Incidence of low bone mineral density in patients with advanced prostate cancer before hormonal manipulation

Background: Prostate cancer is the second most commonly diagnosed cancer in men with an estimated 1.3 million cases diagnosed in 2018 according to the most recent International Agency for Research on Cancer (IARC) report.A large proportion of men still present with advanced disease and in this situation androgen deprivation therapy (ADT) is the mainstay of treatment.Prostate cancer is largely androgen-dependent and responds to endocrine therapy. ADT is an effective treatment modality which decreases the rate of disease progression, alleviates symptoms, and prolongs patients’ survival. ADT can be achieved through surgery (i.e., bilateral orchidectomy) or medical therapy (gonadotropin releasing hormone agonists, antagonists and antiandrogens).Methods: With the approval from institutional ethic committee, a case control study was planned at the urology outpatient department (OPD) at SMS Hospital from April 2019 to March 2020. Based on inclusion and exclusion criteria, 44 patients with newly diagnosed advanced prostate cancer and requiring hormone manipulation were enrolled in study. Age matched control (age±2 years) was selected from patients attending urology clinics with conditions other than prostate cancer. Ratio of cases and control was kept 1:1. Written consent was taken from all participants.Results: Total 88 patients were enrolled in study, 44 in each group. The age of patients ranged from 57 to 86 years among the case group and 55–85 among the control group. Mean age of cases was 65.24±6.8 and control was 64.98±7.6 years (p=0.25). Body mass index which is calculated with standard formula (weight in kg/height in meter square) was significantly high among controls (24.20±2.46) in comparison to cases (23.42±2.84). Statistically significant difference was observed among case and control groups for PSA (p=0.0001) and serum calcium (p=0.005) however difference for alkaline phosphatase (ALP), parathyroid hormone (PTH) and vitamin D was found insignificant (p>0.05).Conclusions: Low bone mineral density in patients with advanced prostate cancer before hormonal manipulation is nearly 50%. PSA and serum calcium level were significant different among case and control however this difference was not found for ALP, PTH and vitamin D. Consideration should be given to performing BMD studies in these men before initiating treatment, to avoid or minimize potential bone-related complications in these patients

Regional model for the protection of human rights in Asia

After considering all the regional model for the protection of human rights in the world, the researcher tried to gave the regional model in Asia. There is need to care of diversified socio, economic, political and cultures of India while forming regional model for protection of human rights in Asia

STUDY ON THE ESSENTIALS PARTS OF COOPERATIVE LEARNING

Over the previous decade, cooperative learning has arisen as the main new way to deal with study hall guidance. One significant justification its support is that various examination concentrates in K–12 study halls, in assorted school settings and across a wide scope of content regions, have uncovered that understudies finishing cooperative learning bunch jobs will in general have higher scholastic grades, higher selfesteem, more prominent quantities of positive social abilities, less generalizations of people of different races or ethnic gatherings, and more noteworthy cognizance of the substance and abilities they are concentrating Furthermore, the viewpoint of understudies functioning as "scholarly introverts" in homerooms is altogether different from that of understudies working cooperatively and cooperatively in and as "cooperative learning scholarly groups" Even with it's anything but, a larger part of the gathering assignments that instructors use, even educators who guarantee to utilize "cooperative learning," keep on being cooperative gathering undertakings not cooperative learning bunch errands. For example, virtually all "jigsaw" exercises are not cooperative learning jigsaw exercises. Just on the grounds that understudies work in little gatherings doesn't imply that they are collaborating to guarantee their own learning and the learning of all others in their This accentuation on scholarly learning accomplishment for every person and all individuals from the gathering is one element that isolates cooperative learning bunches from other gathering undertakings

An Analytical Study on the Evolution of Education as a Discipline

The unique development of life on earth is human beings. Since their origin, their greater curiosity always encouraged them to speculate about the operation of the universe and to remain engaged in constant search of knowledge. Knowledge involves acquiring knowledge, facts, information, descriptions or abilities through experience or study. The argument provided deals with criticism of education as an academic subject with epistemological problems. The argument consists of a study that has classified the education field as based on three basic knowledge traditions. Contrasts with other disciplines, including mathematics and physics, are created to study the coherence of education as a field. The paper also examines the academic scholarship in regard to, and its significance to, the notion of near-practice education research as an academic field. The article concludes by suggesting a new model that shows the relationships between practical knowledge and academic knowledge that are an intrinsic part of education. There is also a stronger representation of education as an academic field

Ubiquitous adulterants in the microbiological investigations of tertiary care centre in mid-Nepal

