bluuebunny/crossref_metadata_2025 huggingface dataset:
Державне управління у формуванні відповідального суспільства в умовах розвитку діджиталізації
Authors: Г.В. Ортіна , Н.П. Рибальченко
Published: July 2021

Україна, як і весь світ, поступово виходить з карантину, викликаного пандемією
коронавірусу. Втім, поетапне ослаблення обмежувальних заходів навряд чи колись поверне життя до звичного для всіх ритму, що існував до епідемії. Пандемія Covid-19
дуже швидко охопила весь світ, ці обставини були непередбачуваними та зумовили
глобальний процес цифровізації. В умовах швидкого розвитку інформаційних технологій суспільство зазнає динамічних та глобальних змін. Діджиталізація виступає каталізатором інноваційного розвитку. Безперервні технологічні зміни призводять до
появи таких можливостей, як гнучкість, реактивність та індивідуалізація продукції і
послуг, однак разом із тим з’явилися й нові перешкоди, такі як швидкі технологічні перетворення, високий рівень складності, зміна переваг та вимог законодавства країн.
Діджиталізація, перш за все, потрібна для того аби перейти від несистемної
діджіталізації бізнесу, яка має залишитися позаду, та створити нову споживчу
цінність і зовсім нову і якісну модель бізнесу. В Україні завдяки освіті та людям є
необхідний потенціал для розвитку цифрових технологій, також є здобутки окремих
компаній (технологічний сектор). Але є і серйозні проблеми: повільний розвиток системи, відсутність комплексного підходу і втрата часу. Поряд із використанням
традиційних підходів до державотворення Україна, крокуючи в ногу з часом, враховуючи суспільні потреби та технологічні зміни, має всі підстави застосовувати досвід
провідних країн світу, де одним із пріоритетних напрямків відповідального суспільства
еволюції стало використання публічно-управлінських інновацій. Одним із таких модерних підходів, що формує складову сучасних нововведень у сфері публічного управління є
діджиталізація публічних послуг – державних і громадських. Розширивши власний ресурсний потенціал, людина сьогодні стає дедалі вибагливішою до сфер публічних послуг, зокрема соціальних, які повинні повноцінно реалізувати інтерес її буденного існування.
Mathematical Investigation of Functions
Authors: Torres Rene
Published: July 2021

Generally, when the independent variable of a given exponential function is used as an exponent, the function is considered an exponential. Thus, the following can be examples of exponential functions: $f(x) = ab^x + c$, $f(x) = ae^bx + c$, or $f(x) = e^{a^2+bx+c}$. However, deriving functions of these types given the set of ordered pairs is difficult. This study was conducted to derive formulas for the arbitrary constants a ,b, and $c$ of the exponential function $f(x) = ab^x + c$. It applied the inductive method by using definitions of functions to derive the arbitrary constants from the patterns produced. The findings of the study were: a) For linear, given the table of ordered pairs, equal differences in $x$ produce equal first differences in $y$; b) for quadratic, given the table of ordered pairs, equal differences in $x$ produce equal second differences in $y$; and c) for an exponential function, given a table of ordered pairs, equal differences in $x$ produce a common ratio in the first differences in y. The study obtained the following forms: $b=\sqrt[d]{r}$, $a=\frac{q}{b^n {(b^d-1)}}$, $c=p-ab^n$. Since most models developed used the concept of linear and multiple regressions, it is recommended that pattern analysis be used specifically when data are expressed in terms of ordered pairs.
Key user ERP capability maintaining ERP sustainability through effective design of business process and integration data management
Authors: Tarigan Zeplin Jiwa Husada , Oktavio Adrie , Soeprapto Widjojo , Harjanti Dhyah , Malelak Mariana Ing , Basana Sautma Ronni
Published: July 2021

Business competition is increasingly complex, and there are no clear boundaries between products, so company operational processes are needed efficiently and effectively. The performance achieved is obtained through the implementation of an integrated information technology known as ERP. ERP implementation requires a person in charge of a business function called a key user who understands business processes and collaborates with ERP system vendors. The study obtained data that can further process from 77 manufacturing companies in East Java by purchasing an ERP or self-development package. Data processing uses PLS to answer all research hypotheses. The results show that key user capability was able to have a direct effect on the effective design of business processes of 0.643 and integration data management of 0.373. In contrast, it had no direct impact on ERP suitability. Effective Design of Business Processes has an immediate effect on Integration Data Management of 0.338 and ERP suitability of 0.395. The results also show that Integration Data Management has a direct effect on ERP suitability of 0.462. The data processing results for the indirect effect showed that key user capability influenced ERP suitability through the effective design of business processes of 0.507. Key user capability affects ERP suitability through Integration Data Management, and it is obtained as much as 0.254. The last hypothesis, key user capability, influences ERP suitability through effective Design of Business Processes and Integration Data Management of 0.182. The study results provide theoretical contributions to ERP implementation success factors, while practical gifts give key users a good understanding of the company's business processes and ERP systems.
Co-administration of Ondansetron with Tramadol Decreases efficacy of Tramadol in Intensive Care unit patients
Authors: Bhalerao Nikhil , Singam Amol
Published: July 2021

