bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of peer education on knowledge and frequency of smoking among high school students in disadvantaged districts: a quasi-experimental study
Authors: Mermer Gulengul , Nurcan Bilgic  , Keskin Salih , Gunay Turkan
Published: May 2024

Objective: To evaluate the effectiveness of peer education on changing the knowledge and frequency of smoking of high school students.
Method: The quasi-experimental study was conducted at the Vocational and Technical Anatolian High School, Turkey, during the 2021-22 academic year, and comprised students of either gender from the 9th to the 11th grade. After baseline assessment, training that blended peer education with the photovoice technique was administered between March 2021 and January 2022. Post-intervention assessment included smoking frequency, cigarette exposure and health literacy. Data was analysed using R version 4.0.5.
Results: Of the 465 students available, 395(84.95%) were part of the baseline assessment, while 434(93.3%) took the post-intervention assessment. At the baseline, 365(93.8%) participants were males and 24(6.2%) were femaes. The overall median age was 15 years (interquartile range: 15-16 years). Post-training, smoking rate and indoor exposure to cigarette smoke among the students were statistically lower than the baseline values (p<0.05). The mean health literacy score post-intervention was significantly higher than the baseline score (p<0.05).
Conclusion: Photovoice combined with peer education seemed beneficial in terms of positive effect on smoking behaviour among youths.
Key Words: Peer education, Smoking cessation, Peer influence, Smoking prevention, Adolescent, Health literacy.
Exploring side effects of corticosteroids in myasthenia gravis: Unveiling alternatives for safer treatment
Authors: Nawaz Sanwal Sardar , Imran Muhammad Waleed , Moaz Muhammad
Published: May 2024

Myasthenia Gravis (MG) is a chronic organ-specific autoimmune disease that weakens voluntary muscles by affecting neuromuscular junctions. The formation of antibodies against acetylcholine receptors is the most prevalent cause. The incidence and prevalence rates of (MG) are increasing exponentially (1).
In addition to symptomatic medication, corticosteroids continue to be the first-line treatment for MG due to their affordability, ease of access, and efficacy (2). Although corticosteroids are frequently prescribed, they are not without drawbacks. Long-term corticosteroid use can result in various side effects, including osteoporosis, weight gain, acne, elevated blood pressure, mood fluctuations, and a cushingoid appearance. It has also been linked to rare complications such as gastric and esophageal irritation, compressive fractures, and aseptic femoral head fracture (3). Given the hazards associated with long-term corticosteroid use in treating MG, researchers and healthcare professionals should investigate alternative MG treatments. By doing so, new and safer treatment options can be identified, which could contribute to improved treatment and substantially enhance the quality of life for MG-affected populations. Numerous nonsteroidal medications, including mycophenolate mofetil, methotrexate, and azathioprine, have demonstrated success in clinical trials for kidney transplantation, rheumatoid arthritis, and myasthenia gravis, respectively. To confirm the efficacy of these pharmaceuticals in the treatment of MG, urgent research and trials based on in vitro and animal models are required. Based on well-designed clinical trials, these also require human testing (4).
The tapering of prednisone is an alternative option. Prednisone tapering is still a problem in the therapeutic management of patients with generalized MG because, although it is a useful treatment, it has a number of adverse effects that make it necessary to find the lowest possible effective dose as quickly as feasible. Rituximab and azathioprine enable quick tapering. It is necessary to evaluate and contrast the corticosteroid-sparing effect of novel treatments with that of azathioprine and rituximab. Given their impact on MG status, it's possible that these novel therapies will make it possible to drastically cut back on corticosteroids or possibly stop taking them entirely(5)
The abnormal immune responses in MG can be managed and resolved with the new drugs that specifically target them. These agents include chimeric antigen receptor T [CART-T] cell therapy, autologous stem cell transplantation, B cell depleting agents (anti-CD 19 and 20, and B cell activating factor [BAFF] inhibitors), proteosome inhibitors, terminal complement C5 inhibitors, Fc receptor inhibitors, T cells, and cytokine-based therapies (subcutaneous immunoglobulin [SCIG]).
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Global prevalence of quackery practices: a scoping review of definitions, regulations, and allied healthcare
Authors: Veesar Ghulam Yaseen , Ather Akhlaq  , Siddiqi Ahson Qavi
Published: May 2024

Advancements in medical science and digital access made it easier for individuals to seek appropriate treatment. Despite living in the current information era, the practice of quackery has continued worldwide. The current scoping review was planned to explore different definitions and laws related to quackery, and the acceptance of allied healthcare services in traditional, cultural and legal contexts. The review examined a total of 3,327 published studies and 400 pieces of grey literature, including existing laws, regulatory authority websites, news articles and reports. A total of 56 studies and 21 excerpts were shortlisted for analysis. The definitions of quackery varied significantly across regions, but a general consensus is that unauthorised healthcare practices constitute quackery. Legal perspectives differed worldwide, with Europe, North America and Oceania discouraging allied healthcare services, such as homeopathy, naturopathy and traditional methods, considering them quackery.
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Association of eating habits with mitochondrial DNA copy number in eveningness chronotypes: origin research
Authors: Ali Shazia , Maqsood Madeeha , Ahmed Suhaib , Feroz Shagufta
Published: May 2024