Aim:The bacterial agents can be isolated even from the aerosol, hands, cloths,and floors of the laboratory .So, the microbiological agents isolated from these areas can act as contaminant in the microbiology laboratory and may be an obstacle in the routine processing and culture of the specimen. This leads to the false positive results and false negative results. As a consequence of which, inaccurate therapeutic regimens are prescribed to the patients, this causes unusual serious effects in the other unaffected parts of the body.The purpose of this study was to illustrate the bacterial agents that are responsible to act as a contaminant in the laboratory.Methods:The samples were collected from the floors,working surface and aerosol of the laboratory whereas the samples were also obtained from the hands and cloths of the laboratory staffs of Chitwan Medical College and Teaching Hospital. The isolates were identified bythe standard microbiological protocols applied routinely in the lab.Results:Out of 180 samples, growth was observed in 38 of them. Among 38 positive samples, Micrococcusspp. was isolated in 14(36.8%) followed by Bacillus subtilis in 7 (18.4%). Diphtheroids were observed in 4 samples (10.5%). Staphylococcus epidermidis was found in 6 (15.8%) samples whereas Staphylococus aureus were isolated in 5(13.1%)samples.Conclusion:Hence, the bacteriological agents can be isolated from various areas of laboratory and may act as a contaminant which might degrade the quality or the accuracy of the reporting of the results

TRIBAL IN ERA OF GLOBALIZATION

This paper highlights the tribal community in era of the global world, where globalization diffused everywhere. Tribal community is known as the earliest society. Globalizations have various aspects in which it the affect tribal communities in both ways: - positive and negative. In 1991, India announced the New Economic Policy in which the Liberalization, Privatization and Globalization are introduced. In the name of this economic policy, where tribal community lives and they continue their livelihood affected. Globalization continuously shaped and reshaped the market needs.  &nbsp

Green Finance for Sustainable Aviation: Stakeholder Perspectives and Systematic Review

Purpose: This systematic literature review aims to examine the relationship between ESG ratings, sustainability performance, and green finance in the aviation industry. The primary purpose of this study is to provide insights into the opportunities and challenges of green and sustainable finance in the aviation industry.   Theoretical framework: The study draws on the concept of green finance, which has gained significant attention in recent years. The theoretical framework of this study is based on the need for a comprehensive approach that includes policy incentives, technological innovation, and sustainable fuels to achieve sustainable aviation.   Design/methodology/approach: The study adopted the systematic literature review (SLR) method to analyse the existing literature, following three steps for research; planning the review, conducting the review, and reporting.   Findings: The study finds that sustainable finance and investment are critical in achieving sustainable aviation. The use of sustainable aviation fuel is essential, but investment is needed to scale up production and reduce costs. Stakeholder involvement in financing ESG factors and sustainability issues is crucial, with standardization, awareness, and incentives necessary to promote sustainable finance and ESG practices in the aviation industry. Green finance can support emissions reduction and promote sustainable development in aviation, but more investment and collaboration are required.   Research, Practical & Social implications: The study recommends transitioning to a low-carbon industry, with sustainable finance playing a critical role in making this transition possible. The study has practical implications for understanding the subject in the context of ESG criteria and its contribution to sustainability in the aviation industry. The originality value lies in the comprehensive analysis of the existing literature, highlighting the importance of green and sustainable finance in achieving sustainability goals. The study's social implications are significant, given the critical role aviation plays in global emissions, underscoring the need for a sustainable aviation industry.   Originality/value: The study's originality value lies in the comprehensive analysis of the existing literature, highlighting the importance of green and sustainable finance in achieving sustainability goals. It provides insights into the opportunities and challenges of green and sustainable finance in the aviation industry, making a significant contribution to the existing literature

A Study on Appropriateness of Antibacterial Use in Acute Wards of a Teaching Hospital

Objective: A study to analyse the appropriateness of use of antibacterials in acute wards of a tertiary care hospital. Design: A pharmacoepidemiological research study. Intervention: Non-interventional descriptive study. Main Outcome Measure: The antibacterial prescriptions were analyzed for their adherence to or deviation from the standard national treatment guidelines. Results: There were a total of 207 patients comprising of 35 in acute medical ward, 65 in ICU, 53 in acute surgical ward and 54 in family ward, who were prescribed antibacterials. These consisted of a total of 383 prescription counts for appropriateness of AMA use. One third of the antibacterial prescriptions of inpatients surveyed were for prophylactic use followed by the treatment of respiratory and gastrointestinal diseases. The highest prescription counts were seen with carbapenems followed by nitroimidazoles, cephalosporins, aminoglycosides and penicillins. 99% of the prescriptions were appropriate for the dose used and 49.6% of the prescriptions were inappropriate for duration of use. 74.5% of the surgical prophylaxis prescriptions were used for more than 24 hours. Ceftriaxone and cefotaxime were used instead of the recommended cefazolin, for prophylaxis. High percentage of deviation was observed with prescriptions of cefotaxime and metronidazole for empirical use. No definitive use of antimicrobials for infections was observed in the ICU. Conclusion: A high percentage of appropriateness was observed for dose of antibiotic used. The main targets identified for improvement are duration of antimicrobial use, choice of drug for surgical prophylaxis and the definitive use of antimicrobial agents. Keywords: adherence to treatment guidelines, antibiotic audit, antimicrobials