Provision Of Relief Research Articles

The ‘STRICT’ framework for promoting effective malaria control in Ghana

Abstract Background Malaria remains a significant public health burden, necessitating evidence-based strategies to reduce prevalence and associated morbidity. This study explores the potential of integrated healthcare, encompassing both modern and traditional herbal medicine (THM), for malaria control in Ghana. Methods Employing a qualitative approach, semi-structured interviews were conducted with medical doctors, pharmacists, and THM providers. Thematic analysis approach was utilized to inductively analyse interview data and integrate participants’ lived experiences and suggestions. Results Six themes emerged: Standardization of THM practice; Training on THM broadened; Research on THM expanded; Increasing awareness of THM integration hospitals and inclusion of THM in national health insurance scheme; Constant supply of certified herbal medications; and Tax relief provision. These recommendations form the ‘STRICT’ framework for developing functional health system for promoting an effective malaria control through integrated healthcare in Ghana. Conclusion It was evident that the ‘STRICT’ framework can potentially transform healthcare delivery and improve service quality for malaria patients. Policymakers, healthcare providers, and managers can utilize these insights to advocate for and implement integrated healthcare strategies, ultimately enhancing service delivery for all Ghanaians, particularly those suffering from malaria.

Consensus Statement on Pain Management for Pregnant Patients with Opioid-Use Disorder from the Society for Obstetric Anesthesia and Perinatology, Society for Maternal-Fetal Medicine, and American Society of Regional Anesthesia and Pain Medicine.

Pain management in pregnant and postpartum people with an opioid-use disorder (OUD) requires a balance between risks associated with opioid tolerance, including withdrawal or return to opioid use, considerations around social needs of the maternal-infant dyad, and the provision of adequate pain relief for the birth episode that is often characterized as the worst pain a person will experience in their lifetime. This multidisciplinary consensus statement between the Society for Obstetric Anesthesia and Perinatology (SOAP), Society for Maternal-Fetal Medicine (SMFM), and American Society of Regional Anesthesia and Pain Medicine (ASRA) provides a framework for pain management in obstetric patients with OUD. The purpose of this consensus statement is to provide practical and evidence-based recommendations and is targeted to health care providers in obstetrics and anesthesiology. The statement is focused on prenatal optimization of pain management, labor analgesia, and postvaginal delivery pain management, and postcesarean delivery pain management. Topics include a discussion of nonpharmacologic and pharmacologic options for pain management, medication management for OUD (eg, buprenorphine, methadone), considerations regarding urine drug testing, and other social aspects of care for maternal-infant dyads, as well as a review of current practices. The authors provide evidence-based recommendations to optimize pain management while reducing risks and complications associated with OUD in the peripartum period. Ultimately, this multidisciplinary consensus statement provides practical and concise clinical guidance to optimize pain management for people with OUD in the context of pregnancy to improve maternal and perinatal outcomes.

A Case for the Need to Improve the Unilateral Double Taxation Relief for Estate Duty in South Africa

This article aims to address a specific problem statement, namely how the unilateral relief under the Estate Duty Act can be enhanced to alleviate the potential hardship of double estate taxation on cross-border estates. Double taxation is a common occurrence when a person owns properties in more than one country, which become part of their estate at the time of death and liable for estate tax. The limited estate tax treaty network causes countries to reconsider their unilateral relief provisions under their domestic legislation. South Africa faces the same challenge under the Estate Duty Act. This article highlights the areas where clarity is needed in relation to the type of foreign death duty that may qualify for tax relief, such as the scope of qualifying foreign property, the exchange rate applicable and the date on which the conversion should be done, as well as the limitations and conditions of the unilateral relief available under the Estate Duty Act. Insights are provided that could be considered for possible amendments to the Estate Duty Act to provide greater clarity and certainty in calculating the estate duty liability payable in South Africa.

Pain Relief Interventions in Australian Livestock Husbandry: A Review of Animal Welfare and Pain Duration.