Objective: To determine the relationship between eating habits and mitochondrial deoxyribonucleic acid copy number in adult cases of eveningness chronotypes.
Method: The cross-sectional, analytical study was conducted from September 2022 to June 2023 at the Physiology Department of the Islamic International Medical College, Rawalpindi, in collaboration with the Genetic Resource Centre, Rawalpindi, Pakistan, and comprised adult subjects who were assessed using the Morningness-Eveningness Questionnaire. The participants' eating habits were assessed using the Healthy Eating Assessment Questionnaire, and on they were divided into those with healthy eating habits in group A and those with unhealthy eating habits in group B. Deoxyribonucleic acid was extracted using the Chelex method, the mitochondrial deoxyribonucleic acid copy number of all participants was quantified using quantitative polymerase chain reaction. Data was analysed using SPSS 27.
Results: Of the 80 subjects, 30(37.5%) were males and 50(62.5%) were females. The overall mean age was 24.27±6.91 years (range: 18-45 years). There were 40(50%) subjects in each group. The mean mitochondrial deoxyribonucleic acid copy number in group A was 2.74±0.14 compared to 2.26±0.25 in group B (p<0.001).
Conclusion: Subjects with healthy eating habits exhibited higher mitochondrial deoxyribonucleic acid copy numbers, indicating reduced damage to mitochondrial deoxyribonucleic acid.
Key Words: Mitochondria, Mitochondrial DNA, Eating habits, Chronotype.
A call for increased surveillance: monitoring the use of hydroxychloroquine to prevent retinopathy
Authors: Zahra Tanvir  , Kareem Rutaab
Published: May 2024

Dear Sir / Madam.
Hydroxychloroquine (HCQ) and chloroquine (CQ) are the main drugs used in the control and treatment of malaria. Although the toxicity of these drugs is rare, it has been reported in high-dose ingestions or chronic intravenous administration. Of these retinal manifestations are one of the most common following the poisoning of CQ.
A recent study by Melles et al. found that the overall risk of hydroxychloroquine retinopathy is 8.6% after chronic use with higher dose of HCQ dose being associated with a progressively greater risk for incident retinopathy (1). Retinopathy can lead to serious complications in patients; in fact in most patient’s vision loss. In Melles et al’s study, it mostly led to complaints like reading difficulties, diminished vision, missing center vision, glare, hazy vision, light flashes, and metamorphopsia, while some patients were asymptomatic. The majority of patients exhibited a fundoscopic bull's-eye sign. Other signs include paracentral, central, and peripheral visual field loss, which were present in almost all patients. In the early stages of retinopathy, color vision is typically unaffected, but it too begins to be compromised in the later stages. (2)
Malaria is endemic in Pakistan. In 2023 pooled malaria prevalence in Pakistan was found to be 23.3%, with Plasmodium vivax, Plasmodium falciparum, and mixed infection rates of 79.13%, 16.29%, and 3.98%, respectively. According to the World Health Organization (WHO), Pakistan is one of the seven countries in the Eastern Mediterranean Region that account for 98% of the total malaria burden in the region. Around 217 million people in Pakistan are at moderate risk of malaria and 63 million are at high risk. Approximately 0.47 million malaria cases and 800 deaths have been reported in 2020(3). The recent rise in climate change-induced flooding and other weather changes, waterborne diseases such as malaria, are also rising leading to higher HCQ use. Furthermore, CQ and HCQ are also being used in treating covid 19(4). This, combined with factors such as lack of surveillance, self-medication practises, and rampant over-the-counter use in Pakistan greatly increase the risk of patients taking improperly high doses of HCQ or CQ and, consequently, suffering from retinopathy. To prevent the HCQ-associated retinal toxicity proper surveillance methods should be employed, and the prescription and distribution of these drugs should be monitored. Patients and physicians prescribing HCQ should be aware of its toxicity risks (5).
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Effect of hemodialysis practice guideline on dialysis indicators and hemodynamic complications among patients undergoing hemodialysis
Authors: Ali Amjad , Yaqoob Adnan
Published: May 2024

To assess the effect of haemodialysis practice guidelines on dialysis indicators and haemodynamic complications, the comparative study was conducted at the dialysis unit of Sheikh Zayed Hospital, Lahore, Pakistan, and comprised patients undergoing haemodialysis who were divided into intervention group A in which updated haemodialysis practice guidelines were used, and control group B in which routine base dialysis was given.  Data was collected using a self-structured tool. Data was analysed using McNemar test and Mann-Whitney U-test with p<0.05. Compared to baseline, there was a significant improvement in post-intervention ratio of effective removal of clearance (K) resulting from the treatment characterised by time (t) in the patient with a specific volume of distribution (V), or Kt/V, median & IQR 0.83(0.355) vs 1.21(0.11) and percentage of urea reduction ratio with median & IQR 49(12) vs. 66.5(18.65) (p<0.05).
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Diagnostic characteristics and management outcome in patients with acromegaly: a 15-year experience at a tertiary care hospital in Pakistan
Authors: Shehla Tabassum  , Sajjad Ali khan  , Nanik Ram  , Najmul Islam
Published: May 2024

