bluuebunny/crossref_metadata_2025 huggingface dataset:
সাঈদ আহমদের নাটক : প্রথম পর্ব
Authors: মীর হুমায়ূন কবীর মীর হুমায়ূন কবীর
Published: July 2024

বাংলাদেশের সাহিত্যে আধুনিক নাট্যধারার অন্যতম রূপকার সাঈদ আহমদ (১৯৩১-২০১০)। এক সমৃদ্ধ সাংস্কৃতিক পরিমণ্ডলে বিকশিত হয়েছে তাঁর শিল্পীমানস। খুব বেশি নাটক লেখেননি তিনি। তাঁর রচিত নাটকের সংখ্যা মাত্র পাঁচটি। তবে স্বল্পসংখ্যক নাটক রচনার মধ্য দিয়ে এদেশের সাহিত্যাঙ্গনে তিনি মুদ্রিত করেছেন স্থায়ী আসন। সাঈদ আহমদের নাট্যকর্মগুলোকে দুটি পর্বে বিন্যস্ত করা যায়। প্রথম পর্বের নাটকসমূহ বিভাগোত্তরকালে রচিত। এ পর্বের তিনটি নাটক : কালবেলা (১৯৬২), মাইলপোস্ট (১৯৬৫) এবং তৃষ্ণায় (১৯৬৯)। এ নাটকগুলোতে তিনি প্রচলিত নাট্যশৈলী পরিহার করে এদেশের শিল্পাঙ্গনে প্রথমবারের মতো অ্যাবসার্ড ধারার প্রচলন করেন। আঙ্গিক এবং উপস্থাপনায় পাশ্চাত্যধর্মী হলেও এ পর্যায়ের নাটকের বিষয়বস্তু সমকালীন বাংলাদেশ। ষাটের দশকের ঘূর্ণিঝড়, জলোচ্ছ্বাস এবং দুর্ভিক্ষের হাহাকার প্রথম পর্বের নাটকে যেমন ভিন্ন মাত্রায় চিত্রিত হয়েছে, তেমনি লোককাহিনির আবরণে উচ্চারিত হয়েছে স্বৈরাচারী অপশক্তিকে প্রতিহত করবার ইঙ্গিত। দ্বিতীয় পর্বের নাটকগুলো রচিত হয়েছে মুক্তিযুদ্ধোত্তরকালে। এ পর্যায়ে তিনি রচনা করেন প্রতিদিন একদিন (১৯৭৪) এবং শেষ নবাব (১৯৮৯)। আলোচ্য প্রবন্ধে নিরূপিত হবে সাঈদ আহমদের প্রথম পর্বের নাটকের বিষয়বৈচিত্র্য এবং শিল্পসৌন্দর্য।
জীবনানন্দ দাশের কবিতায় 'সময়' প্রসঙ্গ
Authors: নিপা জাহান নিপা জাহান
Published: July 2024

কবি জীবনানন্দ দাশের কবিতায় ‘সময়' শব্দগত এবং ভাবগতভাবে পুনরাবৃত্ত একটি প্রসঙ্গ। এর একটি দৃশ্যমান পরিক্রমা নিবিড় পাঠে ধরা পড়ে। সমকাল-চেতনার সঙ্গে সমীকৃত করে এবং দৈশিক ও বৈশ্বিক প্রেক্ষাপট-লগ্ন করে এই কবির সময়-চেতনার স্বরূপ সমালোচকগণ উন্মোচন করলেও সময়-সংক্রান্ত তত্ত্বের আলোকে তাঁর কবিতা ব্যাখ্যাত হয়নি। কবির ব্যক্তিগত সময়-ভাবনা, সমকালিক প্রভাবজাত সময়, প্রাচীন দার্শনিক থেকে আধুনিক বৈজ্ঞানিকদের সময়-চিন্তনের সূত্রে জীবনানন্দ দাশের কবিতায় সময়-প্রসঙ্গের বিশ্লেষণাত্মক এবং পুনর্নির্মাণমূলক প্রচেষ্টা আমাদের এই প্রবন্ধ।
বাংলা সাহিত্যে ঋষ্যশৃঙ্গ মিথের ব্যবহার
Authors: অলোক কুমার চক্রবর্ত্তী অলোক কুমার চক্রবর্ত্তী
Published: July 2024

আধুনিক বাংলা সাহিত্যে ঋষ্যশৃঙ্গ মিথকথা উল্লেখযোগ্য সৃজন-উৎস; যার মধ্য দিয়ে জীবনবীক্ষার বিবিধ বিষয়, সাহিত্যসৃষ্টির নানামুখী সম্ভাবনাকে সাহিত্যিকেরা তুলে ধরেছেন। ব্যক্তি তার অন্তর্গঢ় সত্তায় ও অবচেতনে শুধু নিজের অভিজ্ঞতা-অভিজ্ঞান বহন করেন না; সৃষ্টিলগ্নে তার হৃদয় হয়ে ওঠে সামূহিক চৈতন্যের আধার। এই সামূহিক চৈতন্যের অংশ মিথ বিশেষত, ঋষ্যশৃঙ্গ মিথকথায় সাহিত্যিকেরা সমকালীন জীবন ও বাস্তব পরিপ্রেক্ষিতের মধ্যে অন্তর্দৃঢ় অভীপ্সার প্রতিমান অন্বেষণ করেছেন। এ প্রবন্ধে বাংলা সাহিত্যে ঋষ্যশৃঙ্গ মিথের নানাবিধ ব্যবহারের মধ্য দিয়ে মিথ অনুষঙ্গী সাহিত্য শিল্পীর সৃজনক্ষম প্রজ্ঞার অনন্য শিল্পবীক্ষণ তুলে ধরা হয়েছে।
Pengaruh Self Esteem, Self Efficacy dan Kecerdasan Emosional Terhadap Kinerja Pegawai Dinas Ketahanan Pangan, Pertanian Dan Perikanan Kota Probolinggo
Authors: Wulandari Siska , Tumini Tumini , Widayanto Mutinda Teguh
Published: July 2024

