bluuebunny/crossref_metadata_2025 huggingface dataset:
Guaranteeing Performance in a Fault Tolerant Architecture Solution using Software Agent’s Coordination
Authors: Festus O Oliha
Published: October 2022

Performance is a critical attribute in evaluating the quality and dependability of service-oriented systems dependent on fault-tolerantarchitectures. Fault-tolerant architectures have been implemented with redundant techniques to ensure fault-tolerant services. However, replica-related overhead burdens fault-tolerant techniques with associated performance degradation in service delivery, and this consequentially discourages service consumers with discredits for service providers. In this paper, a fault-tolerant approach thatadopts replication and diversity was employed on agent-oriented coordination toward guaranteeing the performance of the proposedfault-tolerant architecture solution under a large-scale service request load. In addition, the resultant architecture solution was simulated with Apache JMeter for performance evaluation considering the performability in the absence and presence of a fault load. The simulation experiments and results revealed the architecture’s efficiency in fault tolerance via the timely coordination of logicaland replica-related activities by software agents. Noteworthily, the continued service availability and performance were guaranteed for the architecture solution with a significant rate of regularity in the absence and presence of a replica-related fault. Therefore, this study’s performance evaluation methods and results could serve as a veritable milestone for building fault-tolerant service systems with appreciable performability and contribute to the service-oriented fields where performance is inevitable.
CASE STUDY ON THE IMPLEMENTATION OF GOODS AND SERVICES TAX (GST) IN MALAYSIA AND SINGAPORE
Authors: Ikhsan Dr. Mohammad Fajar , Aziz Norsyuhada Azwin , Mahyudin Emil
Published: October 2022

Goods and Services Tax or GST is one of the most controversial taxes, causing dissatisfaction among the people. The distribution of justice and the implementation and effectiveness of GST policies tend to be the most frequently debated issues. The objective of this study is to examine the implementation, impacts, effectiveness, and challenges of GST policy in Southeast Asian countries, particularly Malaysia and Singapore. By employing a critical analysis perspective such as from Marxism’s lens of view, it is expected that this article will provide a new perspective in analysing GST policy implementation in the region. A descriptive qualitative analysis approach was used in this study, emphasising the content analysis method and the data obtained from official sources and literature studies. The study found that GST contributed to Singapore and Malaysia’s economy and revenue. Nevertheless, the GST impact affected the citizens of Singapore and Malaysia, especially the lower-income earners. The study argued that there is a dilemma in the GST tax policy implementation. It can be assumed through the findings that the GST policy did not meet the conscience of the Marxist perspective as it is regressive. Thus, in several parts of GST implementation, it has both advantages to the country’s production and productivity. On the other hand, it disadvantages society, particularly the lower- and middle-class groups.
REVISITING THE RESPONSIBILITY TO PROTECT AS AN INTERNATIONAL NORM
Authors: Bhattacharya Swatilekha
Published: October 2022

The purpose of the paper is to revisit the origin of the principle of responsibility to protect (R2P) focusing on few cases and reflecting on the troubled journey that it has made maneuvering its structural constraints posed by hegemonic powers and geopolitical manipulations, by employing historical methods in tracking its evolution. The inter-state aggression during the Cold War, largely gave way to war and violence within, after the end of it, rather than between, states. There were two opposing views at the United Nations (UN): those who supported right of humanitarian intervention and those who viewed such a doctrine as an infringement upon national sovereignty. In this regard, R2P remains a developing principle and, the absence of definitive state practice in this area means that states wanting to intervene to protect foreign populations from atrocities are left without clear legal justification for such action. In the absence of UN Security Council authorisation, use of force under the banner of R2P remains contentious. Lastly, the paper discusses the prospects the principle will have in future as constraints and manipulations are still present.
Optimal Asset Planning for Prosumers Considering Energy Storage and Photovoltaic (PV) Units: A Stochastic Approach
Authors: Achiluzzi Eleonora , Kobikrishna Kirushaanth , Sivabalan Abenayan , Sabillon Carlos , Venkatesh Bala
Published: October 2022

In the distribution system, customers have increasingly use renewable energy sources and battery energy storage systems (BESS), transforming traditional loads into active prosumers. Therefore, methodologies are needed to provide prosumers with tools to optimize their investments and increase business opportunities. In this paper, a stochastic mixed integer linear programming (MILP) formulation is proposed to solve for optimal sizes of prosumer assets, considering the use of a BESS and photovoltaic (PV) units. The objective is to minimize the total cost of the system, which is deﬁned as the combination of a solar PV system investment, BESS investment, maintenance costs of assets, and the cost of electricity supplied by the grid. The developed method deﬁnes the optimal size of PV units, the power/energy capacities of the BESS, and the optimal value for initial energy stored in the BESS. Both deterministic and stochastic approaches were explored. For each approach, the proposed model was tested for three cases, providing a varying combination of the use of grid power, PV units, and BESS. The optimal values from each case were compared, showing that there is potential to achieve more economic plans for prosumers when PV and BESS technologies are taken into account.
Which came first, spacetime or clocks?
Authors: Ord Garnet
Published: October 2022

Emergent quantum mechanics seeks a deeper level theory, anticipating that such a theory will provide a clearer picture of the relation between the quantum and classical worlds. In this work we show that the quantum-classical divide is a manifestation of the transition from Newton’s absolute time to relativity’s path-dependent time. The prior theory in this case is that particles are intrinsic clocks. The emergence of separate classical and quantum behaviour is seen by considering different continuum limits in a single digital clock model. A continuum limit that constructs a continuous worldline provides a simple basis for Minkowski spacetime. An alternative limit in which the clock itself contains boost information leads to the Dirac equation. 
How Does Spacetime “Tell an Electron How to Move”?
Authors: Ord Garnet
Published: October 2022

