bluuebunny/crossref_metadata_2025 huggingface dataset:
PENGARUH RASIO EPOKSI/AMPAS TEBU DAN PERLAKUAN ALKALI PADA AMPAS TEBU TERHADAP KEKUATAN BENTUR KOMPOSIT PARTIKEL EPOKSI BERPENGISI SERAT AMPAS TEBU
Authors: Akhmad Nadji Shabiri  , Rizky Salaam Ritonga  , M. Hendra S. Ginting
Published: October 2019

This study was aimed to determine the effect of alkali treatment and fiber composition on the impact strength properties of epoxy composites filled with bagasse fiber. Composites are made by hand lay-up method by mixing epoxy and bagasse fiber with variation of volume ratio between matrix and filler are 100/0, 70/30, 60/40, and 50/50 (v / v) and the concentration of NaOH slolution in the alkali treatment are 0% , 1%, 2%, and 3%. Mechanical propertie tested was impact strengthand analized  by SEM analysis. The results obtained from this study was the maximum impact strength value obtained of the composite was on the composition 70:30 with 2% NaOH concentration was 8,005 kJ/m2.
DESORPSI β-KAROTEN MINYAK KELAPA SAWIT (CRUDE PALM OIL) DARI KARBON AKTIF MENGGUNAKAN ISOPROPANOL
Authors: Nurul Aini  , Olyvia Putri Wardhani  , Iriany
Published: October 2019

The aim of the research is to study the ability of isopropyl alcohol in the desorption of β-carotene and to obtain kinetic model and desorption isoterm which is suitable in β-carotene desorption. The main material used were isopropyl alcohol and activated carbon containing β-carotene. The variabels used in this research are desorption temperature,  activated carbon concentration  and parameter observed is concentration of β-carotene in isopropyl alcohol. In the desorption process, activated carbon which adsorp β-carotene was soaked in isopropyl alcohol. To review the desorption kinetics, this research was carried out in various temperature such as 40 oC, 50 oC, and 60 oC. In desorption isoterm process is, various mass of activated carbon was used. Desorption process will be analyzed at spesified time. This research used the first order of desorption kinetics model. The desorption constant rate obtained for 40 oC, 50 oC, and 60 oC are 0,013, 0,014, and 0,036 minute-1 with activation energy is 0,226 kkal/mol. The maximum desorption percentage obtain is 41,94 %. The desorption isoterm model which fit with the β-carotene desorption was Langmuir isoterm model with constanta value 1,2077 L/mg and -0,2218.
The Effect of Complete Dentures on The Body Mass Index of Elderly Patients
Authors: Asegaff Andi Alifianti Puteri , Adrian Nova
Published: October 2019

Introduction: As people age, physical changes, such as complete tooth loss, can occur. The therapy for complete tooth loss is to wear complete dentures (CDs). However, this can affect patients’ body mass index (BMI) and overall health, especially in patients who are elderly. BMI is an indicator that is often used to determine a person’s nutritional status.

 

Objective: The aim of this study was to analyze the effect of wearing a new set of full upper and lower dentures affects the BMI of elderly patients, one month after insertion at Dental Hospital of Dentistry Faculty, Trisakti University.

 

Method: This was an observational analytic study with a cross-sectional design. The subjects of this study were 31 elderly patients (according to the World Health Organization [WHO] age classification).

 

Result: Of the 31 elderly patients studied, 7 had an unstable or fluctuating BMI, 12 had a stable BMI from the beginning of CD insertion, 4 showed a consistent increase in BMI, and 2 showed a consistent decrease in BMI but remained in the normal BMI range. Using Spearman’s rank correlation coefficient, the result was shown to be significant (p=0.00), which means there was a strong correlation between CD use and change in BMI (0.76–0.99).

 

Conclusion: It can be concluded that elderly patients at Dental Hospital of Dentistry Faculty, Trisakti University who are wearing CDs encounter a significant change in BMI. Most of the subjects reached a normal BMI by one month after CD insertion, caused by an increased ability to masticate effectively.
The Prosthodontics Care For Geriatric Patients Nowadays
Authors: Oktaria Indriani , Shen Robert
Published: October 2019

The global geriatric (elderly) population is growing as a result of increasing life expectancies. One impact of this development is an increase of lifestyle difference. In the scope of health, especially dental health, the patient’s education is important. The decrease in edentulism cases showsed public awareness of the importance in maintaining the health, function and quality of life in the elderly as well as the necessity of preventive attitudes and interventions against disease. Dental services for geriatric patients are affected by the cost of dental services, dental insurance, dental clinics’ access, debt and needs. The current prosthodontic treatment that improve of missing tooth replacements is in demand is an increasing interest in dental implant treatment. Losing  tooth has a negative impact on mastication, aesthetic- and oral health-related quality of life. Excessive bone resorption can occur for many reasons, including age, infection, trauma, metabolic disorders and nutritional deficiencies. The resorption of the alveolar bone, especially in medically compromised patients, is caused by focal infections in the mouth and systemic diseases. Periodontitis or other chronic infections resulted from bacterial and host inflammatory cells. The pathology observation can result in a loss of bone support after a long period of extraction procedures is named residual ridge resorption (RRR). The best treatment for RRR is to avoid tooth extraction so that the loss of teeth and their supportive tissues can be prevented. When there is a loss of teeth and RRR, dentures have been made to reduce the occlusal load are necessary. In addition, the importance of periodic control, utilizing vitamins, oral rinse, topical gels or others, and the intake of nutrients greatly affect the good function of dentures and improve the health of the geriatric patient.
The Effect of Red Beetroot Juice (Beta vulgaris, sp.) on the Tooth Color
Authors: Wulansari Selviana , Cristandy Gabriela Lintang , Suwartini Tien
Published: October 2019

Introduction: Tooth discoloration is one of the problems and the reason why people begin to notice the appearance of their teeth. Phenolic compounds are often found in foods and beverages, one of them is red beetroot juice that cause discoloration on the tooth surface. The acidity of red beetroot juice is a factor of color changes on the tooth surface extrinsicly.

