bluuebunny/crossref_metadata_2025 huggingface dataset:
EXPLORING TRENDS IN SOCIAL SECURITY MANAGEMENT: A BIBLIOMETRIC REVIEW
Authors: Md Radzi Elias
Published: July 2024

Social security systems worldwide encounter a range of challenges including poverty, inequality, pandemic-induced impacts, non-traditional employment, aging populations, and threats posed by the collaborative economy. These challenges call for various reforms that encompass private sector engagement, expenditure reduction, expanded coverage, improved management practices, decoupling benefits from employment, inclusion of local stakeholders, and support for self-employed workers. Implementing these reforms is imperative for safeguarding the well-being of vulnerable populations. The current bibliometric review aims to analyse research trends related to social security management. This review utilised ScientoPy and VOSviewer to comprehend the nature of collected datasets from Scopus and Web of Science (WoS) databases. The findings of this review revealed that the number of publications in both databases peaked in 2019, suggesting that previous studies continue to be interested in the current topic. The scholarly publication “Social Security Bulletin” is renowned for its extensive coverage of social security management research for empowering employees welfare. The keyword “social security” has significantly impacted the thematic content of scholarly social security management for the past three decades, from 1990 to 2023, as previous researchers have used it most frequently. Based on overlay visualisation mapping, the current review demonstrates that the terms "coverage," "social security legislation," and "atypical work," have been accorded greater significance since 2018. This study provides a thorough and worldwide perspective on the crucial subjects of social security management in order to empowerment of employees welfare. It is aimed at potential readers and researchers interested in better understanding these concepts and conducting more rigorous research on social security management.
THE PUBLICATION DEVELOPMENT OF SOCIAL PROTECTION AND CLIMATE CHANGE RESEARCH
Authors: Muhammad Faidzulaini , Azizan Azliyana , Tan Chee Yu , Wan Alias Wan Maryam Jameelah
Published: July 2024

Social protection incorporates a variety of interventions, such as cash transfers, insurance mechanisms, and employment safeguards, designed to assist underprivileged households and enable them to cope effectively with various adversities resulting from climate change. Using datasets from the Scopus and Web of Science (WoS) databases, the current study seeks to examine publication trends on research on social protection and climate change. The software packages ScientoPy and VOSviewer are used to analyse the retrieved datasets. This study found that the number of papers on social protection and climate change published in Scopus and WoS since 2000 has increased substantially. The journal “Sustainability” has developed as a significant venue for disseminating research. The study’s findings demonstrated cooperation among researchers from various geographical regions, highlighting the significance of knowledge sharing and the advancement of global solutions. The top ten most used keywords in previous research are “climate change”, “adaptation”, “sustainability”, “welfare”, “animal welfare”, “food security”, “agriculture”, “resilience”, “sustainable development”, and “vulnerability”. The study outcomes provide significant implications for policymakers, researchers, or practitioners to guide decision-making or foster collaborations in social protection and climate change research.
ACQUIRING TECHNICAL COMPETENCY CERTIFICATION FOR ENHANCED SOCIAL SECURITY IN ORGANIZATIONS: THE INFLUENCING FACTORS
Authors: Pangil Faizuniah , Musa Munzir
Published: July 2024

Technically competent employees are important to ensure social security issues in organizations can be addressed effectively. However, motivating employees to acquire technical certification is not easy. This study examines the financial gains, job security, status, and opportunities to advance, advisory received and financial assistance, age, position category and income level factors on technical employees’ intention to acquire technical certification. A survey was conducted among TNB Genco Technical Service staff, involving a sample of 215 respondents. The findings indicated that only age and position category affect employees’ intention to acquire technical certification. Thus, organizations should take note of these factors when revising career development policies.
gibbonNetR: an R Package for the Use of Convolutional Neural Networks and Transfer Learning on Acoustic Data
Authors: Clink Dena , Ahmad Abdul
Published: July 2024

Automated detection of acoustic signals is crucial for effective monitoring of vocal animals and their habitats across large spatial and temporal scales. Recent advances in deep learning have made high performance automated detection approaches more accessible to more practitioners. However, there are few deep learning approaches that can be implemented natively in R. The 'torch for R' ecosystem has made the use of transfer learning with convolutional neural networks accessible for R users. Here we provide an R package and workflow to use transfer learning for the automated detection of acoustics signals from passive acoustic monitoring (PAM) data collected in Sabah, Malaysia. The package provides functions to create spectogram images from PAM data, compare the performance of different pre-trained CNN architectures trained on the ImageNet dataset, deploy trained models over directories of sound files, and extract embeddings from trained models. The R programming language remains one of the most commonly used languages among ecologists, and we hope that this package makes deep learning approaches more accessible to this audience. In addition, these models can serve as important benchmarks for more state-of-the-art approaches.
Intonational Meanings of Discourse Markers in Spoken Colloquial Arabic
Authors: Al-Jarf Reima
Published: July 2024

