Inbound Tourism In Malaysia: Unlocking the potential traveling experience of European and Oceanian Tourists

This study explores the memorable traveling experience (MTE) of 143 tourists from Europe and Oceanian in Malaysia. The researchers conducted a survey to investigate the factors that influence their revisit intention to Malaysia as an attractive destination. Partial least square structural equation modeling (SEM-PLS) results indicated that tourist attitudes, destination images, electronic Word of Mouth (eWOM), and perceived quality have positive and significant influences on travel intention. However, the eWOM failed to mediate the tourists’ attitudes, perceived quality, and destination image towards their revisit intentions.     Keywords: eWOM, Malaysia, Memorable Travelling Experience, Revisit Intentions eISSN: 2398-4287 © 2022. The Authors. Published for AMER ABRA CE-Bs by e-International Publishing House, Ltd., UK. This is an open-access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under the responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians), and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v7i21.371

“Is percutaneous extraction of gallstones safe and effective in high-risk patients? Evidence from a systematic review”

Gallstone disease in high-risk patients presents a management dilemma as cholecystectomy is often not performed due to their co-morbidities. Alternatively, such patients can be managed by percutaneous removal of gallstones. To date, there is paucity of high-quality evidence addressing the safety and efficacy of percutaneous cholecystolithotomy in high-risk patients.We aimed to conduct a systematic review on the feasibility of percutaneous gallstone removal in high-risk patients. MethodsA literature review was conducted using the Cochrane review and preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines without setting the time limits to assess the outcomes of percutaneous gallstone removal in high-risk patients. ResultsTwelve studies were identified. A total of 435 patients underwent percutaneous gallstone removal. Success rate was 91%. Overall complications (including minor and major) were 28%. The mean length of stay was 7 days (range, 1–80). Procedure related mortality was 0.7%. The recurrence rate was 7%. ConclusionPercutaneous cholecystolithotomy is a safe and effective technique. Although, it cannot substitute the current standard treatment for gallstones i.e., laparoscopic cholecystectomy. However, it may be considered for the patients who cannot undergo laparoscopic cholecystectomy due to their comorbid conditions

Inbound tourism in Malaysia: unlocking the potential traveling experience of European and Oceanian tourists

This study explores the memorable traveling experience (MTE) of 143 tourists from Europe and Oceanian in Malaysia. The researchers conducted a survey to investigate the factors that influence their revisit intention to Malaysia as an attractive destination. Partial least square structural equation modeling (SEM-PLS) results indicated that tourist attitudes, destination images, electronic Word of Mouth (eWOM), and perceived quality have positive and significant influences on travel intention. However, the eWOM failed to mediate the tourists’ attitudes, perceived quality, and destination image towards their revisit intentions

Evaluating the antidiabetic and antioxidant properties of 5- benzyl-1,3,4-oxadiazole-2-thiol

Purpose: To evaluate 5-Benzyl-1,3,4-oxadiazole-2-thiol (OXPA) for antidiabetic and antioxidant properties. Methods: Antidiabetic activity was evaluated using three in vitro models, glucose uptake by yeast cells, alpha amylase inhibition assay and hemoglobin glycosylation inhibition assays. Antioxidant potential was determined by DPPH radical scavenging, reducing power and lipid peroxidation assays. Results: OXPA showed antidiabetic activity in all the three models. The activity of the compound was comparable with that of metronidazole in glucose uptake by yeast cells, but the alpha amylase inhibition activity of the compound was slightly lower than that of acarbose, whereas the hemoglobin glycosylation inhibition activity of the compound was higher than that of vitamin E. DPPH free radical and hydrogen peroxide scavenging activity of the compound was comparable with that of vitamin C. In reducing power assay, the activity of the compound was lower than that of vitamin C (p > 0.05). Conclusion: The results of antidiabetic and antioxidant activity indicate that OXPA may be a drugcandidate for treating both diabetes and its associated oxidative stress

Statistical analysis of climate trends and impacts on groundwater sustainability in the Lower Indus Basin

Agricultural intensification is increasing global demand for water, with groundwater especially susceptible given its year-round reliability. Climate change impacts on groundwater recharge exacerbate uncertainties for future access and use, especially for large aquifers across alluvial plains such as the Indus Basin of Pakistan. To generate better understanding of climate change impacts on groundwater balances in such contexts, we used MODFLOW 2005 to quantify the groundwater budget of the Northern Rohri Canal Command Area under RCP 4.5 and 8.5 climatic scenarios, while also taking climatic regionalisation into account. Under a baseline scenario, total annual pumping in the northern Rohri command was estimated to be 3.619 billion cubic metres (BCM), and the total net loss in storage over the simulation period from October 2010 to April 2014 was estimated at 1.244 BCM per year. By 2047, net decline in storage is projected to more than double to 2.185 per year under RCP 4.5 scenario and 2.214 under RCP 8.5. Our estimates suggest that a sustainable yield across the command area should be managed at approximately 3 ± 0.3 BCM per year to ensure sufficient adaptive reserves of groundwater for access during times of drought and inadequate surface supply, while also reducing waterlogging impacts from high watertables. This first-time estimate of sustainable yield provides irrigation system managers with an overall guide from which divisional-scale measures to achieve the goal can be identified through stakeholder engagement.Australian Centre for International Agricultural Researc

Assessing the impact of clinical pharmacy services on the healthcare outcomes of patients attending an outpatient haemodialysis unit in a rural hospital in Egypt: a quasi-experimental study