 

Objectives: This study aims to determine the effect of red beetroot juice on color changes of tooth surface.

 

Methods: This experimental laboratory research conducted pretest and posttest. Twenty maxillary premolar samples within inclusion criteria were stored in the artificial saliva at 37oC and treated for 30 minutes using 50 mL red beetroot juice, followed by immersion in artificial saliva overnight. Treatment was repeated 7 times for 7 days consecutively. The teeth was tested by using Vita Easyshade V before and after treatment and then the acquired data was statistical tested using paired T-test.

 

Result: T-test showed variable E, C and H with p=0.000 (p<0.05) showed a significant changes in total color deviation, chroma and hue, while the variable of L with p=0.015 (p>0.05) meant no significant change of value.

 

Conclusion: It can be concluded that red beetroot juice (Beta vulgaris, sp) can affect color changes on the tooth surface.
The African Tradition and the Nexus Between Public Sector Ethics and Culture: A Critical Analysis
Authors: Chigudu Daniel
Published: October 2019

Globalisation of public service delivery practices must overcome cultural and ethical barriers in their diversity. The pervasive Christian gospel and Islamic religion are believed to be concerned more in spirituality and less concerned with governance and political systems. The objective of this study is to expound the dilemma facing an ethical public service delivery system and to suggest possible solutions. The research methodology is a qualitative approach employed through content analysis. Findings indicate that for African states, alternative public service delivery is a question of choice by those wielding power, authority and political will. The study provides ethical initiatives to accommodate such diversity in building public sector ethics and culture. Simply relaying public service delivery strategies deemed successful in other states may not necessarily translate into success due to some ethical and cultural variations. What obtains is that, states that claim to be faith based or to carry religious ethical practices sometimes lead way ahead of others in unethical administrative practices. The contribution of the study is an additional item to the list of factors militating against effective service delivery and lack of public sector cultural ethics. This phenomenon should be tackled head-on so that service delivery is not compromised.
Hydrothermal refining of biomass - an overview and future perspectives
Authors: WIKBERG HANNE , GRÖNBERG VIDAR , JERMAKKA JOHANNES , KEMPPAINEN KATARIINA , KLEEN MARJATTA , LAINE CHRISTIANE , PAASIKALLIO VILLE , OASMAA ANJA
Published: October 2019

Biomass is a promising alternative for the production of energy, novel materials, chemicals, and other valuable products. A certain degree of processing is required to achieve those results. Hydrothermal processes offer a unique way to obtain a wide range of biorefinery products. They can be considered as environmentally friendly processes, using solely water at different temperatures as a process medium to convert abundant and inexpensive biomass into products. We provide a short overview on hydrothermal processes that use water in its liquid state, including hot water extraction, pressurized hot water extraction, liquid hot water pretreatment, hydrothermal carbonization, and hydrothermal liquefaction. We also provide examples of current research and realworld findings. We then present a novel hydrothermal biorefinery concept for sequencing these single processes, giving concrete examples of possible raw materials and products. Sequencing gives new possibilities for biorefineries to exploit all the biomass components as valuable products with zero losses. The added value comes from the increased efficiency of the bio-based products’ value chain, by reducing losses and generating higher-value products and services.
Fractionation by micro-hole pressure screening and hydrocyclone applied to deinking line rationalization and future manufacturing concept
Authors: KUMAR SAURABH , SAINT AMAND FRANÇOIS JULIEN , PASSAS RAPHAËL , FABRY BENJAMIN , CARRÉ BRUNO
Published: October 2019

This study pursued two objectives related to deinking. The first objective deals with the application of fractionation for deinking operations rationalization, which requires all free ink separation in one fraction and treatment in ink removal operations. Following accomplishment of the first objective, the second objective was fractions generation for stratified sheet formation. The first objective requires separation based on length, and the second requires separation by development of surface characteristics. The experimental plan was focused on selective fines separation and further valorization of fiber and fines fractions.
It was shown that fractionation by a pressure screening system equipped with a smooth hole basket with 0.25mm perforations was very selective towards fines (free ink, fillers, cellulosic fines) separation in the accepts. Long
fibers, as well as specks, were retained in the rejects fraction. Due to the higher selectivity of the micro-hole screen, fibers are retained on the screen basket. Hence, they are not subjected to flotation operations, thereby effectively reducing their probability of being lost during flotation. This essentially translated into a fractionation-deinking concept. It was also shown that 1-stage micro-hole fractionation and fines flotation provided higher yield than conventional direct pulp flotation, though the final residual ink content was high. A multistage fractionation process would
allow further reduction in long fiber residual ink.
The second objective was achieved by applying hydrocyclone fractionation on the fine and fiber fractions generated.Separation was based on fiber and fines development. This new fractionation strategy allowed production and characterization of four different fractions: well developed fibers/coarse fibers and fibrillar/flake type fines.
KORELASI KADAR KREATININ SERUM DENGAN HASIL TES ALBUMIN URINE PADA PASIEN DENGAN PENYAKIT GINJAL DI RSUD dr. SOEGIRI LAMONGAN
Authors: . Intashofal , . Sukarjati
Published: October 2019

