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Linear Accelerator Based External Beam Radiotherapy in Glomus Jugulare Tumour: A Retrospective Review from a Tertiary Cancer Hospital in Kenya

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Case Reports in Clinical Medicine 2022年第4期11卷 122-132页

作者： Vijayakumar Narayanan Asmeeta Patel james mbogo HCG-CCK Nairobi Kenya Aga khan University Hospital Nairobi Kenya Department of Clinical Oncology HCG-CCK Nairobi Kenya

Objective: Tumours originating from jugular bulb, carotid bifurcation, Vagus nerve are collectively called Paragangliomas. They are slow growing, essentially benign tumours, but can be detrimental if untreated. There is limited evidence on the effectiveness of fractionated radiotherapy in the management ofs Glomus jugulare tumours. The aim of this study is to determine the efficacy of Linear accelerator based fractionated external beam radiotherapy on unilateral inoperable Glomus jugulare paragangliomas. Method: This is a retrospective analysis of all the 12 cases of inoperable, unilateral Glomus jugulare tumours treated during the period 2011-2016 at a tertiary cancer centre in Kenya. Minimum follow up duration was 3 years. Patient characteristics, disease staging, immediate complications and therapeutic efficacy were analysed from the case files. Results: The 12 patients diagnosed with inoperable Glomus jugulare tumours reported in this period were treated with external beam radiotherapy to a tumour dose of 54 Gy in 30 fractions over a period of 6 weeks using IMRT technique in 6 MV Linear accelerator. 2/3rd of the patients were females in 5th and 6th decade of life. Onset of first symptom to initiation of treatment was found to be 1.7 years. Headache, earache, and tinnitus were the main complaints. No major side effects were recorded during therapy. Mean length of the tumour in its maximum dimension at the time of diagnosis was 4.5 cm. At the end of one-year post therapy, a mean reduction of 6.5 mm in the tumour length was observed, (Range: 0 - 15 mm). Tumour size remained static for a year and thereafter a slow growth pattern of 1mm per year was observed. Conclusion: Fractionated external beam radiotherapy is an effective and non-invasive treatment for advanced, inoperable Glomus jugulare paragangliomas. Clinical stability through tumour control was observed. Though newer radiation techniques like Cyberknife, Proton therapy offer

关键词： Glomus Jugulare Paragangliomas External Beam Radiotherapy

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Towards an Effective Communication in the Care of Patients with Long Term Disease in Kenya via Cybernetic—A Systematic Review

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Open Journal of Applied Sciences 2023年第11期13卷 2094-2126页

作者： Christopher Oyuech Otieno Martha W. Kiarie Makara Naomi N. james Grace mbogo Liyai Computer Science Daystar University Nairobi Kenya

In this paper, to effectively treat chronic disorders and improve the standard of care, effective communication between patients and healthcare professionals was essential. The aim of the study was to review the literature on how good communication might improve treatment outcomes for Kenyan patients with chronic and terminal illnesses and to determine whether Cybernetic electronic communication can improve those outcomes even more. We uncovered the history of treatment outcomes for chronic and terminal diseases in this research study, both with and without communication at the core of the patient’s care plan. We discussed the importance of good communication in the treatment of patients with chronic and terminal illnesses and why it is a momentous endeavor comparable to medical diagnosis and treatment for the long-term health of patients. To locate pertinent material for the background literature study, we carried out a comprehensive literature search. Although the preliminary literature review was a continuation of the introduction research, it also highlighted the paucity of local Kenyan literature and suggested that improved communication might help patients with chronic and terminal illnesses have better treatment outcome. Methodology maintained the literature search, as a systematic literature review focused on core of the study, making separate sections of the same body necessary. This ensured that a methodological literature search section is as comprehensive as possible. We used an integrated PRISM model to limit a comprehensive literature search and a systematic literature review design as part of the overall process. Non-probability sampling and snowball approaches on literary papers over the previous 17 years were used in this arrangement. Since this was a multidisciplinary study, the four experts who also serve as authors were chosen from within their respective fields of expertise to design the study. They created search strategies, generated key words

关键词： A Preliminary Literature Review Meta-Analysis Indigenous Cancer Palliative Care Ontology Epistemology Phenomenological Approach Effective Communication Chronic Illnesses Enhanced-Patient Care A Non-Probability Sampling A Snow Ball Technique Cybernetics

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