bluuebunny/crossref_metadata_2025 huggingface dataset:
Penurunan Jumlah Cacat Produksi Melalui Pendekatan Seven Tools Of Quality
Authors: Gerry Gerry , Budiastuti Dyah
Published: June 2016

PT Cipta Lestari Packindo is a manufacturing company engaging in the manufacture of cardboards. In its operational activities, the company experiences problems like defects or faults in the cardboard production process. Therefore, there’s a need for continuous improvements so that the company won’t suffer either from loss or cost of quality that will appear in the future. To achieve that, the seven tools of quality approach were used in an attempt to repair and reduce the level of errors and the defects in production. Results of this research found there are eight types of the cardboard defection occurred during the productions. By using pareto diagram, research found three major problems that took the biggest roles: pieces that are not aligned with the rotary engine, pieces that are not aligned with the coak engine, and missing in the printing process. In the analysis process of the reduction of defective productions within the three major problems, there are six factors causing the defections: men, machines, methods, measurements, materials, and environments—with men and machines as the biggest contributors. By doing continuous improvements, the level of the defective production will decrease eventually.
Analisis Faktor-Faktor yang Memengaruhi Tingkat Kepatuhan Wajib Pajak Orang Pribadi di Lingkungan Kantor Pelayanan Pajak Pratama, Tigaraksa Tangerang
Authors: Tantio Dharma Maya , Ariyanto Stefanus
Published: June 2016

Tax collection is not an easy matter. Active participation from the tax authorities also requires the willingness of the taxpayer. A public reaction can be seen from the taxpayer’s willingness to pay taxes. Willingness and awareness to pay taxes represent a value contributed by someone (which has been determined by regulation). Tax is used to finance public expenditures without any direct benefit. Taxpayer’s awareness about taxation functions as state funding is needed to improve tax compliance and to determine the level of tax compliance in implementing their tax obligations. Limitation of the scope of this study is the effect of the level of awareness of paying taxes, taxpayer’s understanding about tax benefits, tax penalties, and understanding of service quality to the tax authorities of individual taxpayer compliance in the fulfillment of tax obligations, as well as restricted to data obtained through questionnaires received and filled by the individual taxpayer of Tigaraksa Pratama Tax Office area. Data were obtained through questionnaire and processed and analyzed using parametric statistical tests and multiple linear regression with 4 independent variables and one dependent variable resulted in the conclusion that the factors that most influence taxpayer compliance in carrying out its tax liability is the use of sanctions against taxpayers who do not carry out its obligations under applicable legislation.
Audit Sistem Informasi Akuntansi Siklus Pengeluaran pada PT. Lagio Furniture
Authors: Wicaksono Aries
Published: June 2016

Rapid technological developments make the whole thing easier. Many companies also take advantage of these technological developments. Similarly, the corporate accounting system that uses the benefits of information technology in the form of Accounting Information Systems (AIS). PT. Lagio Furniture is amanufacturing company that produces furniture for the premium class. Information system is an important part that helps the company's operations become more effective and efficient, therefore it is important for information systems running properly.This research aimed to audit the general control and applications control on the expenditure cycle accounting information system at PT. Lagio Furniture. This type of audit is audit around the computer. And then also collecting data through observation and interviews with relevant parties. Results of thereserarch is the expenditure cycle accounting information system at PT. Lagio Furniture was good. But there is still need to be improved in the control plan security, operational management control, and control inputs.
Analisis Tingkat Pemahaman KPR Syariah pada Bank Syariah di Indonesia: Studi Pendahuluan
Authors: Heykal Mohamad
Published: June 2016

Sharia banking has been growing in many countries since the birth of post-neo revivalist movement in the mid-20th century. The development of Indonesian sharia banking began with a workshop related with interests and banking held by MUI in Cisarua on 18th to 20th of August 1990. Since 1992 to 2013 it has been established 11 sharia commercial banks and 24 sharia conventional banks that open sharia business units and 156 Islamic Financing Bank. In terms of existing office, Islamic banks in Indonesia have reached 1737 bank offices and also Islamic bank units. Moreover, the market share of Islamic banking has almost reached 5% of the total market share banking in Indonesia. Islamic banking also has a mortgage product that is essentially different from the existing mortgage in the conventional banking. It is expected that the Islamic mortgage product will result a profit. The product is a product released for customers who require financing from Islamicbank to have a house. This early study used literature review method and secondary data. This study built an analysis of the mortgage program issued by Islamic banks in Indonesia. Research concludes that the notion of Islamic banking on mortgage product, especially Islamic financing mortgage, from the internal party has not well distributed yet.
Analisis Kelompok Usaha Peningkatan Pendapatan Keluarga Sejahtera di DKI Jakarta, 2014
Authors: Simanjuntak Menara
Published: June 2016

This research aims to explore and find the determinant factors as it is important for the development of group UPPKS management in Jakarta Provincial through a qualitative descriptive approach. The number of respondents was limited for 2 groups that are still active in the Regional Municipality of East Jakarta in Pulogebang Village and West Jakarta in Kemanggisan Village. Research was conducted through in-depth interview with 2 officers and 2 members of the group; focus group discussion was followed by 8 members at each location. The findings of this study indicate that the lack of funds/start-up capital has not gained sufficient leverage; the absence of other sources of funding, in fact, almost all are individual business, so that managed such as savings and credit groups. Growing effort is being supported by additional capital that sought its own members, as well as the selection of profitable business activities. Group leader and members favored form of technical training, certain items are more salable. More individual businesses selling food and beverages are for their money-faster turnaround, rest handicraft products do not sell quickly, and thus this is the advantage of learning process through UPPKS. Recommendation for Jakarta Provincial Government is to make regulation and build relationship with Financial Institution to support the UPPKS.
Analisis Kualitas Pelayanan PT Jasa Raharja dengan Metode Servqual
Authors: Hindarwati Enny Noegraheni , Jayasari Anintia
Published: June 2016