In veterinary medicine and livestock production, ensuring good animal husbandry is vital for the physical and emotional wellbeing of animals under our care. Pain poses challenges for assessment and mitigation, especially in species unable to express pain overtly. This review examines current pain mitigation interventions in routine husbandry, focuses on the duration of pain after procedures and implications for animal welfare. Pain behaviours have been observed for days or weeks after regular husbandry procedures, and many studies have noted pain-related behaviour persisting until study finalisation, suggesting potential undocumented pain beyond study completion. Current products registered in Australia for pain mitigation in livestock primarily target immediate pain associated with procedures. The future of pain relief in livestock demands longer-acting solutions to address post-procedural pain adequately. Providing pain relief for at least 72 h post surgery is recommended, but current products require retreatment intervals to achieve this, posing practical challenges, especially in livestock. Methods of pain relief provision, such as voluntary consumption of medicated feed, transdermal medication delivery and long-acting formulations offer potential solutions for prolonged pain relief, with research ongoing in these areas. There is a need for further research and development of longer-acting pain relief to ensure optimal welfare of livestock.

Effects of Interventions on Household Food Security in Ilchamus Ward, Marigat Sub-county, Kenya

Widespread hunger and malnutrition persist today despite considerable growth in per capita food availability. This has prompted an evolving conceptualization of food security and of mechanisms to attain and maintain food security. Government and Non-governmental organizations are shifting from food relief provisions to diversification intervention strategies at the household level. However, there has been limited literature, especially from a sociological perspective, on the effects of effects of interventions on household food security. The study adopted the descriptive research design, where household experiences were documented using a structured questionnaire. A proportionate stratified sampling method was used to divide the sample of 170 households into 4 locations. The obtained data was analyzed using SPSS v25.0, and the findings were reported using descriptive statistics, including frequencies and percentages presented in tables and charts. The results show that interventions are on nutrition, health, sanitation, education and local knowledge as ways of improving household food security. The study recommends that apart from providing food relief responses, the government, together with food provision stakeholders, should lay out sustainable food policies, implement them, and conduct capacity building with the farmers by arranging and conducting training seminars and sessions to equip the community with appropriate household food security information.

Using Natural Language Processing to Explore Social Media Opinions on Food Security: Sentiment Analysis and Topic Modeling Study.

Social media has the potential to be of great value in understanding patterns in public health using large-scale analysis approaches (eg, data science and natural language processing [NLP]), 2 of which have been used in public health: sentiment analysis and topic modeling; however, their use in the area of food security and public health nutrition is limited. This study aims to explore the potential use of NLP tools to gather insights from real-world social media data on the public health issue of food security. A search strategy for obtaining tweets was developed using food security terms. Tweets were collected using the Twitter application programming interface from January 1, 2019, to December 31, 2021, filtered for Australia-based users only. Sentiment analysis of the tweets was performed using the Valence Aware Dictionary and Sentiment Reasoner. Topic modeling exploring the content of tweets was conducted using latent Dirichlet allocation with BigML (BigML, Inc). Sentiment, topic, and engagement (the sum of likes, retweets, quotations, and replies) were compared across years. In total, 38,070 tweets were collected from 14,880 Twitter users. Overall, the sentiment when discussing food security was positive, although this varied across the 3 years. Positive sentiment remained higher during the COVID-19 lockdown periods in Australia. The topic model contained 10 topics (in order from highest to lowest probability in the data set): "Global production," "Food insecurity and health," "Use of food banks," "Giving to food banks," "Family poverty," "Food relief provision," "Global food insecurity," "Climate change," "Australian food insecurity," and "Human rights." The topic "Giving to food banks," which focused on support and donation, had the highest proportion of positive sentiment, and "Global food insecurity," which covered food insecurity prevalence worldwide, had the highest proportion of negative sentiment. When compared with news, there were some events, such as COVID-19 support payment introduction and bushfires across Australia, that were associated with high periods of positive or negative sentiment. Topics related to food insecurity prevalence, poverty, and food relief in Australia were not consistently more prominent during the COVID-19 pandemic than before the pandemic. Negative tweets received substantially higher engagement across 2019 and 2020. There was no clear relationship between topics that were more likely to be positive or negative and have higher or lower engagement, indicating that the identified topics are discrete issues. In this study, we demonstrated the potential use of sentiment analysis and topic modeling to explore evolution in conversations on food security using social media data. Future use of NLP in food security requires the context of and interpretation by public health experts and the use of broader data sets, with the potential to track dimensions or events related to food security to inform evidence-based decision-making in this area.