Background: Tramadol is routinely used analgesic postoperatively in ICU patients, it is known to cause nausea and vomiting. Pharmacologically it has analgesic action, centrally as it blocks the reuptake of serotonin at spinal pathway. Ondansetron is a serotonin receptor antagonist used in postoperative time, cancer chemotherapy, radiation therapy, as an anti-emetic. In-spite of known pharmacological antagonism centrally, these two drugs are routinely used together postoperatively. The purpose of this study was to assess tramadol's analgesic efficacy when given alone versus when given along with ondansetron. Requirement of rescue analgesic and side effects like sedation, nausea and vomiting amongst two groups were also evaluated. Methods: This prospective randomized study was conducted at surgical ICU enrolling 60 patients. We have separated patients into two groups of 30 each. Group A was given 100milligram of injection tramadol intravenously slowly over ten minutes and after 12mg/hour tramadol plus ondansetron in the dose of 0.8mg/hour. Group B was given 100milligram of injection tramadol slowly over ten minutes followed by infusion of tramadol 12mg/hour. In both A and B groups, hemodynamic parameters were evaluated at 0, 3, 6, 12, and 24 hours along with pain assessment using the Visual Analog Scale (VAS) in the range of 0 to 10. Rescue analgesia was administered in the form of paracetamol 1 gram IV at any time if VAS > 4. A four point ordinal scale was used to measure side effects such as nausea, vomiting, and the degree of sedation. Results: In group A, postoperative VAS scores were higher up to 24 hours compared to group B, suggesting greater analgesia in the tramadol infusion group only. There was a significant difference when both the groups were compared with respect to requirement of rescue analgesia with 4 patients in group A and no patient in group B requiring rescue analgesia. No significant difference was found with respect to nausea and vomiting and the degree of sedation in both classes. Conclusion: In ICU patients administration of tramadol along with ondansetron should not be practiced as ondansetron decreases the analgesic efficacy of tramadol.
Evaluation of Antidiabetic, Antidiarrheal and Sedative Effects of the Methanolic Extract of Clerodendrum viscosum Roots in Mice
Authors: Mohammed S. Rahman , Yasmin Hasina , Rashid Md. Harun , Adnan Nihad , Jamiruddin Mohd. R. , Kabir Md. Tanvir
Published: July 2021

Background: Clerodendrum viscosum is one of the most well-known plants in traditional practices. The study aims to explore the antidiabetic, antidiarrheal and sedative effects of methanolic extract of Clerodendrum viscosum roots (MECV) in mice. Methods: For each experiment, four groups of animals were used consisting of three mice per group. Each group was treated individually: group I treated as negative control, Group II received reference drug of each experiment, Group III and IV received MECV at 200 and 400 mg/kg body weight, respectively. Antidiabetic effect of MECV was evaluated by oral glucose tolerance test. Antidiarrheal activity was examined by the method of castor oil induced diarrhea and reduction in amount of diarrheal feces was determined. To assess the sedative activity of MECV, total sleeping time was determined in phenobarbitone induced mice. Results: MECV showed statistically significant (p<0.05) blood glucose lowering activity which was comparable to the standard drug, glibenclamide and the effect was found to be dose dependent. The extract reduced the diarrheal feces in mice by 51.85% and 65.56% at 200 and 400 mg/kg doses, respectively. The observed activity was found significant (p<0.05) in comparison to the positive control. Also, the test extract showed significant (p<0.05) sedative activity with respect to the control suggesting that the extract potentiated the phenobarbitone induced sleeping time. Conclusion: This is the first report on the therapeutic importance of methanolic extract of Clerodendrum viscosum roots in diabetes, diarrhea and sedation and thus supporting the uses of the plant in traditional medicine.
Simultaneous method development and Validation by HPLC for Capecitabine and Oxaliplatin in mucoadhesive microspheres containing capsules
Authors: Patel Krishna , Patel Dipti
Published: July 2021

A simple, specific and accurate reversed-phase high performance liquid chromatographic method was developed for the simultaneous determination of Capecitabine and Oxaliplatin, using a Hypersil BDS C18, 150x4.6 mm, 5μ column and a mobile phase composed of 10mM dipotassium hydrogen phosphate+0.1% TEA pH 5.0: Acetonitrile (50:50%v/v). The flow rate was 1.0 ml/min, and the detection wavelength was 245 nm. The injection volume was 20 μL. The retention times of Capecitabine and Oxaliplatin found 4.29 min and 5.52 min, respectively. Linearity was established for Capecitabine and Oxaliplatin in the range of 60-210μg/ml and 20-70 μg/ml, respectively. The percentage recoveries of Capecitabine and Oxaliplatin found to be in the range of 99.1-101.5% and 97.9-99.7 %, respectively. The proposed method validated for precision, accuracy, linearity range, and robustness. This method can successfully be employed for simultaneous quantitative analysis of Capecitabine and Oxaliplatin in the capsule.
Iraq Crude Oil Exports – August, September, October 2017
Authors: SOMO Ministry of Oil / Oil Marketing Company
Published: July 2021

Table 1. Iraq Crude Oil Exports – August 2017 ….………….……….…..1Table 2. Iraq Crude Oil Exports – September 2017………….….….……..2Table 3. Iraq Crude Oil Exports – October 2017 . …………...….………..3
¿Es el pensamiento transhumanista una amenaza a la dignidad humana?
Authors: Silva Julio
Published: July 2021

Este ensayo examina críticamente la tesis – defendida por filósofos bioconservadores – que sostiene que el pensamiento transhumanista constituye una amenaza a la dignidad humana. A partir de esta consideración, defenderemos las siguientes tesis: primero, el pensamiento transhumanista nos conduce a replantear la noción de dignidad humana para hacerla más amplia y ofrecer, en su lugar, la noción de dignidad de los seres sintientes; segundo, la principal preocupación no es si llegasen a existir tales seres (los transhumanos): la preocupación principal es que tales seres sean lo suficientemente moral, al igual que hoy en día tememos a los humanos que no son lo suficientemente moral y que tienen grandes poderes tecnológicos.
A Contrapuntal Reading of Joseph Conrad’s Lord Jim in the Light of Edward Said’s Culture and Imperialism
Authors: Nawsher Oan Md. , Mahbubur Rahman A.S.M. , Faisal Haque Md. , Lutful Arafat Md. , Hossain Sohrab
Published: July 2021