    

Minkowski spacetime provides a background framework for the kinematics and dynamics of classical particles. How the framework implements the motion of matter is not specified within special relativity. In this paper we specify how Minkowski space can implement motion in such a way that ’quantum’ propagation occurs on appropriate scales. This is done by starting in a discrete space and explicitly taking a continuum limit. The argument is direct and illuminates the special tension between ’rest’ and ’uniform motion’ found in Minkowski space, showing how the formal analytic continuations involved in Minkowski space and quantum propagation arise from the same source. 
Displacement-related stressors in a Sri Lankan war-affected community: Identifying the impact of war exposure and ongoing stressors on trauma symptom severity
Authors: Thomas Fiona , Coulombe Simon , Girard Todd , Hart Tae , Doherty Shannon , Dass Giselle , Wickramage Kolitha , Siriwardhana Chesmal , Surenthirakumaran Rajendra , McShane Kelly
Published: October 2022

In recent years, there has been a shift in the literature towards identifying how ongoing stress adversely affects mental health beyond the effect of direct exposure to war-related violence. The goal of the current study was to investigate the relationship between displacement-related stressors and trauma symptom severity. Participants (N 1⁄4 1015) were recruited from primary healthcare clinics (PHCs) in Northern Sri Lanka and completed a demographic and displacement history questionnaire, the Stressful Life Events Checklist, and the Harvard Trauma Questionnaire. Four latent stressor constructs were identified through exploratory and confirmatory factor ana- lyses: 1) personal safety concerns; 2) war-related loss; 3) material loss, and 4) personal hardships. Structural equation modeling was used to examine the relationship between stressors and trauma symptom severity. In the final structural equation model, war-related loss and material loss were positively related to symptom severity whereas psychosocial hardship was found to be negatively related to symptom severity. Results highlight how an integrated model of mental health can more fully inform the needs stemming from displacement-related stressors. 
Beyond genes-for-behaviour: the potential for genomics to resolve questions in avian brood parasitism
Authors: Rönkä Katja , Eroukhmanoff Fabrice , Kulmuni Jonna , Nouhaud Pierre , Thorogood Rose
Published: October 2022

Brood parasite-host interactions are among the most easily observable and amenable natural laboratories of antagonistic coevolution, and as such have intrigued evolutionary biologists for decades. It is therefore surprising they have not been at the forefront of genomic studies on evolutionary adaptation. Here we review state-of-the-art molecular methods in studying avian brood parasitism, a model system in behavioural ecology. We highlight outstanding questions to bring examples of how genomic tools are not merely about ‘finding a gene for behaviour’, but can be used to study the causes and mechanisms of (co)evolutionary adaptation. In doing so, we promote behavioural and molecular ecologists to integrate Tinbergen’s questions into a collaborative, coherent science aiming to solve the mysteries of nature and apply current methodology into other model systems in behavioural ecology.
Analysis of Chicken Temperature Control Using a Control System
Authors: Junaidi Junaidi , Siagian Tony , Ritonga Din Aswan Amran , Siregar Irpansyah , Rahmadsyah Rahmadsyah
Published: October 2022

Chicken is one of the side dishes favored by many people in the world. Therefore, many entrepreneurs do business with chicken. This research is the result of a survey of several technical journals about the temperature of the chicken coop taken. From observations and tests carried out in the field carefully, this research was carried out to analyze the temperature. The chicken coop regulation system is carried out with the aim of preventing livestock from dying due to the surrounding temperature not being appropriate for his age. This study uses the Atmega 8535 microcontroller as the main controller, LM35 as the main controller temperature sensor in the enclosure, and IC L293D as a DC motor driver. The microcontroller will instruct DCmotor to work if the measured temperature is above the specified temperature limit and will instruct the relay to turn on or turn off the incandescent light if the measured temperature is below the specified temperature limit. By using this relay, the temperature of the chicken coop will be appropriate for anticipating disease outbreaks from the chickens.
The Oedipus Complex in Eugene O’Neill’s Desire Under the Elms
Authors: Sumarsono Irwan , Fanani Abu , Masofa Ima
Published: October 2022

This research was conducted to analyze the Oedipus complex of Eben’s in Eugene O’Neil’s play entitled Desire Under the Elms. To analyze it, the writers use the psychological approach, especially Freud’s psychoanalysis theory. The writers got the main source of the data from the play, while the supporting data, the writers got from literary books, journals of English Literature, and the internet. Data were gathered then they were examined using the descriptive-analytic techniques. The focus of the study was divided into three discussions, namely the factors behind the reasons why Eben had the Oedipus complex, what made him have a rivalry with his own father, and had a forbidden relationship with his stepmother, Abbie. The forbidden relationship between Eben and Abbie is the manifestation of Eben’s Oedipus complex and his way to break his father’s deep heart as his revenge for his mother’s death. The study found out that Eben’s Oedipus complex was influenced more by Eben’s id than his ego and superego.
Competitiveness of enterprises in the context of sustainable development
Authors: Golda Nadiia
Published: October 2022