Abstract: Examination of blood creatinine levels is one of the parameters used to assess renalfunction, since serum and urinary excretion concentrations within 24 hours are relatively constant.However, in another clinical guideline, there is a type of examination that is more recommended inmost patients with the risk of kidney failure, urine albumin test. In the event of renal dysfunction,the ability of creatinine filtration will decrease and serum creatinine will increase as well as somesubstances that should not exist in the urine, such as albumin, to appear. Reduced albumin excretion in the urine may be able to slow the rate of renal failure and help to delay the body’s need forkidney or dialysis transplantation. This cross-sectional study aims to analyze the relationship between serum creatinine and albuminuria in patients with kidney disease. Serum creatinine levelexamination by Jaffe method and urine albumin examination were qualitatively performed on therespondents who met the inclusion criteria. A total of 92 data were then analyzed by Chi-squarewith α<0,05. The results of this study indicate that there is a significant relationship betweenserum creatinine and albuminuria levels in patients with general kidney disease (p = 0.000, r =0.728), and in male patients (p = 0.000, r = 0.736) and females (p = 0,000; r = 0.686) with theage level 41-50 years. There is no relationship between serum creatinine and albuminuria in maleand female patients at the age of 20-30 years and 31–40 years.
Healthcare professionals and interactions with the medical devices industry
Authors: Purnell Paris
Published: October 2019

Compliance laws for healthcare professional practices are evolving continuously. It can therefore remain difficult to remain abreast of all laws that apply across all countries. This paper serves as guidance for best practice for healthcare professionals (HCPs) working alongside the medical devices industry.
Microbial Agents Causing Infective Corneal Ulcer and their Anti-microbial Susceptibility pattern
Authors: Jhuma Azima Aktar , Haque Md Moynul , Ahmed Jamil , Das Shantanu , Paul Tarun Kanti , Rahman Md Mahbubur
Published: October 2019

This study was designed to identify the microbial agents causing infective corneal ulcer and to carry out the antimicrobial susceptibility patterns of isolated bacteria causing infective corneal ulcer. Out of 80 samples, 67 (83.75%) cases were positive by microscopy and culture. This study showed pure fungal growth in 39 (48.75%) cases, pure bacterial growth in 8 (10%) cases, mixed microbial growth (both fungi and bacteria) in 20 (25%) cases and no growth was observed in 13 (16.25%) cases. Among the fungal isolates, Aspergillus species was the leading agent detected in 37(46.3%) cases followed by Penicillium species in 7 (8.8%) instances. Pseudomonas aeruginosa was the most common bacterial pathogen found in 11 (13.8%) cases followed by Staphylococcus epidermidis present in 9 (11.3%) cases. Gentamicin, Ciprofloxacin and Levofloxacin were found to be better efficacious drugs against most of the bacterial pathogens noted in antimicrobial susceptibility test. This study showed that infective corneal ulcers are caused by both bacterial and fungal agents but fungal agents are more common. The findings of this study would help the ophthal- mologists in evidence based management of their patients of infective corneal ulcer.

Bangladesh Med J. 2018 May; 47 (2): 1-6
Use of Human Granulocyte Colony-Stimulating Factor (G-CSF) in Consolidation Chemotherapy in Adult Acute Myeloid Leukaemia (AML)
Authors: Rumi Muhammad Shahidul Islam Sikder , Yunus ABM , Kabir Amin Lutful , Begum Masuda , Irshadullah Naseeb Muhammad , Wasim Mohammed , Chowdhury Md Sazzad Zayed , Hossain Mohammed Murad , Rahman Md Safiur , Islam Khaza Amirul , Hasan Nazmul
Published: October 2019

Acute myeloid leukaemia (AML) is treatable and potentially curable disease. Significant morbidity is related to the prolonged, severe neutropenia resulting from the disease as well as the intensive chemotherapy. The administration of granulocyte - colony stimulating factor (G-CSF) is recommended to reduce the neutropenic period. But the current information and guidelines are insufficient about the most appropriate time to start   G-CSF and the optimum duration of treatment after chemotherapy in consolidation phase. This study explores  better timing to start G-CSF after completion of chemotherapy in consolidation phase of AML patient. This prospective study was conducted in the department of Haematology, Bangabandhu Sheikh Mujib Medical University among AML patients, who received consolidation chemotherapy (high dose cytarabine). Samples were grouped into two arms. Arm-A (Absolute Neutrophil Count >1000/cmm) received prophylactic G-CSF and Arm-B (Absolute Neutrophil Count <1000/cmm) received G-CSF during neutropenia. Filgrastim was used as G-CSF and daily 300 micrograms were given subcutaneously according to study protocol. Statistical analysis was done by parametric (t test) test and appropriate using computer based SPSS (21) Program. Total sample was 19, out of which 6 in prophylactic G-CSF group (Arm-A) and 13 in delayed G-CSF group (Arm-B). Most of the patients were male (63.16%), male to female ratio 1.7:1 and mean age of sample 35 years. Mean ANC at the 1st day of G-CSF application in Arm-A 1170.5/cmm & in Arm-B 272.6/cmm (p=<0.001); mean requirements of G-CSF accordingly 11.5 and 5.9 (p=0.0014), mean 1st day of G-CSF application 9.5th day and 14.5th day (p=0.001). Outcomes in Arm-A and Arm-B were accordingly, mean duration of ANC recovery 10 and 9.85 days (p=0.913), febrile neutropenia 2.67 and 2.57 days (p=0.961), hospital stay 20 and 20.3 days (p=0.259), red cell concentrate transfusion 1.83 and 1.46 units (p=0.550), platelets concentrate transfusion 11.83 and 7.77 bags (p=0.2405), and there was no death case in two arms. Differences of timing to start G-CSF and its requirements between two groups were significant, but the outcomes did not show any statistically significant difference.

