Doctors' approaches to decision support in counseling patients with localized prostate cancer: an Asian perspective

There are many treatment options for localized prostate cancer, and there is clinical equipoise in relation to the treatment outcomes. This study aimed to explore doctors’ approaches to decision support in counselling patients with localized prostate cancer in a country with a less established system of support and care delivery for cancer treatment. Four in-depth interviews and three focus group discussions were conducted with seven government policy makers/consultant urologists, three oncologists, four private urologists and six urology trainees in Malaysia between 2012 and 2013. Doctors facilitated the treatment decision by explaining about the disease and the treatment options, which included monitoring, side effects and complications of each treatment option. Paper-based (charts and diagram drawings) or electronic (ipad apps and websites) illustrations and physical models were used as patient education aids. Further reading materials and websites links were often provided to patients. Patients were given time till subsequent follow up to decide on the treatment and family involvement was encouraged. Referral to other healthcare professionals (oncologist, radiotherapist or other urologist) for second opinion was offered to the patients. The doctors would recommend patients to speak to prostate cancer survivors for peer support but official support groups were not easily accessible. This study highlighted a multi-faceted approach to support patients with localized prostate cancer in making a treatment decision. It not only involved the doctors (urologist or oncologist) themselves, but also empowered the patients and their social network to support the decision making process

Supporting patients in making treatment decisions for early prostate cancer: a qualitative study of healthcare professionals' views on barriers and challenges in an Asian country

Background: The aim of this study is to explore the challenges faced by healthcare professionals (HCPs) in Malaysia in supporting patients with early prostate cancer in making treatment decisions. Methods: Four in-depth individual interviews and three focus group discussions were conducted with urologists (n=11), urology trainees (n=5), oncologists (n=3) and policy makers (n=1) in Malaysia in 2012-2013. A semi-structured interview guide was used to facilitate the interviews, which were audio-recorded, transcribed verbatim and checked. Thematic approach was used to analyze the data. Results: Challenges reported by HCPs in supporting patients in making decisions about prostate cancer treatment consisted of patient, social, healthcare professionals and health system factors. Patient-related challenges were: distrust of HCPs, difficulty in communicating information, preconceptions, attitudes to treatment, preparedness for decision making, viewing prostate cancer as taboo and fear of treatment complications, or side-effects. Social factors, such as influence of family or others, also posed a problem for HCPs seeking to support patients’ decision-making. HCP-related challenges included: differences of opinion among HCPs, uncertainty about the best treatment option and lack of interdisciplinary cooperation. Healthcare system factors challenges included: lack of support staff, time constraints, treatment availability and treatment costs. HCPs suggested that delivery of care by multi-disciplinary teams, and more use of audio-visual media, would help patients to make decisions. Conclusions: HCPs faced various challenges in supporting patients with prostate cancer in making decisions about treatment. Delivery of care by a supportive team in a specialist centre may improve the support patients receive in making decisions

Lack of association between polymorphism rs540782 and primary open angle glaucoma in Saudi patients.

Background To investigate whether polymorphism rs540782 on chromsome 1, in close proximity to the Zona Pellucida Glycoprotein 4 (ZP4) gene, is a risk factor for primary open angle glaucoma (POAG). Method The study genotyped 92 unrelated POAG cases and 95 control subjects from Saudi Arabia using Taq-Man® assay. Results The genotype frequency distribution did not deviate significantly from the Hardy-Weinberg equilibrium (p > 0.05). Overall, both the genotype and allele frequencies were not significantly different between cases and controls. The minor ‘C’ allele frequency was 49.4%, which was comparable to the Japanese population and higher than the Indian and Afro-Caribbean populations. Similarly, no significant association was found between genotypes and systemic diseases and health awareness/behavior domain variables. Importantly, glaucoma specific indices, such as intraocular pressure, cup/disc ratio and number of anti-glaucoma medication, also showed no statistically significant effect of genotypes within POAG cases. Conclusion Polymorphism rs540782 is not a risk factor for POAG in the Saudi cohort

Photocatalytic decolorization of methyl orange dye using SnO2-TiO2 nanocomposite particles synthesised by Ultrasonic Assisted Co-Precipitation Method