In the current development of the economy, the problem of competitiveness is relevant for all businesses that produce and sell products or services. Prospects for increasing the competitiveness of the national economy is one of the priorities of public policy. Against the background of the international market, the process of globalization is inevitable for Ukrainian enterprises and therefore the competition is becoming tougher and gaining global scale. Not all Ukrainian products meet the level of competitiveness in both foreign and domestic markets. The current state of development of most domestic enterprises does not allow to compete successfully with foreign manufacturers. The consolidation and globalization of markets intensifies competition between its actors and helps to find new ways to maintain the level of competitiveness. From the point of view of globalization, competitiveness implies the ability to find a competitive position in a constantly changing environment, which is formed under the influence of strengthening the relationship of national economies. To maintain a competitive position and achieve leadership, companies must constantly update technology, expand the scope of activities, look for competitive advantages, which is a more powerful source of development of any enterprise. Improving the market position of the enterprise by achieving Ukrainian competitive advantages in domestic and foreign markets is impossible without creating an effective system of competitiveness management. The main factors that significantly affect the competitiveness of products are the degree of satisfaction of demand for it, the capacity of individual market segments, the presence of competitors, socio-demographic characteristics, sales network development and after-sales service. Considering competitiveness as a generalized economic category related to the situation on the commodity market in conditions of free competition, and including design, production, distribution and consumer aspects of economic results, it should be borne in mind that products are a passive component of the market and active components are business entities that can be indirect carriers of competitiveness. In modern conditions, there is an objective need to adapt theoretical and methodological techniques and management methods in the creation and implementation of competitive products, taking into account the specific conditions of functioning of domestic enterprises. In conditions of intensifying competition in both domestic and foreign markets, one of the main means of achieving success of domestic industrial producers in the competition is to increase its competitiveness.
Demonstrative consumption - the way of life of part of the elite group of citizens of Ukraine
Authors: Dovgan Anatoliy
Published: October 2022

The essence of demonstrative consumption of material and spiritual goods in modern Ukraine are researched in the article. Consumer activity is seen as a process of conscious active behavior based on the needs and excessive financial capabilities of a person with the use of social benefits intended for material and spiritual development. Therefore, consumer activity can be considered as an element of the way of life of a person, and the cult of demonstrative consumption – an integral part of the way of life of a particular social stratum of the population of Ukraine. The emergence of distorted in the value dimension of some forms of commodity fetishism is revealed. In representatives of a particular social group (stratum), it asserts itself in the form of consumption of various objects of human activity. Such objects are not only material things, but also materialized cultural values, cultural mass events (theatrical performances, private parties with the participation of famous actors of theater and cinema and music, dance and singing shows). Functional and social properties and characteristics of things affect a person's acceptance of the way they are consumed. It is noted that people of this execution are beginning to demonstrate their own lifestyle, just as people of the previous, less overwhelmed by the choice of the era (twentieth century), consumed ordinary foods. In the context of the basic worldview principles of secular humanism, the significance of the "lazy class" theory of the famous American economist, sociologist and psychologist T. Veblen for the scientific analysis of everyday behavior of such representatives of the modern Ukrainian elite is revealed. Emphasis is placed on the manifestation of Ukrainian patronage in the late twentieth and early twentieth centuries.
Improvement of Clinical Reasoning
Authors: Uddin Md Mokhles
Published: October 2022

Abstract not available

JCMCTA 2017 ; 28 (2) : 1 - 2
Peripheral Arterial Disease in Chronic Kidney Disease Patient
Authors: Hamid Md Abdul , Paul Sujat , Dutta Pradip Kumar
Published: October 2022

Among the different complications of chronic kidney diseases, Peripheral Arterial Disease (PAD) is not uncommon which is an indicator of wide spread atherosclerosis in other vascular territories, such as the cerebral and coronary circulations. Traditional cardiovascular risk factors, such as black race, male gender, age,tobacco use, diabetes, hyperlipidemia, and hypertension are also associated with PAD. But in kidney patients this disease is sometimes neglected. This present review tends to describe epidemiology, risk factors and necessities for screening of PAD in chronic kidney disease patients.

JCMCTA 2017 ; 28 (2) : 3-11
Prevalence of Risk Factors of Cerebrovascular Diseases in Hospitalized Patients
Authors: Rahman Mohammed Habibur , Hassan Md Mahtab Uddin , Khanom Mehrunnissa , Das Kajal Kanti , Lohani Md Kamrul Hasan , Chowdhury Forhad Uddin Hasan
Published: October 2022

Background: Stroke is one of the foremost causes of morbidity and mortality in Bangladesh. It has diverse risk factors. The present study is aimed to observe the common risk factors of stoke in our perspective. Materials and methods: This observational study was conducted for a 1 year period (April 2010 to March 2011) on 100 patients of stroke admitted in different medicine units of Chittagong Medical College Hospital. Different risk factors were identified along with clinical features after diagnosis of stroke of 100 patents. After collection, data were analyzed and presented to find out demographic pattern, clinical presentation and association with different irreversible and modifiable risk factors. Results: Among the 100 patients of stroke age distribution revealed most of the stroke patients were age group 51-60 years (58%) next to which was 61-70 years (22%). Male was 68 (68%) and female 32 (32%). Male to female ratio was 2.1:1. Among the all study patients most were doing business (22%) and engaged in service (20%). Majority of women were housewife (28%). Regarding type of stroke, 82 (82%) cases were ischemic and 18 (18%) were hemorrhagic type of stoke. Regarding analysis of risk factor of stroke hypertension (62%) was found to be the most common risk factor. Next to which was smoking (54%) followed by DM (28%) and heart disease (24%). Conclusion: From the above findings we can conclude that Hypertension, Cigarette smoking, Diabetes mellitus and Ischemic heart disease are the major risk factor of stroke in our setting.