Bangladesh Med J. 2018 May; 47 (2): 23-28
Aetiological Diagnosis of Pleural Eusion: A cross sectional study
Authors: Hossain Md Billal , Alam Md Rafiqul , Paul Harasit Kumar , Biswas Sunil Kumar , Shahin Md Abu
Published: October 2019

Pleural effusion is a common clinical problem with different possible causes. It can be due to local, systemic, infectious or non-infectious causes. Aetiological diagnosis is important for proper treatment. To evaluate the aetiological diagnosis of pleural effusion of hospitalized adult patients this cross-sectional, descriptive study conducted from April to September 2012 at Bangabandhu Sheikh Mujib Medical University (BSMMU). A total of 100 cases were selected by purposive sampling. Data were collected using a structured questionnaire. Complete history was taken either from patient or accompanying attendants. Clinical examination was done and relevant investigations report were collected. Data were analyzed using statistical package for the social sciences (SPSS). The mean age of the patient was 41.2 SD± 7.4 years with a male to female ratio of 3:1. Over half (52%) of the patients were poor, 34% were middle class and 14% were rich. Over two-third (67%) of the patients were smoker and the remaining 33% were non smoker. Out of 100 patients with pleural effusion, 52 had tuberculosis and 16 patients had malignancy. Among the malignant cases 14 were found to have bronchial carcinoma  and 2, had lymphoma. The remaining 32 patient had other causes of pleural effusion which included nephrotic syndrome 14, congestive cardiac failure 5, cirrhosis of liver 4, rheumatoid arthritis 3, amoebic liver abscess 2, and undiagnosed 4. Tuberculosis is the predominant cause of pleural effusion in our country and the second leading cause is malignancy.

Bangladesh Med J. 2018 May; 47 (2): 29-34
Non-small Cell Carcinoma of Lung in a 19-year-old Male Presented as Malignant Pleural Effusion
Authors: Kabir Ahmed Imran , Sarkar Shish Mohammad , Hasan Md Nazmul , Hossain AKM Mosharraf
Published: October 2019

Bronchial carcinoma is rare in younger age group. Smoking, environmental and occupational exposure are the major risk factors. Radiological imaging, bronchoscopy, FNAC and biopsy are the main mode of investigations. Surgery, radiotherapy and chemotherapy are the treatment of choice. Here, we report a case of 19-yearrs-old male and diagnosed as a case of non-small cell carcinoma of lung (NSCC). Cytological examination of pleural fluid showed non-small cell carcinoma. This may be indicating the changing trend of developing NSCC in young adults.

Bangladesh Med J. 2018 May; 47 (2): 41-43
Evans Syndrome: A Case Report
Authors: Biswas Sunil Kumar , Biswas Tonmoy , Khondoker Noornabi , Alam Md Rafiqul , Rahim Md Abdur , Paul Harasit Kumar , Shahin Md Abu , Hasan Md Nazmul , Bhuiyan AKM Motiur
Published: October 2019

Evans syndrome, a combined clinical condition of autoimmune haemolytic anaemia (AHA) and idiopathic thrombocytopaenic purpura (ITP) and has non-specific pathogenesis. The clinical cases are extremely rare, since only 4% of AHA or ITP are incorporated with Evans. It is distinguished from differentials, such as lupus, IgA deficiency, and acquired immunodeficiency, by peripheral blood film, bone marrow, Coombs test, and coagulation profile. A case of adult female from Pabna, Bangladesh is documented in this report. She complained of high grade intermittent fever, exertional dyspnea, icteric skin and sclera. Other features included mild splenomegaly, dark urine, and profuse sweating after fever. Investigation reports were consistent with AHA and ITP, with normal coagulation and viral profile. However, the patient was treated with corticosteroids, platelet and blood transfusion. And in follow-up visits, there was a pattern of gradual decline in erythrocyte sedimentation rate (ESR) and reticulocyte count, with normalization of haemoglobin, red cell, and white cell count. No association with other diseases was found in this case.

Bangladesh Med J. 2018 Jan; 47 (3): 37-40
Painful, Tender Loin Mass is an Atypical Presentation of Perforation of Retrocaecal Appendix - A Case Reoirt
Authors: Hossain M Mosarraf , Mizan Mizanur , Maruf Maruful , Md Jabed - , Ullah Md Sk Shahid
Published: October 2019

Right painful, tender loin mass is an unusual presentations of acute appendicitis that arises difficulty in surgical practice. This "case of  right painful, tender loin mass results from perforation of retrocaecal appendix with known case of diabetes mellitus patient 50 years old age. This case facilitates the significance of contrast for abdominal computerized tomography scan for critically ill patient.

