Detailed Study on Pattern of Cancer Pain in Patients Admitted at a Tertiary Care Centre in Northern India- A Prospective Observational Study | Chapter 1 | Innovations in Medicine and Medical Research Vol.2

Aims: Pain being the commonest symptom in cancer, its prevalence and pattern needs to be studied. The aim of this study was to evaluate the prevalence and pattern of cancer pain in admitted patients. Study Design: Prospective observational study. Place and Duration of Study: This study was carried out at Cancer Research Institute, Swami Rama Himalayan University, Dehradun, India, between January 2018 and April 2018. Methodology: After institutional ethical clearance and written informed consent 393 patients were enrolled in the study. We prospectively evaluated patients admitted with diagnosis of cancer for presence, severity and pattern of pain, using clinical assessment and numerical pain scale at admission and at discharge. Chi-square test was used for categorical data and multivariate analysis was performed with multinominal regression and ANNOVA tests. Results: In 393 patients prevalence of pain, moderate-severe pain, neuropathic pain (NPP), mixed pain was 67%, 47.8%, 10.2% and 31.9% respectively. More than one pain site was present in 43% of patients. The median numerical pain score was 2 overall, 4 in patients with pain and 7 in patients with NPP or mixed pain. Prevalence of severe pain and NPP or mixed pain was highest in hepatobilliary, lung, head and neck and genitourinary cancers. As many as 42.97% (113/263) patients had more than one pain site. On multivariate analysis severity of pain was significantly associated with primary tumor site (P=0.002), NPP (P=0.000), number of metastatic sites (P=0.02) and number of pain sites (P=0.009); NPP with primary tumor site (P=0.000), number of pain sites (P=0.000) and severity of pain (P=0.014). The proportion of patients with moderate-severe pain reduced from 47.8% before admission to 10.7% at discharge with adequate analgesic management. Conclusion: The prevalence of cancer pain and moderate-severe pain is high in admitted patients. Various patient, disease and pain variables need to be considered for an adequate cancer pain assessment and management. Team approach with active participation of primary medical team, adjunct support from palliative care specialist is desirable for cancer pain management.

Author (s) Details

Anshika Arora,
Department of Surgery, Cancer Research Institute, Himalayan Institute of Medical Sciences, SRHU, Dehradun, Uttarakhand, India.

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Genetic Variability of Sugarcane Clones as Affected by Major Endemic Diseases in Ferké, Northern Ivory Coast | Chapter 08 | Advances and Trends in Agricultural Sciences Vol. 1

Background: Sugarcane is a major commercial crop grown in tropical and subtropical areas of the world, including West and Central Africa. Across this region, smut, leaf scald and pokkah boeng are considered as endemic diseases, the first two being economically important.

Aims: The overall objective of study was to contribute to sugarcane yield improvement in Ivory Coast. The specific objective was to evaluate the diversity of susceptible sugarcane genotypes mainly in first ratoon crop to three major endemic diseases under natural infection, namely leaf scald, smut and pokkah boeng.

Methodology: The study was carried out over 2 seasons (2016-18) as plant and first ratoon cane at Ferké 1 experimental station under full covering sprinkler irrigation in northern Ivory Coast. Treatments were composed of 863 sugarcane genotypes split into 39 families planted at single row density. Planting was done per genotype in rows of 3 m long depending on families, without replication and compared to the check variety SP70/1006. That check was replicated every five rows to ease comparison with the clones. Phytosanitary observations regarding the three endemic diseases made at the age of five months were subjected to a series of multivariate analyses.

Results: The study showed that most relevant diseases determining the diversity of susceptible sugarcane genotypes were, in descending order, pokkah boeng, smut and leaf scald. Increase in clone infestations on first ratoon cane compared with plant cane was observed regarding the three endemic diseases but more importantly for smut by 51%. The dendrogram deduced from cluster analysis showed that infected genotypes were split into six groups with same families belonging often to different clusters so that no family investigated specifically susceptible or resistant to any disease was determined. In other words, each family investigated was composed of disease-free as well as susceptible genotypes in proportions varying from one family to another.

Conclusions: All families investigated were relevant to maintain the diversity required for the breeding process under way. Examples of recommended families were the following: disease-free (F02, F03, F04, F05, F06), resistant (F01, F06, F07, F08, F09), moderately resistant (F10, F11, F12, F13, F14). It came out from the study that most relevant diseases determining the diversity of susceptible sugarcane genotypes were, in descending order, pokkah boeng, smut and leaf scald. Increase in clone infestations on first ratoon cane compared with plant cane was observed regarding the three endemic diseases but more importantly for smut by 51%. Each family investigated was composed of disease-free as well as susceptible genotypes in a certain proportion which varied from one family to another. Cluster 5 was the most prolific of infected genotypes with 286 clones (33%) split into 36 families (92%) whereas clusters 2, 3 and 4 were the least prolific ones, with 42, 52 and 56 infected genotypes split into 14, 23 and 21 families, respectively. Clusters 1 and 2 were much more associated with genotypes susceptible to smut and pokkah boeng but also with genotypes moderately susceptible to pokkah boeng. Clusters 3 and 4 were associated with genotypes susceptible or highly susceptible to leaf scald. In contrast, clusters 0, 5 and 6 were related to disease-free, resistant or moderately resistant genotypes and which crosses or families would, therefore, be recommended for Ferké agro-ecology. Examples of such families were the following: disease-free (F02, F03, F04, F05, F06), resistant (F01, F06, F07, F08, F09), moderately resistant (F10, F11, F12, F13, F14).

Author  Details:

Yavo Yanick Michaël Béhou

Department of Research and Development, SucafCI/SOMDIAA, 22 Rue Des Carrossiers Treichville Zone 3, 01 P.O.Box 1967 Abidjan 01, Ivory Coast, Côte d’Ivoire and UMRI: Agricultural Sciences and Engineering, EDP/National Polytechnic Institute (INPHB), P.O.Box 1313 Yamoussoukro, Ivory Coast, Côte d’Ivoire

Crépin B. Péné

Department of Research and Development, SucafCI/SOMDIAA, 22 Rue Des Carrossiers Treichville Zone 3, 01 P.O.Box 1967 Abidjan 01, Ivory Coast, Côte d’Ivoire.

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