition to coping with their illness. Conclusions: There is a need for healthcare professionals, policy makers, and civil society to better address the needs of MBC patients through patient-centered, multidisciplinary and multi-organizational collaboration.

We, the participants in the Asia Pacific Association of Medical Journal Editors (APAME) Convention 2012, gathered in Kuala Lumpur, Malaysia, from 31 August to 3 September 2012; CONSIDERINGThat scholarly, scientific and technical health information is an invaluable resource for universal health promotion and policy development, disease prevention, diagnosis and treatment, habilitation and rehabilitation, support and palliation; That this health information must be reliable, comprehensible and available to health care providers and beneficiaries within the Asia Pacific Region and the rest of the World; That the Western Pacific and Southeast Asian Regions of the World Health Organization together represent over 50% of the global population, who both generate and need an enormous amount of health information; That the Asia Pacific Association of Medical Journal Editors (APAME) is an important catalyst for the promotion of scholarly writing skills and standards that will increase the reliability, comprehensibility and availability of health information generated within the region; CONFIRMOur commitment to promoting quality scholarly writing skills and standards that will ensure greater access to publication by authors and researchers, especially for developing countries in the Asia-Pacific Region, elevating loco-regional research and publishing to the global arena;Our commitment to the continuing education of researchers, authors, reviewers and editors, to empower them to write, review and edit scholarly manuscripts for publication and dissemination, thereby promoting health and well-being in the region and the world;Our commitment to collaboration with academic societies, universities, government and non-government organisations to promote research and publication to support evidence-based policies for the betterment of health and societal development in the region and globally; COMMITOurselves, to improving our scholarly writing skills and standards, setting the example for our peers, authors, reviewers, editors and librarians in the region;Our publications, to attaining increasing scholarly quality worthy of continued production and dissemination through analog and digital library services including, but not limited to, the Western Pacific Region Index Medicus (WPRIM), Asia Pacific Medical Journal Articles Central Archives (APAMED Central) and GlobalHealth Library;Our organization, the Asia Pacific Association of Medical Journal Editors, to building further networks, convening conferences, and organizing events to educate and empower editors, peer reviewers and authors to achieve and maintain internationally acceptable, but regionally appropriate, scholarly skills and standards. Kuala Lumpur, Malaysia, 2 September 2012 This declaration was launched at the 2012 Convention of the Asia Pacific Association of Medical Journal Editors (APAME) held in Kuala Lumpur from 31 August to 3 September 2012. It is concurrently published by Journals linked to APAME and listed in the Western Pacific Region Index Medicus (WPRIM). Copyright © APAME. www.wpro.who.int/apame

Introduction: The goal of palliative care is the provision of the best quality of life (QOL) for terminally ill and dying patients. Advances in medical treatment has seen an increase in overall survival of all stages of malignant diseases. This includes advanced and/or inoperable malignancies where management is mainly palliative involving different modalities. Methods: We designed a cross-sectional descriptive study of surgical patients in a palliative care unit in a 1000-bedded teaching hospital in Kuantan, Malaysia. Objectives of this study are: to study the demographic characteristics and indications for admission of surgical patients in palliative care unit, to study the options of treatment modalities and their complications, to identify the barriers in decision making in surgical treatment and finally to objectively assess the quality of life of these patients by utilizing QUALITY OF LIFE (WHOQOL) –BREF –questionnaire. Results: One hundred and one eligible patients (53%) male, (47%) female of mean age of 54yrs, majority Malay and Chinese patients were included in the study. All patients had malignancies and they were Breast (30%), Lower gastrointestinal (GI) (24%), (18%) upper GI, (15%) hepato-biliary, and (7%) pancreatic cancers. Thirty two percents of patients had emergency treatment while the rest had supportive treatment. Barriers to decision making were mainly due to patient factors in 71%, while 12% was due to the disease presenting at an advanced stage and 15% due to limitation of care. The final results of overall quality of life rating were shown as poor (1%), neither poor nor good (42%), good (52%) and very good (2%). Conclusions: Palliative care and end of life decision making from surgical point of view is a delicate issue. Like all other fields in medicine, palliative care must be evidence-based with specific goal directed therapy. Our study shows that we are able to positively impact the quality of life in more than two thirds of our patients. Our aim is to achieve 100% success. As such, it is imperative to inculcate the goal of palliative care to all grades of health care personnel. ‘To cure sometimes, To relieve often, To comfort always’ should not be mere words.