In order to improve the image of insurance company, this study was done to find a picture of the accident victim’s satisfaction with the service of insurance company Jasa Raharja. Descriptive quantitative research was conducted with a population of accident victims. Data were taken with questionnaires by 80 respondents and data analysis used SERVQUAL. The results showed that the overall levels of accident victim’s satisfaction with the service of insurance company Jasa Raharja levels are disatisfied. This is evident from the value of the gap between perception and negative expectation. Dimensions of perceived service quality as dissatisfaction by the accident victims are the reliability, responsiveness, assurance, and empathy dimension. Result was obtained from this research gap between perception and expectation of service with a value of - 0.0284. Therefore, it is suggested to the insurance company Jasa Raharja to improve services to accident victims, especially dimensions unsatisfactory service for accident victims.
Analisis Perbandingan Experiential Value antara Hong Tang dan Black Ball serta Hubungannya dengan Customer Satisfaction
Authors: Gunawan Annetta
Published: June 2016

Black Ball and Hong Tang are two pioneers of Taiwanese dessert sellers in Jakarta. Both of them have product offering characteristics that are alike and have the same target market. From the initial observation, the researcher found that even though Black Ball has more outlets than Hong Tang, but Black Ball seems to be less popular than Hong Tang. The consumers’ preferences are varied, there are some consumers prefer Hong Tang, but there are also those who choose Black Ball, because of the food quality, the service provided, and also the experiences they get during the consumption process. Therefore, both Black Ball and Hong Tang have to consider about the experiential value to be offered to their customers, in order to increase their customer satisfaction, so that they can sustainably survive in the midst of challenging competition. The objectives of this research are to examine whether there is any difference of experiential value dimensions and customer satisfaction between Hong Tang and Black Ball and to examine the relationship between experiential value dimensions and customer satisfaction of Hong Tang and Black Ball. The result of this research concludes that there is no difference of all experiential value dimensions and customer satisfaction between Hong Tang and Black Ball and there is a strong and significant relationship between all experiential value dimensions and customer satisfaction of Hong Tang and Black Ball.
Konsep Business Process ReenginEering untuk Memperbaiki Kinerja Bisnis Menjadi Lebih Baik: Studi Kasus Perusahaan Susu Kedelai “XYZ”
Authors: Wimpertiwi Dotty , Sasongko Agung Hari , Kurniawan Antonius
Published: June 2016

Business Process Reengineering is a phase of redesigning business process to improve performance. Business Process Reengineering can be applied to improve micro or medium businesses. One example from them comes from a soymilk company. XYZ Soymilk Company is one of the examples of Small and Medium enterprises with home-industry system. Its organizational structure consists of the director and some divisions. Those divisions, which are run by employees, are: production division, procurement division, finance division, and marketing division. The produced soymilk is packed in plastic bags with Susu Kedelai “XYZ” label on it. This product later is marketed in the canteens of universities, some stores around neighborhoods, and supermarkets. The main market target of this product is university students and people around the location. The promotion is done by attaching promotion flyers on some strategic places. The problem that occurs is a shortage in operational management, the number of command and control in the operating system, as well as recording done still manually. The purpose of using Business Process Reengineering concept processing system is to be more computerized for a better, faster, more accurate, effective and efficient, and improvement in operation management system as an attempt to survive among other competitors. The results of the business process reengineering are some business process ideas.
REKONSTRUKSI MAKNA MURTAD DAN IMPLIKASI HUKUMNYA
Authors: Ibn Smith Abdur Rahman
Published: June 2016

Riddah interpreted by fuqahā’ as those who leave Islam. The punishment was killed based on hadith “man baddala dīnahu faqtulūh.” That understanding is different from the description of the Qur'an in the related verses that actually gives punishment neither physical, but non-physical. Those verses are: al-Ḥajj: 11, al-Mā’idah: 54, al-Naḥl: 106, al-Nisā’: 137, Āli ‘Imrān: 86, and al-Baqarah: 217. Study of the verses of the Qur’an shows that none of the text with ṣāriḥ-lafẓiyyah approach that lead to aggressive and emotional attitude to the suspect of riddah. On the other hand the Qur’an asserted that the type of the punishment is eschatological and negates physical punishments. This qualitative research will intends to make reconstruction of riddah meaning and its legal implications. With a historical approach, juridical, philosophical, ideological and comparative of the riddah meaning contained in the Koran, hadīth, and socio-historical perspective, then the reconstruction of the meaning of riddah should be understood to be more humane, comprehensive, and in accordance with maqāsid sharī'ah.