This article targets to converge in analyzing the novel Lord Jim and Said’s Culture and Imperialism to illustrate the critical development of the term ‘contrapuntal reading’ that demonstrates spatial rather than temporal relationship between them. This study deeply endeavors to present the relation between the colonized and colonizer as it is marked in Said’s Culture and Imperialism that demonstrates Conrad’s Lord Jim while it exposes the relationship of Jim and all other characters and the experiences of Jim that he gathers in his journey in the novel. In addition, this study scrutinizes the different aspects related with the term ‘contrapuntal reading’-colonialism, modernism and imperialism. However, qualitative approach has been applied to analyze the novel Lord Jim. As a consequence, this effort will pave the way to interpret the novel Lord Jim with an in-depth analysis that will lead the researchers to investigate other texts under the light of the term ‘contrapuntal reading’. More specifically this research paper investigates the inner incidents that took place in the novel Lord Jim in the light of Said’s Culture and Imperialism to establish various relationships as a contrapuntal reading study.
PEMANFAATAN APLIKASI POWTOON DALAM PEMBUATAN MEDIA PEMBELAJARAN BAGI GURU SMAN 4 KEPAHIANG
Authors: Purwanto Andik , Risdianto Eko , Putri Desy Hanisa , Masito Fitri , Oka I Gusti Agung Ayu Mas
Published: July 2021

Di era disrupsi seperti saat ini, dunia pendidikan dituntut mampu membekali para peserta didik dengan ketrampilan abad 21 (21st Century Skills). Tidak hanya bagi peserta didik, Guru dan dosen pun harus harus siap menghadapi ketrampilan ini. Guru dan dosen harus memiliki core kompetensi yang kuat, memiliki softskil antar lain : Critical Thingking, kreatif, komunikatif dan koloberatif. Untuk mencapai keterampilan abad 21, trend pembelajaran dan best practices juga harus disesuaikan, salah satunya adalah dengan menggunakan pendekatan model pembelajaran berbasis ICT seperti Media Pembelajaran Berbentuk Video Animasi yang dibuat menggunakan aplikasi PowToon. Kegiatan ini bertujuan untuk (1) mendeskripsikan peningkatan ketrampilan khususnya literasi digital guru-guru dalam pembuatan media pembelajaran menggunakan PowToon, sehingga nantinya dapat meningkatkan pemahaman siswa (2) meningkatkan motivasi guru dalam mempergunakan Teknologi Informasi khususnya menggunakan aplikasi PowToon dalam membantu pembelajaran khususnya pada siswa SMAN 4 Kepahiang sehingga dapat memotivasi guru-guru dalam menggunakan inovasi pembelajaran terkini. Metode Kegiatan menggunakan RPA (Participatory Rural Appraisal) adalah pendekatan dan metode yang memungkinkan masyarakat secara bersama-sama menganalisis masalah kehidupan dalam rangka merumuskan perencanaan dan kebijakan secara nyata. Bentuk kegiatan ini berupa pelatihan atau workshop yang di ikuti oleh 33 orang guru SMAN 4 Kepahiang. Dari hasil pengabdian ini hampir seluruh guru yang mengikuti kegiatan ini antusias dan dapat menyerap materi yang diberikan dengan baik. Dari hasil pengabdian ini hampir seluruh guru yang mengikuti kegiatan ini antusias dan dapat menyerap materi yang diberikan dengan baik. Sehingga dapat disimpulkan bahwa kegiatan pelatihan ini berjalan sesuai dengan tujuan yang diinginkan dan dapat ditindakljuti untuk program pengabdian berikutnya.
Potensi Bahaya pada Ujung Runway 24 Bandar Udara: Sebuah Implementasi Manajemen Resiko
Authors: Riyadi Rahmat , Hendra Oke , Sadiatmi Rini , Nugraha Wildan , Amalia Direstu
Published: July 2021

This research aims to analyzethe hazards that exist at the end of runway 24 at Juwata Tarakan Airport.Then how to reduce the risks that exist in the area.The method that used for this research is the qualitative method. the data collection has been gained by observation, attendingdirectly into the field to analyze the hazards that exist at the end of the runway 24, depth interview with key informant, and document study on the accident historical data of the airport, respectively. Furthermore, the data was analyzed by risk management standardizationof AS/NZS 4360. Theresult show thatthe runwaypositionis near withthe road so it couldendanger motorists who pass on the highway. Moreover, therisk of jet blastbursts might cause an accident. After this research was carried out, a solution was obtained to reduce the existing risks by implementing a system of opening and closing traffic on the highway. In addition, it can also be done by diverting the flow of traffic on the highway.
PENGARUH LATIHAN FISIK SELAMA HEMODIALISIS TERHADAP KEKUATAN OTOT PASIEN GAGAL GINJAL KRONIK DI RUANGAN HEMODIALISA RUMAH SAKIT AWAL BROS PANAM TAHUN 2017
Authors: Murniarsih Elvi
Published: July 2021

Patients who have chronic renal failure, one of the therapies that can be done to prolong his life is hemodialysis. A phenomenon found in the room of hemodialysis at Awal Bros Panam hospital, most of the patients undergoing hemodialysis experienced muscle weakness, muscle atrophy, and pain in standing after hemodialysis. This study was aimed to determine the effect of physical exercises during hemodialysis towards strength patients with chronic kidney failure on hemodialysis room at Awal Bros Panam hospital. Moreover, this research employed Quasi-Experiment method with time series design. The sample of this study was patients who underwenthemodialysis included in the inclusion criteria of 45 people. Physical exercise was done with time 45 minutes, 2 times a week according to hemodialysis schedule for 4 weeks or 8 times physical exercise. Expanding Dynamometer and Back Leg Dynamometer were used as the measuring instruments. The analysis that used was univariate analysis to figure out frequency and bivariate with Paired sample t -test and Wilxocon. The results showed there was an effect of physical exercise on hand muscle strength of 2.76 kg and an effect of physical exercise on leg muscle strength of 13.5 kg. Also, The results of statistical tests showed the effect of physical exercise on hand and foot muscle strength in hemodialysis patients with p-value 0.001 <α (0.05). In other words, these results indicated that physical exercise can improve muscle strength of patients undergoing hemodialysis. Regarding the research findings, Educationalinstitutions and services need to hold discussions in the development of nursing actions during hemodialysis because physical exercise during hemodialysis is still a novelty.
EFEKTIFITAS INSTRUMEN TLC TERHADAP ANGKA KEJADIAN PHLEBITIS DI RUANGAN ORCHID RS AWAL BROS PEKANBARU
Authors: Rachmawaty M Noer  , Elvi murniasih  , Yulia harmon
Published: July 2021

Pemasangan  infus  termasuk  salah  satu  prosedur  medis  yang  paling  sering  dilakukan  sebagai  tindakan  terapeutik. Terapi infus merupakan tindakan yang paling sering dilakukan pada pasien yang menjalani rawat inap sebagai jalur terapi intravena (IV), pemberian obat, cairan, dan pemberian produk darah, atau sampling darah.