JCMCTA 2017 ; 28 (2) : 12-15
Association of Anti Phospholipid Antibodies in The Patients With Ischemic Stroke Under 45 Years of Age In Tertiary Level Hospital: A Case Control Study
Authors: Islam Md Rafiqul , Paul Sujat , Barua Anupam , Rahman Mohammed Habibur , Biswas Rajat Sanker Roy , Chowdhury ANM Manzurul Kader
Published: October 2022

Background: Antiphospholipid antibodies have been associated with a clinical syndrome consisting of thrombosis and recurrent, unexplained fetal loss. Stroke may be caused by Antiphospholipid Antibodies (APLA) especially in young persons without other conventional risk factors like Diabetes mellitus, Hypertension, Dyslipidemia, Smoking etc. The aim of this study was to evaluate the association of antiphospholipid antibodies (Anticardiolipin antibody and lupus anticoagulant) in young ischemic stroke patients presenting with sudden neurological deficit. Materials and methods: This was a case-control study performed in Medicine and Neurology department of Chittagong Medical College Hospital, Chittagong, a tertiary care government hospital. A total no. of 195 respondents consisting of 95 consecutive young patients (Age less than 45 years) diagnosed as ischemic stroke and 100 age and sex matched healthy controls were included in this study. The clinical details and related investigations of the respondents were reviewed. Anticardiolipin antibodies (IgM, IgG isotypes) were evaluated by an Enzyme-Linked Immunosorbent Assay (ELISA) and lupus anticoagulant by phospholipid dependent coagulation test Activated Partial Thromboplastin Time (APTT). When APTT was found more than 5 sec prolonged than control value, mixing studies using a 50:50 mixture of patient and normal plasma were performed and the result was considered positive if prolongation of APTT was not corrected which were needed to be confirmed after 12 weeks. The tests of Anticardiolipin antibodies (aCL) were repeated after 12 weeks when prior results were abnormal and the tests were considered positive when both results of aCL were found above normal value (IgM > 7.2 MPL/ml, IgG>14.4 GPL/ml). Results: Anticardiolipin antibodies Anticardiolipin antibodies (aCL) were present in 10.5% of the patients (IgM in 3 cases, IgG in 6 cases, IgM/IgG both in 1 case) and in 1% (IgG type) of control, but none of the study subjects were found LA positive. The odds ratio of aCL was 11.647 (95% Confidence interval= 1.461 – 92.852). Overall, the risk factors profile in cases were, Hypertension (32.6%) Diabetes mellitus (10.5%) Cigarette smoking (26.3%) and Dyslipidaemia (25.3%). Among the 10 aCL positive cases, 3 were Hypertensive, 1 was Diabetic, 2 were Smoker and 2 were Dyslipidemic but anticardiolipin antibody positive group did not differ significantly with respect to distribution of major risk factor frequency from anticardiolipin antibody negative group. Conclusion: Anticardiolipin antibodies are associated significantly with ischemic stroke in young patients less than 45 years of age (p= 0.004). Hence screening for anti-cardiolipin antibodies in young patients with stroke is recommended.

JCMCTA 2017 ; 28 (2) : 27-33
Outcome of Anterior Cervical Discectomy and Fusion In Degenerative Compressive Myelorediculopathy With Stand-Alone Titanium Cage
Authors: Karim Md Rabiul , Islam Md Manzoorul , Khan Md Anisul Islam , Chowdhury Dhiman , Sanaullah Mohammad , Kibria Anwarul , Hossain Md Ismail
Published: October 2022

Background : Anterior Cervical Discectomy and Fusion (ACDF) is widely performed for cervical degenerative disease with autograft or allograft with long term satisfactory outcome. But the complications of autogenous bone grafting cause the spinal surgeons to seek alternative method. This prospective study was conducted to observe the outcome of using stand-alone titanium cage in ACDF. Materials and methods : Total 50 patients (68 levels) with degenerative compressive cervical myelorediculopathy were operated using stand-alone titanium cage from July 2013 to June 2015 in the Department of Neurosurgery, Chittagong Medical College Hospital. All patients were examined and evaluated preoperatively by plain X-ray and MRI and postoperatively by plain X-ray at one, three and 12 months. Clinical and neurological outcome was assessed by Japanese Orthopedic Association (JOA) score. Results: The mean age was 42.04±7.94 years ranged from 30 to 66 years. Maximum patients were in 41-50 years age group. Quadriparesis was found most common symptom (60%) followed by brachialgia (20%). Out of 50 patients, 32 (64%) suffered from single level compression while 18 (36%) patients suffered from two level compression. Among all operated levels, C5-6 (n-30, 44.2%) was most common level followed by C6-7 (n- 20,29.4%) and C4-5 (n-12, 17.6%) level. All patients improved in terms of their neck pain, redicular arm pain, clumsy hand movement and quadriparesis after surgery. Subsidence was observed in 15 (30%) patients and kyphosis was observed in 10 (20%) patients. All patients with subsidence and kyphosis were neurologically stable and no revision was required. Mean preoperative JOA score was 8.38±3.71 and mean post operative JOA score was 12.92±3.39. Among all patients in post operative follow up, 22 (44%) patients showed excellent recovery and 15 (30%) patients showed good recovery. Conclusion: Anterior cervical fusion using a stand-alone titanium cage is a safe and effective procedure allowing excellent to good functional recovery and avoiding donor site morbidity. Titanium cage can be an effective alternative to iliac bone autograft.