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Riddah dimaknai oleh ulama fikih sebagai orang yang keluar dari Islam. Hukumannnya adalah dibunuh berdasarkan hadis “man baddala dīnahu faqtulūh.” Pemahaman ter¬sebut berbeda dengan gambaran al-Qur’an dalam ayat-ayat terkait yang justru memberikan hukuman yang tidak satu pun bersifat fisik, melainkan non fisik. Ayat-ayat al-Qur’an tersebut adalah: al-Ḥajj: 11, al-Mā’idah: 54, al-Naḥl: 106, al-Nisā’: 137, Āli ‘Imrān: 86, dan al-Baqarah: 217. Telaah atas ayat-ayat al-Qur’an tersebut menunjukkan bahwa tidak satu pun teks secara ṣāriḥ-lafẓiyyah yang mengarah kepada sikap agresif dan emosional terhadap pelaku riddah. Sebaliknya, al-Qur’an menegaskan sanksinya ber¬sifat eskatalogis; dan menegasikan sanksi fisik. Penelitian kualitatif ini menawarkan upaya rekonstruksi makna riddah dan implikasi hukumnya. Dengan pendekatan historis, yuridis filosofis, ideologis dan komparatif terhadap makna yang terdapat dalam al-Qur’an, hadis, dan sosio-historis yang terkait dengan riddah, rekonstruksi terhadap makna riddah semestinya menjadi lebih humanis, komprehensif dan sesuai maqasid syari’ahnya.

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Keywords: riddah, jināyah, implikasi hukum, sanksi hukum
PERSPEKTIF COULSON TERHADAP RUMUSAN DIALEKTIKA HUKUM ISLAM
Authors: Fanani Akhwan
Published: June 2016

Law will always evolve and dialectic with social dynamics. Coulson see that the dynamics of the Islamic law occurs through the efforts of reinterpretation of Islamic sources when there is a gap between theory and practice. With a historical approach, Coulson mapped the development of Islamic law so that he made six dialectic formulation of Islamic law which is an in-depth reading in seeing the historical development of Islamic law. According to Coulson, Islamic law is idealistic and away from social reality. Islamic law is determined by social facts and reduced as a man-made law. Coulson’s propositions departed from empirical studies of the historical development of Islamic law. Coulson formulas can be used to understand further the reality of the development of Islamic law, so Muslims can understand what really happened in the history of Islamic law and scientific perspective. It can be used to perform introspection for Muslims to develop further the Islamic legal thought and in accordance with the existing social development. This paper intends to review critically the ideas of Coulson.

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Hukum akan selalu berkembang dan berdialektika dengan dinamika sosialnya. Coulson melihat bahwa dinamika hukum Islam terjadi melalui upaya penafsiran kembali sumber-sumber Islam ketika ada kesenjangan antara teori dengan praktek. Dengan pendekatan historis Coulson memetakan perkembangan hukum Islam sehingga ia membuat enam rumusan dialektika hukum Islam yang merupakan sebuah pembacaan yang mendalam dalam melihat sejarah perkembangan hukum Islam. Menurut Coulson hukum Islam bersifat idealistik dan jauh dari realitas sosial dan apa yang ia inginkan adalah hukum Islam ditentukan oleh fakta-fakta sosial dan direduksi sebagai hukum buatan manusia. Proposisi-proposisi Coulson berangkat dari penelitian empiris mengenai sejarah perkembangan hukum Islam. Rumusan-rumusan Coulson dapat digunakan untuk lebih memahami realitas perkembangan hukum Islam, sehingga umat Islam bisa memahami apa yang sebenarnya terjadi dalam sejarah perkembangan hukum Islam dan perspektif keilmuan. Hal itu bisa dipergunakan untuk melakukan introspeksi bagi umat Islam untuk mengembangkan pemikiran hukum Islam lebih lanjut dan sesuai dengan perkembangan sosial yang ada. Artikel ini bermaksud untuk mereview secara kritis pemikiran Coulson tersebut. 

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Keywords: dialektika, Hukum Islam, conflict and tension, ijtihād
HUKUM ISLAM DAN DINAMIKA FEMINISME DALAM ORGANISASI NAHDLATUL ULAMA’
Authors: Mulia Musdah
Published: June 2016

The development of the feminist movement has significantly demonstrated in the history of the Nahdlatul Ulama’ (NU) organization. In the midst of the discriminatory issues against women and gender mainstreaming bias, NU consciously and courageously opens up to make space for an expanded discussion of the role of women even in the area of Islamic law (fiqh), which is considered sacredly. Not only in theoretical-normative, but also NU showed consistency in the implementation for the ideas of women roles in the public sphere significantly, although a number of issues is still on the agenda of feminist struggle in the Muslimah community, such as violence against women in the household (domestic violence) and gender mainstreaming issues in a variety of positions in the executive, legislative, and judicial branches of government as well as other strategic institutions. The certain thing is that the feminist movement in Indonesia showed a significant effect on the changes in the political, social, legal, and economical areas.
MODEL APLIKASI FIKIH MUAMALAH PADA FORMULASI HYBRID CONTRACT
Authors: Murtadho Ali
Published: June 2016

Modern literatures of fiqh mu’āmalah talk alot about various contract formulation with capability of maximizing profit in shariah finance industry. This new contract modification is the synthesis among existing contracts which is formulated in such a way to be an integrated contract. This formulation is known as a hybrid contract or multicontract (al-'uqūd al-murakkabah). Some of them are, bay' bi thaman 'ājil, Ijārah muntahiyah bi ’l-tamlīk dan mushārakah mutanāqiṣah. This study intends to further describe models of hybrid contract, and explore the shari'ah principles in modern financial institutions. This study found a potential shift from the ideal values of the spirit of shari'ah into the spirit of competition based shari'ah formally.
PENEMUAN HUKUM DALAM PUTUSAN MAHKAMAH AGUNG DAN RELEVANSINYA BAGI PENGEMBANGAN HUKUM ISLAM INDONESIA
Authors: Budiman Achmad Arief
Published: June 2016