Infiltrasi intravena merupakan kejadian yang sangat sering terjadi pada pasien anak. Kejadian infiltrasi infus pada pasien anak cenderung  mengalami peningkatan. Jenis penelitian ini adalah eksperimen dengan rancangan pre-post perlakuan yaitu menghitung angka kejadian phlebitis sebelum dan sesudah di berikan instrumen TLC pada pasien di ruangan orchid Rumah Sakit Awal Bros Pekanbaru.

Berdasarkan hasil penelitian insiden phlebitis sebelum edukasi TLC sebanyak 15 orang dan setelah edukasi sebanyak 8 orang. Hasil uji independent t-test didapatkan nilai p value sama dengan 0,001 (p value < 0,05) maka terdapat pengaruh edukasi TLC terhadap angka kejadian phlebitis diruangan Orchid Rumah Sakit Awal Bros Pekanbaru.
Persepsi Budaya Organisasi yang Dianut Oleh Perawat Ruang Rawat Inap Terhadap Turnover Intention di Rumah Sakit Awal Bros Batam Tahun 2019
Authors: Multiyaningsih Multiyaningsih
Published: July 2021

Budaya organisasi merupakan elemen penting yang memiliki pengaruh tinggi terhadap komitmen karyawan, kepuasan kerja, dan retensi atau loyalitas karyawan. Apabila organisasi memiliki budaya organisasi yang positif maka akan meningkatkan komitmen karyawan, kepuasan kerja, serta mengurangi employe turnover. Penelitian ini merupakan penelitian kualitatif, metode yang digunakan yaitu metode fenomenologi dimana metode ini menggunakan metode wawancara mendalam ( in dept interview ). Informan  penelitian ini ialah perawat ruang rawat inap yang masih aktif bekerja di RSAB Batam. Besarnya Informer diambil dengan  cara Purposive sampling. Analisis data yang digunakan ialah standar proses analisa data yang sistematis yaitu analisis coding. Hasil penelitian ini menunjukkan bahwa  perawat ranap inap di RSAB Batam tahun 2019 bisa memberikan persepsi terhadap budaya organisasi yang ada di Rumah Sakit Awal Bros Batam dan bisa menerapkan menerapkan budaya organisasi yang ada.
HUBUNGAN PERAWATAN PAYUDARA IBU HAMIL TRIMESTER III DENGAN KELANCARAN PRODUKSI ASI
Authors: Suharmi
Published: July 2021

Air susu ibu (ASI) sebagai makanan alamiah adalah makanan terbaik yang dapat diberikan oleh seorang ibu pada anak yang baru dilahirkan. Penelitian ini bertujuan Untuk mengetahui Hubungan Perawatan Payudara Ibu Hamil Trimester III dengan Kelancaran Produksi Air Susu Ibu yang melakukan kunjungan Antenatal Care di  Puskesmas Wilayah kerja Kabupaten Polewali Mandar. Penelitian ini dilakukan pada mulai September sampai dengan Desember 2014. Pengambilan sampel menggunakan tekhnik sampling Consecutive Sampling dengan  jumlah sampel sebanyak 60 ibu hamil trimester III yang dibagi menjadi 2 kelompok, 30 responden untuk kelompok Intervensi dan 30 responden untuk kelompok kontrol. Hasil penelitian dengan menggunakan uji chi Square menunjukkan bahwa ada perbedaan proporsi kelancaran produksi ASI antara kelompok intervensi dan kelompok kontrol dengan p value=0,000 pada pengukuran hari keempat yang berarti H0 ditolak sehingga terdapat hubungan antara intervensi perawatan payudara ibu hamil trimester III dengan kelancaran produksi ASI.
Factors Influencing Student Enrollment in Career Academy Programs
Authors: Ketchledge Whitney , Kosloski Michael , Reed Philip
Published: July 2021

There is considerable research demonstrating strong benefits of the career academy model to students and teachers, but there is little indicating why students enroll in academies and what methods of recruitment may work best. This study assessed factors influencing students' decisions
to enroll in career academy programs by looking at factors that influence students to apply for academy programs and reasons students have for choosing not to enroll in academy programs. A survey was used to collect the necessary data with n = 401 responses from students enrolled in an academy
and n = 2,421 responses from students not enrolled in an academy. A factor analysis resulted in two larger groupings linking items together based on program experience and student attitudes. A Pareto analysis indicated that counselors were the greatest influencing factors on student decisions
to enroll in career academy programs. Parents, teachers, other students, the course catalog, website, and brochure also played a considerable role in how students learned about the academies. The most influential reasons students have for not applying included not knowing, not interested,
and missed deadline.
Texas High School Counselor Perceptions of Agricultural Education
Authors: Spacek Amanda , Rayfield John , Doss William , Lawver David , Ritz Rudy
Published: July 2021