JCMCTA 2017 ; 28 (2) : 34-38
Improvement of Medical Education in Developing Countries Through Best Practices
Authors: Khan Mohammad Asif , Afrin Nahida , Khatun Munira , Das Sandipan , Hossen Md Abul , Dutta Mukesh Kumar
Published: October 2022

Background: Improvement of quantitative and qualitative dimensions of medical education is essential to provide quality health care. Research showed that medical students are facing challenges and barriers in building capacity in patient-centered health care. The study was conducted to assess opinion on factors influencing the optimum performance of medical students and collect their opinion on challenges and suggestions to overcome barriers of their learning. Materials and methods: This study was conducted at the Faculty of Medicine, University of Science & Technology Chittagong Bangladesh, in February 2014. Purposive sampling was done. Open ended questionnaire developed through modified Delphi technique was used to collect their responses. Students’ satisfaction status on quality of education and related factors was assessed and graded using Likert scale. Data analysis was conducted by excel. Results: Response rate was 87.71 % and gender difference was observed (M: F Ratio 1:2). Most of the students (39 out of 50) showed concern for further intervention to improve the existing learning environment in medical colleges. Sixty percent (60%) of respondents expressed their interest to join in any initiatives for capacity building. Conclusion: The findings of this study can be used to design cost effective strategies involving students to prepare rationally for a career in a field as challenging as medicine.

JCMCTA 2017 ; 28 (2) : 39-45
Status of Anaemia in Different Stages Of Chronic Kidney Disease Patients
Authors: Khatun Monira , Chowdhury Mohammed Nasim Uddin , Rawnak Nihad , Akhter Shahin , Khanam Shaheda , Akhter Nayeema
Published: October 2022

Background: Anemia is the universal complication of Chronic Kidney Disease (CKD) and reflects problem either in abnormally low production of RBC by the bone marrow or excessive haemolysis or blood loss. This study has been designed to observe the status of anaemia in different stages of chronic kidney disease patients. Materials and methods: It is a hospital based cross sectional comparative study. 100 patients of diagnosed case of chronic kidney disease admitted in the Department of Nephrology, Chittagong Medical College Hospital were selected as cases and 100 apparently healthy persons, age and sex matched were selected as controls. According to stages of CKD, cases were subdivided into three groups stage III, IV and V. Haemoglobin estimation was done manually by traditional method (Sahli’s acidhaematin method) in the Department of Physiology, Chittagong Medical College, Chittagong. Peripheral Blood Film (PBF) study also was performed in the department of Physiology, Chittagong Medical College, Chittagong. Data were analyzed by different statistical methods. Results: In our study, among the case group (100 patiens), we found that 5.5% are on CKD stage III, 21% on stage IV, 23.5% on stage V. And 50% (100 apparently healthy subjects) were taken as control. Here the mean (±SD) hemoglobin concentrations were 8.75(± 1.45) and 12.07(±1.77) gm/ dl of blood in case and control group respectively. Peripheral blood film study among the study groups showed that RBCs were found microcytic hypocromic in 69% of case and 20% control group. On the other hand RBCs were normocytic normocromic in 31% of case and 80% of control group. Again among the case group it was found that 54.5%, 71.4% and 70.2% of RBCs were found microcytic hypocromic in CKD patients with stage III, IV and V respectively. On the other hand RBCs were normocytic normocromic in 05%, 12% and 14% of CKD patients with stage III, IV and V respectively. Conclusion: The results of this study revealed that all the patients (100%) of the study were found anaemic and 69% CKD patients had microcytic hypochromic anaemia.

JCMCTA 2017 ; 28 (2) : 59-63
Role of Gardnerella Vaginalis Among Symptomatic Bacterial Vaginosis Patients Attending at Chittagong Medical College Hospital
Authors: Ara Nura Nasrin Rowshan , Husain Md Anwar , Rahman Md Mostafizur , Karim Chowdhury Abu Hena Md Saiful
Published: October 2022

Background : Now a day’s bacterial vaginosis is an extremely common health problem for women in the world which causes many complications both in the pregnancy and non-pregnancy states. G. vaginalis is most important cause of bacterial vaginosis. Materials and methods : A cross sectional study was conducted to assess the role of Gardnerella vaginalis as an etiological agent of bacterial vaginosis. This study was undertaken to assess the patients attending at the outpatient department of Gynaecology and Obstetrics of Chittagong Medical College Hospital, Chittagong. A total of 170 sexually active female in the age group of 15-45 years, with abnormal vaginal discharge were selected for the study. A detailed history and a thorough clinical examination of all the cases were done. pH of the vaginal discharge was measured and three high vaginal swabs were collected. Bacterial vaginosis was diagnosed using Amsel’s criteria and Nugent’s method. Gardnerella vaginalis was isolated and identified with their drug sensitivity test by standard methods. Results : In this study 38(22.35%) Gardnerella vaginalis were isolated by culture and bacterial vaginosis was detected by Amsel clinical criteria (Clinical method) 43(25.30%), Gram stain Nugent criteria (Gold Standard) 45(26.47%).Our study showed a relatively high prevalence of bacterial vaginosis and high isolation rate of Gardnerella vaginalis within the positive bacterial vaginosis patients. Conclusion : This result helps proper management and treatment.