Objectives: To assess the diagnostic features of acromegaly, and analyse its management outcomes over a 15-year period in a tertiary care setting.
Method: The descriptive, cohort, retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of adult patients of either gender diagnosed with acromegaly based on biochemical and radiological evidence between January 2005 and December 2019. Data was retrieved from the medical records. Data was analysed using SPSS 19.
Results: Of the 84 subjects, 54(64.3%) were males and 30(35.7%) were female. The overall mean age was 38.69±13.52 years. The patients presented 5.43±4.3 years after the onset of symptoms, with somatic growth features, such as enlarged hands and feet which was the most common complaint 81(96.4%). Of all the patients, 73(86.9%) underwent trans-sphenoidal surgery for the removal of the pituitary adenoma, while 11(13.1%) opted out of the surgical option. Further, 9(12.3%) patients showed biochemical and radiological remission 6 months post-surgery. Out of the remaining 64(87.7%) patients, 38(59.4%) received radiosurgery or radiotherapy, 15(23.4%) underwent repeat trans-sphenoidal surgery, and 11(17.2%) chose medical treatment.
Conclusion: Majority of patients failed to achieve remission after trans-sphenoidal surgery, which is the first line of treatment. Radiotherapy/repeat surgery was generally the options taken by those with persistent disease.
Key Words: Acromegaly, Characteristics, Diagnosis, Management, Outcome, Pituitary tumour, Growth hormone.
Attenuation of acute postoperative pain and opioid requirement with the use of magnesium sulfate in patients undergoing limb amputations
Authors: Qureshi Rabeea Sajid , Alam Tanveer , Khan Ahsun Waqar , Muhammad Bilal Shafiq
Published: May 2024

Objective: To compare the effects of magnesium sulphate on the total dose of intravenous morphine consumption postoperatively following limb amputations along with rescue analgesia requirement, pain scores and side effects.
Method: The prospective, triple-blinded, randomised controlled study was conducted from October 2021 to May 2022 at the Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, and comprised patients scheduled for limb amputations. They were randomised into 2 equal groups. The anaesthesia protocol was uniform for all patients. Intervention group A was administered 30mg/kg loading dose and 10mg/kg/hr maintenance dose of magnesium sulphate intravenously, while patients in control group B received the same amount of plain isotonic saline. Morphine consumption was measured for 24 hours postoperatively and included rescue analgesia, if required by the patient in the post-anaesthesia care unit, and patient-controlled analgesia. Numeric rating scale was used for the evaluation of postoperative pain in both groups at 15min, 1h, 2h, at discharge from the post-anaesthesia care unit and at 12h and 24h in the ward. Data was analysed using SPSS 23.
Results: Of the 24 patients enrolled, the study was completed by 20(83.33%). There were 10(50%) patients in group A; 8(40%) males and 2(20%) females with mean age 24.8±14.14 years and mean surgery time 130.5±47.86 minutes. There were 10(50%) patients in group B; 8(40%) males and 2(20%) females with mean age 23.2±7.4 years and mean surgery time 117±23.85 minutes (p>0.05). Total morphine used over 24 hours in group A was 16±3.1mg compared to 29.6±11.2mg in group B (p<0.05). The time for first use of patient-controlled analgesia after arriving in the post-anaesthesia care unit was significantly delayed in group A 72.2±24.95 minutes compared to that in group B 25±26.68 minutes (p<0.05). Pain scores were significantly higher in the group B at 15min compared to group A (p<0.05), but not at the rest of the time points (p>0.05).
Conclusion: Intravenous magnesium sulphate proved to be effective in lowering postoperative opioid requirement following limb amputations.
Key Words: Postoperative pain, Analgesia, Amputation, Surgical amputation, N-methyl-D-aspartate receptors, Magnesium, Magnesium sulphate, Opioid analgesics, Morphine, Patient-controlled analgesia.
Common variable immunodeficiency associated enteropathy: a diagnostic enigma in developing countries
Authors: Hassan Muhammad Aftab , Muhammad Hussain  , Dawood Ahmad  , Muhammad Omair Riaz  , Muhammad Zain Arshad
Published: May 2024

Common variable immunodeficiency (CVID) is the most prevalent primary immunodeficiency disorder with different phenotypes and aetiologies. It is characterised by hypogammaglobulinaemia, defects in specific antibody response, erroneous activation and proliferation of T cells, leading to increased risk of recurrent infections. In CVID, "Variable" refers to the heterogeneity of clinical presentations, which include recurrent infections, autoimmunity, enteropathy, and increased risk of malignancies. This wide spectrum of disease manifestations and being a diagnosis of exclusion poses a diagnostic challenge. It is pertinent to mention that CVID along with associated complications is the commonest symptomatic primary antibody deficiency but is scarcely mentioned in local literature. The main aim of presenting this case is to impress upon the importance of systematic immunological workup in cases of suspected immunodeficiency to prevent morbidity and mortality.
Key words: Common Variable Immunodeficiency, Enteropathy, Primary Immunodeficiency.
Congenital eyelid imbrication syndrome: a rare occurrence in Pakistan
Authors: Qidwai Nazia , Bukhari Sadia Shah , Rameez Faiza
Published: May 2024

Congenital eyelid imbrication syndrome (CEIS) is a rare condition presenting at birth and is characterised by overriding of the upper lid on the lower lid. It is due to longer upper lid, than the lower lid. Overriding leads to spontaneous eversion of the upper lids. In our patient, examination revealed canthal tendon laxity and hyperaemia of the tarsal conjunctiva. All the rest of the structures in the eyeball and adnexa were normal. Spontaneous eversion occurred in two weeks as the upper lid grew with time. No treatment was required.
Keywords: Congenital imbrication syndrome, Overriding upper lid, Hyperaemic conjunctiva, Floppy eyelids.
The risk of under-nutrition in hospitalised Malaysian children: use of 3-minute nutrition screening-paediatrics (Paediatric 3-MinNS)
Authors: Yeo Pei Sien , Abdul Majid Hazreen
Published: May 2024