Objective: Access to cancer drugs is a public health concern in low and middle-income countries. In Cameroon, the National Cancer Control Programme (NCCP) faces various obstacles to ensure accessibility of cancer drugs. This research aims to analyse the strategies implemented by the NCCP to ensure drugs selection and supply chain management,and obstacles encountered at the central level. Methodology: A qualitative cross-sectional situational analysis was carried out at the NCCP and the National Essential Medicines Supply Central (NEMSC)in Yaounde. For this purpose, tape-recorded interviews were conducted with key informants using two interview guides. After transcription, the verbal data were kept in a textual corpus and rendered in verbatim. The content analysis was done manually on the basis of a dimension matrix. SPSS version 20 was used to determine descriptive parameters like frequencies and means. Results: 47% of the drugs retained were part of the National list of essential medicines. The NEMSC ordered 13 princeps. Among these, 35% had generics on the market. In logistics chain management, drug needs estimation and supply planning were based on approximation. As there was no sure information trackability and coordination between actors, not ensured. Also, a monitoring and evaluation plan had not been put in place. Furthermore, the only source of funding was the Government through the annual budget line. Limited financial resources allocated to supply was the main bottle neck, due to the high cost of the therapies and the ever-increasing demand. This resulted in a long stock-out(up to 15 months) for all the drugs and complete unavailability for others, like morphine, despite its great palliative care demand. Conclusion: There are many challenges around cancer drugs accessibility in Cameroon. Therefore it is an urgent need to strengthen drug provision services within the NCCP. Peer Review History: Received: 4 September 2021; Revised: 10 October; Accepted: 4 October, Available online: 15 November 2021 Academic Editor: Dr. Ali Abdullah Al-yahawi, Al-Razi university, Department of Pharmacy, Yemen, alyahawipharm@yahoo.com UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file: Reviewer's Comments: Average Peer review marks at initial stage: 5.5/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, amaka_mgbahurike@yahoo.com Dr. Muhammad Zahid Iqbal, AIMST University, Malaysia, drmmziqbal@gmail.com Similar Articles: EVALUATION OF CURRENT SCENARIO OF CANCER DISEASE AT CHATTAGRAM IN BANGLADESH TREATMENT OF PATIENTS WITH ADVANCED CANCER FOLLOWING CHEMOTHERAPY AND TRADITIONAL MEDICINE - LONG TERM FOLLOW UP OF 75 CASES

Abstract Focus and outcomes for participants Rationale for the symposium, including for its inclusion in the Congress Cervical cancer, caused by persistent infection with oncogenic human papillomavirus (HPV), is one of the most preventable and treatable forms of cancer, yet more than 300,000 women die from the disease annually and over 500,000 cases are diagnosed. Modelling has shown that effective integration of HPV immunization programmes, HPV-based screening, and access to high-quality cancer treatment and palliative care services has the potential to eliminate cervical cancer in most countries in the world over the next century. In 2018, the Director-General of WHO made a global call to action for the elimination of cervical cancer as a public health problem. As a result, WHO has developed a global strategy towards eliminating cervical cancer as a public health problem due for endorsement at the World Health Assembly in May 2020, which proposes an elimination threshold of four cases per 100 000 women and includes 2030 triple-intervention coverage targets for scale-up of HPV vaccination of 90%, twice-lifetime cervical screening of 70%, and treatment of pre-invasive lesions and invasive cancer of 90%. As the first country to establish a national HPV immunization programme and one of the first countries to move to an HPV based screening programme, Australia has played a leading role in the global battle against cervical cancer and is on course to eliminate the disease within the next decade. However, while the burden of disease and the highest mortality from cervical cancer occur in lower income countries, factors such as the inequitable cervical cancer burden in Indigenous populations and vaccine hesitancy mean that significant barriers to the elimination of cervical cancer also exists within high-income countries. This session will have seven experts working in four countries within the Asia Pacific region. By sharing experiences and providing evidence-based guidance on key technical and strategic issues, we hope to generate a comprehensive understanding and new knowledge on factors impacting participation in, and the potential for effective scale up of, cervical cancer control programmes within the region. Presentation program Names of presenters -Dr Kate Simms is a Postdoctoral Research Fellow at Cancer Council NSW, Australia. Her research focusses on modelling the impact of HPV vaccination and cervical cancer screening across a range of settings, including predictions for the potential elimination of cervical cancer across 181 countries. -Associate Professor Julia Brotherton is a public health physician and Medical Director of VCS Population Health. She is involved in research and policy development informing the implementation and evaluation of HPV vaccination programs in Australia and is member of the WHO Director General's Expert Advisory Group on Cervical Cancer Elimination. -Assistant Professor Sharon Hanley is a cancer epidemiologist at Hokkaido University, Japan. Her research interests include HPV vaccine hesitancy and HPV self-sampling to increase cervical screening uptake in never/under screened Japanese women. - Associate Professor Lisa Whop is an Indigenous Senior Research Fellow at the Australian National University, Canberra, Australia. Her research focuses on improving health outcomes for Aboriginal and Torres Strait Islander people with cancer, with a key focus on equity. - Dr Megan Smith is a Postdoctoral Research Fellow whose research focuses on optimizing and successfully implementing cervical cancer prevention, at the population level and in different population subgroups. She has contributed to a large number of reports to government, including several evaluations that have directly informed policy in Australia, New Zealand and England. -Professor Andrew Vallely is a clinical epidemiologist at the Kirby Institute, University of New South Wales, Australia. He recently completed a field evaluation comparing point-of-care Xpert HPV testing using self-collected specimens with visual inspection of the cervix with acetic acid (VIA), to detect high-grade cervical disease. - Professor Woo Yin Ling is a Consultant Obstetrician and Gynaecologist at the University of Malaya. She is the programme designer of Project ROSE (Removal of Obstacles to Cervical Screening), a novel cervical screening research programme which employs HPV self-sampling and digital technology to increase access to cervical screening in Malaysia. Names of facilitator or chair Assistant Professor Sharon J.B. Hanley, Hokkaido University and Professor John Kaldor, Kirby Institute, University of New South Wales?