Initial Experiences With Integration of Palliative Medicine and Specialist Pain Services in a Tertiary Cancer Care Center in India

Pain management constitutes a pivotal aspect of palliative care. Certain instances of distressing pain are significantly relieved through interventional pain methodologies, demanding the expertise of pain specialists. Our perspective revolves around the integration of these 2 facets, envisaging a symbiotic relationship that could enhance patient outcomes. A prospective assessment was carried out within a collaborative clinic, uniting the realms of pain management and palliative medicine. Anonymized patient information was scrutinized to grasp the advantages of this amalgamation and identify strategies to address any inherent deficiencies. Furthermore, an illustrative case study was delineated, spotlighting the collaborative dynamics at a systemic level. During the period spanning from November 2020 to June 2021, a total of 43 patients received consultations at this collaborative clinic. Each patient was exposed to a comprehensive pain management regimen, with the most frequently conducted procedure being an intercostal nerve block, which was administered in 9.30% of cases. For the provision of effective pain relief within the palliative care context, the confluence of joint consultations from cancer pain specialists emerges as a requisite measure. This approach carries the promise of optimizing pain control and augmenting the quality of palliative care.

The Role and Responsibility of Third Parties in Provisional Relief in International Commercial Arbitration: A Critical Review

The Role and Responsibility of Third Parties in Provisional Relief in International Commercial Arbitration: A Critical Review

Minding the gap: China contesting norms for public debt management?

This article addresses the questions of whether, to what extent, and how China contests the norms and practices for public debt management in developing countries as currently preferred by the Group of Seven (G7) and G7-led multilateral institutions. More specifically, it considers three norms: debt sustainability, debt transparency and conditional debt relief. To that end, I elaborate a norm contestation typology and apply it to analyse how China discursively contests these norms. Equally, I contrast China’s rhetoric with its actual behaviours. Two findings emerge from the analysis. First, there are notable efforts by China to contest the three norms, with Chinese officials emphasising a qualitatively distinct understanding of debt sustainability and debt transparency and the appropriateness of non-conditionality and equality in the provision of debt relief. Second, there is an apparent disjunction between China’s words and actions, with its actual lending and debt relief practices (becoming) more aligned with what is currently preferred or advocated by the established actors.

EFFECTIVENESS OF KALTENBORN MOBILIZATION TECHNIQUE VERSUS CONVENTIONAL EXERCISE FOR SUBJECTS WITH CERVICAL SPONDYLOSIS

BACKGROUND & AIM: The application of joint mobilization to the upper thoracic spine has been reported to have an positive effect, sometimes immediately, on cervical spine dysfunction, in conjunction with the provision of pain relief. However, previous including joint mobilization, have been ineffective in a busy clinical setting because they involve the direct and passive intervention of therapists. So the purpose of this study is to evaluate the effectiveness of kaltenborn mobilization technique among cervical spondylosis. OBJECTIVE: • To determine the effectiveness of kaltenborn mobilization technique on reducing pain by using VAS • To evaluate the effectiveness of kaltenborn mobilization technique on improving cervical spine range of motion (ROM) by using goniometer. METHOD: STUDY DESIGN: experimental study SAMPLING TECHNIQUE: Convenient sampling technique SAMPLE SIZE: 30 RESULT: Statistical study revealed that among 30 individuals, The test shows that the subjects received kaltenborn mobilization along with interferential therapy have improved reduction in pain and increased in ROM among cervical spondylosis. CONCLUSION: From this results it has been concluded that there was a definite and positive effect of Kaltenborn mobilization technique along with Interferential therapy for cervical spondylosis patients. KEYWORDS: kaltenborn mobilization, goniometer, cervical spondylosis, isometric exercises.