Bangladesh Med J. 2018 Jan; 47 (3): 41-43
Effect of Perioperative Administration of Tranexamic Acid on Postoperative Bleeding Following on Pump CABG
Authors: Shahidullah AYM , Rahim AM Asif , Hossain ASM Iftekher , Islam Syed Monirul , Bari Md Sajedul , Hosain Nazmul
Published: October 2019

Background: One of the main causes of post-operative morbidity in cardiac surgical patient is excessive bleeding requiring transfusion of blood component after CPB. Re-exploration due to bleeding occurs in 2% to 7% of post bypass patient and 50% to 80% of these patients not having any identifiable surgical bleeding source. Tranexamic acid is competitive inhibitor of plasminogen activator and at higher concentration a non-competitive inhibitor of plasmin. It is 10 times more potent than Epsilone Aminocaproic Acid in preventing post-operative haemorrhage following CPB.

Methods: This study was conducted in the Department of Cardiac Surgery, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh between January 2009 and December 2010. The Study population was divided into two groups. Group A comprised of 35 patients, who had received Tranexamic Acid 10 mg /kg after induction and then 1 mg/kg/hour till time of protamin infusion and Group B comprised of 35 patients who had received same amount of normal saline 0.9% NaCl as placebo.

Results: The postoperative bleeding during both 1 to 4 hours and 4 to 24 hours was significantly lower in the Tranexamic Acid group as compared to the placebo group (p value <0.001). There was no significant difference between groups in terms of platelet count and prothrombin time.

Conclusion: From the study, we conclude that “Perioperative Administration of Tranexamic acid reduces post operative bleeding and also reduces the need for postoperative blood transfusion in CABG patents using Cardiopulmonary bypass”. Therefore it is recommended that routine prophylactic use of Tranexamic Acid should be carried out to decrease the postoperative hemorrhage and requirement blood transfusion.

Cardiovasc. j. 2019; 12(1): 20-23
Serum Lipid Profile in Young Adults admitted with Myocardial Infarction in the Chittagong Region
Authors: Imam Hasan , Hosain Suman Nazmul , Chowdhury Ibrahim , Murshed AKM Manzur
Published: October 2019

Background: Ischemic heart disease (IHD) is a common cardiac disorder and significant cause of mortality and morbidity Worldwide. Dyslipidemia plays an important role in the pathogenesis of young MI as evidenced from different studies. This present descriptive study is designed to evaluate the pattern of dyslipidemia in young patients of Chittagong region, suffering from MI.

Methods: 100 patients of young myocardial infarction diagnosed by clinical, biochemical and ECG criteria were included in the study. Fasting lipid profile was measured in the patients with age less than 40 years.

Results: Among the patients 44% patient had hypertension, 15% were diabetic, 40% patients had history of smoking and 12% patient were obese. Change of socioeconomic status found to have an influence in lipid profile like low density lipoprotein (LDL), total cholesterol (TC) and triglyceride (TG) (p<0.05) but high density lipoprotein (HDL) had no change (p>0.05). LDL was changed in relation with nature of works. TG was significantly found higher in rural community and advanced age group (p<0.05). HDL level was found varied with gender and others were found insignificant.

Conclusion: Varied lipid profile was found among the young victims of MI in Chittagong region. It might be concluded that control of blood lipid might lower the coronary events among young patients.

Cardiovasc. j. 2019; 12(1): 30-32
Characteristics of Children Hospitalized with Infective Endocarditis at Dhaka Shishu Hospital
Authors: Rima Rezoana , Mamun Mohammad Abdullah Al
Published: October 2019

Background: The characteristics of infective endocarditis (IE) have significantly changed in pediatric age group during last few decades. The present study was conducted to study the clinical & lab profile, risk factors, site of cardiac involvement and outcome of infective endocarditis in the largest children hospital of Bangladesh.

Methods: This prospective cross-sectional study was conducted in cardiology department with a diagnosis of IE from February 2014 to August 2016. Twenty- four children fulfilled the modified Duke diagnostic criteria.

Results: Definite IE was found in 58% (14/24) patients, while the rest had possible IE. The most common presenting symptom was prolonged fever (> 2 weeks) & heart murmur. Most commonly encountered risk factors included congenital heart disease (54%), most commonly ventricular septal defect (21%). Two patients (8.3%) had history of rheumatic heart disease. Other important risk factors include post cardiac surgery (16.7%), prolonged ICU stay of neonates (20.8%). Nineteen patients (79%) were classified as having culture-negative endocarditis and five (21%) as culture positive. The most frequently isolated organisms were streptococci and followed by staphylococci and candida. Fifteen (62.5%) patients had right-sided cardiac involvement. Seven (29%) patients died of endocarditis or its complications.

Conclusion: Clinicians should have a high index of suspicion of endocarditis in persistently febrile patients with congenital heart disease and send blood cultures or refer appropriately before prescribing antibiotics.

Cardiovasc. j. 2019; 12(1): 33-39
Clopidegrol Resistance in Patients Undergoing Percutaneous Coronary Intervention (PCI): our experiences at Apollo Hospitals Dhaka
Authors: Islam AHM Waliul , Munwar Shams , Hossain Azfar , Reza AQM , Talukder Sahabuddin , Ahmed Tamzeed , Rahman Mizanur
Published: October 2019

Background: Dual antiplatelet (DAPT) treatment with Clopidegrol and Aspirin after percutaneous coronary intervention(PCI) is common practice for the interventionist to prevent thrombotic event after coronary stent placement. In spite of this, significant number of thrombotic events still occur. Exact data on our population regarding the thrombotic events after successful PCI and uses of DAPT not yet available. Therefore, we have carried out this study to see sensitivity resistance in our population by measuring Clopidegrol resistance test (CYP2C19 assay).