The purpose of this study was to determine the perceptions of high school counselors across the state of Texas toward agricultural education. This study was descriptive in nature. High school counselors had an overall positive attitude toward agricultural education. They did not believe
agricultural education courses were intended for lower-performing students. High school counselors agreed their local agricultural education program was valuable for college bound and non-college bound students. An overwhelming majority (85%) of high school counselors reported that student
interest was their top priority when advising students to enroll in an agricultural education course. They had low to very low awareness of many opportunities available for agricultural education students. It is recommended that agricultural education teachers continue to develop strong, positive
relationships with school counselors to provide education and awareness of the agricultural education program opportunities.
Enhancing Maternal Ability: Mediating for Pre-school Age Children’s Cognitive Development
Authors: Latifah Leny , Yunitawati Diah , Nurcahyani Yusi Dwi , Kumorowulan Suryati
Published: July 2021

The multifactorial risks that accompany IDD (Iodine Deficiency Disorders) aggravate cognitive development deficits in children. The most important factors are poor cognitive stimulation and parenting. This study aimed to analyse the impact of parenting training on maternal skills to mediate cognitive development in children. The study was quasi-experimental pre-post with a control group design. A total of 78 mothers and their children, aged four to five years, from Purworejo participated in the research. Palpation to assess maternal goiter status and Mother-Child Picture-Talk Task (MCPTT) assessed the ability to perform cognitive mediation in children. The Smart Mother Class, a parenting skill intervention, was given for six months (16 meetings), each lasting 60-90 minutes. The risk of low family resources, both economic and caring resources, is indicated by the work and education of the fathers and mothers. Most mothers and fathers have elementary school education and below (60.3). The result show that three months after the intervention there was a significant effect at the positive level, and at six months, the intervention group showed a significant improvement (p< 0.001). Parenting training in low parenting resource settings could improve maternal skills for mediating cognitive development in pre-school age children.
Manfaat Matrikektomi Kimia Dalam Mencegah Rekurensi Onychocryptosis
Authors: Pradnya Wisnu Gusti Ngurah
Published: July 2021

Pendahuluan: Onychocryptosis merupakan penyakit kuku yang dikarakteristikkan oleh rasa nyeri, kemerahan hingga bengkak ataupun timbulnya nanah yang disebabkan oleh kuku yang tumbuh memotong paronikium. Penyakit ini merupakan penyakit yang sering dijumpai dalam praktik dokter sehari-hari dan seorang dokter umum harus dapat melakukan tindakan avulsi kuku sebagai salah satu pilihan tatalaksana operatifnya. Avulsi kuku merupakkan tatalaksana yang efektif, namun tidak mencegah rekurensi di kemudian hari. Untuk tujuan itu, setelah dilakukan prosedur avulsi kuku, dapat dilakukan tindakan matrikektomi. Meskipun efektif, prosedur tindakan ini tidak banyak dibahas.

Pembahasan: Matrikektomi bertujuan untuk menghancurkan matriks kuku sehingga kuku tidak tumbuh memotong paronikium. Beberapa penelitian menunjukkan keunggulan avulsi kuku yang dilanjutkan dengan matrikektomi kimia dalam mencegah rekurensi onychocryptosis dibanding dengan prosedur avulsi kuku saja. Tindakan matrikektomi paling sering dilakukan dengan menggunakan agen kimia berupa fenol, tricloracetic acid (TCA) atau natrium hidroksida. Ketiga agen ini akan menyebabkan nekrosis pada matriks kuku sehingga tidak terjadi pertumbuhan kuku pada daerah yang diaplikasikan. Berbagai penelitian menunjukkan bahwa penggunaan ketiga agen kimia ini memiliki angka kesuksesan yang tinggi dalam mencegah rekurensi onychocryptosis.

Kesimpulan: Matrikektomi kimia merupakan tindakan yang dapat dilakukan setelah tindakan avulsi kuku untuk mencegah rekurensi onychocryptosis. Agen kimia yang dapat digunakan adalah fenol, TCA atau natrium hidroksida. Ketiganya memiliki efektifitas yang setara.

Kata kunci: Avulsi kuku, Matriektomi, Onychocryptosis
Kehamilan Mola Hidatidosa Disertai Hipertiroid
Authors: Andriana Ria , Islamy Nurul
Published: July 2021

Tirotoksikosis didefinisikan sebagai manifestasi klinis dari kelebihan hormon tiroid pada sirkulasi. Investigasi epidemiologis melaporkan 0,2% tirotoksikosis disebabkan oleh mola hidatidosa. Kehamilan mola adalah salah satu penyakit daripada Penyakit Trofoblas Kehamilan (GTD), dengan amenorea dan perdarahan yang tidak teratur dengan adanya keluarnya vesikel per vagina. Namun, keadaan ini jarang dapat dikaitkan dengan hipertiroidisme, yang mungkin terkait dengan fitur klinis hipertiroidisme. Patogenesis dasar tirotoksikosis adalah kesamaan subunit HCG dengan TSH yang menghasilkan stimulasi berlebihan hormon tiroid. Berikut ini adalah laporan seorang wanita berusia 23 tahun yang mengalami amenore diikuti oleh perdarahan yang tidak teratur per vagina, tiromegali dan kadar hormon tiroid yang abnormal. Ultrasonografi transabdominal terdapat tanda-tanda kehamilan mola. Evakuasi dengan kuretase dilakukan setelah kadar serum β-hCG berkurang dan kadar hormon tiroid juga berkurang. Kasus dan literatur yang relevan disajikan di sini.

 

Kata Kunci: Hipertiroid, kehamilan, mola hidatidosa, tirotoksikosis.
A Hidrocloroquin tatalaksana COVID-19, Apakah sudah tepat dan adakah alternatif lain?
Authors: Devantoro Mohammad Ridho
Published: July 2021

telah terjadi fenomena pandemik yang dikenal dengan COVID-19, namun WHO belum menetapkan guidline tatalaksana medikamentosa untuk penyakit tersebut. banyak perdebatan mengenai penggunaan hidrocloroquine/ cloroquin dengan berbagai penelitian in vitro dan sebagian obat seperti anti-inflamasi diusulkan untuk menjadi terapi alternatif dengan mekanisme kombinasi terapi dikarenakan lebih efektif dibandingkan dengan monoterapi.
KADAR KALSIFEDIOL SEBAGAI PREDIKTOR DERAJAT KEPARAHAN RETINOPATI DIABETIK PADA PASIEN DENGAN DIABETES MELLITUS TIPE 2
Authors: Octavius Gilbert Sterling , Edgina Alvita Suci , Tanto Stefany , Tobing Werlison
Published: July 2021

Pendahuluan    : Terdapat peningkatan prevalensi pasien diabetes mellitus (DM) dan morbiditasnya, termasuk retinopati diabetik. Retinopati diabetik adalah penyebab paling sering dari kasus baru kebutaan di antara orang dewasa berusia 20-74 tahun yang akan mempengaruhi produktivitas kelompok usia ini jika dibiarkan atau tidak diobati.

