May 25, 2014
October 3, 2021
CGHS empanelled hospitals in NCR
Book appointment with CGHS doctor online
Go to this.
Medicine reimbursement rules
CIRCULARS REGARDING MEDICINES FROM LOCAL CHEMIST TILL 31 OCTOBER 2021
September 27, 2021
Astra Zeneca (Covidshield)
Europe stopped the Astra Zeneca vaccine (which comes here as Covishield) for people under the age of 55 years because maximum harm was seen in this younger group. Gap between two doses of the vaccine is three months for Covishield.
Johnson and Johnson vaccine has also been related with the clotting side effect, although the incidence is said to be low in both cases. This one dose vaccine is coming in November.
Bharat Biotechs Covaxin. With that clotting is not much reported. That can be considered. Gap between two doses of the vaccine is 4 weeks for Covaxin
The Russian vaccine Sputnik is another alternative. Gap between two doses of the vaccine is 3 weeks for Sputnik.
For persons with DVT
The vaccine is given Intramuscular and in a person taking blood thinners there is a small risk of formation of local hematoma or blood leakage and collection. To prevent that perhaps same precaution of missing the prior day evening dose can be applied.
September 27, 2021
September 19, 2021
This is a good summary: https://www.cancercenter.com/cancer-types/neuroendocrine-tumors/treatments
WHY INSUFFICIENT RESEARCH
“this orphan group of tumors which does not hold much interest to the pharmaceutical companies.” [Source]
Depending on the type of NET, medications that may be used include:
- Somatostatin analogs
- Targeted therapy
- Peptide receptor radionuclide therapy (PRRT) [Source]
This is a form of somatostatin treatment: From somatostatin to octreotide LAR: evolution of a somatostatin analogue
“Octreotide is a potent synthetic somatostatin analogue that has become the mainstay of medical therapy for tumor control in neuroendocrine disorders. The multiple effects of octreotide throughout the body, combined with its established safety profile, make it an appealing and reliable option for clinicians. ”
“the antiproliferative effect of octreotide LAR in patients with well-differentiated metastatic GEP-NETs of the midgut” – but this is POORLY differentiated.
“Octreotide was among the first biotherapeutic agents used in the management of GEP-NETs and continues to be a mainstay of therapy today, although it is rarely curative”
“In response to results from the PROMID study, guidelines from the National Comprehensive Cancer Network (NCCN) have been updated to recommend octreotide LAR 20–30 mg as a management option in patients with recurrent or unresectable metastatic carcinoid tumors originating from any primary site of disease (small bowel, colon, rectum, appendix, lung, thymus, stomach) irrespective of functional status, symptomatology and progression status” [While there might be an origin in the colon/rectum, there is also a possible link with the prostate]
SIDE EFFECTS OF CHEMOTHERAPY
September 16, 2021
etoposide and cisplatin/ carboplatin (at 50% for 2 days at a time)
Chemotherapy medications commonly used to treat LCLC include Altima (pemetrexed) and Platinol (cisplatin) [Source]
Chemotherapy causes death in more than 25% of cancer patients
Palliative care patients are more likely to die of chemo than others. Those who have a lot of weight from cancer are more likely to die.