Needs Assessment and Survival Pattern of Elderly People in Rural Bangladesh

At present, aging is a buzzword that is recognized as a global issue. Bangladesh recently experiences a significant number of people who have faced many types of challenges due to its huge number of elderly people. It is the multidimensional process of physical, mental, and social change, both males & females aged 60+ years. Aging is now a global problem and an upcoming threat for developing countries like Bangladesh. Major social problems of elder people in a rural area are their adjustment in their surroundings, special needs, care giving and care receiving, neglect and harassment. This research aimed to know the needs assessment and survival pattern of elderly people in a rural area. The study has been conducted qualitative and quantitative in nature with a sample size of 120. Necessary data were collected through structured interview schedules, observation, questionnaires, and case study techniques. The survey findings indicate that elderly people are lack access to educational facilities, agricultural resources, decision-making process, sufficient family income, basic health care and they have faced social and physical problems such as lack of social security, personal security, burden feeling, loneliness, special services, heart disease, diabetics, sleeping disturbances, urinary and stomach problem, eye, hearing, dental problem. The government should have a social welfare policy to give special health and medical services through separate wards and units for elderly people.

Treatment and Survival Patterns of Primary Adenosquamous Carcinoma of the Liver: A Retrospective Analysis

Background and AimsPrimary adenosquamous carcinoma (ASC) is a rare liver malignancy with very little data published so far. We describe the clinical characteristics of this tumor and analyze its survival pattern to improve the diagnosis and treatment.Materials and MethodsThis study collected data of 15 patients with primary hepatic ASC in our hospital within 10 years (from 2009 to 2018). We analyzed the clinical characteristics, imaging data, treatment, and survival of ASC in the study. Two of these cases have been reported.ResultsThe common clinical symptoms of hepatic ASC are liver pain and jaundice. Laboratory examination showed that carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) increased, but Alpha-FetoProtein (AFP) did not. Primary hepatic ASC is a rare subtype of intrahepatic cholangiocarcinoma (ICC) and meets the requirements of pathological diagnosis: CK20 (-), CK7 (+), CK19 (+), and p63 (+). Of the 15 patients, 11 were treated surgically, of which 3 patients received adjuvant chemotherapy. The prognosis of ASC patients is poor with a median survival time (MST) of 6 months (range: 2 to 15). The duration of MST in surgically treated patients was longer than that of nonsurgical patients (7.0 months vs. 3.0 months). Patients that received adjuvant chemotherapy survived longer (MST: 15 months). Patients with lymph node metastasis had a worse prognosis.ConclusionPrimary hepatic ASC is a rare malignant tumor with a poor prognosis. Radical surgery may be an effective treatment for prolonging survival. Surgical treatment combined with adjuvant therapy may further improve survival.

The mortality outcomes and survival pattern of patients of Myeloproliferative Neoplasms in Malaysia

Background: The prognostication of myeloproliferative neoplasm (MPN) has always been challenging even in the advent of Janus kinase 2 (JAK2 V617F) molecular studies. The survival pattern of MPN in a developing country such as Malaysia is still undetermined.Materials and Methods: This was a retrospective study using information from 774 patients from the National MPN Registry conducted from the year 2009 to 2015 in Malaysia. Patients with the diagnosis of essential thrombocythaemia (ET), polycythaemia vera (PV), primary myelofibrosis (PMF) and unclassified MPN (MPN-U) were included. Survival data were traced until December 2018. Results: The cohort consisted of 42.0% ET, 41.0% PV, 8.9% PMF and 8.1% MPN-U, with 48.8% Malay, 39.1% Chinese, 7.1% Indian, 5.0% Others. The subtypes analysis revealed that male MPNs was more than female MPNs except in ET. The Chinese ethnicity was associated with the highest incidence of ET. The mortality rate was the highest in PMF followed by MPN-U then PV and ET (p<0.0001). Survival analysis revealed that the overall survival differed significantly according to characteristics such as sex, sub-types, JAK2 V617F mutation, bone marrow fibrosis, presence of splenomegaly, diabetes mellitus, hypertension, and bleeding manifestation. Cox regression analysis identified age, haemoglobin level, sex, and subtype as a significant risk factor for mortality outcome. Conclusion: Patients with ET had the slightly better OS while PMF had the worst OS. This is in conjunction with low haemoglobin, worsening bone marrow fibrosis, splenomegaly, diabetes mellitus, hypertension and bleeding. JAK2 V617F mutation was seemingly resulting in inferior overall survival especially in ET and PMF. The survival outcome of the MPN registry is instrumental for future policy development of effective healthcare in Malaysia.