Penelitian ini dilakukan untuk mengetahui pengaruh self esteem, self efficacy dan kecerdasan emosional secara parsial dan simultan terhadap kinerja pegawai. Metode penelitian ini menggunakan penelitian kuantitatif. Populasi dalam penelitian ini yaitu pegawai dinas ketahanan pangan, pertanian dan perikanan kota probolinggo dengan sampel 60 responden. pengambilan sampel menggunakan probability sampling dengan teknik proportionate stratified random sampling. Sumber data yang digunakan adalah data primer dan data sekunder. Data dikumpulkan menggunakan penyebaran kuesioner yang dikelola dengan uji validitas, uji reliabilitas, uji asumsi klasik, analisis regresi berganda, koefisien determinasi dan uji hipotesis. Diketahui self esteem, self efficacy dan kecerdasan emosional berpengaruh signifikan terhadap kinerja pegawai secara parsial dan simultan.
Emotional Intelligence And Test Anxiety Among Secondary School Students In EGOR Locality Of EDO State, Nigeria
Authors: ADEYEMI FLORENCE TOYIN , OSENWEUGWOR NGOSI AIHIE
Published: July 2024

The study investigated emotional intelligence and test anxiety among secondary school students in Egor Locality of Edo State, Nigeria with a view to guide them to overcome the usual fear syndrome associated with examinations.The study adopted a descriptive survey design.The target population consisted of 6069 (six thousand and sixty-nine) students in the 10 (ten) public Senior Secondary Schools in Egor Local Government Area of Edo State, Nigeria. A sample size of 380 (three hundred and eighty) secondary school class 2 students, were randomly selected from five randomly selected secondary schools in the study area. Two instruments, the Schutte self-report Emotional intelligence test (Schutte et al., 1998) and the Test Anxiety Questionnaire (Nist & Diehl, 1990) were adapted to collect data for the study. Mean, Standard Deviation, Pearson Product Moment Correlation and t-test were adopted to analyse the data. Findings indicated a moderate level of test anxiety among the students, though not found to be dependent on the sex of students. A non-significant negative correlation was also found to exist between emotional intelligence and test anxiety. Based on the findings, it was recommended that the government should continue to deploy professional counsellors to schools to assist in improving the usual fear syndrome associated with examinations among students. In addition, school counsellors as a routine service, should provide students with skills to improve emotional intelligence and strategies that would help to overcome test anxiety.
NATIONAL INTERESTS OF UKRAINE IN THE FIELD OF FINANCIAL SECURITY
Authors: SHARYI Viacheslav , SHARYI Ivan
Published: July 2024

The article investigates the system of financial security in Ukraine and its national interests in this domain. It proposes to consider the financial security of the state as ensuring the development of the financial system and financial relations, as well as economic processes, creating the necessary financial conditions for the socio-economic and financial stability of Ukraine's development, maintaining the integrity and unity of the financial system (including the monetary, budgetary, credit, tax, and currency systems), and successfully overcoming internal and external threats to the country in the financial sphere.
It is substantiated that financial security reflects the state and readiness of the state's financial system for timely and reliable financial support of economic needs on a scale sufficient to maintain the necessary level of economic and military security of Ukraine.
It is proven that the most important national interests of Ukraine in the financial sphere include: supporting state expenditures in accordance with available resources; ensuring targeted financing of state programs (primarily social ones); investing in the field of high-tech and knowledge-intensive production; mitigating the impact of global financial crises on the national economy; overcoming discrepancies regarding the distribution and use of budgetary resources; strengthening measures to restrain inflationary processes in the economy and maintaining a stable high exchange rate of the national currency; countering illegal capital outflow abroad; attracting foreign investments (especially long-term ones in the industrial sector of the economy); adopting effective regulatory legal acts ensuring the normal functioning of the country's financial system; building an effective law enforcement mechanism to protect state finances from the influence of criminal activities and encroachments.
Scoping review of barriers to mental health service utilization among medical students and residents
Authors: Brar Sukhmanjit Singh , Maddipatla Akshath Sai , Gupta Snehil
Published: July 2024

Background: Undergraduate medical students and resident doctors face high rates of anxiety, depression, and psychological distress. Despite these issues, their mental health service utilization is very low; this can be attributed to various structural and attitudinal factors. The current research aims to highlight such barriers to accessing mental health care and bridge the existing research gap. Methods: A literature search on barriers to mental health treatment for medical students was conducted involving PubMed, Web of Science and Scopus databases, along with bibliographic search, from inception till 30th April 2023 to identify relevant English records with full-text available. Studies not involving medical students or not assessing treatment barriers, and non-original papers were excluded. Results: Our comprehensive literature search yielded 12 articles. We identified six key themes concerning barriers to accessing mental health services: stigmatization, attitudinal barriers, confidentiality concerns, time constraints, lack of knowledge, and access to services. Discussion: Stigmatization was found to be a prominent barrier, while attitudinal barriers included beliefs that mental health problems are a sign of weakness and should be managed independently. Medical students and residents also worried about breaches in confidentiality affecting their interpersonal relationships and career prospects. Time constraints due to demanding academic and clinical responsibilities also posed challenges in seeking mental health care. These critical barriers to mental health service utilization among medical students and residents can be addressed through mental health awareness campaigns in college campuses, universal mental health screening in medical schools, providing internet-based services and collaborative programs with local mental health professionals to widen the treatment options.
A Brief Discussion of the Impact of Service- Learning Experience on Physicians´ Manner of Practice
Authors: Brunger Fern , Penney Olivia
Published: July 2024