JCMCTA 2017 ; 28 (2) : 81-87
Syringo-Peritoneal Shunt for Late Syringomyelia In a Patient of Post Tubercular Meningitis: A Case Report With Literature Review
Authors: Chowdhury Dhiman , Rahman Asifur , Karim Rabiul , Bkakta Ananta Kumar , Chaurasiya Ranjit kumar , Barua Kanak Kanti
Published: October 2022

Background: Tuberculosis (TB) is one of the commonest infectious diseases in the developing countries like Bangladesh. Tubercular Meningitis (TBM) is a common sequel of TB involving the Central Nervous System (CNS) and is one of the leading causes of mortality and morbidity. Syringomyelia following TBM as late or early complication of TB is very rare. Case Description: We report a case of syrigomyelia in a 32 years old lady as a sequel, following treatment for tubercular meningitis after 8 years of successful treatment of tubercular meningitis with a full course of Anti tubercular drugs. She developed gradual weakness of her both lower limbs along with tingling and numbness and bladder incontinence for 5 months before presentation. MRI of Brain and Spine revealed syringomyelia from upper cervical region down to lower dorsal region. Syringostomy at D7 level was done initially but with not much significant improvement. Rather over a period of time she deteriorated and became bed ridden. We put a syringoperitoneal shunt. One month after surgery her lower limb power improved to MRC Grade 4 which enabled her to walk with support. She also had significant improvement of bladder function with full control. Conclusion: High index of suspicion with new neurological signs in patients of TBM, despite proper treatment, is worthwhile considering syringomyelia as a possible cause. Timely diagnosis and appropriate treatment thereby can reduce the morbidity with better neurological outcome.

JCMCTA 2017 ; 28 (2) : 116-121
Kegiatan Kuliah Kerja Nyata Pencegahan Covid Dan Peningkatan Kapasitas Masyarakat Mangkurakyat Garut
Authors: Fitriani Leni , Irawan Muhammad Randy , Jubaedah Dede , Wicaksono Agung , Fajri Mufti Al , Nugraha Muhammad Dimas Maulana , N Novita Fitri , Hidayat Tedi , Surur Yoga Muhammad , Hamdi Wildan Hidayatul , Wafa Adhima Rasyadani
Published: October 2022

Kuliah Kerja Nyata Institut Teknologi Garut pada tahun 2021 yang dilaksanakan pada masa pandemi Covid-19 ini lebih memfokuskan pada sosialisasi pencegahan Covid-19 dan Edukasi Pandemi untuk desa yang lebih sehat. Salah satu program yang dilakanakan adalah Webinar yang diselingi sosialisasi pencegahan Covid-19 yang di jadikan sebagai prosedur kesehatan yang diterapkan di indonesia dan khususnya oleh desa Mangkurakyat Kabupaten Garut. Pengetahuan pencegahan Covid-19 di desa Mangkurakyat masih minimnya informasi tentang gejala Covid dan banyaknya masyarakat yang kurang percaya akan ada Covid-19. Baik pengetahuannya tentang virus ini dan juga tepat guna pencegahan-pencegahan yang diterapkan. Kegiatan pengabdian kepada masyarakat dan komunitas maya dilaksanakan dengan tujuan untuk meningkatkan desa yang lebih sehat masyarakat dalam pencegahan covid dan pemahaman  teknologi informasi yang berguna di masyarakat desa Mangkurakyat sebagai tempat Kuliah Kerja Nyata. Kegiatan dilaksanakan melalui tahapan masukan, peyelesaian masalah, dan keluaran. Kegiatan dilaksanakan bersama pemerintah desa dan berhasil meningkatkan pemahaman pencegahan dan teknologi informasi yang diajarkan guna membantu masyarakat sekitar.
Literasi Digital Sebagai Pondasi Awal Menjadi Masyarakat Informasi Dimasa Pandemi
Authors: Ahdan Alfin Muhamad , Muttaqin Epwan Nurul , Nurhisyam Fahmi , Nurahman Gia , Salsabil Ilham , Rusdiawan Mohamad Mihradi , Handayani Nanda , Fitriyani Ranti , Fauzan Wildan Ahmad Nur , Hidayattuloh Yusuf , Tresnawati Dewi
Published: October 2022

Literasi digital adalah menggunakan teknologi informasi dan komunikasi untuk menemukan, mengevaluasi, memanfaatkan, membuat, dan mengkomunikasikan konten atau informasi dengan kecakapan kognitif maupun teknikal. Kemajuan teknologi menjadi salah satu jembatan penyampaian informasi dimasa pandemi Covid-19 dan literasi digital di masyarakat menjadi sangat penting karena perkembangan teknologi semakin cepat, Tetapi disisi lain teknologi menjadi berbahaya karena banyak terjadi penyebaran informasi yang tidak benar atau hoax tersebar seperti penyebaran informasi tentang Covid-19 yang berlebihan sehingga menyebabkan masyarakat menjadi resah dan ketakutan. Covid-19 menyebar dengan cepat dari kota sampai ke perdesaan, tetapi tidak sedikit masyarakat yang mengabaikan protokol kesehatan sehingga penyebaran sangat sulit dihentikan, tidak sedikit masyarakat yang terpapar Covid-19 dan berakibat pada ekonomi yang semakin menurun karena banyak orang yang berhenti berbinis pasca Covid-19. Untuk itu Kegiatan Kuliah Kerja Nyata (KKN) daring masa pandemi Covid-19 dengan tema pengabdian kepada komunitas maya menjadi sarana bagi kami untuk menyampaikan edukasi tentang himbauan kembali protokol kesehatan supaya lebih diperhatikan, pemanfaatan media online sebagai lapak berbisnis serta mengenali dan mencegah penyebaran berita hoax. Metode yang digunakan yaitu metode kuantitatif yang nantinya akan terlihat dari banyaknya partsipan yang mengisi pre-test dan post-test. Diharapkan masyarakat lebih mengetahui serta memahami cara memanfaatkan literasi digital dengan tepat seperti pada kondisi pandemi Covid-19.
ÜRÜN YENİLİĞİ VE KALİTESİNİN MÜŞTERİ SADAKATİNE ETKİSİNİ MARKA MEMNUNİYETİ NASIL ETKİLER? TEKSTİL SEKTÖRÜNDE PANDEMİ SÜRECİNDE KESİTSEL BİR UYGULAMA
Authors: TURUNÇ Ömer , ZEYBEKOĞLU Ayşe
Published: October 2022