This qualitative research aimed to criticize the form of legal invention by the Supreme Court (MA) and its relevance to the development of Islamic law on Indonesia. This study also aims to find a model of the development of Islamic law through the dicovery made by the judge when adjudicating the case. The samples of this study were selected verdicts of MA based on the presence or absence of legal invention parameters in it. The result of this study is that the two verdits of MA, precisely describe the form of the legal invention by showing courage and creativity at the same time in deciding the case. The legal invention of MA has significant contribution to the development of Islamic law in Indonesia. Because of the standing points of MA as the top judiciary, it’s verdits would be as jurisprudence for the other judges, especially at the lower level court.
OBSERVASI HILĀL DI INDONESIA DAN SIGNIFIKANSINYA DALAM PEMBENTUKAN KRITERIA VISIBILITAS HILĀL
Authors: Sudibyo Muh. Ma'rufin
Published: June 2016

This research aim to analyze of the data generating a modern empirical visibility criterion called Indonesia visibility criteria (RHI criteria) in the form aD ³ 0,099 DAz2-1,490 DAz + 10,382. Although based on a local database, but these criterion are consistent with the international visibility databases such as Yallop and ICOP, along selected only for data sourced from the tropical region. These criterion also were consistent when compared to the tropical visibility database not from Indonesia. So this criteria is the national visibility criterion (for Indonesia) and also regional visibility criterion (tropical region). Comparative analysis showed that although different in form than modern visibility criterion that have similar variables as Fotheringham-Maunder and Bruin criterion, but the form of the Indonesia visibility criterion (RHI criterion) may still be accepted because it is supported by the recent observation data. The difference in shape is due to the Indonesia visibility criterion (RHI criterion) does not distinguish between optical aid-based observations with naked-eye observations.
REDEFINISI HUKUM ISLAM DALAM KERANGKA DEMOKRASI Eksperimentasi Muḥammad Shaḥrūr
Authors: Fanani Muhyar
Published: June 2016

This article discusses the new paradigm of Islamic law which is offered by Muḥammad Shaḥrūr, one of the contemporary Muslim thinkers from Suria. The focus of study on this paper is an attempt to criticize the redefinition of the basic concepts of Islamic law in Shaḥrūr view. According to Shaḥrūr, redefinition basic concepts in Islamic law must be done as a starting point to develop a new paradigm of Islamic law which is based on anthropocentric approaches, —not theocentric approaches. Islamic law is civil law, democratic and positive. Therefore, it requires more realistic, elastic, and implementable definition. For Shaḥrūr, the existence of a new paradigm, such as the democratization of Islamic law is very urgent in the midest of the Muslim world today on the era of the nation state, constitutionalism and democracy, rapidly changing, and increasingly distant from the tyranny period
JA’FAR AL-ṢĀDIQ DAN PARADIGMA HUKUM MAZHAB JA’FARI
Authors: Muhtada Dani
Published: June 2016

This article explores the legal paradigm of the Ja’fari school of law. The article presents the profile of Imam Ja’far, the founder of this school of law. It also discusses some legal thoughts presented by the Ja’fari school of law, which seemed to be fundamentally different from the legal thoughts of the Sunni school of law (e.g., khumus and mut’ah). This article concludes that the legal sources used in the Ja’fari school of law are not fundamentally different from those used in the Sunni school of  law, which include the Quran, the Sunnah, Ijma, and reasoning. Although there might be different approaches among the Ja’fari school of law and the Sunni school of laws in defining these legal sources, this article indicates no principle difference in legal making procedure. As a matter of fact, the differences in the legal making process could also exist among the Sunni school of laws.
Absence of horizontal fissure right lung
Authors: Rauf Bushra , Nasim Maimoona , Ul Ain Qurat
Published: June 2016

Objectives : To examine the dissected cadavaric right lungs for the presence or absence of minor (horizontal) fissure right lung . Design: Descriptive study. (cadavaric study). Place and duration: - The study was conducted in dissection halls of various Medical colleges of Lahore (FMHC, FJMC & KEMC) from January 2003 to February 2004. Material &methods: A total number of 112 cadavaric specimens of right lung were dissected &examined for the presence or absence of minor fissure. Results: - Out of 112 specimens 9(9%) of specimens were showing the absence of minor fissure of right lung whereas 103(91%) of specimens of right lungs were showing presence of minor fissure. Conclusion: The percentage of anatomical variation (absence)of minor fissure of right lung is 09%. The study of anatomical variations of fissures of lungs is important for anatomists, surgeons& radiologists.
The outcome of Closed Lateral Internal Sphincterotomy for the chronic Anal Fissure
Authors: Arshad Muhammad Saleem , Khan Aamer Zaman , Khanum Andleeb , Bhutta Amer , Abid Khalid Javed
Published: June 2016