Tujuan : Mengevaluasi kemungkinan tingkat kalsifediol sebagai prediktor keparahan retinopati diabetik pada pasien dengan diabetes mellitus tipe 2.

Metode : Kami mencari di PubMed, Kemajuan Oftalmologi, Laporan Ilmiah dan Ilmu Pengetahuan Langsung menggunakan istilah “25(OH)D3 Level”, “Diabetic Retinopathy”, “Prevalence of Diabetes Mellitus”, “Type 2 Diabetes Mellitus”, dan “Predictor” dalam berbagai kombinasi dan menemukan 7 studi yang digunakan dalam ulasan ini.

Hasil                : Kami menemukan 4 literatur yang menyatakan bahwa ada hubungan positif antara level 25 (OH) D3 sebagai prediktor untuk keparahan retinopati diabetik sementara ada 3 literatur yang menyatakan sebaliknya. Enam literatur menggunakan desain cross sectional sedangkan satu dilakukan dengan menggunakan case control. Tingkat pemotongan 25(OH)D3 pada pasien dengan masing-masing 18,9-24,3 ng/ml, 17,4-21,7 ng/ml, dan 14,7-21,1 ng/ml.

Kesimpulan      : Sementara penggunaan 25(OH)D3 sebagai prediktor tingkat keparahan retinopati diabetik masih tidak meyakinkan, hubungan proporsional terbalik terlihat antara kedua variabel.
Association of Uric Acid Level With Severe Preeclampsia in Pregnancy Women in RSUD Dr. H Abdul Moeloek Province Lampung
Authors: Tri Utami Citara
Published: July 2021

ABSTRAK

 

Pendahuluan: Preeklampsia adalah suatu sindrom kehamilan setelah umur kehamilan 20 minggu dan merupakan salah satu kegawatdaruratan obstetrik. Dibutuhkan suatu deteksi dini untuk diagnosis preeklampsia sehingga dapat menghindari prognosis yang buruk dari preeklampsia. Asam urat selama kehamilan merupakan salah satu biomarker preeklampsia yang dapat digunakan sebagai penilaian diagnosis preeklampsia. Tujuan penelitian ini untuk mengetahui hubungan kadar asam urat yang dengan kejadian preeklampsia berat di RSUD Dr. H. Abdul Moeloek Provinsi.

Metode: Rancangan pada penelitian ini adalah case control. Populasi kasus adalah ibu hamil dengan preeklampsia dan populasi kontrol adalah ibu hamil tanpa preeklampsia. sampel kasus sebanyak 31 responden dan kasus kontrol sebanyak 31 responden. Data preeklampsia didapatkan pemeriksaan sedangkan kadar asam uat didapatkan dari pemeriksaan laboratorium. Analisis bivariat menggunakan Chi Square.

Hasil: Pada ibu hamil dengan preeklampsia memiliki kadar asam urat tinggi (74,2%) dibandingkan kelompok kontrol (tanpa preeklampsia) yaitu (35,5%). Berdasarkan analisis bivariat, didapatkan nilai p =0,0005 dan OR 5,227 (CI 95% =1,7-15,5).

Pembahasan: Kegagalan remodeling arteri spiralis yang abnormal pada preeklampsia menyebabkan iskemik seluler plasenta yang akan meningkatkan aktivitas Xantin Oksidase yang dapet meningkatkan produksi asam urat dari jaringan ibu, janin atau plasenta.

Simpulan: Terdapat hubungan kadar asam urat yang tinggi selama kehamilan dapat meningkatkan risiko preeklampsia sebesar 5 kali bila dibandingkan dengan kadar asam urat normal selama kehamilan.

 

Kata Kunci: asam urat, kehamilan, preeklampsia
TINGKAT PENGETAHUAN SISWA/SISWI SMA MUHAMMADIYAH 01 MEDAN TERHADAP PENURUNAN KETAJAMAN PENGLIHATAN
Authors: Ritonga Maysaroh Ritonga , Ritonga Maysaroh , Sp.M Dr. Zaldi
Published: July 2021

yaitu faktor lingkungan yang memegang peranan penting pada terjadinya kelainan refraksi seperti kebiasaan beraktivitas dalam jarak dekat termasuk membaca, menggunakan komputer dan bermain video game.

Tujuan: Penelitian ini adalah mengetahui tingkat pengetahuan siswa/siswi SMA Muhammadiyah 01 Medan terhadap penurunan ketajaman penglihatan.

Metode: Jenis penelitian yang digunakan adalah observasional yaitu penelitian deskriptif analitik dengan desain potong lintang (cross-sectional).

Hasil:Sebanyak 44 responden laki-laki, 4 dengan pengetahuan kurang, 7 dengan pengetahuan cukup dan 33 dengan pengetahuan baik. Sebanyak 42 responden perempuan, 1 responden dengan pengetahuan kurang, 7 dengan pengetahuan cukup dan 34 dengan pengetahuan baik.