Objective: To evaluate the under-nutrition risk of children admitted to hospitals using a validated tool.
Methods: The cross-sectional study was conducted from September 2017 to June 2018 in the paediatrics wards of a tertiary referral paediatric government hospital, a tertiary teaching hospital and a government district hospital in Malaysia. The sample comprised paediatric patients aged 2-12 years within 24-72 hours of hospital admission. Data was collected using the 3-Minute Nutrition Screening-Paediatrics tool.
Data was analysed using SPSS 20.
Results: Of the 341 patients screened, 284(83.3%); 170(59.9%) boys and 114(40.1%) girls. The overall median age was 4.85 years (interquartile range: 4.33 years). The median length of hospital stay was 3 days (interquartile range: 3 days). There were 72(25.4%) participants at high under-nutrition risk, with the highest proportion being at the district government hospital 31(33%). Among those with high risk, 5.4% subjects had severe acute malnutrition, 9.7% had severe chronic malnutrition, and 11.1% had severe thinness.
Conclusion: The 3-Minute Nutrition Screening-Paediatrics scale was found to be effective as a nutrition screening tool for hospitalised children in Malaysia.
Key Words: Hospitalised children, Nutrition, Screening tool.
Social intelligence in health professions educationists: how it helps to deal with challenges at the workplace? a mixed-method study
Authors: Abbasi Laila Shakeel , Yasmeen Rahila , Ali Shabana
Published: May 2024

Objective: To identify the social intelligence of medical educationists, and the coping strategies used to deal with workplace challenges.
Method: The mixed-method study with an explanatory sequential design was conducted from March 15 to July 30, 2021, after approval from the ethics review committee of Riphah International University, Rawalpindi, Pakistan, and comprised medical educationists working in medical and dental colleges and institutions across the country. Data was collected using Tromso social intelligence scale in the quantitative phase. The socially intelligent educationists were identified, and were interviewed. Qualitative data was subjected to thematic analysis to identify predominant themes explaining the coping strategies used.
Results: In the quantitative phase, there were 80 participants; 51(63.7%) females and 29(36.3%) males, with 24(30%) having >10 years of professional experience. Of them, 11(13.8%) scored low, 54(67.5%) moderate and 15(18.8%) high on the social intelligence scale. In the qualitative phase, there were 13 subjects; 9(69.2%) females and 4(30.8%) males. There were 4 themes identified as coping strategies; inspire respect and trust, bringing readiness before a change, a collaborative and inclusive approach, and soft skills.
Conclusion: Variation was seen in the levels of social intelligence among medical educationists working in academic institutions. Those with high levels of social intelligence used their non-cognitive soft skills to manage workplace challenges.
Key Words: Social intelligence, Medical education, Workplace, Coping strategies, Coping skills.
A Possible Solution to Statin Noncompliance
Authors: Muhammad Daniyal  , Abdullah Ahmad
Published: May 2024

Dear Sir/Madam
Pakistan is one of the top six countries for Cardiovascular deaths and it is estimated that 4.7 million people will die from Cardiovascular deaths between 2005-2027[1]. Considering the burden of cardiovascular disease, it is imperative that we focus our efforts on preventing and addressing risk factors while simultaneously ensuring that the goals of our preventive strategies are met. One such issue arises with statins.
Statin drugs are the first line drug therapy for dyslipidemia (a significant risk factor for CVDs) and the most widely prescribed drugs for dyslipidemia treatment as per both the American and European guidelines [2]. Statin drugs are essential for improving cardiovascular outcomes [2].  However, a challenge with statin therapy is nonadherence to the drug as shown by various studies. The percentage of patients taking statin dropped to 60.3% in one year and 48.8% in five years as shown by a cohort study on 1221 patients [3]. Statin associated muscle symptoms are the most common side effect implicated in patients discontinuing therapy.
A meta-analysis showed that patients with statin-associated myopathy had significantly lower vitamin D levels than non-myopathy patients. This study pooled the results of four studies to show a significant increase in tolerance rate after vitamin D supplementation [4]. A randomized control trial showed a decrease in cardiorespiratory fitness with statin drugs, significantly reduced in the group of statins plus vitamin D supplementation [5]. These studies show the positive results of vitamin D supplementation when given with statin. It is, thus, possible for us to increase compliance with statin therapy and improve patients' exercise performance on statin drugs.
Considering the impact of CVDs on our population and the pivotal part of Statin therapy, any related development can have a vast clinical impact and should be welcomed. We believe that general physicians should be made aware of such discoveries. Further, guidelines could be updated with inclusions of Vitamin D with high intensity Statin therapy. Finally, the importance of these drugs warrants further clinical trials to assess the feasibility of their use with vitamin D.
Endoscopic pilonidal sinus treatment (EPSiT) for sacrococcygeal pilonidal sinus disease: a prospective long-term study
Authors: Muhammad Amir  , Farooqui Fareeha , Latif Sehrish , Sohaib Khan  , Sibgha Aiman  , Uneeb Muhammad
Published: May 2024