The aims and objectives of the study are to determine the efficacy of closed lateral internal sphincterotomy to relieve symptoms of chronic anal fissure and postoperative complications of procedure. The study was conducted at Surgical Department, Sir Ganga Ram Hospital, Lahore over a period of two years from April, 2001 to Feb., 2003. The first 100 consecutive patients of either sex irrespective of age were included in this study. All these patients were with symptomatic, anal fissure, with failed medical treatment and long history. All these patients were operated under spinal and general anesthesia in lithotomy position. Digital examination and proctoscopic examination was done. Among 100 patients 56 patients (56%) were free of pain within 24 hours and 42 patients (42%) had no pain after 48 hours. Two patients (2%) complained of persistent moderate to severe pain. Among 100 patients 6 patients (6%) had haemorrhage with soakage of gauze piece but there was no active bleeding. Only oozing was detected. Two patients (2%) had hematoma at operative site. Four patients (4%) C/o impaired control for flatus and soiling of underwear but these recovered within hospital stay. Closed internal sphincterotomy is a procedure of choice for chronic anal fissure. It is minimally invasive procedure. Postoperative discomfort is of shorter duration, wound heals quickly and recurrence is uncommon.
Clear Cell Sarcoma (Malignant Melanoma of Soft Part): A Rare Soft Tissue Sarcoma
Authors: Abdullah Muhammad
Published: June 2016

Clear cell sarcoma is a rare malignant neoplasm usually presenting as soft tissue mass in foot of young adult. Ultrastructural studies reveal neuroectodermal origin with melanocytic differentiation. Thus it is considered as malignant melanoma of soft parts. Though the prognosis is apparently better as compared to the conventional melanoma, local recurrences and metastases are frequently seen. Large tumor size and extent of necrosis are factors for poor prognosis. A case of clear cell sarcoma with classical presentation is reported.
An example of Non-Cooperative patient attitude and legal implications
Authors: Ahmad Khurram , Solehria Tahira Bashir
Published: June 2016

Previous two Cesarean Section is a clear indication for C/section at term for safe mode of delivery. In earlier gestation if labour sets in and it fails to respond to tocolytics or in situations where tocolysis is contraindicated, even then operative delivery is safe mode. This is a case report of a patient with history of laparotomy for repair of uterine rupture followed by four cesarean section. In her last pregnancy she presented with premature preterm established labor obstetrician decided about cesarean section on failure of primary management with tocolytics and dexamethasone. But she refused to give consent for cesarean section. Although she went safe and sound along her baby after three days of delivery but exposed her self, her baby and the obstetrician to multiple hazards.
Spaso technique for reduction of bilateral Anterior Dislocations of Shoulder
Authors: Wain Ali Asghar , J. Martin
Published: June 2016

Spaso technique has been in use for anterior shoulder reductions less then a decade. Kocher`s manoeuvre, Hippocratic & Scapular methods for reduction of anterior dislocation of shoulder are well known conventional methods in practice. All have a high success rate. They dislocations are rare. We report a patient with bilateral anterior shoulder dislocations following an assault. Spaso technique was used to reduce dislocated shoulders.
An experience with patients with venous Thromboembolism at Sir Ganga Ram Hospital, Lahore
Authors: Nazeer Asma , Shabir Bilquis , Kamal Asma , Qaisera Saleema
Published: June 2016

Venous thromboembolism is responsible for substantial morbidity and mortality if left unsuspected especially in the presence of certain risk factors. The purpose of our study was to review patients of deep vein thrombosis regarding the underlying risk factors, its complications, treatment and outcome. Our study at Sir Ganga Ram Hospital, Lahore consisted of 56 patients out of which 42(75%) were females. The presence of Deep vein thrombosis was confirmed by venous ultrasonography. Various risk factors were identified in 45(80.3%) patients. All patients were given LMWH in initial phase followed by warfarin. Clinical response was monitored for period of three months. Two patients (10%) develop gastrointestinal bleeding as complication of therapy. Three patients (5.35%) died of pulmonary embolism. Early recognition of disease and its complication along with timely treatment and adequate follow up can reduce morbidity and mortality.
Surgery for Pleuropulmonary Tuberculosis
Authors: Nabi Muhammad Shoaib , Bilal Aamir , Shah Shahkar Ahmad , Ahmad Zahoor , Hussain Shafqat , Jawed Farhan , Rana Omar Aziz , Khalil Amina , Randahawa Fawad Ahmad , Raza Hammad , Khan Tippu , Farooq Khalid
Published: June 2016

The purpose of our study was to analyze current indications for surgery in pleuropulmonary tuberculosis (TB). We present our experience with TB patients presenting with indications for surgery between 1998 and 2003. Material and Methods: The indications for surgical intervention included 220 cases of empyema, mediastinal lymphadenopathy 48 cases, hemoptysis 25 cases, destroyed lung 24 cases, undiagnosed pleural effusion 24 cases, bronchiectasis 18 cases, cavitary lesion with MDRTB 13 cases and pulmonary aspergilloma 10 cases. Thirteen patients with multidrug-resistant tuberculosis required surgical intervention, although 26 were treated with second line drugs during this period. Results: The techniques utilized included decortication in 152 cases, lobectomy in 62 cases, rib resection for pleural drainage in 50 cases, anterior mediastinotomy in 48 cases, pneumonectomy in 28 cases, open pleural biopsy in 24 cases, and thoracoplasty in 18 cases. In 12 patients (3.1%), two procedures were performed, and in one case, 3 procedures. In 65 cases (17%) there were complications, of which persistent air leakage after decortication & pulmonary resection was the most frequent (n=26). There was a mortality rate of 2.8% (11 cases). Conclusions: In our experience, surgery in the treatment of TB is indicated to resolve sequalae or complications, since cases of simple or multidrug-resistant TB can be managed pharmacologically. The morbidity and mortality rates in our series were acceptable.
Misses & near misses: Drug administration errors
Authors: Cheema Huma Arshad , Majeed Muhammad Hamid , Cheema Muhammad Arshad
Published: June 2016