Background: Service-learning combines student education with volunteer activities which benefit the community. The authors examined how service-learning through a Canadian medical student-run clinic for refugee newcomers shapes the subsequent practice style of physicians. The clinic (known as “The Gateway Program”) aims to improve access to medical care for refugees in the urban center in which the medical schoolis located, while teaching students about cross-cultural medicine. The connection between current practice styles and prior service-learning has not been well documented in the literature, despite value existing in examining the impact this educational tool has on physicians. The research question was: How does participation in service-learning shape the manner in which physicians subsequently deliver healthcare? Methods: The study qualitatively examines the experiences of former student coordinators of The Gateway Program who are now practicing Canadian physicians. Eight participants were interviewed. Data was subjected to thematic analysis. Results: Three key themes were identified: Advocacy, Social Determinants of Health, and Transferable Skills for Underserved Populations. Conclusion: Time served in the clinic is reported to have had a profound impact on participants’ current style of practice. The clinic exposed students early in their medical education to a functional model of care for the underserved which valued physician advocacy. As practicing professionals, they were able to draw upon this learning to inform their professional morals and style of practice.
Validation of the Dundee Ready Education Environment Measure in Iran through factor analysis
Authors: Salahshouri Arash , Mohamadian Hashem
Published: July 2024

Introduction: Although the Dundee Ready Educational Environment Measure (DREEM) has been accepted for educational environment assessment in various health education backgrounds, limited studies have confirmed evidence for its use in Iran. This study examined a shortened version of the DREEM-50 among Iranian students. Method: A sample of 316 medical and paramedical students from Iran's selected southwest Universities of Medical Sciences in 2020–2021 were invited to complete DREEM-33, a shortened version of the DREEM questionnaire. Psychometric criteria for assessing reliability included Cronbach's alpha, intracluster correlation coefficient (ICC), and composite coefficients. In the construct validity section, discriminant validity was measured using the Fornell and Larcker criteria based on the confirmatory factor analysis approach, and principal component analysis with varimax rotation using the exploratory factor analysis approach. Data were analyzed using SPSS 25, Smartpls 3.2.8, and Lisrel 8.8 software. Results: The shortened version had 33 items spread across all five components of DREEM-50. The exploratory factor analysis showed that the five components with eigenvalues > 1 accounted for 61% of the variance. Also, standard factor loadings ranged from 0.52 to 0.86. Confirmatory factor analysis supported the original five components of the DREEM (χ2= 2106.35; DF=490; P<0.001; CFI=0.94; GFI=0.86; AGFI=0.91; NFI=0.93; SRMR=0.038; RMSEA=0.08). The ICC and Cronbach's alpha for the whole DREEM was 0.92. All subscales had values ranging from 0.72 to 0.93. Conclusion: With satisfactory psychometric properties, the abbreviated DREEM-33 demonstrated its validity and reliability for future use in Iran in various educational environments.
Newer Anti-Diabetic Agents and Heart Failure
Authors: Mithal Ambrish , Koirala Praphulla , Chopra Vijay
Published: July 2024

According to the International Diabetes Federation (IDF), the burden of diabetes mellitus (DM) in India has been increasing steadily since 1990, growing exponentially in the last decade.[1] At present, diabetes mellitus is highly prevalent in India, affecting 10.1 crore individuals, as reported by the 2023 ICMR INDIAB study. Almost three-quarters of people with diabetes die due to cardiac causes. Besides myocardial infarction and atherosclerotic cardiovascular disease, studies have now recognised the link between diabetes and heart failure (HF). Although DM and HF are individually associated with considerable morbidity and mortality, they often occur together. The synergy between DM and HF also adversely affects quality of life, patient outcomes and escalates healthcare costs. There is a bidirectional relationship between diabetes and heart failure, where individuals with diabetes have an elevated risk of developing heart failure and those with heart failure are at a greater risk of developing diabetes.[2]
Complicated Case of Coexisting Cataract, Uveitis, High Myopia & Glaucoma-Surgical Management
Authors: Sharma Parul
Published: July 2024

A 54-year-old female presented in OPD with very poor vision in both eyes. She had a history of recurrent redness with pain diagnosed as recurrent uveitis and high intraocular pressure in the past and was on topical steroids and antiglaucoma drops. She had high pathological myopia since childhood and wore thick glasses until she could see a year back. She had a family history of high myopia and glaucoma on her maternal side.
A Challenging Case of Post Septic Sequelae of Hip in a Young Adult Female Treated with Total Hip Replacement and Limb Lengthening
Authors: Singh Kshitiz , Arora Anil , Chavan Vivek , Thomas Alex
Published: July 2024

A 20-year-old girl presented to us with a history of septic arthritis of the right hip in childhood, with complaints of painful limp and shortening. Examination revealed restricted hip ROM and an ipsilateral hypoplastic limb. Radiographs revealed a high overriding trochanter with destruction of the head and neck of the femur. CT scan revealed a dysplastic acetabulum, giving a dysplastic hip picture. After thorough pre-operative evaluation and ruling out of quiescent infection, we performed total hip replacement with Subtrochanteric osteotomy followed by a limb lengthening procedure. Union at the osteotomy site was achieved at four months follow-up. The shortening was managed with a limb lengthening procedure using a limb reconstruction system on the tibia. On subsequent follow-up, the patient did well with a painless stable hip and elimination of limp.
Evaluation of Efficacy of a Quality Improvement Haemodialysis Safety Checklist for Nursing Staff: A Comparative Analysis
Authors: Sabharwal Saksham , Bhasin Alka
Published: July 2024