A Network of Contacts: Metropolitan Influences in the Delivery of Poor Relief in the London Hinterland (1778–1785)

Existing studies of poor relief have focused on parishes either metropolitan or wholly rural, whereas the focus of this article is on the distinctive experience of Battersea, a village in the London hinterland. Although the village suffered from the rising cost of poor relief experienced nationwide at the end of the eighteenth century, this article argues that the response of its vestry was shaped by Battersea’s liminal location. Consideration is given to the central role that the workhouse played in the provision of poor relief, and demonstrating that the social networks of parochial leaders were key to the development of policy. Many of the vestry members had commercial and professional interests in the metropolis and elsewhere, and these, together with their patronage of London charitable institutions, helped both to shape their response to the problems of poverty that they encountered, and influenced their administration of the Battersea workhouse.

Completion of the Emergency Department "Big 6" in Patients with an Acute Hip Fracture Is Associated with a Lower Mortality Risk and Shorter Length of Hospital Stay.

The aims of this study were to assess whether completion of the emergency department (ED) Big 6 interventions (provision of pain relief, screening for delirium, early warning score (EWS) system, full blood investigation and electrocardiogram, intravenous fluids therapy, and pressure area care) in those presenting with an acute hip fracture were associated with mortality risk and length of acute hospital stay. A retrospective cohort study was undertaken. All patients aged ≥50 years that were admitted with a hip fracture via the ED at a single centre during a 42-month period were included. A total of 3613 patients (mean age 80.9; 71% female) were included. The mean follow up was 607 (range 240 to 1542) days. A total of 1180 (32.7%) patients had all six components completed. Pain relief (90.8%) was the most frequently completed component and pressure area assessment (57.6%) was the least. Completion of each of the individual Big 6 components, except for pressure areas assessment, were associated with a significantly (p ≤ 0.041) lower mortality risk at the 90-days, one-year and final follow-up. The completion of all components of the Big 6 was associated with a significantly (2.4 hours, p = 0.002) shorter time to theatre. Increasing number of Big 6 components completed were independently associated with a lower mortality risk: when all six were completed, the hazard ratio was 0.64 (95% CI 0.52 to 0.78, p < 0.001). Completion of an increasing number of Big 6 components was independently associated with shorter length of hospital stay and completion of all six was associated with a 2.3 (95% CI 0.9 to 3.8)-day shorter acute stay. The findings provide an evidence base to support the ongoing use of the Big 6 in the ED.

Comparison of the Efficacy of Opioid-Free Anesthesia With Conventional Opioid-Based Anesthesia for Nasal Surgeries - A Prospective Randomized Parallel Arm Triple-Blinded Study.