Background: Mistakes made during administration of drugs to patients can be lethal. In order to analyse these mishaps we need to study the particular circumstances of each accident and define the reasons behind the mistake or lapse. This paper reports the findings of a confidential pilot study designed to highlight the frequency of such unfortunate incidences and formulate recommendations applicable in our society to prevent some of these tragic outcomes. Methods: Sixty doctors and nurses from different hospitals were randomly enquired about the personal knowledge of pharmacological mistakes with which they were either closely associated or they had first hand information of the incident. All data was collected in confidence on condition of anonymity. Results: We discovered 21 instances of drug administration errors. Dispensation of wrong drug to a patient was the commonest mistake discovered. Nurses gave majority of these injections during the night. Half the victims of these mishaps lost their lives. Conclusions: From this confidential inquiry, we have found that tragedies with loss of life are not infrequent in our set up: Typical scenario involved muscle relaxant given instead of narcotic analgesic by a student nurse during the night. When the mistake was not detected in time it frequently ended in tragic loss of life. It is disturbing to note that minimum basic facilities of proper cardiopulmonary resuscitation were not available in some hospitals. Recommendations: Only senior nurses / doctors should give IV injections. Conscious effort should be made to minimise the use of IV medication, drugs should be used only with proper indications when suitable oral alternatives are not feasible. The nurses` training as well as nurse patient ratio needs to be improved. Muscle relaxants should not be available outside operating rooms and critical care units. We need to set up a central confidential data-reporting centre for voluntary (anonymous?) reporting of such mistakes or mishaps so that they could be analysed and concrete preventive measures recommended.
An experimental study of albino rats fed on Nigella sativa and aspirin for four weeks duration: determination of coagulation profile
Authors: Munir Akhtar , Tayyib Muhammad , Farooq Muhammad , Mashraf Muhammad , Rashid Anjum , Farooq Muhammad
Published: June 2016

Ninety albino rats were selected and were divided into six groups on the basis of different diets given. Control group (I) was fed on synthetic diet and experimental groups (IIA, IIB, IIC, IID and IIE) were fed on 1 mg aspirin, 15mg, 30 mg, 45 mg Nigella Sativa per kg body weight respectively while HE was given 30 mg NS and 1 mg aspirin/kg body wt. Blood samples were collected by heart puncture and Coagulation parameters were done. BT was prolonged in groups taking aspirin only. APTT was reduced significantly in groups taking different concentration of NS when compared with control. Percentage of clot retraction was weak significantly in groups taking aspirin only when comparing with other groups.
Screening for anti HCV
Authors: Mehboob Fatima
Published: June 2016

Purpose of this study is to evaluate the different indications for screening for Anti HCV. This study was carried out in outdoor and indoor department of North Medical Ward of Mayo Hospital, Lahore. This is a non-interventional observational study. Two hundred patients ELISA proved HCV infection were evaluated to find out what were the different circumstances or symptomatology when tests for HCV infection were advised. So that a screening strategy can be formed. As hepatitis C virus infection has varied presentation and clinical features, the general practitioners, physicians, dermatologists and psychiatrists should be conscious about it an advise for Anti HCV detection whenever it is suspected. Screening of the early cases is beneficial both for the patients and its relatives.
Frequency of asymptomatic spontaneous bacterial peritonitis in chronic liver disease patients with first presentation of ascites
Authors: Khan Dur Muhammad , Sh Ahsan Rauf , Ashfaq Muhammad , Waheed Imran , Bhatti Tanveer , Ahmad Sajjad
Published: June 2016

Objective: This study is done to assess the frequency of asymptomatic spontaneous bacterial peritonitis in chronic liver disease patients with first presentation of ascites. Design: Case control study. Place & duration of study: This study was carried out on patients attending Medical special ward Services hospital & PTCL medical center Lahore from June 2002 to October 2003. Patients & method: One hundred & fifty chronic liver disease patients with first presentation of ascites were screened for presence of asymptomatic spontaneous bacterial peritonitis. Results: 9.3 % of patients in this study had asymptomatic spontaneous bacterial peritonitis. Conclusion: Asymptomatic spontaneous bacterial peritonitis can be present in first presentation of ascites in chronic liver disease patients. It is suggested that this condition should be actively sought in all chronic liver disease patients who develop ascites for the first time. Further studies should be done to assess for prognostic implications of treating such cases.
Evaluation of the management of penetrating abdominal injuries - Lahore General Hospital Experience
Authors: Farooq Ajmal
Published: June 2016