Objectives This study aimed to investigate the impact of newly introduced clinical pharmacy services on the health care of chronic haemodialysis patients attending an outpatient haemodialysis unit in a rural hospital with limited resources in Alexandria, Egypt. Methods A quasi-experimental pre-/post-test study was conducted from November 2016 till June 2018. Clinical pharmacists collected relevant information using a pre-specified form. Patients’ data were reviewed for drug-related problems (DRPs), which were documented using the Pharmaceutical Care Network Europe (PCNE) classification system, version 8.02 and resolved by the clinical pharmacists. Measured values of calcium, phosphorus and haemoglobin were compared with target levels set by the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. Proportions of patients achieving therapeutic values of each parameter were compared before and after implementing the program using the McNemar test. We also reported the analysis of DRPs identified and addressed by the clinical pharmacy team. Key findings A total of 685 DRPs were identified during the follow-up period. Improper dose and inappropriate drug selection were the most common DRPs (45.8% and 18.9%, respectively). There was a statistically significant increase in the proportion of patients achieving target corrected calcium levels (30% pre-intervention versus 69.6% post-intervention, P = 0.001) and haemoglobin levels (9.1% pre-intervention versus 31.9% post-intervention, P = 0.003), but not in phosphorus levels (18.6% pre-intervention versus 22% post-intervention, P = 0.7). Conclusions Clinical pharmacists were able to resolve frequent DRPs and improve some markers of health care in haemodialysis patients

Short-term surgical outcomes following neoadjuvant immunotherapy in mismatch repair-deficient colorectal cancer: initial experience from a tertiary referral center

Purpose Immunotherapy has demonstrated remarkable efficacy in mismatch repair-deficient (MMR-D) colorectal cancer (CRC). Due to their significant response rates, immune checkpoint inhibitors have emerged as a promising neoadjuvant therapy. However, data regarding short-term surgical outcomes following immunotherapy remain limited. The aim of this study is to evaluate the safety and feasibility of surgical resection after immunotherapy, as well as its short-term clinical outcomes. Methods A retrospective review of prospectively collected data was performed at a tertiary referral center from January 2020 to July 2024. Fifteen consecutive patients with MMR-D CRC treated with pembrolizumab were analyzed. The patients’ demographics, tumor characteristics, clinical outcomes, and histopathological responses were assessed. Results In total, 15 patients diagnosed with MMR-D locally advanced or metastatic colorectal cancers received neoadjuvant immunotherapy followed by surgery. Of the 15 patients, 11 (73.3%) were male, 12 (80.0%) presented with T3/T4 tumors, and 3 (20.0%) had metastatic disease at diagnosis. The median number of immunotherapy cycles was 5 (range, 3–13). Surgery was performed without any anastomotic leaks or 30-day mortality. The median length of hospital stay was 5 days (range, 3–14 days). All surgical specimens had negative resection margins. Major pathological response was observed in 11 patients (73.3%), including complete response in 8 (53.3%) and near-complete response in 3 (20.0%). The median follow-up was 14 months (range, 1–56 months). One patient developed liver metastasis, which was successfully resected. Conclusion Surgical resection of MMR-D CRC following neoadjuvant immunotherapy is safe and associated with low morbidity. Neoadjuvant immunotherapy in MMR-D CRC facilitates high rates of major pathological response

Burden of cancer in the Eastern Mediterranean Region, 2005–2015: findings from the Global Burden of Disease 2015 Study

Objectives: To estimate incidence, mortality, and disability-adjusted life years (DALYs) caused by cancer in the Eastern Mediterranean Region (EMR) between 2005 and 2015. Methods: Vital registration system and cancer registry data from the EMR region were analyzed for 29 cancer groups in 22 EMR countries using the Global Burden of Disease Study 2015 methodology. Results: In 2015, cancer was responsible for 9.4% of all deaths and 5.1% of all DALYs. It accounted for 722,646 new cases, 379,093 deaths, and 11.7 million DALYs. Between 2005 and 2015, incident cases increased by 46%, deaths by 33%, and DALYs by 31%. The increase in cancer incidence was largely driven by population growth and population aging. Breast cancer, lung cancer, and leukemia were the most common cancers, while lung, breast, and stomach cancers caused most cancer deaths. Conclusions: Cancer is responsible for a substantial disease burden in the EMR, which is increasing. There is an urgent need to expand cancer prevention, screening, and awareness programs in EMR countries as well as to improve diagnosis, treatment, and palliative care services

Maternal mortality and morbidity burden in the Eastern Mediterranean region : findings from the Global Burden of Disease 2015 study

Assessing the burden of maternal mortality is important for tracking progress and identifying public health gaps. This paper provides an overview of the burden of maternal mortality in the Eastern Mediterranean Region (EMR) by underlying cause and age from 1990 to 2015. We used the results of the Global Burden of Disease 2015 study to explore maternal mortality in the EMR countries. The maternal mortality ratio in the EMR decreased 16.3% from 283 (241-328) maternal deaths per 100,000 live births in 1990 to 237 (188-293) in 2015. Maternal mortality ratio was strongly correlated with socio-demographic status, where the lowest-income countries contributed the most to the burden of maternal mortality in the region. Progress in reducing maternal mortality in the EMR has accelerated in the past 15 years, but the burden remains high. Coordinated and rigorous efforts are needed to make sure that adequate and timely services and interventions are available for women at each stage of reproductive life