Günümüzün değişen ve gelişen şartlarında işletmeler varlıklarını sürdürebilmek ve rekabet avantaj sağlayabilmek için teknolojik gelişmelere ayak uydurmalı, değişimi yakından takip etmeli ve müşterilerin istek ve ihtiyaçlarını doğru analiz etmelilerdir. Rekabet avantajı sağlamının müşteri memnuniyeti ve sadakati üzerinde etkili faktörlerin geliştirilmesi ile gerçekleştirilebileceği değerlendirilmekteir. Ürün yeniliği ve kalitesinin bu faktörlerden olduğu bilinmektedir. Bu bağlamda Antalya’da pamdemi sürecinde parekende tekstil sektöründe bir araştırma yapılmış ve ürün yeniliği ve kalitesinin müşteri memnuniyeti ve sadakatini nasıl etkilediği araştırılmıştır. Elde edilen bulgular ürün yeniliği ve kalitesinin müşteri sadakatini pozitif ve anlamlı olarak etkilediğini; ürün yeniliği - müşteri sadakatini ilişkisinde marka memnuniyetinin düzenleyici olduğunu ve ürün kalitesi - müşteri sadakatini ilişkisinde de (marka) memnuniyetinin düzenleyici rolü olduğunu göstermiştir.
Performance Analysis of Systemic Important Banks with IDOCRIW and CoCoSo Methods: Example of Turkey
Authors: ÇİFTASLAN Malik Ejder , RENÇBER Ömer Faruk
Published: October 2022

The function of banks in financial markets is developing day by day. The risk potential increases in proportion to the importance of the sector in the economy. In particular, the impact of the 2008 financial crisis on the global economy prompted the supervision and surveillance mechanisms to be more careful. Performance measurements of banks are among the topics that are frequently examined in the literature. In this study, it is aimed to examine the performance of banks in terms of CAMELS variables. Accordingly, to determine the weights of the variables, the IDOCRIW method, one of the Entropy-based objective criterion weighting methods; CoCoSo method was used for financial performance ranking. Within the scope of the research, 8 banks, called systemic banks, were preferred. In this direction, annual bank data for the period 2010-2020 were evaluated using 20 variables. It has been observed that Ziraat Bank, İşbank and Garanti Bank are in an increasing trend in terms of performance scores, while Halkbank is in a decreasing trend in terms of calculated performance scores.
Discover the Potential: Exploring New Frontiers of IL-23 Inhibitors
Authors: Tonarelli Lorena
Published: October 2022

Affecting up to 11.4% of the population worldwide,1 psoriasis is one of the most common chronic autoinflammatory diseases. It is associated with multiple comorbidities and can have profound negative effects on physical and emotional wellbeing and overall quality of life, making it a serious public health concern. A primary objective of this symposium was to explain the pathogenesis of psoriasis and its relation to the development of novel targeted immune therapies. Psoriasis is characterised by skin and systemic damage consequent to pathogenic cytokine production under the influence of both environmental and genetic factors. Differentiation of Th17 cells from naïve T cells is central to the development of psoriasis, and recently pathogenic models have identified IL-23 as the pathogenic cytokine responsible for promoting Th17 cell proliferation and IL-17 production. Therefore, selective blockade of IL-23 may be instrumental in controlling Th17-mediated inflammation in psoriasis. Another key objective of the symposium was to evaluate key learnings from the latest available clinical trial data on agents targeting the IL-23/Th17 signalling pathway and how these learnings can be harnessed to improve the management of patients with psoriasis. Both IL-17 inhibitors (e.g., ixekizumab and secukinumab) and IL-23 inhibitors (e.g., guselkumab and risankizumab) have demonstrated high efficacy and a good safety profile. Anti-IL-17 agents have faster onset of action and allow the achievement of good response rates very rapidly. Efficacy is better maintained over time with anti-IL-23 agents, including in patients who have stopped and those that then restarted anti-IL-23 therapy after a withdrawal period. Despite the availability of effective treatments, undertreatment in psoriasis is common. This can be attributed to factors such as the heterogeneous nature of psoriasis and relatively large prevalence of addictive behaviours in patients with the condition. When making treatment decisions, it is important to consider these factors as well as patient preferences and expectations, so that treatment can be individualised as much as possible. The symposium concluded with an interactive session, which offered the audience the opportunity to ask questions and discuss relevant issues of interest.
Chronic Spontaneous Urticaria in Patients with Common Variable Immunodeficiency
Authors: Frossi Barbara , De Carli Riccardo , De Carli Marco
Published: October 2022