Objectives To study the changing pattern of penetrating abdominal injury, to check the effectiveness of management, to audit the associated morbidity and mortality and to suggest ways and means to improve serious outcome. Study Design: Prospective interventional. Place and Duration of study: Department of surgery Lahore General Hospital, Lahore from March 1998 to March 2004. Subject/Method: Exploratory laparotomy of all patients with history of penetrating abdominal injury with at least breach of peritoneum. Results: In a 114 20 patient exploratory laparotomy was performed their average pulse rate was 110 / min, systolic blood pressure 90 / mm Hg with Hb range of 5.5 gm / dl to 11.5 g / dl. There were 68% victim of firearm injury and 32%o were suffered from stab on exploration virtually no organ found to escape injury while 42 (10%) cases turned out to be negative with uneventful postoperative recovery. 94(24.2%) patients developed post operative complications while 42(10%) patients expired. Conclusion: Time should not be wasted in investigating unstable patients rather these should be resuscitated in Operation Theater and early exploratory laparotomy should be performed more sophisticated diagnostic facilities like ultrasound, CT, MRI, Endoscopy, selective angiography should be made available in emergency and there should be regular audit of all penetrating abdominal injuries.
Serum lipid profile in patients of acute & transient psychotic disorders
Authors: Rafique Ahmed , Tayyib Muhammad , Ditta Allah , N S Khan M , Farooq Muhammad , Nazar Zahid , Sultan Muhammad , Khan Muhammad Ayub , Farooq Muhammad
Published: June 2016

Forty subjects, aged 15-45 years were randomly selected. Subjects were separated age wise into 1st group (15-30 years) and 2nd group (31-45 years). They were divided into groups A & C. Group A included twenty patients of acute & transient psychiatric disorder while group C includes 20 age & sex matched normal controls. Serum total cholesterol (TC), Serum triglyceride (TG), Serum HDL-c & Serum phospholipid were done by using colorimetric methods. Serum LDL-c was calculated by Friedwald equation. Results obtained were analyzed by using students `t` test & level of significance was done. Altered lipid metabolism was found in patients of acute & transient psychotic disorders with decreased Serum TC, LDL-c and phospholipids.
Vaginal birth after Cesarean section (VBAC)
Authors: Iqbal Javed , Nausheen Fouzia , Bhatti Fozia Ali , Sheikh Shahida
Published: June 2016

Aims & Objective: To find out the rate of vaginal delivery after one caesarean section Study Design: Non-interventional, descriptive study Study Setting: Department of Obstetrics & Gynaecology, Allama Iqbal Medical College and Jinnah Hospital, Lahore. Materials and Methods: A trial of vaginal delivery was carried out on 100 patients with previous one caesarean section. Selection criteria were subjects with normal pregnancy, adequate maternal pelvic dimensions vertex presentation and spontaneous onset of labour with previous one uncomplicated LSCS. Patients with classical caesarean section, medical complications, multiple pregnancy, IUGR, placenta previa and extensive myomectomy were excluded from the study. Informed consent was taken from all patients; trail of scar was given with vigilance. Maternal and fetal monitoring was carried out with facility of operation theatre, anaesthesia and paediatrician. Results: Majority of patients was between 20-24 years of age. 58% of the patients were primipara. Successful vaginal delivery was achieved in 72% and rate of repeat section was 28%. Leading indications for repeat section were failure to progress, (50%), fetal distress (28.5%) and scar tenderness (21.43%). No maternal & fetal mortality occurred. Conclusion: Trial of scar after one LSCS should be encouraged with vigilant monitoring provided no obstetric contraindication exists.
A comparison of the effect of breast feeding, mixed feeding and top feeding on weights of infants and children
Authors: Javed Bushra Karim , Karim Samina , Rasool Ghulam , , Iftikhar , Kazi Yaqoob
Published: June 2016

A retrospective analysis of 503 patients admitted to diarrhoea ward between June to August 2003 was done regarding their weight and feeding practices. Out of them 36 children were excluded as they did not full fill the required criteria. So a total of 467 patients were studied. The patients were divided into three groups depending upon whether they were breast fed, mixed i.e. both breast and top fed, or top fed respectively. All patients between the ages of birth and 24 months were included. The number of patients in breast fed, mixed fed and top fed were 134,135 and 198 respectively. Male to female ratio was 1.4:1,1.5:1,1.4:1,with mean age in breast fed group for females 6.9± 4.7 months and males 10.3±7.63,in mixed fed group 8.3± 5.97 months and 8.4 ± 6.4 months and in top fed group 8.25±7.35 months and 7.65 ±5.72 months respectively. Mean weight in each group was 6.1±1.9, 5.7 ± 2.1 and 4.9±2.0 kg. When weight of breast fed children was compared with those of mixed fed the difference was not statistically significant with p value of 0.236 while the comparison with top fed was highly significant with p value of 0.000. Similarly babies on mixed feeding had significantly better weight than that of top fed with p value of 0.004. Although it has been stressed upon and a lot of effort has been put in to encourage breast feeding but still top feeding and mixed feeding are on the top resulting in malnourished and wasted children. From our study it is obvious that top fed children are grossly malnourished, and exclusive breast feeding is low. We need to take more steps to encourage breast feeding.
Retinoblastoma; bone marrow infiltration - A study of 30 cases
Authors: Khurshid Irfan , Naeem Samina , Bashir Faiza , Lone Ayyaz , Aslam Noman , Hayee Abdul , I A Naveed
Published: June 2016