Introduction In the setting of nasal surgeries, the use of opioid-free anesthesia involving the use ofdexmedetomidine,and lignocaine is being investigated as a potential alternative to opioids. This combination of drugs provides sympatholysis, pain relief, and sedative properties, thereby aiming at reducing the negative effects commonly associated with opioid usage. The objective of this study is to evaluate and compare the effectiveness of opioid-free anesthesia using dexmedetomidineand lignocaineversus conventional opioid anesthesia with fentanylfor nasal surgeries. The comparison will be based on the primary outcome of postoperative visual analog scale(VAS) scores. Secondary outcomes assessed were the amount of rescue analgesic consumption, intraoperative sevoflurane usage, intraoperative blood loss, hemodynamic stability, postoperative nausea and vomiting (PONV) scores, and postoperative Ramsay Sedation Scores. Methods A triple-blind, prospective, randomized, parallel arm study in which 48 patients planned for elective nasal surgery were allocated randomly to one of two groups. In the study, the population labeled as Group D, comprising 24 participants, received dexmedetomidine at a dosage of 1 mcg.kg-1 via intravenous infusion lasting for a duration of 10 minutes prior to the induction of anesthesia. This was followed by a continuous infusion of 0.6 mcg.kg-1 h-1 throughout the intraoperative period, and intravenous Lignocaine 1.5 mg.kg-1 was administered three minutes prior to induction, subsequently an intraoperative infusion of 1.5 mg.kg-1 h-1. In Group F, consisting of 24 participants,intravenous fentanyl of 2 mcg.kg-1was administered three minutes before the induction. This was subsequently followed by a fentanyl infusion of 0.5 mcg.kg-1h-1in the intraoperative period. Results The study findings indicate that Group D had considerably lower postoperative VAS scores from 30 minutes to two hours compared to Group F (p<0.05). The utilization of sevoflurane during the intraoperative period was comparatively reduced in Group D in order to achieve the desired bispectral index (BIS) range of 40-60 (p<0.01). Mean intraoperative blood loss was also lower in Group D (85 ml) compared to Group F (115 ml )(p<0.01). Additionally, Group D had significantly lower rescue analgesic consumption and lower incidence of PONV up to 60 minutes compared to Group F (P-value <0.01).A statistically significant difference was observed between Group D and Group F in terms of lower mean values of both mean arterial pressure (MAP) and heart rate in Group D(p<0.01). The results indicate that the postoperative sedation scores within the first two hours were significantly greater in Group D compared to Group F(p<0.01). Conclusion The usage of opioid-free anesthesia has been found to be superior to a traditional opioid-based approach in various aspects, including the provision of sufficient pain relief after surgery, maintenance of stable hemodynamics during the operation, and reduction in occurrences of postoperative nausea and vomiting.

Selected Nutrition and Management Strategies in Suckling Pigs to Improve Post-Weaning Outcomes.

Weaning is a critical period in a pig's life. Piglets are confronted with abrupt changes to their physical and social environment, as well as management and nutritional changes. Weaning has always been associated with a growth check and is frequently accompanied by post-weaning diarrhoea in piglets. However, rapid increases in litter size in the last decade have increased within-litter piglet weight variation, with piglets now generally lighter at weaning, making the challenges associated with weaning even greater. Many interventions can be employed during the suckling period to ease the weaning transition for piglets. Pre-weaning strategies such as supervised farrowing (assistance with suckling and oxytocin provision), the provision of pain relief to sows around farrowing, split-suckling, early oral supplementation with glucose, bovine colostrum, faecal microbiota transplantation, feed additives and solid and liquid creep feeding (milk and liquid feed) have all been investigated. The objective of these strategies is to stimulate earlier maturation of the digestive tract, improve immunity, reduce latency to the first feed post-weaning and increase early post-weaning feed intake and growth. This review focuses in particular on: (1) pain relief provision to sows around farrowing, (2)split-suckling of piglets, (3) pre-weaning provision of supplementary milk and/or liquid feed, (4) other strategies to stimulate earlier enzyme production (e.g., enzyme supplementation), (5) other nutritional strategies to promote improved gut structure and function (e.g., L-glutamine supplementation), and (6) other strategies to modulate gut microbiota (e.g., probiotics and prebiotics). Correctly implementing these strategies can, not only increase post-weaning growth and reduce mortality, but also maximise lifetime growth in pigs.