The ultrasonic-aided co-precipitation method was used to create SnO2-TiO2 nanocomposite particles. Scanning electron microscopy (SEM), X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), and UV-vis spectroscopy were used to characterize the nanocomposite particles. XRD patterns revealed the crystalline structure of particles and the average particle size determined by Debye Scherrer’s equation was found to be 11.355, 4.9577, and 4.333 nm for TiO2 nanoparticles, SnO2 nanoparticles, and SnO2-TiO2 nanocomposites, respectively. The Ti, Sn, and O species were confirmed to exist by energy-dispersive X-ray spectroscopy (EDS). The UV absorption peaks at 288, 305, and 350 nm were attributed to SnO2, TiO2-SnO2, and TiO2 respectively. The photocatalytic aspect was investigated in a model organic contaminant (methyl orange). Data obtained by the above-mentioned characterization methods confirmed the superior photocatalytic activity of SnO2-TiO2 nanostructure than SnO2 or TiO2 alone

The Function of Micro Credit System in Social Amendment A Case Study on Rajshahi District in Bangladesh

Micro-credits an extremely small loan given to impoverished people to help them become self employed havebecome an important tool in development economics and play an essential role in the fight against poverty, inparticular with respect to the self-sufficient of women. Since Muhammad Yunus, the founder of the Grameen Bank2,received the Nobel Prize for Peace in 2006, microcredit-systems have been increasingly conceptualized as part of aprofit-oriented “financial system approach”.For more than twenty years, microcredit has been widely heralded as theremedy for world poverty. Recent news stories, however, have sullied microcredit’s glowing reputation with reportson scandals, exorbitant compensation to managers, skyrocketing interest rates, and aggressive marketing schemes.Once praised as a universal panacea, microlenders are now being widely attacked as predatory loan sharks. (Korten,2011)However, in this paper we will discuss different approaches to micro-credits dealing with the question of howfar different concepts influence societal gender arrangements and under which circumstances micro-credits are usefultools for the self-sufficient of women in a sustainable way. For this reason, the results of an empirical studyconducted in Rajshahi will be presented in order to develop a multilayer model for the self-sufficient of womenwhich shows possible impacts of micro-credits on the individual level (micro level), the community level (centrallevel) as well as the socio-political level (macro level)Keywords: Self -sufficient Women, Micro credit, Social Amendment, Fund for Development (SFD)

Awareness and likelihood of accepting COVID-19 vaccines among the university students of Bangladesh

Massive vaccination is very important to end the coronavirus disease 2019 (COVID-19) pandemic. This study determined the willingness to receive a COVID-19 vaccine by the university students of Bangladesh and identified their apprehension about the effectiveness and safety of COVID-19 vaccines. Students were invited to complete an online cross-sectional survey (April 3 to June 10, 2021) to explore the intention to receive a COVID-19 vaccine and other factors regarding the responsiveness of the COVID-19 vaccine. Among the 191 respondent students, 52.9% willingly agreed to receive a vaccine, where the remaining was either not decided yet (27.7%) or was not intended to get vaccinated (15.7%). The odd of getting a vaccine were only 1.15. About 83.2% of students were conscious about the severity of COVID-19 and many students responded that they are well-versed about vaccine activity (67.5%) and risk factors (66%). Among the approved vaccines, most students preferred the Oxford-AstraZeneca COVID-19 vaccine ChAdOx1 (38.7%) and Pfizer-BioNTech COVID-19 vaccine BNT162b2 (34%). As some of the students still have lesser intent to accept vaccines, public health officials need to be more proactive to focus on vaccine safety and benefits to enhance vaccine coverage among university students of Bangladesh

Does Carbon Emission Matter for Health Care Expenditure? Evidence from SAARC region using Panel Cointegration

