Optimizing quality of life: integrating palliative care for patients with hand-foot syndrome in oncology practice.

Hand-foot syndrome (HFS) emerges as one of the common dermatological side effects associated with anticancer medications such as 5-fluorouracil (5-FU), capecitabine and docetaxel. This condition can be notably debilitating, exerting a predominant impact on the clinical, functional and psychosocial domains of health. With prevalence rates of HFS, ranging from 43% to 71%, there exists an unmet need among palliative care physicians to comprehend this syndrome in addressing physical, psychological dimensions and its integrated management within healthcare. This understanding enables them to adopt diverse approaches aimed at preserving the quality of life for patients, by enhancing the overall healthcare experience. Our primary objective is to underscore the imperative for the high-quality integration of palliative care with respect to HFS in contemporary oncology practices. We aim to achieve this by providing evidence-based insights to enhance patient outcomes.The intent of this study: (1) The article delves into the range of symptoms linked to HFS, and stresses the necessity of a holistic strategy and the difference that a palliative physician can contribute during cancer treatment-in picking up certain intricate aspects of patient care and addressing them. (2) The article also highlights the comprehensive approach through the incorporation of quality-of-life assessments, with the goal of enhancing patient outcomes, overall care experience within an integrated healthcare framework.

Prolonged Indwelling Percutaneous Nephrostomy Leading to Purple Urinary Bag Syndrome in Palliative Care Setting: A Case Report.

Purple urine bag syndrome (PUBS) is a complication and a rare phenomenon associated with bacterial colonisation in bladder catheters in which urine turns purple in the tubing and the catheter bag. This condition can be distressing and panicking for the patients and their families as well as the medical staff caring for them. It is an interesting and unusual presentation that affects people with long-term indwelling catheters and chronic constipation. We report one such case in our hospital, a 73-year-old woman with stage 4 cancer of the vaginal vault, post-bilateral percutaneous nephrostomy (PCN) 4 months ago, currently on best supportive care, presented to the emergency room with symptoms of urosepsis, while a purple urine bag may appear innocuous and not need any particular care beyond replacing the catheter and giving the patient the proper antibiotics, it may indicate an occult urinary tract infection (UTI), which can have catastrophic effects in a patient using a urinary catheter for an extended period of time. Only a few examples of PUBS with an underlying nephrostomy have been documented in the literature. This is a case of a palliative care patient who had a poor prognosis despite receiving the right antibiotic treatment for an upper UTI that caused purple staining of the PCN catheter bag. Using this case report as a guide, we could manage a complex UTI in a palliative care context.

Pericapsular Nerve Group Block as an Effective Intervention for Pain Relief and Improving Functional Mobility in Cancer Patients: A Case Series.

Pericapsular nerve group block (PENG) is an ultrasound-guided regional block technique that blocks the articular branches of the femoral nerve, accessory obturator nerve and obturator nerve. These nerves richly innervate the anterior capsule of the hip joint and blocking these nerves helps in hip analgesia. PENG block is commonly used in hip fracture pain perioperatively. In this case series, we have used PENG block in cancer patients with hip pain. PENG block was given to six patients with bupivacaine and triamcinolone, out of which five patients had good pain relief and their functional mobility to activities of daily living improved.

Management of Malignant Ascites by Indwelling Tunnelled Catheters in Indian Setup: A Case Series.

Malignant Ascites (MA) poses significant symptom burden in patients with peritoneal malignancies at the end of life. Various treatment options are available and Indwelling Tunneled Catheters (ITC) have the advantage of increased patient comfort being soft on abdomen, less painful, easy to tap fluid, and less chances of infection etc. A total of 5 patients underwent insertion of ITC after proper counseling and assessment. Insertion was done in operation theatre under combined ultrasonogram and fluoroscopy guidance. Results: 4 out of 5 patients had favorable outcomes in terms of symptom free days spent at home at end of life. ITC's are a suitable option to manage symptoms in patients with terminal malignant ascites. Careful patient selection and proper education of the caregivers will increase the success rates of procedures.

Efficacy of xenon anesthesia in preventing postoperative cognitive dysfunction after cardiac and major non-cardiac surgeries in elderly patients: a topical review.

Elderly patients undergoing major cardiac and non-cardiac surgeries have a high propensity (up to 40-60%) of developing postoperative cognitive dysfunction, which are caused by patient's factors, type of surgery, intraoperative and postoperative factors. All these pose a challenge to the clinicians. The noble gas xenon does not undergo metabolism or any kind of biotransformation in the body owing to its inert nature. Xenon confers excellent hemodynamic stability and provides excellent recovery at the end of surgery. This topical review discusses advantages of xenon anesthesia in elderly patients undergoing major cardiac and non-cardiac surgeries and whether it is worth using a costly anesthetic in elderly patients for preventing postoperative cognitive dysfunction.