The inclusiveness of China’s development finance: China’s hybrid approach to aid and poverty reduction in Africa

Recent years have seen China emerging as a new donor outside of the West’s club of traditional donors, seeking to fill the financing gap for the Sustainable Development Goals (SDGs). The Chinese government has adopted a hybrid approach to international aid, in which it supplies trade credit and other types of loans to underdeveloped countries through its policy banks and state-owned enterprises in addition to traditional aid. As such a hybrid approach is considered more market-oriented than traditional donors, much of the literature on it has focused on its impact on economic growth rather than on social welfare and poverty reduction. It is critical to note, however, that in reality, the Chinese government has long-valued poverty reduction as a priority of the SDGs, regardless of the context of domestic governance or international aid. Therefore, this article used the panel data of African countries between 2000 and 2016 to test the relationship between China’s development finance and its corresponding poverty-reduction effect in Africa. Empirical results shown that China’s hybrid approach reduced poverty in Africa, particularly in poorer sub-Saharan countries and “heavily indebted poor countries.” Further, in a similar vein to China’s domestic inclusive-growth model, its poverty reduction in Africa tended to be achieved indirectly through production sectors rather than directly through the provision of social relief.

THE ROLE OF ARTIFICIAL INTELLIGENCE IN HEALTHCARE: APPLICATIONS AND CHALLENGES AFTER COVID-19

The COVID-19 outbreak served as a stark reminder that the global community is not fully prepared for pandemics. In order to effectively deal with potential future health risks, such as diseases that might be more lethal and widespread than COVID-19, strong and adaptable health systems will need to be built. The provision of relief by the government in the form of aid for healthcare and contingency planning becomes a source of delight in light of the insights gained from the present predicament. The advancement of general healthcare as well as the identification and control of epidemics might benefit significantly from the use of AI. The use of artificial intelligence (AI) in healthcare has expanded more rapidly in recent years as a direct result of the pandemic; yet, there are still a great number of challenging issues that need to be handled before the approaches can be used in real-world contexts. It is imperative that the World Health Organization's Department of Health Research and Technology, which is in charge of digitizing COVID-19, be established in order to provide assistance to nations whose levels of digital development differ greatly. The World Health Organization (WHO) is dedicated to assisting nations in the use of these cutting-edge technologies in order to improve the ability of health systems to respond to outbreaks and prevent future ones.

Quoi qu’il en coûte : prêts alimentaires et aide aux victimes de la famine dans l’Empire russe tardif

Late Tsarist Russia commanded a unique system of famine relief that provided food aid on credit. No other state operationalized debts this copiously in order to prevent its populace from starving. The article analyses the hunger relief operation between 1891 and 1893, examining why the Russian Empire resorted to food loans as the major tool to counter the threat of famine. It shows how it worked and to what extent it actually provided relief. It demonstrates how the Russian government was structurally and culturally dependent on this cost ineffective and provisional relief system that neither by design nor by name was supposed to be humanitarian but in essence saved millions of lives. It shows how on the one hand cultural fears of peasant indebtedness and unproductiveness stalled relief efforts while on the other hand these very fears prompted the state to turn loans into donations. The autocracy systematically addressed social needs – by balancing humanitarianism and financial accountability.

Bureaucratic Representation and State Responsiveness during Times of Crisis: The 1918 Pandemic in India

AbstractI combine personnel records with vital statistics for 1910 to 1925 to study how bureaucratic representation affected mortality in 1,271 Indian towns during the 1918 influenza pandemic. Exploiting the rotation of senior colonial officers across districts and a cross-border comparison, towns headed by Indian (as opposed to British) district officers experienced 15 percentage points lower deaths. The lower mortality effects extended beyond the urban areas and coincided with greater responsiveness in relief provision. Bureaucratic representation can thus be a powerful way to increase state responsiveness during times of crisis.

Comparison of different delivery modalities of epidural analgesia and intravenous analgesia in labour: a systematic review and network meta-analysis.