Haemodialysis is a life-sustaining procedure performed on patients with end-stage renal disease. However, it is not without risks and patient safety during haemodialysis is of utmost importance. This research study aims to evaluate the efficacy of a quality improvement Haemodialysis Safety Checklist in enhancing patient safety and improving the performance of nursing staff. A comparative analysis approach was employed to assess the impact of implementing the Haemodialysis Safety Checklist. The study involved two groups: an intervention group where the checklist was implemented and a control group where the checklist was not introduced. Patients’ health records were assessed then to check the frequency of complications/ serious events and deaths. The results of the study showed that the implementation of a checklist had a positive impact on compliance and safety during the dialysis procedure. Before dialysis, only one participant (0.1%) did not comply with thermometer reading, while the majority, 749 (99.9%), followed the protocol. Similarly, 5 participants (0.7%) did not undergo weight checks before dialysis, which decreased to four participants (0.5%) after checklist implementation. In terms of vital signs, 35 participants (4.7%) did not have them checked before dialysis, while only two participants (0.3%) skipped them post-dialysis. Adverse events were minimal, with most participants not experiencing hypoglycaemic or hypotensive episodes, complications at the access site, requiring Renal Replacement Therapy (RRT) or encountering Code Blue situations, blood loss, falls, or needle stick injuries. The introduction of the checklist reduced the percentage of participants not having their weight measured after dialysis from 6.7% to 0.4%, with a statistically significant chi-square value ( <0.001*). Similarly, the occurrence of cramps decreased from 99.7% to 98.9% after dialysis. These findings demonstrate the checklist’s effectiveness in improving compliance and reducing adverse events during dialysis.
‘To Drain or Not’ in Abdominal Surgery
Authors: Nigam Vinod Kumar , Nigam Siddharth
Published: July 2024

The use of drains in abdominal surgeries is a matter of debate, especially the prophylactic use of a drain. In present times, the prophylactic use of drain is reducing due to some studies not supporting it. We are, in this study, discussing the pros and cons of using drains in abdominal operations. We are stressing through this study that drain helps in prevention and early detection of complications like bleeding, collection (pus, blood, bile, infected fluids) and anastomotic leaks. It also helps in early detection of the kind of fluid, which would be otherwise difficult even by radiological investigations, if drain has not been placed. Total of 50 cases of various abdominal surgeries, open and laparoscopic, are included in this study where drains were used. Informed written consent was taken. None of the patients had residual collections. Drains helped in prevention of post operative fluid collection. We advise placing a drain routinely, in cases of acute or chronic inflammation, or in cases with extensive dissection, in cases with risk of post op collection is high, cases with pus present in cavity, perforation peritonitis, trauma. Drains can always be removed early if they have a low output. But not placing a drain when it should have been placed, can result in preventable complications and add to the morbidity of the patient, sometimes significant.
Advancing Critical Care Nursing Competence: A Comprehensive Report on Specialised Training Initiatives at Max Healthcare
Authors: Sharma Binu , Thulung Swapnil
Published: July 2024

This case report provides a meticulous analysis of a specialised training initiative aimed at enhancing the competence of critical care nurses within Max Healthcare. The programme focuses on elevating clinical skills, fostering adaptability to new technologies and nurturing a collaborative, patient-centric approach. The report explores the positive impact of the training on nursing practice, patient outcomes and overall healthcare quality
A Study of Comparison of Non-Invasive Fibrosis Scores and Ultrasound with Liver Biopsy for Evaluating Liver Fibrosis in Morbidly Obese Patients Undergoing Bariatric Surgery
Authors: Bindal Vivek , Gupta Shailesh , Lahoti Deepak , Barde Akshay K
Published: July 2024

Obesity has emerged as a global epidemic. Non-alcoholic fatty liver disease can progress to liver fibrosis, cirrhosis and hepatocellular carcinoma. Efforts to detect liver fibrosis early is crucial for effective intervention and preventing advanced stages like cirrhosis or liver failure. Liver Biopsy is gold standard for diagnosing liver fibrosis. The study assesses the efficacy of ultrasonography and non-invasive methods, including AST to platelet ratio index (APRI), fibrosis-4 (FIB-4) and NAFLD Score, in patients with morbid obesity scheduled for bariatric surgery. A prospective observational study was conducted among 53 patients having morbid obesity and who were planned to undergo bariatric surgery. Pre-operative ultrasound (USG) and invasive scores, such as FIB-4 and APRI, were found to be inadequate screening tools for diagnosing advanced liver fibrosis in patients undergoing bariatric surgery. Conversely, the NAFLD score proved to be an excellent tool for this purpose.
Innovation in Non-formal Education in Indonesia
Authors: Bahri Efri Syamsul , Aslam Mohd Mizan Mohammad , Hermawan Yudan
Published: July 2024

Non-formal education has a strategic role in improving the quality of Indonesia's human resources. One effort to maximize the strategic role of non-formal education is to innovate non-formal education. This research aims to identify innovations in non-formal education in Indonesia. This research uses a qualitative, descriptive approach and literature study. Research data comes from journal articles related to non-formal education innovation from the Google Scholar database. The research results show that non-formal education innovation has been carried out in nine dimensions: social innovation, non-formal education supervision, institutional communication, the strategy of adversity quotient, standard operational procedures, methods, learning media, programs, and learning innovation. Therefore, the government needs to support the development of non-formal education innovations to optimize its strategic role in developing human resources in Indonesia. Apart from that, non-formal education entities need to increase collaboration with their strategic stakeholders.
SOSTENIBILIDAD AMBIENTAL Y DECENCIA LABORAL: CUESTIONES A CONSIDERAR EN LAS INICIATIVAS DE DIGITALIZACIÓN VINCULADAS AL DESARROLLO RURAL
Authors: Megino Fernández Diego
Published: July 2024