Kesimpulan: tingkat pengetahuan siswa/siswi kelas XII SMA Muhammadiyah 01 Medan terhadap penurunan ketajaman penglihatan pada umumnya dalam kategori baik.
The Potensi Ikan Gabus (Ophiocephalus stratius) untuk Meningkatkan Kadar Albumin Pada Penderita Hipoalbuminemia
Authors: Pratiwi Agnes Trilansia
Published: July 2021

ABSTRAK

Pendahuluan: Hipoalbuminemia adalah suatu kondisi abnormal yang ditunjukkan dengan level albumin dalam darah yang rendah. Hipoalbuminemia dapat disebabkan oleh penurunan produksi albumin atau peningkatan kehilangan albumin melalui ginjal, saluran gastrointestinal, kulit, atau ruang ekstravaskular atau peningkatan katabolisme albumin atau kombinasi dari 2 atau lebih mekanisme ini. Hipoalbuminemia berhubungan dengan status fungsional yang buruk, durasi rawat inap yang lebih lama serta morbiditas dan mortalitas yang lebih tinggi. Penderita hipoalbuminemia karena malnutrisi di Indonesia sebesar 40-50% pasien mengalami ataupun berisiko hipoalbuminemia, dimana sebesar 12% mengalami hipoalbuminemia berat. Pemberian nutrisi protein tinggi secara oral serta pemberian albumin parenteral merupakan salah satu alternatif penanganan hipoalbuminemia.

Metode:  Artikel disusun dengan metode literature review, melibatkan 24 pustaka baik buku dan jurnal nasional atau internasional.

Pembahasan: Ikan gabus (Ophiocephalus stratius) memiliki kandungan protein tinggi, terutama albumin. Kandungan albumin yang tinggi dari ekstrak ikan gabus dapat berfungsi sebagai sumber asam amino yang dibutuhkan untuk sintesis albumin. Berbagai khasiat ekstrak ikan gabus telah dilaporkan diantaranya mempercepat penyembuhan luka, memiliki aktivitas antinociceptive, anti inflamasi, dan memiliki efek penting untuk mengatasi hipoalbuminemia dengan meningkatkan kadar albumin dalam darah. Ekstrak ikan gabus juga dapat meningkatkan level IGF-1 dimana dapat mengurangi peradangan yang mungkin menjelaskan korelasinya dengan peningkatan kadar albumin.

Kesimpulan: Kandungan asam amino dalam ikan gabus (Ophiocephalus striatus) berpengaruh untuk meningkatkan kadar albumin pada penderita hipoalbuminemia.
Perkembangan Terapi Farmakologis pada Gagal Jantung Akut Dekompensasi
Authors: Nursabur Bistamy Muhammad
Published: July 2021

ABSTRAK

Pendahuluan: Gagal jantung akut dekompensasi ialah penyakit pada jantung yang merupakan manifestasi dari gagal jantung yang kronik maupun dapat muncul secara de novo. Dengan prevalensi kejadiannya yang tinggi, maka terdapat berbagai pengembangan dan penemuan baru dari terapi-terapi secara farmakologis.Metode: Artikel ini ditulis menggunakan metode literature review, meliputi 24 sumber yang berasal dari jurnal dan buku berbahasa inggris hasil literature searching dari search engine Google Scholar.Pembahasan: Kontrol neurohormonal yang terganggu menyebabkan terjadinya gagal jantung akut dekompensasi yang ditandai dengan peningkatan cairan yang abnormal pada plasma darah sehingga bermanifestasi pada berbagai kelainan yang terjadi pada jantung dan paru-paru. Sistem saraf simpatis, sistem renin-angiotensin-aldosteron, vasopresin arginin, dan peptida natriuretik mengalami peningkatan fungsi dan konsentrasi yang berperan dalam gagalnya kontrol neurohormonal dari jantung. Selain itu, gagal jantung menyebabkan dilepaskannya molekul-molekul seperti adrenomedullin dan troponin kardiak. Berbagai terapi farmakologis dikembangkan sebagai manajemen dari gagal jantung akut dekompensasi, yaitu adrecizumab, sacubitril-valsartan, donor nitroxyl, dan diuretik.Simpulan: Penelitian-penelitian terhadap terapi-terapi farmakologis pada gagal jantung akut dekompensasi perlu terus dilakukan dalam menemukan terapi-terapi yang baru maupun mengembangkan terapi yang sebelumnya sudah diterapkan.Kata kunci: gagal jantung akut dekompensasi, terapi
Restrictive covenants, use of land, and the restraint of trade doctrine
Authors: Capper David
Published: July 2021

The common law doctrine of restraint of trade has a well-established presence in relation to contracts of employment and contracts for the sale of a business. Beyond those specific areas it reared its head from time to time, but the legal test for its applicability was not a model of clarity. Where the covenantor ceded a pre-existing freedom to engage in commercial activity, the decision of the House of Lords in Esso Petroleum Co Ltd v Harper’s Garage (Stourport) Ltd [1968] AC 269 brought it within the doctrine, but the recent decision of the Supreme Court in Peninsula Securities Ltd v Dunnes Stores (Bangor) Ltd [2020] UKSC 36, on appeal from the Northern Ireland Court of Appeal [2018] NICA 7, has discarded that test in favour of one based on the structure of a trading society. Peninsula Securities was a case concerned with the applicability of the restraint of trade doctrine to covenants affecting the ability of a landowner and its successors in title to use the land in a way that potentially competed with the business of an adjoining occupier. The decision that the restraint of trade doctrine was not engaged in these circumstances was set against the power of the Lands Tribunal to modify or extinguish covenants affecting land under article 5 of the Property (NI) Order 1978.
Time to initial physician contact: Operational changes assessment
Authors: Jenkins Dominic , Thomas Sarah Alice , Hannan Ashad , Pathare Ankush , Hodges Thomas Stephen , Pathan Sameer A.
Published: July 2021