In labour, neuraxial analgesia is the standard in the provision of pain relief. However, the optimal mode of delivering epidural solution has not been determined, and some parturients may need an alternative to epidural analgesia. We sought to conduct a systematic review and network meta-analysis to compare continuous epidural infusion (CEI), programmed intermittent epidural bolus (PIEB), computer-integrated CEI, computer-integrated PIEB, patient-controlled epidural bolus (PCEA), fentanyl patient-controlled analgesia (PCA), and remifentanil PCA, either alone or in combination. We searched CENTRAL, CINAHL, Ovid Embase, Ovid Medline, and Web of Science for randomized controlled trials that included nulliparous and/or multiparous parturients in spontaneous or induced labour. The maintenance epidural solution had to include a low concentration local anesthetic and an opioid. Specific subgroups in the obstetric population such as preeclampsia were excluded. Network meta-analysis was performed with a frequentist method, and continuous and dichotomous outcomes are presented as mean differences and odds ratios, respectively, with 95% confidence intervals. Overall, 73 trials were included. For the first coprimary outcome, the need for rescue analgesia, CEI was inferior to PIEB and PIEB + PCEA was superior to PCEA alone, with a low certainty of evidence given the presence of serious limitations and imprecision. The second coprimary outcome, the maternal satisfaction, was improved by PIEB + PCEA compared with CEI + PCEA and PCEA alone, with a low quality of evidence in view of the presence of serious limitations and imprecision. Fentanyl PCA increased the requirement for rescue analgesia and decreased maternal satisfaction relative to many methods of delivering epidural solution. In terms of secondary outcomes, PIEB increased analgesic efficacy compared with CEI, and PCEA reduced local anesthetic consumption at the expense of inferior analgesia relative to CEI and PIEB. PIEB+PCEA was superior to CEI+PCEA in regard to the pain score at 2h and 4h, consumption of local anesthetic, incidence of lower lower limb motor blockade and the rate of spontaneous vaginal delivery. Fentanyl and remifentanil PCA did not provide the same level of analgesia as all epidural methods, resulted in increasing analgesic ineffectiveness with time spent in labour, and predisposed to a higher incidence of side effects such as nausea and/or vomiting and sedation. Remifentanil PCA was superior to fentanyl PCA for analgesia at an early time point, and it increased the incidence of oxygen desaturation relative to other strategies of delivering epidural solution. Opioid PCA did not provide the same level of analgesia as epidural methods with a higher incidence of side effects. We interpret the findings of our systematic review and network meta-analysis as suggesting PIEB + PCEA to be the optimal delivery mode of epidural solution. Nevertheless, the potential differing importance of the various maternal, fetal, and neonatal outcomes in determining which is optimal has not, to our knowledge, been elucidated yet. PROSPERO (CRD42021254978); registered 27 May 2021.

Misery of cancer pain

Cancer is one of the major causes of mortality and morbidity in the world. Pain is the most debilitating and exhausting symptom of the cancer. It also has deep and intense impact on patient’s quality of life. In advanced stages of cancer, the incidence of pain approaches up to 70–80%. Cancer pain can be effectively treated by expert hands. Strong opioids are the mainstay in the WHO analgesic ladder, specifically for cancer pain patients. Unfortunately, in most of the developing countries patients with cancer pain remains under-treated because of the non-availability of strong opioids. This situation is a real challenge for a pain physician. Regardless of all the knowledge and skill, provision of effective pain relief becomes an uphill task. This editorial is an attempt to highlight the plight of the cancer pain patients and the frustration of the treating physicians. We need to strengthen and upgrade our policies and protocols to provide comfort to cancer patients.&#x0D; Key words: Cancer pain; Pain Management; WHO Guidelines; Opioids.&#x0D; Citation: Mushtaq S, Waheed H, Ghafoor AUR, Bashir K. The misery of cancer pain. Anaesth. pain intensive care 2022;27(1):03−05; DOI: 10.35975/apic.v27i1.2130&#x0D; Received: December 13, 2022; Accepted: December 24, 2022