Common variable immunodeficiency (CVID) is a predominantly antibody deficiency and is one of the most common primary immunodeficiencies in adulthood. Replacement therapy with Ig has significantly reduced infectious complications; however, malignant, autoimmune, and inflammatory diseases are still current major causes of morbidity and mortality. In recent years, interest has increased regarding allergic manifestations that may be associated with primary immunodeficiencies; however, no data are currently available on chronic spontaneous urticaria (CSU). In this report, the authors describe CSU in patients with CVID attending their centre. Three CVID patients were affected by CSU and were unresponsive to antihistamines. Patients were screened for the presence of serum autoreactivity by an autologous serum skin test; only one patient was positive for serum autoreactivity. The serum of this patient was found to induce CD63 upregulation on basophils and degranulation of LAD2 mast cells. All patients were treated with omalizumab therapy at the standard dose of 300 mg every 4 weeks. The patient with autoreactive serum was the best responder to omalizumab therapy, whereas the other two patients experienced urticaria flares related to intercurrent infections. In this article, the authors describe the presence of CSU in patients with CVID for the first time. Although autoimmunity is a feature of CVID, autoreactivity was documented in one patient only, thus showing that CSU in patients with CVID reflects the heterogeneity of this immune defect.
Translating Knowledge of IL-23 Targeting into New Solutions for Psoriasis Treatment
Authors: Tonarelli Lorena
Published: October 2022

Following a brief introduction by Prof Lambert, the symposium started with an in-depth review of the current unmet needs in the clinical management of psoriasis, provided by Prof Radtke, who also reported on the multiple and cumulative negative effects of the condition on patients’ health, activity engagement, family relationships, and overall quality of life (QoL). Prof Radtke went on to describe the factors contributing to the burden of psoriasis, other than disease severity, and highlighted the importance of taking a holistic approach to the management of the condition that takes into consideration the individual patient’s expectations and needs. Prof Lambert continued the symposium with an overview of the core pathways involved in disease pathogenesis in relation to the development of novel targeted immunotherapies.

Prof Lambert reviewed the current clinical paradigms for the treatment of psoriasis, including targeted biological therapies, such as TNF-α inhibitors and newer agents acting on IL-17 and IL-23, which research shows may represent a more effective approach to the treatment of psoriasis and other autoimmune inflammatory disorders. The latest Phase III clinical trial data on therapies selectively targeting the upstream cytokine IL-23 were then presented by Dr Piaserico, with a focus on the monoclonal antibodies guselkumab, risankizumab, and tildrakizumab, and their potential to achieve consistent rates of skin clearance long-term, with the added benefit of prolonged dose intervals and intermittent treatment in some patients.
Emerging Insights in the Treatment of Psoriasis and Psoriatic Arthritis
Authors: Scutt Paul
Published: October 2022

Guselkumab is a monoclonal antibody targeting IL-23 that is approved for the treatment of patients with moderate-to-severe plaque psoriasis. Two of the posters reviewed in this article provide new insights into the clinical efficacy of guselkumab in patients with plaque psoriasis from the VOYAGE trials, firstly among those previously failing to respond to adalimumab and secondly in the setting of drug withdrawal and subsequent retreatment. In addition, data from a study reporting 56-week results from a Phase IIa study exploring the efficacy and safety of guselkumab in patients with psoriatic arthritis (PsA) are reviewed. The article concludes with a summary of the results of a survey highlighting the potential importance of evaluating gastrointestinal (GI) signs and symptoms during the management of patients with psoriasis.
PROGRAM TALK SHOW “KATA SANDI” DI INEWS DAN MINAT BERWIRAUSAHA MASYARAKAT KELURAHAN PULO GEBANG DI MASA PANDEMI COVID-19
Authors: Vaagna Ferina Syafa , Riyantini Rini , Sevilla Vinta
Published: October 2022

Pengangguran di DKI Jakarta masih menjadi permasalahan yang belum teratasi. Hal ini akibat dari rendahnya persentase kewirausahaan dan terbatasnya lapangan pekerjaan yang bertambah akibat adanya pandemi Covid-19. Berdasarkan data dari BPS, DKI Jakarta menjadi penyumbang angka pengangguran tertinggi karena jumlahnya yang semakin meningkat sebesar 10,95%. Melalui stimulus program talk show “Kata Sandi” diharapkan masyarakat tidak terpaku menjadi pencari kerja tetapi harus beralih sebagai pencipta lapangan kerja dengan memulai tekadnya untuk memiliki minat berwirausaha. Penelitian ini memiliki implementasi yang berkaitan dengan Teori S-O-R, sehingga dari relevansi tersebut penelitian ini bertujuan untuk membuktikan apakah stimulus dari program program talk show “Kata Sandi” berpengaruh terhadap hadirnya respon masyarakat dengan memiliki minat berwirausaha. Penelitian ini menggunakan pendekatan kuantitatif dengan metode penelitian eksplanatif. Teknik pengambilan data menggunakan jenis survei melalui kuesioner yang dibagikan melalui whatsapp kepada 100 orang responden wilayah Kelurahan Pulo Gebang. Melalui uji regresi memperoleh hasil terdapat pengaruh antara variabel program talk show terhadap variabel minat berwirausaha, dan uji hipotesis dinyatakan dengan ketetapan H1 diterima dan H0 ditolak. Maka kesimpulannya adalah Program talk show “Kata Sandi” berpengaruh terhadap minat berwirausaha, terutama kepada masyarakat Kelurahan Pulo Gebang, Jakarta Timur.