Los efectos que conllevan las herramientas de lucha contra el cambio climático hacen insoslayable apostar por una transición equitativa hacia economías verdes, lo cual exige integrar los objetivos climáticos con políticas sociales y económicas destinadas a reducir la vulnerabilidad, apoyar a los afectados por el cambio climático y crear empleos dignos. Por tal razón, la transición justa pretendida ha de tutelar la innovación de las distintas actividades, poner en valor aquellas ocupaciones calificadas como esenciales asociadas a los empleos denominados verdes y apostar por la inversión en la reconversión organizativa de los ámbitos funcionales clásicos. Bajo tales premisas, una transición hacia la economía verde constituye una oportunidad no sólo para introducir cambios en los procesos productivos de las industrias más tradicionales capaces de mejorar la competitividad empresarial y las posibilidades de negocio, sino para la creación de nuevos puestos de trabajo en ámbitos emergentes sostenibles desde el punto de vista de la neutralidad climática. Tales fenómenos contribuirán no sólo a la mejora del medio ambiente sino también a la dignificación y seguridad en las condiciones de trabajo, fomentando, a la postre, la ansiada cohesión social interterritorial, a través del impulso de actividades variadas, tal y como sucede con el sector de energías renovables, reciclaje, tratamiento de residuos y reutilización, automoción y transporte sostenible, agricultura, ganadería y pesca, industria química o construcción de edificios ecológicos y regeneración de los existentes.
SPONTANEOUS BILATERAL TUBAL PREGNANCY: A CASE REPORT
Authors: Girma Anberbir , Fikadu Gudina , Girma Woubishet
Published: July 2024

ABSTRACTBACKGROUND: Ectopic pregnancy is implantation outside the uterine cavity and its one of obstetrics emergency and it is among the common causes of maternal death in the first trimester of pregnancy. It complicates up to 2% of all pregnancies, but bilateral tubal pregnancies are among the rarest medical occurrence and its incidence 1 in 1580 to 1 in 200,000 pregnancies. CASE: This is a case report of a 38-year-old woman who presented with lower abdominal pain and vaginal bleeding of 3 days. She had left sided unruptured tubal ectopic and right sided ruptured tubal ectopic pregnancy . Trans abd ominal Ultrasonography revealed a 5 X 3cm left ad nexal mass suggestive of ectopic pregnancy, uterine cavity was empty and free fluid was seen in the pelvis and paracolic gutter. The diagnosis of bilateral tubal ectopic was made intraoperatively. Bilateral salpingectomy was performed. Histopathology examination confirmed bilateral tubal ectopic pregnancy. CONCLUSION: It is very important to carefully review both adnexa during sonographic evaluation and when exploratory laparotomy or laparoscopy is undertaken for ectopic pregnancy. KEYWORDS: Pregnancy, tubal, ectopic, bilateral, salpingectomy
MAGNITUDE AND FACTORS ASSOCIATED WITH LOW BIRTH WEIGHT AMONG WOMEN DELIVERED IN PUBLIC HOSPITALS OF BENCH MAJI, KEFFA AND SHEKA ZONES SOUTH WEST OF ETHIOPIA, 2018
Authors: Abera Gudeta Tesfaye , Mekonnen Regassa Tilahun , Chewaka Gamtesa Lalisa , Lolaso Lenjebo Tsegaye , W/kidan Mengistu Fekede
Published: July 2024

BACKGROUND: The burden of low birth weight has decreased dramatically worldwide in the past 40 years.Despite this, there is still a large gap between the developing and developed countries. Ethiopia is one of thedeveloping countries with limited data on the prevalence and main risk factors of low birth weight. Therefore;providing information on this problem is very important for planning maternal and child health care services.OBJECTIVE: To assess the magnitude and factors associated with low birth weight among women deliveredat Mizan-Tepi university teaching hospital, Tepi general hospital, Wacha hospital and Gebretsadik Shawo hospitalsSouthwest, Ethiopia, 2018.METHODS: A cross-sectional study was conducted at selected hospitals on all women who gave birth duringstudy period. Data was entered to Epidata version 3.1 and exported to SPSS version 20 for analysis. Logisticregression analysis was carried out to identify associated factors at confidence interval of 95% and significance levelof P-value<0.05.RESULT: The magnitude of low birth weight was 7.5%. Educational status of the mother [AOR 3.6, 95% CI(1.46-8.92)], iron intake during pregnancy [AOR 2.88, 95% CI (1.37-6.05)], Current pregnancy complication [AOR5.98, 95% CI (3.37-10.62)], induced labor [AOR 2.37, 95% CI (1.08-5.12)] and gestational age [AOR 37.61, 95% CI(20.61-68.56)] were significantly associated factors with low birth weight.CONCLUSION: The magnitude of low birth weight was found to be high in the study area. Educationalstatus of the mother, iron intake during pregnancy, pregnancy complication, induced labor and gestational age wereidentified predictors of low birth weight.KEY TERMS: Low Birth Weight, Pregnancy, Delivery, Women.
A structural model of college students’ mathematics performance: the role of psychological, physiological, and psychosocial factors
Authors: Susada Bryan
Published: July 2024

