PurposeProviding appropriate information to patients about their illness helps them to cope with the diagnosis. Shared decision making is a key concept in managing patients with cancer. There are no data available about the desire for information and preference for participation in treatment decisions among Indian patients with cancer. The objective of this study was to estimate the proportion of patients who have information needs and to study the patient preference for participation in treatment decisions and the factors associated with them.MethodsA cross-sectional survey was conducted among patients with cancer older than 18 years. They were interviewed with a questionnaire after signing an informed consent. The association of sex, educational level, residence, diagnosis (type of cancer), Eastern Cooperative Oncology Group performance status, and treatment status with information needs and decision-making preference was analyzed using χ2 testResultsApproximately 81% of patients said that they had an absolute need to know if the illness was cancer, and > 70% of patients either had an absolute need to know or would like to know about the prognosis, treatment options, and adverse effects. Regarding the decision-making preferences, 97% wanted their treating physicians to make the decision regarding their treatment, and 66% preferred to share decision making with their family.ConclusionThe majority of the patients with cancer expressed a need for knowing whether they had cancer. When it comes to treatment decisions, most of them preferred a passive role, and the majority wanted to involve their families in the decision-making process. We recommend that the treating physician should elicit the patient’s preference in participating in treatment decisions and their preference about involving their family in making treatment decisions
Laparoscopy-assisted TAP block is faster and equally efficacious when compared with USG-guided block and has a definite role in centers where ultrasound is not available in operating rooms.
Gastric lipomas are rare benign tumours of the stomach, representing less than 3% of all benign gastric neoplasms. They are usually asymptomatic but larger lesions can present with abdominal pain, gastric outlet obstruction and haematemesis. Malignant transformation is extremely rare. Accurate preoperative diagnosis can be established with computed tomography. Being benign, extensive surgery is not necessary and simple excision of the lesion is adequate. Small asymptomatic lesions can be followed up. We present a case of 80-year-old woman with gastric submucosal lipoma who presented with haematemesis.
Internal hernias are a rare cause of intestinal obstruction. Among the internal hernias, left paraduodenal hernia is the most typical type followed by the right paraduodenal hernia. It is impossible to make a clinical diagnosis of internal hernia, as there are no specific symptoms or physical signs. A high degree of suspicion is required, and an accurate diagnosis can be made using cross-sectional imaging of the abdomen like a Computed Tomography (CT) scan or Magnetic Resonance Imaging (MRI) scan. In this case report, we present our experience in managing a patient who had a right paraduodenal hernia with small bowel strangulation. We present this case report to highlight the importance of considering internal hernias like right paraduodenal hernia in the differential diagnosis of intestinal obstruction.
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