Objective: To assess short-term and long-term outcomes of endoscopic pilonidal sinus treatment for pilonidal sinus disease.
Method: The prospective study was conducted at Shifa International Hospital, Islamabad, Pakistan, from July 2015 to July 2021, and comprised all pilonidal sinus cases undergoing minimal invasive endoscopic pilonidal sinus treatment who were treated by a single surgical team. The primary outcomes were duration of healing, post-operative morbidities, persistence of discharge and recurrence at 1-7 years. The secondary outcomes were operative time, return to work, cosmetic results and patient satisfaction. The patients were observed for wound healing and discharge on follow-up in the out-patient department at 1, 3, 6 and 24 weeks. They were further followed up every year through telephonic survey for persistence or recurrence of symptoms. Patient satisfaction was assessed using the 36-item Short Form Survey questionnaire filled at admission and then at 6 weeks post-surgery. Data was analysed using SPSS 23.
Results: Of the 67 patients, 55(82%) were males and 12(18%) were females. The overall mean age was 25.69±8.305 years. There were 13(19.4%) patients with a history of recurrent disease and previous procedures for pilonidal sinus, while 54(80.6%) had no previous surgery. The median operative time was 35 minutes (interquartile range: 20-45 minutes). Complete wound healing was achieved in 60(89.6%) patients, while recurrence was seen in 7(10.4%). The median time off work was 2.5 days (interquartile range: 1-3 days). Patient satisfaction with the procedure was significantly high (p<0.05).
Conclusion: Endoscopic pilonidal sinus treatment appeared to be a good minimally invasive surgical technique for the treatment of pilonidal sinus disease in terms of both short-term and long-term outcomes.
Key Words: Pilonidal sinus disease, Minimally invasive surgery, Endoscopic pilonidal sinus treatment, EPSiT, Recurrent pilonidal sinus.
Bending Analysis of Smart Functionally Graded CNT Reinforced Composite Plates
Authors: Manish Kumar  , Rashmi Rani  , Saroj Kumar Sarangi
Published: May 2024

Analysis of smart functionally graded plate of carbon nanotube reinforced composites combined with piezoelectric constituents has been introduced by finite element model (FEM). Material parameters of CNT reinforced composite plates are supposed to varies along the thickness direction following extended rule of mixture. Finite element model of the FG plates combined with piezoelectric materials is developed using ANSYS software. This model is tested against previously published work and found to be in accord with them. The numerical results are evaluated using verity boundary conditions. The effectiveness of piezoelectric materials for control of deflection of this FG plate is presented. The results revealed that the piezoelectric layer of the smart FG plates efficiently controls the nonlinear deformations of the presently studied smart CNT reinforced functionally graded plate. Results are also presented considering different material profiles for the grading of the FG plate.
Pengaruh Content Marketing dan Influencer Marketing Terhadap Keputusan Pembelian dengan Brand Image Sebagai Variabel Mediasi: Studi pada Pembelian Produk Luxcrime di Kota Malang
Authors: Alviana Mawarda  , Fani Firmansyah
Published: May 2024

One current trend that can spark consumer interest is through the use of marketing content distributed via social media platforms. The main goal of this content creation strategy is to move potential consumers into active consumers. Apart from building good relationships with consumers, Influencer marketing also has a significant impact on online sales. Apart from that, the brand image also has a big influence on purchasing decisions, because not only do consumers pay attention to the content and influence of influencers, but also the image of the brand itself. This research is a type of quantitative research that uses a descriptive approach, involving 128 respondents who are consumers of Luxcrime products in Malang City. The sample was selected purposively, and data was collected via a Google form which was then processed using SEM Pls 3.0 software. The research results show that Influencer marketing and brand image have a significant impact on purchasing decisions, while Content Marketing does not have a significant impact. In addition, brand image can mediate the relationship between Content Marketing and Influencer marketing in purchasing decisions..
Size Perusahaan Memoderasi Hubungan Good Corporate Governance, Green Supply Chain Management dan Green Accounting Terhadap Kinerja Keuangan Perusahaan
Authors: Topan Pamungkas  , Iin Rosini  , Suripto
Published: May 2024

This research aims to examine how company size influences the relationship between Good Corporate Governance, Green Supply Chain Management, and Green Accounting on Company Financial in Sri-Kehati index companies listed on the BEI from 2016 to 2022. This type of research is known as associative quantitative research . The population in this research is the Sri-Kehati index business actors listed on the Indonesia Stock Exchange between 2016 and 2022, totaling 25. The sampling approach is a saturated sampling technique. The sample for this research consists of 25 companies listed on the Indonesia Stock Exchange from 2016 to 2022, with 175 observation data obtained based on sample criteria. The data analysis method used is panel data regression analysis with Eviews-12.0. The findings of this study show that good corporate governance has a partial impact on company financial performance, while environmentally friendly supply chain management has a small impact and environmentally friendly accounting does not. The company size variable cannot moderate the influence of good corporate governance on the company's financial performance, the influence of green supply chain management on the company's financial performance, or the influence of green accounting on the company's financial performance.
Matematik Öğretiminde İlişkilendirmeyle İlgili Eğitimin Öğretmen Adaylarının Matematiksel İlişkilendirme Becerilerine Yönelik Öz Yeterlik Algılarına Etkisi
Authors: Sezgin Kalelioğlu Zülal , Pişkin Tunç Mutlu
Published: May 2024