The study aimed to find the best-fit structural model to describe the mathematics performance of freshmen secondary education students majoring in mathematics concerning psychological, physiological, and psychosocial factors. Psychological factors were measured in terms of self-efficacy and attitudes toward mathematics, while physiological factors were assessed about nutritional status, and wellness and well-being. Psychosocial factors were measured in terms of math anxiety and math interest. A questionnaire was administered to 312 randomly selected mathematics teacher education students who have experienced struggles in their board examination performance. These students came from various higher education institutions in the Davao and the SOCCSKSARGEN (South Cotabato, Cotabato, Sultan Kudarat, Sarangani and General Santos City) regions. The validity and reliability of the questionnaire were established through factor analysis and an internal reliability test, respectively. The findings indicate that students exhibit strong performance in mathematics, possess moderate levels of psychological and psychosocial competencies, and maintain relatively healthy physiological statuses. Additionally, the results reveal a structural model depicting students’ mathematics performance with psychological, physiological, and psychosocial factors, which can explain 78% of the data considered in the study. Higher educational institutions may enhance support for students’ psychological and psychosocial skills and integrate health and wellness programs to boost their physiological status, given its impact on academic performance. Further research is encouraged to explore additional factors affecting academic success, aiming to develop a more comprehensive understanding of influences on students’ performance.
A IMPORTÂNCIA DO CONTADOR NO TERCEIRO SETOR
Authors: da Silva Darcio ,   Paulo Sergio Santos Paiva, de Souza Luan
Published: July 2024

O presente estudo teve como objetivo investigar qual a importância do profissional contábil ao terceiro setor, apresentando as peculiaridades das instituições ligados a este, assim como sua legislação e seus aspectos contábeis. Uma vez que com o agravamento dos problemas sociais, faz-se necessário meios que procurem amenizar esta situação. Surge então, constituído por organizações sem fins lucrativos, o terceiro setor e a contabilidade através de suas ferramentas, possibilita analisar, registrar e controlar o patrimônio dessas entidades, além de demonstrar seus atos e fatos contábeis. Diante desta prerrogativa, surge as seguintes questões de pesquisa: de que forma a contabilidade pode contribuir em uma instituição do Terceiro Setor? Qual a percepção do profissional contábil sobre essas Instituições? Para tanto, a metodologia utilizada para se encontrar as respostas para as questões abordadas acerca da atuação do profissional contábil quanto as implicações da contabilidade no Terceiro Setor, foi aplicação de uma pesquisa bibliográfica para fundamentação do trabalho apresentando com uma abordagem qualitativa, pesquisa descritiva, na seção destinada à metodologia. Ao final deste trabalho e de posse dos resultados, pode-se observar que o profissional contábil tem papel fundamental no Terceiro Setor, pois através de seus demonstrativos é possível auxiliar na prestação de contas das organizações, proporcionando maior transparência nas suas operações e consequentemente sendo de grande importância para estabelecer a credibilidade dos serviços realizados por essas entidades, além de possibilitar uma visão do controle financeiro da instituição e como está pode continuar atuando.
Enhancing Financial Decision-Making: Predictive Modeling for Personal Loan Eligibility with Gradient Boosting, XGBoost, and AdaBoost
Authors: Özkurt Cem
Published: July 2024

This study aims to improve the prediction of personal loan eligibility through the application of advanced machine learning techniques. Accurate prediction of creditworthiness is crucial for financial institutions to mitigate risks and optimize their lending processes. We evaluated three algorithms: Gradient Boosting, XGBoost, and AdaBoost, using a comprehensive dataset containing demographic and banking information. Among these, XGBoost proved to be the most effective model, achieving an accuracy, precision, recall, and F1 score of 0.95. These results demonstrate XGBoost's superior ability to accurately identify individuals likely to repay loans, making it an invaluable tool for enhancing decision-making in loan approvals. By leveraging XGBoost, banks can reduce the risk of defaults, streamline their operations, and provide better customer service, ultimately leading to more efficient and reliable lending strategies.
INDIA’S JUMBLED PUBLIC POLICY JURISPRUDENCE: STRETCH, DEMARCATE AND ‘SAW (PIPES)’
Authors: Katrak Malcolm
Published: July 2024

The incorporation of arbitration clauses in commercial contracts has become a norm. By incorporating an arbitration clause, contracting parties promise to refer their future disputes not to a court of law but to an arbitral tribunal that may consist of one or more arbitrators.2 The rationale behind waiving one’s right of going to court is the efficacy of the arbitral process, as it aspires to be a quicker and cheaper alternative.
Percutaneous Transluminal Mitral Valve Repair (Mitraclip): A First Successful Case in the Philippines
Authors: Valdez Ivan Paul A , Co-Sia Melissa , Panlilio Aristides G , Dy Timothy C
Published: July 2024

INTRODUCTION: Mitral regurgitation (MR) is a common valvular disease. The major causes of MR include mitral valve prolapse (MVP), rheumatic heart disease, infective endocarditis, annular calcification, cardiomyopathy and ischemic heart disease. MR is classified as primary MR (or degenerative), which is caused by intrinsic disease of the mitral leaflets, and secondary MR which is caused by diseases of the left ventricle and/or mitral annulus. Surgical treatment should be considered for patients with functional disability and/or for patients with no symptoms or only mild symptoms but with progressively deteriorating left ventricular (LV) function or progressively increasing LV dimensions. Without surgical treatment, the prognosis for patients with MR and heart failure is poor, so mitral valve repair or replacement is indicated for symptomatic patients. However, in patients with MR due to primary abnormality of the mitral apparatus (degenerative MR) who are deemed high risk for mitral valve surgery, MitraClip Clip Delivery System provides an alternative option in reducing significant symptomatic MR (MR ≥ 3+).