Thirty patients of Retinoblastoma presenting in the Haematology Department of King Edward Medical College, Lahore were included in the study to find out the bone marrow involvement. The patients underwent bone marrow aspiration and peripheral blood examination was also done. The aspirates were screened for the presence of tumor cells. Of the patients studied 21(70%) were males while 9(30%) were females giving a male to female ratio of 2.8:1. Maximum number of patients were in the 2-3years age group. Twenty seven patients had unilateral Retinoblastomas while three patients had bilateral disease at presentation. The bone marrow of three patients showed presence of tumor cells.
Management of acute pancreatitis: an experience at Mayo Hospital, Lahore
Authors: Ali Abrar Ashraf , Niazi Behzad Akram , Naqvi Nabeel , Gondal Khalid Masood , Islam Haroon Rafiul , Chaudhry Abdul Majeed
Published: June 2016

This is a retrospective as well as prospective study of 46 patients with acute pancreaitis who were managed in North Surgical Unit of Mayo Hospital, Lahore. This study was carried out with special emphasis on need of surgical treatment and its outcome. No age group or sex was found immune to this disease. It was more common in 3rd to 4th decade of life and female sex. The commonest etiology is gall stones (54%) followed by alcohol (8%) and idiopathic (15%). Pain epigastrium is a constant symptom. Judicious use of serum amylase urinary amylase and ultrasonography can help in early diagnosis of the acute pancreatitis. Complications are best diagnosed on CT scan. Majority of patients were treated successfully by conservative measures (44%) but developed complications which carried high morbidity and mortality. Surgical treatment of associated gall stones has prevented recurrent attacks of acute pancreatitis. Hence cholecystectomy for associated gall stones is recommended during same admission for mild to moderate pancretitis after resolution of symptoms.
The impact of dementia on antidiabetic drug use in Medicare beneficiaries with diabetes: findings post-Medicare part D
Authors: Lu Z Kevin , Li Minghui , McGee Karen , Phillips Cynthia M , Yuan Jing , Sutton S Scott
Published: June 2016

Aim:
The objectives of the study were to measure the utilization rates of antidiabetic drugs in diabetic patients with dementia and to assess the impact of dementia on antidiabetic drug use.
Materials & methods:
This study was a pooled cross-sectional study of the Medicare Current Beneficiaries Survey from 2006 to 2010.
Results & conclusion:
Lower utilizations of biguanides, DPP-4 inhibitors and thiazolidinediones were observed in dementia patients. The likelihood of using antidiabetic drugs was about 30% (odds ratio: 0.69; 95% CI: 0.56–0.84) lower in dementia patients and 40% (odds ratio: 0.61; 95% CI: 0.44–0.84) lower in patients with Alzheimer's disease. Healthcare providers should be aware of underuse of antidiabetic drugs in patients with dementia.
A Tool for Tire Handling Performance Evaluation
Authors: Siramdasu Yaswanth , Taheri Saied
Published: June 2016

In the past, handling performance of the tire–vehicle combination has been evaluated using tire models such as the Pacejka Magic Formula. These models usually lack realistic representation of tire–road interaction and are not suitable for combined steering and braking maneuvers that may activate the antilock braking system. The objective of this study is to develop a computationally simple and accurate tire model, which can be used in the development and evaluation of handling performance of the tire on uneven road surfaces. For an emergency obstacle avoidance maneuver at high speeds, transient tire behavior plays a crucial role in the generation of forces between tire and road. Road undulations and steering inputs both induce high-frequency tire belt vibrations, which have detrimental effects on the handling and tractive behavior of the tire. To meet these requirements, a dynamic six degrees of freedom tire model–based rigid ring approach is developed and integrated with a multiple tandem elliptical cam to include enveloping behavior of the tire. The tire model that is developed in this research is partially based on the work of Schmeitz found in the literature. The tire model was parameterized using experimental parameters found in the literature. The tire model is validated using fixed axle high-speed oblique cleat experimental data. The developed tire model is integrated with the vehicle model in CarSim®. From the simulation of successive step steering input, the increasing influence of tire belt vibrations at higher slip angles was observed due to sudden steering wheel inputs. From the simulation of the step steering input on the bad asphalt road surface with an added cleat and on the flat smooth road surface, it was observed that the lateral performance of the tire at higher slip angles is strongly influenced by the vertical load variations. A single lane change maneuver was simulated on the smooth and bad asphalt road surfaces, demonstrating the strong influence of tire lateral and vertical belt vibrations on the lateral performance of the vehicle. Simulation of high-speed emergency obstacle avoidance braking maneuvers on measured rough and smooth roads showed that the influence of high-frequency vibrations due to road undulations and step steering inputs causes large variations of longitudinal and lateral forces at the axle, thus creating large variations in slip and slip angle of the tire with a degraded braking distance on rough roads.
The Effects of Structured Transfer Pathways in Community Colleges
Authors: Baker Rachel
Published: June 2016

Most of the students who set out to earn degrees in community colleges never do. Interventions that simplify the complex organizational structures of these schools are promising solutions to this problem. This article is the first to provide rigorous evidence of the effects of structured transfer programs, one such intervention. Leveraging the phased rollout of transfer programs in California, I find large effects of the policy on degrees earned in treated departments. In the first 2 years, this growth was not coupled with growth in total degrees granted or in transfers, but in the third year, there is evidence of increased transfer. The analyses also show that the policy could affect equity; departments that offer transfer degrees became more popular and there is suggestive evidence that the highest achieving student groups enrolled in these classes at higher rates.