Methods: Total 351 patients were enrolled in this observation non randomized prospective cohort. Patient who had percutaneous coronary intervention (PCI) at our center or elsewhere, and on Clopidegrol with Aspirin, were selected for the study. Clopidegrol resistance were measured by PCR assay for CYP2C19 at our hospital molecular lab.

Results: Among the 351 patients, male 292 and female 59. Average age for the male: female was 59:61years. Clopidegrol resistant test was performed by Real Time PCR for CYP2C19. Total 57%(200) patients are Clopidegrol resistant or positive and 43%(151) patients are Negative. Among the resistant case 9.1%(32) patients are Homozygous Positive with probable genotype CYP2C19*2 (*2/*2) and 168 (47.8%) patients were Heterozygous positive with probable genotype CYP2C19(*1/*2). Among the CAD risk factors, Dyslipidemia were more, followed by HTN, DM, FH and smoking. Among the studied group; PCI territory Left Anterior Descending (LAD), total number of Percutaneous Coronary Intervention (PCI) and number of vessel that is Single Vessel Disease (SVD) were more in Heterozygous, Homozygous and CYP2C19 Negative group.

Conclusion: In this single center, observational prospective cohort, we found quiet a significant (57%) number of patients are Clopidegrol resistant. Therefore, we may need to double the Clopidegrol dose and or to start other antiplatelet such as Ticagrelor or prasugrel in addition to Aspirin. Thus, to prevent stent thrombosis or restenosis.

Cardiovasc. j. 2019; 12(1): 45-52
Dilated Cardiomyopathy in Paediatric Population: A Review
Authors: Fatema Nurun Nahar , Nazmi Nure Ishrat
Published: October 2019

Dilated cardiomyopathy (DCM) is a common cardiac diagnosis in children that may result as a consequence of diverse genetic and environmental insults. The differential diagnosis remains quite broad and as a result the approach to diagnosis and management may, at times, be quite difficult. A rigorous work-up can exclude alternative causes of left ventricular (LV) dilation and dysfunction, identify etiologies that may respond to specific treatments, and guide family screening. Assessment of myocardial detection of pre-clinical DCM could significantly reduce morbidity and mortality by allowing early instigation of cardio protective therapy. This review article discusses genetic and acquired causes of DCM, diagnostic modalities and therapeutic implications in the hope of informing physicians of a clinical entity that afflicts a substantial number of children worldwide.

Cardiovasc. j. 2019; 12(1): 64-74
Cardiac Complications of Dengue Fever
Authors: Md Khaliquzzaman -
Published: October 2019

Abstract not available

Cardiovasc. j. 2019; 12(1): 79
Use of intra-urethral steroid clobetasol cream to prevent the recurrence of urethral stricture after optical urethrotomy: Randomized clinical trial
Authors: Ahmed M , Hossain SM , Islam MT , Kobir G , Basu BK
Published: October 2019

Background: One of the most frequently used treatments of urethral strictures is the optical internal urethrotomy (OIU). About 20%-60% of urethral stricture patients develop recurrent stricture after Urethrotomy. Glucocorticoids have proved anti-proliferative effect and thereby used to reduce the formation of scar tissue. In urethral stricture, the main pathology is scar tissue formation.

Objective: The aim of this study is to see the influence the local application of steroid clobetasol cream after Urethrotomy.

Method: Between January to December 2016, all Bulbar urethral stricture patients attended to the hospital and private clinics, were included in this study. They were placed in two groups alternatively. They underwent standard OIU. First group (35 patients) offered clean intermittent self-catheterization (CISC) postoperatively without any steroid cream in urethra. The second group (35 patients) practiced CISC in the same way but used clobetasol cream with catheter. Both groups used topical anaesthesic Lidocain HCL for lubrication of urethra.

Result: No patient developed recurrence with clobetasol cream after 3 months, but two patients developed recurrence without steroid. At 6 months, this result is 6 (17.14%) and 10 (28.57%) accordingly.

Conclusion: Topical steroid clobetasol cream reduces urethral stricture recurrence.

Mediscope Vol. 6, No. 2: Jul 2019, Page 59-63
Neonatal Outcome in Meconium Stained Amniotic Fluid (MSAF): A Study in a Neonatal High Dependency Unit (NHDU) of a Medical College Hospital
Authors: Ali MB , Maruf AA , Naher N , Islam S
Published: October 2019

Background: Meconium-stained amniotic fluid (MSAF) is a potential sign of fetal hypoxia as well as a potential toxin if the fetus aspirates with a gasping breath in utero or when it takes its first breaths following birth.

Objective: To evaluate the outcome of neonates with meconium-stained amniotic fluid (MSAF).

Material and Methods: This prospective observational study was carried out in the department of pediatrics of Gazi medical college Hospital, Khulna during one calendar year from 01 July 2016 to 30 June 2017. Maternal risk factors for MSAF, modes of delivery of neonates were recorded. All neonates born with MSAF were included in this study: they were shifted to neonatal high dependency unit for observation and monitoring as per the pediatrician’s advice. Neonatal outcomes like birth asphyxia, neonatal jaundice, aspiration pneumonia, septicemia, meconium aspiration syndrome (MAS), hypoxic-ischemic encephalopathy (HIE) and death were observed and recorded.