Bu araştırmanın amacı matematiksel ilişkilendirmeye yönelik verilen eğitimin öğretmen adaylarının matematiksel ilişkilendirmeye yönelik öz yeterliklerine katkısını incelemektir. Araştırmanın katılımcılarını 2021-2022 eğitim-öğretim yılının bahar döneminde bir devlet üniversitesinde öğrenim görmekte olan 50 ortaokul matematik öğretmeni adayı oluşturmaktadır. Katılımcıların belirlenmesinde uygun örnekleme yönteminden faydalanılmıştır. Bu araştırmada ön test ve son test uygulanması sebebiyle yarı deneysel desen kullanılmıştır. Matematik öğretmen adaylarının öz yeterlik düzeyleri matematiksel ilişkilendirme dersini almadan önce ölçülmüş daha sonra araştırmacılar tarafından altı haftalık matematiksel ilişkilendirme dersi eğitimi uygulanmıştır. Verilen eğitimin sonunda matematik öğretmen adaylarının matematiksel ilişkilendirme öz yeterlik düzeyleri tekrar ölçülmüştür. Veriler “Matematiksel İlişkilendirme Öz Yeterlik Ölçeği” kullanılarak elde edilmiştir. Araştırmadan toplanan verilerin analizinde betimsel istatistikler ve bağımlı örneklem t testi kullanılmıştır. Matematiksel ilişkilendirmeye yönelik öz yeterlik ölçeğinin ön test uygulamasının analiz edilmesi ile elde edilen sonuçta öğretmen adaylarının öz yeterlikleri orta düzey olarak bulunurken, son test uygulamasının analizinde ise yüksek düzey bulunmuştur. Araştırma sonucunda öğretmen adaylarının öz yeterlik düzeyleri arasında son test lehine anlamlı bir fark bulunmuştur.
ONKOLOJİK TEDAVİYE BAĞLI GELİŞEN ORAL MUKOZİTİN YÖNETİMİ İLE İLGİLİ BİR İÇERİK ANALİZİ
Authors: Deniz Akan Dilan
Published: May 2024

Onkolojik tedavinin en sık karşılaşılan yan etkilerinden biri olan oral mukozit (OM), sıklıkla ağrılı ve ülseratif bir süreç olup hastaların yaşam kalitelerini ve tedavi süreçlerini olumsuz etkilemektedir. Bu araştırmanın temel amacı, onkolojik tedaviye bağlı gelişen OM’in yönetimi ile ilgili hemşirelik alanında yapılan çalışmaların (2013-2023) genel hatlarını ve eğilimlerini ortaya çıkarmaktır. Betimsel içerik analizi kullanılarak yapılan bu çalışmada Scopus, Pubmed, Google Scholar ve Web of Science veri tabanlarında retrospektif tarama yapılmış; dahil etme kriterlerine uygun 37 makale araştırma kapsamında değerlendirilmiştir. Verilerin istatistiksel değerlendirilmesinde, IBM SPSS 21 ve MAXQDA 2022 programları kullanılmıştır. Araştırmada, onkolojik tedaviye bağlı gelişen OM’in yönetimi ile ilgili 2013-2023 yılları arasında yapılan çalışmaların yıllar içerisinde artış gösterdiği ancak henüz istenilen seviyeye ulaşmadığı belirlenmiştir. OM yönetimi ile ilgili en çok çalışma yayımlayan derginin Journal of European Oncology Nursing Society (%16,2) olduğu, en üretken ülkenin Türkiye olduğu (n=10), çalışmalarda büyük oranda nicel araştırma yönteminin (%94,6) kullanıldığı, çalışmaların çoğunda araştırma deseni olarak deneysel tasarım (%67,6) tercih edildiği tespit edilmiştir. Sonuç olarak; OM yönetimi ile ilgili daha fazla sayıda çalışmanın yapılmasının, daha önce yapılan çalışmaların farklı gruplarda ve daha büyük örneklem grupları ile tekrar edilerek test edilmesinin, hemşirelerin bilgi düzeyini arttırmaya yönelik çalışmaların arttırılmasının ve nitel araştırma yönteminin çalışmalarda daha sık kullanılmasının yararlı olacağı düşünülmektedir.
Invasieve groep A-streptokokkeninfectie met evolutie naar sepsis: een casus
Authors: Bouckaert E. , Mulier T. , Verstreken I. , Reynders P. , Eneman B.
Published: May 2024

Invasive group A streptococcal infection with evolution to sepsis: a case report

An increasing incidence of invasive group A streptococci infections (iGAS) has recently been reported worldwide, with a marked increase in Flanders (Belgium) since autumn 2022. Although a turning point in this increase can be seen in March 2023, there are still significantly more infections in absolute numbers than in 2022. iGAS can have an aggressive disease progression and are associated with a significant morbidity and mortality.

This case involves a 16-month-old girl with the clinical presentation of acute monoarthritis of the left knee, diagnosed as Streptococcus pyogenes septic arthritis. Consecutively, she developed osteomyelitis with evolution to a severe streptococcal toxic shock syndrome (STSS). The therapy consisted of antibiotics, especially cefotaxim and clindamycin, as well as surgical drainage and supportive care.

A child with septic arthritis may present first to the general practitioner, but also to other disciplines, which makes general vigilance for iGAS necessary.