THE CASE: We present the case of a 59-year-old female, hypertensive, with a history of progressive easy fatigability. Echocardiography revealed the presence of MVP with severe MR. The patient was initially offered surgical treatment but she refused and opted for percutaneous mitral valve repair (Mitraclip). The patient underwent minimally invasive percutaneous mitral valve repair which resulted in a marked reduction of mitral regurgitation. Two months after the treatment, the patient had significant clinical improvement.

CONCLUSION: Percutaneous mitral valve repair using the Mitraclip Delivery System provides a novel and promising approach to select patients with severe MR as an alternative to open heart surgery. This paper describes a patient with MVP with severe MR who was treated successfully with this latest technique.
New Oral Anticoagulants in Addition to Dual Anti-platelet Therapy After an Acute Coronary Syndrome: A Systematic Review of Randomized Controlled Trials
Authors: Kadatuan Makalutang M
Published: July 2024

BACKGROUND: Despite important advances in the treatment of acute coronary syndrome (ACS), the risk of recurrent ischemic events remains high. This generates interest for improved antithrombotic therapy in addition to the current standard management of dual anti-platelet therapy.

OBJECTIVES: This study aimed to evaluate randomized controlled trials on the efficacy and safety of new oral anticoagulants (NOACs) compared with placebo in patients receiving dual anti-platelet therapy after an ACS.

METHODS: An engine search using Pub Med database, Cochrane Central Registry of Controlled trials and Clinicaltrials.gov was conducted to search for randomized, placebo-controlled trials evaluating the efficacy and safety of NOACs in addition to dual anti-platelet therapy after ACS. Included studies were included in a meta-analysis, evaluating the effect of NOACs on the following endpoints: recurrence of myocardial infarction and severe ischemia; cardiovascular death; ischemic stroke; stent thrombosis; and bleeding based on Thrombolysis in Myocardial Infarction scheme.

RESULTS: Six randomized-placebo controlled trials were included in the analysis, involving 31,264 patients. Compared with placebo, addition of NOACs to dual anti-platelet therapy after ACS was associated with a statistically significant decrease in the recurrence of myocardial infarction and severe ischemia (RR 0.90; 95% CI 0.82-1.00; p=0.041); stent thrombosis (RR 0.71; 95% CI 0.56-0.91; p=0.007); and ischemic stroke (RR 0.79; 95% CI 0.64-0.97; p=0.025). There was also a trend towards decreased cardiovascular death (RR 0.86; 95% CI 0.74-1.00; p=0.057). However, a significantly increased bleeding rate was noted (RR 2.26; CI 2.03-2.50, p<0.001).

CONCLUSION: The addition of NOACs on top of dual anti-platelet therapy in patients with ACS was associated with a significant decrease in ischemic event, stent thrombosis and ischemic stroke, with a trend towards lesser incidence of cardiovascular death. However, its efficacy was limited by higher bleeding episodes.
Comparison of Clinical Outcome of Transcatheter Closure of Ventricular Septal Defect Using Antegrade and Retrograde Approaches
Authors: Causapin Babie Catherine R , Villareal Jean Antonio G
Published: July 2024

INTRODUCTION: Transcatheter device closure became a trending treatment for ventricular septal defect for perimembranous and muscular type with satisfactory results and low morbidity rates. In most centers, the procedure is performed using antegrade method or transvenous approach. In adult patients, recent studies of transcatheter VSD closure via retrograde or transarterial approach have been successful. However, in pediatric patients, this kind of approach have insufficient data available. This study aims to compare the clinical outcome of transcatheter device closure of ventricular septal defect using antegrade and retrograde approaches among patients of our institution from January 2013 to July 2018. 

METHODS: To compare the outcomes of two approaches, we retrospectively evaluated early and mid-term results of device closure for VSD in 72 patients divided into 2 groups (A and B) composed, respectively, of 37 patients (antegrade) and 35 patients (retrograde).  

RESULTS: Procedure time between groups with group A 39.2+13.8 min and with group B 27.3+10.8 min (p<0.0001) were found to be significant. There is a significant difference in clinical outcome between the groups with number of complications in group A is 10 (27%) and in group B is 2 (5.7%). Antegrade patients were more likely to have complications compare to retrograde patients with a p-value of 0.027. Embolization of the device was the early adverse events observed on both groups. Data from midterm follow-up showed that, in antegrade group, new onset valvular insufficiency and residual shunts were more frequent. 

CONCLUSION: Both therapeutic approaches for transcatheter device closure of VSD were immediately safe and effective but retrograde approach is less likely to have complication compared to antegrade procedure. Patients must be accurately selected before choosing VSD device closure approach; operator skills and experience still have a large impact on success rate for this procedure. 

KEYWORDS: Ventricular septal defect, VSD device closure, retrograde approach, antegrade approach
The Efficacy of Oral Trimetazidine in Preventing Contrast-Induced Nephropathy Among Patients Undergoing Elective Coronary Procedures: A Meta-analysis of Randomized Controlled Trials
Authors: Angeles Roland Reuben B , King Rich Ericson , Anonuevo John D , Duya Jose Eduardo  DL , Alajar Elaine
Published: July 2024

Background: Contrast-induced nephropathy (CIN) is a serious but preventable complication of coronary procedures. Trimetazidine has recently been explored for use in preventing post-procedural CIN due to its cellular anti-ischemic and antioxidant properties. The objective of this meta-analysis was to assess the efficacy of oral trimetazidine in the prevention of CIN during elective coronary angiography and percutaneous coronary intervention.