Result: A total of 157 babies were included during the study period. Modes of delivery of babies were: normal delivery 86(54.78%), caesarean section 48(30.57%) and instrumental delivery 23(14.65%). Maternal risk factors were postdated pregnancy 51(32.48%), previous caesarian section 20(12.74%), pregnancy-induced hypertension (PIH) 20(12.74%), premature rupture of membranes 18(11.46%), gestational diabetes mellitus (GDM) 17(10.83%), intrauterine growth retardation (IUGR) 14 (8.92%), cephalopelvic disproportion 9(5.73%) and anemia 8(5.10%). Outcome of babies were: 118(75.16%) babies were discharged without any complications, 10(6.37%) developed neonatal jaundice, 10(6.37%) meconium aspiration syndrome (MAS), 8(5.10%) birth asphyxia, 4(2.55%), aspiration pneumonia, 3(1.91%) hypoxic-ischemic encephalopathy (HIE), 2(1.27%) septicemia and 2(1.27%) baby died in early neonatal period.

Mediscope Vol. 6, No. 2: Jul 2019, Page 65-71
Pretreatment with Magnesium Sulfate to Alleviate Pain on Propofol Injection: A Prospective Randomized Double Blind Study
Authors: Hossain Muhammad Sazzad , Rashid Md Mamunur , Rashid Mohammad Mamunur , Babu Md Anisur Rahman , Sultana Afsana , Saha Devashis , Hasan Mohammad IftaKhiarul
Published: October 2019

Background and aim of study: Propofol is one of the most frequently used medications for inducing and maintaining anesthesia. However, propofol injection causes pain and discomfort in more than 70% of patients. This study was performed to determine the effect of magnesium sulfate on reducing pain at the onset of anesthesia induced by propofol injection.

Materials and methods: A total of 80 healthy adult patients were selected in this study with either sex, scheduled for routine elective surgical procedure under general anesthesia. The patients enrolled were divided randomly into two groups of 40 patients each. Group I received 30 mg/kg of intravenous magnesium sulfate in 5 ml. Group II (placebo group) received 5ml of 0.9% intravenous normal saline 1 minute before propofol injection. The patients were asked to report their pain during injection of propofol. For all statistical tests, p<0.05 was taken to indicate a significant difference.

Results: The incidence of pain experienced in magnesium sulfate group was 30% patients and in saline group was 60% patients, which is statistically significant p<0.05. The severity of POPI was also lower in magnesium sulfate group than the saline group (p<0.05). The incidence of mild and moderate pain in groups I versus group II was 22.5% versus 37.5% and 7.5% versus 22.5% respectively p<0.05. There was no severe pain recorded in any groups.

Conclusion: Magnesium sulfate can be used before induction of anesthesia to reduce pain on propofol injection.

Mediscope Vol. 6, No. 2: Jul 2019, Page 73-77
Suicide kills more peoples than any form of violence
Authors: Sadek A , Anam AMA , Rashid MSA , Akber EB , Khan NT
Published: October 2019

“Suicide is a tragic global public health problem. Globally, WHO said the death toll from suicide – at almost one million people per year – accounts for half of all violent deaths. Estimates suggest fatalities could rise to 1.5 million by 2020. Recently it’s been a great concern to examine suicide trends among teenage people. They are emotional and can’t tolerate difficult situation. They think it is a permanent problem so suicide is the only solution. Last year (2017) large number of SSC candidate students committed suicide in different districts due to not getting expected result. So this is the time to create awareness among society and also family support to child, otherwise no one can predict it. One day these victims will be their family members. Our review articles focuses on causes, risk factors and prevention of teenage suicide in country.

Mediscope Vol. 6, No. 2: Jul 2019, Page 87-92
Self-Selected Individual Music Therapy for Depression during Hospitalization for Cancer Patients: Randomized Controlled Clinical Trial Study
Authors: Widiyono Widiyono , Setiyarini Sri , Effendy Christantie
Published: October 2019

Background: Depression is a psychological distress that often occurs on cancer patients. Depression can increase patient perception about pain, resulting reduced drug efficacy and longer length of stay. Drug treatment for depression sometimes has side effects. Another intervention to decrease depression on cancer patients is music therapy. Music therapy might avoid polypharmacy in cancer patients. The purpose of this study was to determine the effects of self-selected individual music therapy toward depression of cancer patients.Methods: The method used in this study was the randomized control trial (RCT). Simple Random Sampling was assigned randomly by three researcher assistants to participants (N=70) of intervention and control group. The intervention used was self-selected individual music therapy (SeLIMuT). SeLIMuT was applied four times in 2 days with a duration of 15 minutes each session. Beck Depression Inventory (BDI) was employed for selection purposes. The data were analyzed using Mann-Whitney with p < 0.05 and 95% CI. The effectiveness of therapy was analyzed by the effect size test using abs r.Results: Based on the result of the bivariate analysis, there was an effect of giving self-selected individual music therapy to reduce depression with depression gap in both groups with p-value of 0.001 (p < 0.05). The value of the effect test obtained abs r = 0.82 (r > 0.5). At the end, the self-selected individual music therapy had moderate effect toward depression of cancer patients.Conclusions: Music therapy is safe, inexpensive, and easy to use, for and by patients. The nurse can safely recommend any of these interventions for depression on cancer patients. Specific selections or types of music may have different effects on different patients and may provide different effects at different time, so the use of self-selected individual music therapy is recommended.
The mRNA Expression Profile of PD-1 and PD-L1 in Peripheral Blood of Colorectal Cancer Patients
Authors: Ajoedi Ajoedi , Azhar Muhammad Al , Nadliroh Siti , Hartini Sri , Andalusia Rizka , Witarto Arief Budi
Published: October 2019