The diagnosis of (peri)articular infections can be challenging. If septic arthritis is suspected, an X-ray and ultrasound of the involved joint should be performed. An MRI is the golden standard if osteomyelitis is suspected. Early detection of the disease allows a quicker initiation of the treatment (like antibiotics) and minimizes the risk of short- and long-term complications and mortality.
Floristic Composition and Structure of Bimbia-Bonadikombo Commuinty Forest, South West Region, Cameroon
Authors: Penda Nasako Noto , Fuashi Nkwatoh Athanasius , Maurice Melle Ekane , Bumtu Kamah Pascal
Published: May 2024

Purpose: This study was conducted to assess forest structure and floral diversity in Bimbia-Bonadikombo Community Forest (Hereafter BBCF) after over two decades of conservation efforts. Three land use types were identified in BBCF. These include Primary Forest (PF), Secondary Forest (SF) and Agroforestry (AF).
Materials and Methods: Three line transects of 1 km long each were established in each of the land use types and plots of 20 X 20 meters were established at 100 meters’ intervals alternately along each transect. A total of 90 plots were established and each live tree (≥ 5 cm DBH) was measured at 1.3 m and recorded.
Findings: A total of 1600 individual trees were identified belonging to 110 species and 36 families. The first three abundant families were Myristicaceae with 240 individuals (15%), followed by Fabaceae and Urticaceae with 183 (11.44%) and 143 (08.94%) individuals respectively. Families with highest number of tree species were Ebenaceae and Fabaceae with 8 species each. The most abundant species was Musanga cecropioides.  Shannon diversity index (H') was highest in the PF (H' = 3.77) and least in AF (H' = 3.44). There was a significant relationship (X2 = 1.801; p = 0.000) between trees DBH and land use types.
Implications to Theory, Practice and Policy: The 1994 forestry law of Cameroon (part III, section 34) guides creation of community forests with the responsibility of local communities to ensure protection of biodiversity and improve local livelihoods through forest management committees. Our study revealed that forest composition and structure of BBCF has been negatively affected due to unsustainable exploitation of resources by fringe communities. It is therefore recommended that to ensure significant forest reconstitution, appropriate conservation measures should be reinforced by BBCF management committee.
Integrating Islamic Psychological Principles in Enhancing Students' Academic Resilience
Authors: Aprilianti Eka
Published: May 2024

This study examines the concept of resilience within the context of Islamic psychology, an area relatively unexplored by conventional psychological approaches. Employing qualitative methodology, particularly document review, this research aims to understand how principles documented in the Quran and Hadith can influence individual resilience in facing academic stress and challenges. The data analysis process involves data reduction, display, and conclusion drawing, emphasizing validation through credibility, transferability, dependability, and confirmability of results. Key findings indicate that the practical application of Islamic values enhances academic resilience, reflected in individuals’ resilience when facing academic tasks. This study provides new insights into educational psychology by offering an alternative perspective that integrates spiritual dimensions into education. This enriches our understanding of resilience, while also making a significant theoretical contribution to the development of modern educational paradigms. By exploring the methods of Islamization of knowledge, this study also delves into aspects of resilience rooted in Islamic values, providing constructive solutions to criticisms of modern psychology often considered detached from divine values. The practical implications of this research are expected to support more effective mentoring and teaching efforts in value-based educational contexts.
Factors Influencing Aggression Among Adolescents in Indonesia: A Literature Review
Authors: Wangsa Pande Ryan Praba , Tobing David Hizkia
Published: May 2024

Adolescent aggression has long been a major concern in the fields of educational psychology and sociology, especially in Indonesia where social and cultural dynamics play a role in shaping adolescent behavior. This study is a systematic literature review, examining 30 publications from the years 2014 to 2023 to understand the factors influencing aggression among Indonesian adolescents. This method involved collecting data from various sources accessed through Google Scholar using relevant keywords associated with adolescent aggression. The purpose of this review is to specifically ascertain the effects of internal factors such as emotional maturity, emotional intelligence, and self-control, as well as external factors including peer conformity, parental communication styles, parenting styles, and the intensity of online gaming on aggressive behavior in adolescents. The findings from this analysis are expected to provide deeper insights into effective ways to intervene and prevent aggressive behaviors among adolescents in Indonesia, thereby making a significant contribution to parenting practices, education, and social and mental health policy for adolescents.
Learning from Mistakes: A Thematic Analysis of Flight 401's Situational Awareness Lapses
Authors: Yıldız Ezgi
Published: May 2024

Situational awareness is a fundamental pillar in aviation, essential for safety, operational efficiency, and crew training. This study focuses on the tragedy of Eastern Airlines Flight 401 as a case study to illustrate the importance of effective communication and Crew Resource Management (CRM) in preventing accidents. Through thematic analysis, the research reveals how pilot distractions, cockpit instrument malfunctions, and communication failures in critical conditions contributed to the accident. The findings indicate that comprehensive training that integrally incorporates technological aspects and human factors, as well as an emphasis on effective CRM, is crucial. Practical implications of this research include the development of training modules aimed at enhancing interactive and collaborative communication among crew members. The study also recommends future research focus on aviation technology, air traffic control dynamics, and human-machine interactions, with the goal of deepening understanding of situational awareness dynamics and advancing aviation safety practices. These findings are expected to make a significant contribution to the literature on situational awareness and aviation safety practices.
Empowering Health: Unveiling the Impact of Self-Efficacy and Lifestyle on Hypertension Management
Authors: Mega Juli Yosa
Published: May 2024

