Cancer has its own disease burden and patients usually suffer from symptom clusters when they are referred for palliative treatment. Identification of symptom cluster trajectories will help clinician to take into account measures that can optimize quality of life of palliative patients. Therefore the aim of this paper is to determine the overall prevalence of symptoms and symptoms clusters in different disease groups according to etiology at the time of first visit to Palliative care clinic by using HIS Palliative First Assessment note indicating Edmonton symptom scale.

Considering their outstanding mechanical character, it is inevitable to utilize titanium and titanium composite for biomedical engineering application [1-6]. However, the particles releasing from these bulks or composites of biomaterials after long term implanting in human body will cause cell apoptosis or cell death, inflammation, bone

Observational studies have demonstrated association of metformin with reduced cancer incidence and mortality in multiple cancer types, including gastrointestinal (GI) malignancies. Anti-neoplastic effects of metformin are believed through many mechanisms including activation of AMP-activated protein kinase, which controls mammalian target of rapamycin (mTOR) growth regulatory pathway.

With the advent of the direct oral anticoagulants (DOACs), patients requiring anticoagulation for common conditions such as atrial fibrillation and venous thromboembolism no longer need to worry about dietary restrictions or regular monitoring of the international normalized ratio which complicated warfarin treatment.

The incidence of chronic diseases is rapidly increasing worldwide. It has been calculated that, in 2001, chronic diseases contributed to approximately 46% of the global burden of disease and 60% of the total reported deaths with that number expected to increase to 57% by 2020, when chronic diseases will account for almost 75% of all deaths worldwide.