Methods: We searched the Cochrane Central Register of Controlled Trials, Pubmed/MEDLINE, EMBASE and clinicaltrials.gov for randomized controlled trials examining the effects of adding oral trimetazidine to standard therapy in preventing CIN published until June 2016. Outcome measures were incidence of CIN, defined as a 0.5 mg/dl or ≥25% increase in serum creatinine 48-72 hours after contrast exposure, and incidence of dialysis-requiring CIN. Validity of studies was assessed through a risk assessment tool available from Cochrane. Treatment effect was estimated by calculating the Mantel-Haenszel-weighted risk ratio (RR) using a fixed-effects model available from RevMan 5.3.

Main results: A total of four studies comprising 714 patients (352 in the trimetazidine group and 362 controls) were included in the final analysis. Pooled results revealed the trimetazidine group was associated with significantly fewer incidences of CIN compared with control (RR 0.33, 95% confidence interval [CI] 0.20-0.53; p<0.00001) and an absolute risk reduction of 11.04% (number needed to treat of 9). No dialysis-requiring CIN was observed in the included studies.

Limitations: Our analysis included mostly patients with mild to moderate renal impairment. We are unable to generalize results to patients with more severe renal impairment.

Conclusion: The addition of oral trimetazidine to standard hydration confers a significant benefit in preventing CIN after coronary procedures among patients with mild to moderate renal impairment. We recommend the addition of trimetazidine to standard prevention strategies. However, a large well designed trial should be conducted to determine its effect on other outcomes such as prevention of dialysis-requiring CIN and mortality.
Detection of Subclinical Ventricular Dysfunction Using Global Left Ventricular Strain in Patients with Controlled and Uncontrolled Hypertension
Authors: Romero-Sublett Michelle Angelique R , Go Loewe
Published: July 2024

BACKGROUND: Hypertension is closely linked to left ventricular (LV) hypertrophy, which can lead to overt heart failure. The use of global longitudinal strain (GLS) in this subset of individuals seems to be able to detect subclinical changes, thereby allowing for more aggressive therapy. This study aimed to compare the GLS and other echocardiographic measures of patients with controlled and uncontrolled hypertension using Speckle Tracking Echocardiography (STE).

METHODS: This was a cross-sectional study that included 56 hypertensive patients who underwent two dimensional echocardiography in a private hospital from 2016-2017. Blood pressure (BP) was taken in a comfortable sitting position after the initial screening and then five minutes thereafter. Patients were then classified as having controlled (BP<140/90 mmHg) or uncontrolled hypertension (BP≥140/90). Patients then underwent echocardiographic examination with speckle tracking to determine GLS. The echocardiographic measures and GLS of the two groups were then compared.

RESULTS: Of the 56 patients recruited, 41 patients (73%) had controlled hypertension and 15 patients (27%) had uncontrolled hypertension. Patients with uncontrolled hypertension had significantly higher E/e’ (p<0.01), IVS diastolic (p<0.05) and RWT values (p <0.05) compared to those with controlled hypertension. However, the GLS of patients with controlled hypertension was not significantly different from those with uncontrolled hypertension (--19.7 ± 3.04% vs -19.1 ± 2.29%; p=0.468).

Conclusion: Patients with uncontrolled hypertension had significantly higher E/e’, IVS diastolic and RWT values compared to those with controlled hypertension. However, the GLS of patients with controlled hypertension was not significantly different from those with uncontrolled hypertension.
Cardiac Events Occurred Commonly Among Apparently Healthy Filipinos with the Brugada ECG Pattern in the LIFECARE Cohort
Authors: Gervacio Giselle G , Aherrera Jaime Alfonso M , Sy Rody G , Abrahan Lauro L , Agbayani Michael Joseph F , Punzalan Felix Eduardo , Llanes Elmer Jasper B , Reganit Paul Ferdinand M , Sison Olivia T , Castillo-Carandag Nina T , Group Lifecare Philippines
Published: July 2024

Background: Brugada syndrome is the purported mechanism for sudden unexplained death syndrome, also known in the Philippine vernacular as bangungut. The Brugada electrocardiogram (ECG) pattern, which is the most useful marker of this condition, is found in 2% of Filipinos, most of whom are asymptomatic. There is a knowledge gap on the clinical outcome for individuals with asymptomatic Brugada pattern. Previous data show conflicting results.

Objectives: To determine the five-year cardiac event rate for individuals with the Brugada ECG pattern in the Life Course Study in Cardiovascular Disease Epidemiology (LIFECARE) cohort.

Methodology: This is a substudy of LIFECARE, a community-based cohort among apparently healthy individuals 20 to 50 years of age, initially conducted in 2009 to 2010.In our previous study, ECG tracings of 3,072 participants were reviewed, and 163 (5.3%) were identified to have any Brugada pattern. Six of the 163 were nonsurvivors. In this present study, a cardiac event questionnaire was administered to the survivors and a sudden unexplained death questionnaire was administered to the nearest of kin of the six nonsurvivors approximately five years after ECG identification. The outcome determined is the occurrence of any cardiac event (i.e., sudden death, syncope, presyncope, seizure, and nonfatal cardiac arrest).

Results: Of the 163 patients with any Brugada ECG pattern at baseline, 12 (7.4%) had a cardiac event. Eleven of these 12 were asymptomatic on initial ECG diagnosis; five had sudden unexplained deaths; and seven had syncope, presyncope, or nonfatal cardiac arrest. Six of the seven were asymptomatic prior to the ECG diagnosis of a Brugada pattern. All victims of sudden death, as well as majority of those with cardiac events, had a type 2 pattern. Of the 163 participants, seven had a family history of sudden death.

Conclusion: Cardiac events, including sudden unexplained death, occurred commonly among initially asymptomatic Filipinos with the Brugada type 2 ECG pattern. This gives significant implications on our approach to apparently healthy individuals with an incidental Brugada pattern on ECG.