Background: Immunotherapy using immune checkpoint inhibitors has currently emerged as an effective treatment for a subset of colorectal cancer (CRC) patients. The roles of PD-1 and PD-L1 expression levels in peripheral blood to predict patient’s response to immune checkpoint inhibitors are not well established. Therefore, we analyzed PD-1 and PD-L1 mRNA expression levels of peripheral blood in Indonesian CRC patients and explored the association with the clinicopathological features.Methods: Peripheral blood of 25 CRC patients and 10 healthy individuals were collected in Dharmais Hospital-National Cancer Center from 2017 to 2018. PD-1 and PD-L1 mRNA expression levels were analyzed using real time PCR. The associations with clinicopathological variables were analyzed with fisher-exact test or chi square test.Results: PD-1 mRNA expression levels were significantly lower in CRC patients compared to healthy individuals (HI) (mean: 0.0015 ± 0.0013 and 0.017 ± 0.010 respectively, p < 0.001). Although PD-L1 mRNA expression levels were lower in CRC patients, the difference was not statistically significant (mean in CRC and HI: 0.021 ± 0.013 and 0.034 ± 0.028 respectively, p = 0.125). The expression of PD-L1 was higher in CRC females compared to males (p = 0.03). The expression levels of PD-L1 were not associated with different ages (p = 0.673), stages (p = 0.298), histological type of colorectal cancer (p=0.852), patient status (p = 1.000), and body mass index (p = 0.514).Conclusions: The mRNA expression levels of PD-1 and PD-L1 were lower in CRC patients compared to healthy controls. Expression of PD-L1 were correlated with sex, but not correlated with ages, stages, histological type of CRC, patient status, and body mass index.
Procedimiento Metodológico para la Ponderación Relativa de la Importancia Ambiental de las Acciones de Proyectos
Authors: Llamas Susana , Baron Jorge
Published: October 2019

Se presenta un procedimiento metodológico, complementario a la Evaluación de Impacto Ambiental (EIA), que define una estructura jerárquica para el proyecto, permite calcular el peso relativo de cada acción y comparar analíticamente diferentes alternativas. Se asignaron 1000 Unidades de Importancia de Acciones de Proyecto (UIAP) al proyecto en estudio para distribuirlas entre sus elementos, se utilizó decisión multicriterio para calcular el conjunto de coeficientes (pj) que representa el peso relativo de cada acción. Con la aplicación del procedimiento desarrollado a la EIA de un proyecto minero se comprobó la validez del método desarrollado para justificar matemáticamente la alternativa seleccionada.
Physical model for protection of cable lines and radioelectronic means of state and industrial objects from external electromagnetic influence in conditions of prevention of emergency situations
Authors: Lyashenko Vladimir
Published: October 2019

Grounded prerequisites for the development and creation of a physical model of protection of cable lines and radio electronic means of state and industrial objects from external electromagnetic influence in the conditions of emergency prevention.It is determined that the theoretical prerequisites for modeling include the condition of protection, which is the need to ensure complete neutralization of the electromagnetic impact energy, as the main factor in maintaining the proper technical condition of cable lines and radio electronic means. The second prerequisite for the creation of the model is the functional analogy between electricity and pneumatic (hydraulic), which is the basis for the development of protection of cable lines and RES in the direction of replacement of the most vulnerable electrical devices to pneumatic devices (hydraulic), which electrical and jet pneumatic (hydraulic) devices. They will also be linked through energy conversion.The basic scheme of physical model of protection of cable lines and radio electronic means in the conditions of emergency prevention at state and industrial objects connected with external electromagnetic influence, which unlike the existing ones, is created by replacement of separate electronic measuring systems by digital and analog streaming computations Pneumatic devices (hydro-automatic) devices and fiber-optic materials are used to create protection of communication channels.

The proposed physical model will allow us to investigate changes in the technical condition of cable lines and electronic equipment in the event of emergency situations at state and industrial sites related to external electromagnetic effects.
Jeoistatistiksel Modelleme ile Edirne İli Uzunköprü İlçesi Topraklarının Bazı Mikro Element Düzeylerinin Belirlenmesi
Authors: KOCA Yakup Kenan , DERİN Ali , ADİLOĞLU Sevinç
Published: October 2019

Bitki gelişimi
için en az makro besin elementleri kadar önemli olan mikro besin elementlerinin
toprakta yeter düzeyde bulunmayışı, sonuç olarak verim ve ürün kalite
özelliklerine olumsuz etkide bulunmaktadır. Toprakta bulunma düzeyleri makro
besin elementlerine göre nispeten daha düşük olan demir, bakır, mangan ve çinko
mikro besin elementleri olarak adlandırmaktadır. Yapılan çalışmalarda bu besin
elementlerinin noksanlığı durumunda bitkide çeşitli simptomlar meydana geldiği
bildirilmektedir. Bu çalışma ile Edirne ili Uzunköprü ilçesi topraklarının kimi
mikro besin elementi düzeyleri ortaya konmuştur. Bu kapsamda İlçe topraklarını
temsil edecek düzeyde yeter sayıda toprak örneklemesi yapılmış; sonuçlar
jeoistatistiksel modelleme yardımıyla tüm alan için haritalanmıştır. İlçe
topraklarında tamamında bakır yeter düzeyde iken, demir orta ve yüksek
düzeylerde, mangan az ve yeter düzeylerde bulunmuştur. Çinko ise Türkiye
toprakları ile benzerlik göstermekte olup; çalışma alanının önemli bir kısmında
kritik düzeyin altındadır.