This study investigates the impact of increased carbon emissions on per capita health expenditure exploiting the panel data with Engle – Granger based cointegration test, Fully Modified Ordinary Least Square (FMOLS) and Dynamic Ordinary Least Square (DOLS) method. Data for the South Asian Association for Regional Cooperation (SAARC) countries from 1995 to 2014 have been collected from World Development Indicators (WDI). The confirmation of integration order of the variables has been made using two panel unit root tests suggested by Im – Pesaran – Shin, 2003 (IPS) and Levin, Lin & Chu, 2002 (LLC). Following the procedure suggested by Pedroni (1999, 2003) and Kao (1999), existence of long run relationship has been examined among the variables. Application of Fully Modified Ordinary Least Square (FMOLS) and Dynamic Ordinary Least Square (DOLS) further confirmed the presence of long run significant positive relationship between carbon emissions and per capita health expenditure. The coefficients of carbon emissions varied from 0.246 to 0.355 under the model estimated by FMOLS while the coefficients varied from 0.198 to 0.283 under the model estimated by DOLS. The findings can be generalized by saying that increased carbon emissions due to environmental degradation would increase the health expenditure as well as cost of the nations

A study on the welfare of the animals in zoo negara / Liyana Muhd Fuad ...[et al.]

In recent times, there have been many complaints made regarding the welfare of zoo animals by both the public and NGO's upon Zoo Negara. This forms the basis of the research in the light of animal suffering, standards of a zoo and the adequacies of the legislation and execution of laws. This paper sets out to examine the sufficiency of local laws and its enforcement in protecting the welfare of the animals of Zoo Negara as the national zoo of Malaysia. The primary legislation that provides for wildlife in Malaysia is the Protection of Wildlife Act 1972 which is only applicable in West Malaysia, which applies to the targeted area of research, Zoo Negara. Loopholes or shortcomings of the said Act are found throughout the research and has been affirmed by most of the people interviewed for the purpose of this paper. However, problems may surface as to the matter of jurisdiction or limitations of power to compel or take legal action on established zoos. Where rulings based on the old legislation may have been efficient in earlier days, it would be absurd to say the same for its implications 30 years down the road. At the time of research however, the writers were pleased to hear that the Act is soon to be revised. It has been said that the title in itself could be altered, with what is believed to be additional provisions and amendments supplying to a wider scope of laws. Therefore, it may be rightfully presumed that the current Protection of Wildlife Act is questionable and rather ineffective in its content and enforcement in providing protection of welfare for the zoo animals in Zoo Negara

A Comparative Analysis of the Similar Wordformation Processes in English and Arabic

This paper sets out on a comparative analysis of similar word-formation processes in English and Arabic. In doing so, it hopesto emerge and serve assubsequent and reliable, albeit partial, reference material for English and Arabic linguistics, especially in reference to linguistic structures. The framework herein for the study and analysis of word-formation processes in both languages may also be applied in future studies and other genres, corpora, and texts. This study enriches the research findings and meta-theory in the field of linguistics, contributing to the current linguistic intellectualism trends. The specific processes discussed are acronyms, antonomasia, backformation, blending, borrowing, compounding, and derivation

Role of selective neck dissection over anti-TB therapy in retreating patients

Background: Tuberculous cervical lymphadenopathy (TCL) remains a significant public health challenge, particularly in developing countries. This study aimed to analyze the demographic characteristics, treatment responses, and management outcomes in patients with TCL, focusing on the effectiveness of standard anti-TB medication and the role of surgical interventions in non-responsive cases. Methods: This retrospective comparative analysis was conducted at the Department of Otolaryngology, Dhaka Medical College Hospital, Bangladesh, from July 2019 to July 2023. The study included 189 patients diagnosed with TCL. Patients were categorized based on their response to standard anti-TB medication over a period of one year and the subsequent management strategies adopted for non-responsive or slow-responsive cases. Results: The study predominantly involved younger individuals (71.43% aged 15-30 years) with a higher representation of females (68.25%). A significant majority (61.38%) reported symptoms for more than one month. After six months of treatment, 33.86% showed a response to medication, increasing to 46.56% after one year. However, 19.58% exhibited slow or no response. Among non-responsive or slow-responsive cases, 18.92% opted for neck dissection, while 59.46% eventually showed a complete response to medication. The incidence of TB relapse was 6.35%, with the majority occurring at the primary infection site. Conclusions: The study underscores the effectiveness of standard anti-TB medication in most TCL cases, with surgery as a secondary option for specific non-responsive or complicated cases. These findings highlight the need for early detection and individualized treatment strategies, emphasizing medical management as the cornerstone of TB treatment, with surgical interventions reserved for select scenarios