Survival of animal and human associated Listeria monocytogenes in drinking water and biofilms

Land slugs are occasionally observed as contaminants in groundwater wells and drinking water treatment plants including storage tanks. Slugs may feed on carrion and feces, and they are potential vectors of pathogens such as Listeria monocytogenes. We isolated L. monocytogenes from the pest slug Arion vulgaris and examined persistence and survival of human and slug derived L. monocytogenes in groundwater-based drinking water and biofilms. L. monocytogenes survival was evaluated using cultivation and cultivation-independent techniques. L. monocytogenes remained culturable for 35–47 days in drinking water with first order decay rates between 0.314 and 0.457 h−1 (T99 ≥10 days). Attachment of L. monocytogenes to filter sand delayed washout from drinking water filters and increased persistence 2–3-fold. Indigenous biofilms stimulated initial surface attachment 10–100 fold but L. monocytogenes declined more rapidly in drinking water biofilms compared to virgin filters not colonized by microorganisms. Grazing by protozoa likely attenuated L. monocytogenes survival in some drinking water biofilms. A comparable survival pattern was observed for L. monocytogenes and the fecal indicator bacterium E. coli. The study suggests that live L. monocytogenes can persist for weeks as sessile organisms in groundwater-based drinking water supplies and may subsequently be released to the drinking water.

Survival Status of Esophageal Cancer Patients and its Determinants in Ethiopia: A Facility Based Retrospective Cohort Study

BackgroundGlobally, the incidence and mortality due to esophageal cancer are increasing, particularly in low- and middle-income countries. Cancer of the esophagus is the eighth in incidence and seventh in cancer mortality in Ethiopia. A few studies have shown an increasing burden, however, little is known about the survival pattern and its determinants among esophageal cancer patients in Ethiopia. Therefore, we assessed the survival pattern and its determinants among esophageal cancer patients.MethodsWe conducted a retrospective cohort study among 349 esophageal cancer patients who were diagnosed at or referred to Tikur Anbessa Specialized Hospital, Ethiopia from January 2010 to May 2017. Using an abstraction form, nurses who were working at the oncology department extracted the data from patient charts. To estimate and compare the probability of survival among covariate categories, we performed a Kaplan–Meier survival analysis with the log-rank test. To identify the prognostic determinants of survival, we performed a multivariable Cox proportional regression analysis.ResultsThe median follow-up time was 32 months with interquartile range of 15 to 42. Overall, the median survival time after diagnosis with esophageal cancer was 4 months with one-, two- and three-year survival of 14.4, 6.3, and 2.4% respectively. In the multivariable Cox proportional hazards model, receiving chemotherapy [Adjusted Hazard Ratio (AHR)=0.36, 95%CI: 0.27–0.49], radiotherapy [AHR=0.38, 95%CI: 0.23–0.63] and surgery [AHR=0.70, 95%CI: 0.54–0.89] were statistically significant.ConclusionsIn Ethiopia, esophageal cancer patients have a very low one-, two- and three-year survival. Despite a very low overall survival, patients who received either chemotherapy, radiotherapy or surgery showed a better survival compared with those who did not receive any treatment. Hence, it is essential to improve the survival of patients with esophageal cancer through early detection and timely initiation of the available treatment options.

Detection of RpoS Gene in Escherichia Coli O157:H7 and non-O157 and Their Survival Pattern in Water Treatment Methods

This study aimed to detect presence of RpoS gene in Escherichia coli O157:H7 and non-O157 and investigate their survival pattern in different water treatment methods. A total of fifteen serologically and molecularly identified E. coli was selected from a previous work, out of which eight were Escherichia coli O157 and seven were E. coli non-O157. From among these, S30 and S89 identified isolates served as presentative E. coli O157:H7 and non-O157 respectively for survival studies. The water treatment methods used employed included: use of silver, lime, storage, acidification (low pH), high temperature and Moringa oleifera. Survival pattern of the test organisms under the influence of these methods were carried out using standard techniques. Molecular detection of stress response gene, RpoS, in the fifteen (15) test organisms was performed following manufacturer’s instruction. Results showed that for both test organisms, silver was bactericidal at high concentration while storage allows their survival up till 21 days though with a reduction in cfu. Both organisms showed low survival at pH 9 while E. coli O157:H7 and non-O157 could survive at pH 4 and 6 respectively. E. coli O157:H7 survived better than non-O157 at high concentration of lime. While both survived at low temperature, E. coli O157:H7 survive better at 60oC. Sunlight and chlorine showed mild and complete bactericidal action respectively with increased exposure time for both test organisms. Moringa oleifera was only effective at a reduced concentration on the two organisms. Detection of RpoS genes showed that only 66.7% carried the gene in them while 33.3% did not. Findings from this study show that the possession of stressed genes in bacteria causing waterborne disease could allow these organisms to survive water treatment methods adopted in many under developed countries or rural communities. This suggests a threat to health of these communities.