This study aims to investigate the significant relationship between self-efficacy and lifestyle on the prevalence of hypertension. In this context, self-efficacy is defined as an individual's belief in managing blood pressure through health behaviors, while an unhealthy lifestyle includes habits such as a high-salt diet and minimal physical activity. This research utilized a quantitative method with a descriptive correlational design and a cross-sectional approach. Out of 70 respondents, it was found that 27 individuals (38.6%) had sufficient self-efficacy, 36 individuals (51.4%) demonstrated an unhealthy lifestyle, and 37 individuals (52.9%) suffered from hypertension. Statistical analysis showed a significant relationship between self-efficacy (p-value = 0.000) and lifestyle (p-value = 0.000) with the incidence of hypertension. These results support the theory that enhancing self-efficacy and shifting towards a healthier lifestyle can reduce the risk of hypertension, providing significant contributions to the literature and practices in hypertension management.
Abstrak: Studi ini bertujuan untuk menginvestigasi hubungan yang signifikan antara self-efficacy dan gaya hidup terhadap prevalensi hipertensi. Dalam konteks ini, self-efficacy diartikan sebagai keyakinan individu dalam mengelola tekanan darah melalui perilaku kesehatan, sedangkan gaya hidup tidak sehat mencakup kebiasaan seperti diet tinggi garam dan minim aktivitas fisik. Penelitian ini menggunakan metode kuantitatif dengan desain deskriptif korelasional dan pendekatan cross-sectional. Dari total 70 responden, ditemukan bahwa 27 orang (38,6%) memiliki self-efficacy yang cukup, 36 orang (51,4%) menunjukkan gaya hidup tidak sehat, dan 37 orang (52,9%) menderita hipertensi. Analisis statistik menunjukkan hubungan yang signifikan antara self-efficacy (p-value = 0,000) dan gaya hidup (p-value = 0,000) dengan kejadian hipertensi. Hasil ini mendukung teori bahwa peningkatan self-efficacy dan perubahan ke arah gaya hidup yang lebih sehat dapat mengurangi risiko hipertensi, memberikan kontribusi penting terhadap literatur dan praktik dalam manajemen hipertensi.
Impact of Deep Breathing, Murottal, and Hypertension Exercises on Headache Management in Hypertensive Individuals
Authors: Stia Pusporini Lenny , Alifiani Herna , Islamiah Imas
Published: May 2024

Hypertension, characterized by an abnormal increase in blood pressure, often triggers headaches at the back of the head and neck due to vascular disturbances. This study explores the effectiveness of a holistic non-pharmacological intervention—comprising Deep Breathing Relaxation Technique, Qur'anic recitation (murottal), and Hypertension Exercise—to alleviate these headaches in hypertensive patients at Mekarjaya Community Health Center, Indonesia. Employing a quantitative approach, the research utilized a Quasi-Experimental Design with a Pretest and Posttest Control Group. The intervention group underwent IMAS therapy, an integrated approach combining the three techniques, while the control group continued only with routine medication. Conducted in December 2022 with 16 participants in each group, results from both Dependent and Independent T-tests (p < 0.05) confirmed the significant effect of the interventions. This study not only underscores the potential of such integrative therapies in managing hypertension-related headaches but also contributes to broader health care practices by offering a viable alternative to conventional medication. The findings align with and extend existing research on relaxation therapies for hypertension, suggesting substantial benefits in patient well-being and symptom management.
Challenges and Solutions in B3 Waste Management at RSUD X: An Analysis Based on Ministerial Regulations
Authors: Permana Eko Adittya , Hardiana Hedy
Published: May 2024

Hospital services provide significant benefits to the community and generate hazardous and toxic waste (B3) that poses high risks if not properly managed. B3 waste management in hospitals must comply with government regulations, such as Minister of Health Regulation No. 02 of 2023 and Minister of Health Regulation No. 07 of 2019. This study aims to analyze the effectiveness of B3 waste management policies at Hospital X and identify the factors affecting their implementation. The research employs a Realist Evaluation methodology using qualitative methods. Seventeen informants, selected through purposive sampling, including management heads, quality committee members, department heads, and field technical officers, were interviewed in-depth. The findings indicate challenges in implementing B3 waste management policies, such as a lack of trained personnel, inadequate infrastructure, and limited budget. While the policies based on Minister of Health Regulation No. 02 of 2023 and Minister of Health Regulation No. 07 of 2019 have been successfully implemented, there are still challenges that need to be addressed to achieve the desired targets. This study provides significant contributions to the development of more effective B3 waste management policies in the future.
Abstrak: Kegiatan pelayanan di rumah sakit tidak hanya memberikan manfaat besar bagi masyarakat, namun juga menghasilkan limbah B3 yang berisiko tinggi jika tidak dikelola dengan baik. Pengelolaan limbah B3 di rumah sakit perlu mengikuti kebijakan pemerintah, seperti Permenkes Nomor 02 Tahun 2023 dan Permenkes Nomor 07 Tahun 2019. Penelitian ini bertujuan untuk menganalisis efektivitas kebijakan pengelolaan limbah B3 di Rumah Sakit X dan mengidentifikasi faktor-faktor yang mempengaruhi pelaksanaannya. Penelitian menggunakan metodologi Realist Evaluation dengan metode kualitatif. Sebanyak 17 informan yang dipilih secara purposive sampling, termasuk kepala manajemen, komite mutu, kepala ruangan, dan petugas teknis lapangan, diwawancarai mendalam. Hasil penelitian menunjukkan kendala dalam implementasi kebijakan pengelolaan limbah B3, termasuk kekurangan SDM yang terlatih, infrastruktur yang tidak memadai, dan anggaran yang terbatas. Kebijakan pengelolaan limbah B3 berdasarkan Permenkes No. 02 Tahun 2023 dan Permenkes No. 07 Tahun 2019 telah berhasil diimplementasikan, namun masih terdapat tantangan yang perlu diatasi untuk mencapai target yang diharapkan. Penelitian ini memberikan kontribusi penting bagi pengembangan kebijakan pengelolaan limbah B3 yang lebih efektif di masa mendatang.