Methods: This study used five series of National Health and Morbidity Survey data from 1986 to 2015. Healthcare utilisation for inpatient, outpatient and dental care were analysed. SES was grouped based on household expenditure variables accounting for total number of adults and children in the household using consumption per adult equivalents approach. The determination of healthcare utilisation across the SES segments was measured using concentration index.
Results: The overall distribution of inpatient utilisation tended towards the pro-poor, although only data from 1996 (P-value = 0.017) and 2006 (P-value = 0.021) were statistically significant (P < 0.05). Out-patient care showed changing trends from initially being pro-rich in 1986 (P < 0.05), then gradually switching to pro-poor in 2015 (P < 0.05). Dental care utilisation was significantly pro-rich throughout the survey period (P < 0.05). Public providers mostly showed significantly pro-poor trends for both in- and out-patient care (P < 0.05). Private providers, meanwhile, constantly showed a significantly pro-rich (P < 0.05) trend of utilisation.
Conclusion: Total health utilisation was close to being equal across SES throughout the years. However, this overall effect exhibited inequities as the effect of pro-rich utilisation in the private sector negated the pro-poor utilisation in the public sector. Strategies to improve equity should be consistent by increasing accessibility to the private sectors, which has been primarily dominated by the richest population.
MATERIALS AND METHODS: A critical review of preclinical and clinical studies was conducted to summarize the therapeutic interventions that target specific mutations in PDAC, components of the tumor microenvironment, and drug delivery systems, especially nanotechnology, to enhance targeting and efficacy.
RESULTS: Inhibitors and nanotechnology-based targeted therapies have reported promise in preclinical models: drug delivery is enhanced with the loss of PDAC resistance mechanisms. Formulations and combinations targeting KRAS as well as other pathways point toward improved drug delivery over 'orthodox' treatment approaches.
CONCLUSION: This review concludes that although improvement in therapies for PDAC has incrementally been proven in recent literature, however, more research is expected to enhance these approaches so that they can be applied appropriately at the clinical stage. In future studies, it is expected to optimize treatment combinations, address mechanisms of resistance, and improve the delivery of drugs.
METHODS: The current systematic review was conducted in accordance with the PRISMA guideline for the identification of relevant studies in various electronic databases up to April 2023. After reviewing and screening 193 articles, 18 were chosen for this study based on our inclusion and exclusion criteria.
RESULTS: It was shown that quercetin significantly reduced cancer cell proliferation, cell viability, tumor volume, invasion, metastasis and migration. This anti-cancer agent induced oxidative stress and apoptosis in the cancer cells. Quercetin treatment could also induce some biochemical alterations in the cancer cells.
CONCLUSION: According to the results, it can be mentioned that quercetin administration has an anti-cancer effect against oral cancer cells. This agent exerts its anticancer effects via reduced cell viability and different mechanisms, including induce oxidative damage, apoptosis, and reduced invasion and metastasis. However, suggesting the use of quercetin as a therapeutic agent of oral cancer patients requires further clinical studies due to its poor absorption rates, and the exact molecular mechanisms are still not well understood.