Background: The time to initial physician contact or time for medical doctor (tMD) is one of the crucial key performance indicators for the emergency department (ED). The “tMD” helps in improving medical care, administrative benefits, and operational changes. The main aim of this study was to assess the effects of different operational changes on tMD. Methods: The study was a prospectively designed analysis for one year. Data were collected via the study center's electronic records. The study was divided into three operational events (increase in number of consultants, change of shift timings, and increase in consultants covering a shift) in comparison with the baseline (prestudy) period. Data were then downloaded and imported into the statistical software package Stata for a detailed analysis. Results: The study commenced on July 1, 2016, with a 52-week period and 418,899 patient encounters. The coefficient for tMD slope improvement as compared with baseline with confidence interval (CI) and p value was: Phase 1: −2.5 [CI: −4.1 to −0.97 (p = 0.002)]; Phase 2: −1.6 [CI: −2.8 to −0.37 (p = 0.031)]; and Phase 3: −2.4 [CI: −3.4 to −1.4 (p < 0.001)]. The study phases showed a significant improvement over the baseline study period. Conclusion: The study results indicate that different types of interventions (e.g.,., changing shift times, increasing total hours of MD coverage throughout the day) had demonstrated different apparent effects in this study's ED. Further work in this study's ED should aim to continue to reduce absolute tMD and decrease variation by homogenizing dispersion as much as possible across the 24 hours of a day. ED has no control over the concentration or spread of visitors over the period of the day. The data were useful for guiding operations planning both during the study period and thereafter, as operations continue to focus on optimizing tMD.
Can neutrophil-to-lymphocyte ratio be used as a predictor in acute appendicitis?
Authors: Pereira Chirag , Martis Manohar , D'Souza Rohan , Tauro Leo F.
Published: July 2021

Background: To determine if neutrophil-to-lymphocyte ratio (NLR) can be used to diagnose appendicitis and distinguish complicated from uncomplicated appendicitis. The secondary aim was to determine if the appendix cut-off size on ultrasound matches that of existing literature. Methods: We retrospectively analyzed all cases that underwent appendectomy in Father Muller medical college and hospital from 2014 to 2019. The NLR, histopathology, and ultrasound reports for all patients were reviewed. Recommended cut-off values for NLR and appendicular size on ultrasound were determined using receiver operating characteristic analysis (ROC). Data was analyzed using SPSS version 25. Ethical approval was obtained for this study. Results: We included 1623 patients in this study. The patients’ median age was 24 years, with appendicitis being more common in males than females. NLR>2.4 was statistically associated with appendicitis with sensitivity of 70.1% and specificity of 43.2%. NLR>4.3 was statistically associated with complicated appendicitis with sensitivity of 72.25% and specificity of 54.09%. An appendicular diameter >6.1 mm was suggestive of appendicitis on abdominal ultrasound based on our analysis. Conclusions: NLR is a simple adjunct that can be used to diagnose appendicitis and identify complicated appendicitis.
Was a forced lockdown adequate for a country in conflict? A psychological perspective from the Syrian population
Authors: Kakaje Ameer , Mansour Sabina , Ghareeb Amjad
Published: July 2021

Background: Syria has suffered for nine years from a conflict that left over 11.1 million inhabitants in need of humanitarian assistance and over 80% in poverty. A ten-week-long full lockdown was enforced in Syria and successfully minimized the spread of COVID-19. This study aims to estimate the occurrence of mental health disorders after lockdown termination among the citizens of war-torn Syria.

Methods: Online questionnaires, which included demographic and war-related questions, Dimensions of Anger Reactions 5 (DAR-5) and the Depression Anxiety Stress Scale-21 (DASS-21) were distributed to different social media groups.

Results: This study recruited 1445 participants, of which 515 (35.6%) were males, the mean age was 24.8 ± 6.3 years, 38% had problematic anger, 64% had moderate to very severe depression, 42.9% had moderate to severe anxiety and 39.7% had moderate to severe stress. Increased living expenses, not being able to go out and a reduced ability to earn income and provide food were significantly associated with the psychological burden after the lockdown (p < 0.05). The association of war variables with mental disorders was weaker than the effect of the deteriorating economy. Other healthcare workers had more severe distress than doctors, who themselves were found to have less distress than the general population (p < 0.05). Anger scores were approximately equal, regardless of the type of work. Finally, shisha smoking was associated with worse mental health (p < 0.05).

Conclusion: The psychological burden of the damaged economy surpassed the direct damage due to COVID-19 and the effect of years of conflict. Urgent interventions are required, as this burden may continue for years, if not for decades. A full lockdown in countries with fragile economies may delay the spread of the virus, but it will severely damage the economy, which will lead to a deterioration of the mental health of their citizens.
Influence of UV absorbing films on yield, quality and pest activity of protected strawberry crops
Authors:   University of Reading, Reading, UK, Kumar Inder
Published: July 2021

The cultivated strawberry (Fragaria x ananassa Duch.) is a highly valuable and economically crucial soft fruit crop. Strawberries are famous due to their particular flavour, colour, quality, and appearance, as well as their nutritional value. They are one of the top ten crops cultivated and consumed in the UK. However, due to the limited season for cultivation but all year demand, there is still a high level of imported fresh produce from other prominent strawberry producing countries both in Europe and worldwide. There is a potential to develop new horticultural films with in-creased UV absorption to reduce pest and disease incidence, improve the yield of strawberries grown under protection and extend the strawberry season in the UK further; this is because insect visualisation and host recognition are influenced by UV radiation, and the life cycle of many fun-gal diseases relies on UV light. Therefore, an experiment was set-up to study the effect of four newly developed UV absorbing horticultural films (ranging from complete UV transmission to complete UV blocking) on strawberry plant growth, yield and fruit quality, as well as pest infestation. Overall, plant growth and fruit quality were largely unaffected by UV absorbance. Still, the yield was enhanced, and the thrips population significantly reduced, which are beneficial outcomes for the strawberry industry. The partially UV absorbing film (UV 370) performed considerably better than other films regarding fruit quality and yield. The completely UV blocking film (UV 400) was serving better initially but degraded after the second peak harvest resulted in reduced performance later. If the UV 400 film could be stabilised to prevent degradation, there is the potential to improve strawberry fruit yield and quality.