Annals of palliative medicine
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Two different patterns of breathlessness have been identified: chronic or continuous breathlessness and breathlessness crisis (acute, incident, episodic, breakthrough breathlessness). Meta-analysis and systematic reviews prove that opioids are beneficial in either opioid-naïve or -tolerant patients. However, data from two recent randomised controlled trials were not able to show the effectiveness of fentanyl for the relief of exertion-induced dyspnoea.
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Unrelieved neuropathic pain continues to be a substantial health problem in a cancer patient arises either due to disease itself or its treatment. Review of literature showed that neuropathic pain has high prevalence rate, greater severity and analgesic requirement with worse quality of life. Underreporting by patient and under treatment by physician is an important causative factor of indefinite persistence of neuropathic pain. ⋯ To find out the burden and estimation of resource generation of this widely recognized problem, accurate establishment of incidence, prevalence, severity, and effectiveness of treatment is quite mandatory. Complex phenomenon of neuropathic pain abolishes establishment of early diagnosis and accurate etiology of this symptom, emphasizes the need of sensitive and reliable clinical grading scale, international classification system and validated diagnostic tools that correspond with clinical assessment. Multiple studies towards this direction has been culminated and some are still going on, though the data and literature is very scant and require further research for the complete evaluation of neuropathic pain.