Intonation is the rise and fall of the voice while speaking. It expresses the attitudes and emotions and have a grammatical, discourse, linguistic, psychological and indexical functions. It makes significant and systematic contributions to utterance interpretation. This study sought to investigate  the types of meanings and pragmatic functions that the discourse markers (طيب /Tayyib/ O.K, خلاص /xala:S/ (that’s it), إن شاء الله InshaAllah (God willing), ما قَصَّرْت /ma gaSSart/ & ما قَصَّرتِي /ma gaSSarti/ (much appreciated), لا لا /la: la:/ (no…no),  يا ستي /ya sitti/ (ma’am), يا سلام /ya sala:m/ (wow), يا عيني /ya ؟eyni/, يا مسهل /ya: msahhil/ (asking God for making things easy), and يا ساتر /ya sa:ter/ (Oh My God) have when each is uttered with different intonation patterns in spoken Colloquial Arabic. Twenty student-translators received training in uttering the discourse markers with different intonations, identifying the meaning and/or purpose conveyed by each intonation, then they performed an elicitation and a judgment/interpretation task in which they were required to pronounce each discourse marker out loud with as variety of intonations and identify the meaning conveyed by each. Data analysis showed that each discourse marker has a variety of meanings and pragmatic functions when uttered with different intonations. The context makes it clear which meaning each intonation implies. Results of the interpretation of meanings that each discourse marker in the sample are reported in detail.
STUDI KUALITATIF SISTEM INFORMASI MANAJEMEN RUMAH SAKIT UMUM DAERAH BATARA GURU BELOPA KABUPATEN LUWU
Authors: Lestari Sri Ayu , Rusnita  , Rosniati  , Alim Andi
Published: July 2024

Many activities currently rely heavily on information systems, whether in hospitals, health centres, or clinics. A quality system cannot be separated from the role of a system analyst who has great influence and is the backbone of developing a device. The purpose of this study was to find out how the hospital management information system was implemented at Batara Guru Belopa Hospital. The research method used in this study uses a descriptive qualitative approach to describe the management information system of the Batara Guru Belopa hospital at the input, process and output stages. The results of this study found that at the input stage regarding the availability of staff, there was still a lack of staff processing the complete final data according to the format of the Ministry of Health, at the process stage regarding data collection carried out in all outpatient units and inpatient units by filling out the patient register book then entering it into the census form The patient's daily allowance is then paid to the medical record department every month. Before data processing, data correction is carried out first so that incomplete files are sometimes found. Meanwhile, in the output stage, only 3 types of reports were produced (RL 1, RL 2a, RL 2b) which were not by the provisions of the Ministry of Health (RL 1, RL 2a, RL 2b, RL 3, RL 4, RL 5 and RL 6 ). Based on the conclusions, this study suggests that it is necessary to consider additional personnel. Hospitals should be able to include in the Regional Revenue and Expenditure Budget the concept of developing human resources according to their qualifications so that skilled workers can be obtained in their fields. We recommend that the online information network can be optimally enabled immediately. A damaged computer should be repaired immediately.
GAMBARAN PENGETAHUAN PASIEN TENTANG DIABETES MELITUS DI WILAYAH KERJA PUSKESMAS RAWAT INAP SEI MENCIRIM KECAMATAN SUNGGAL
Authors: Elfrida Tetty
Published: July 2024

Diabetes melitus merupakan penyakit metabolik kronis yang disebabkan oleh ketidakmampuan tubuh untuk memproduksi hormon insulin sesuai dengan kebutuhan tubuh atau karena penggunaan yang tidak efektif dari insulin atau keduanya. Diabetes melitus adalah sindrom yang disebabkan oleh terganggunya insulin di dalam tubuh sehingga menyebabkan hiperglikemia yang disertai abnormalitas metabolisme karbohidrat, lemak dan protein. Penelitian ini bertujuan mengetahui gambaran pengetahuan pasien tentang diabetes melitus di wilayah kerja UPT. Puskesmas Rawat Inap Sei Mencirim Kecamatan Sunggal Tahun 2020. Teknik pengambilan sampel adalah accidental sampling dengan jumlah sampel sebanyak 52 orang. Alat ukur adalah lembar kuesioner. Hasil penelitian menujukkan bahwa responden memiliki pengetahuan yang baik mengenai diabetes melitus, 38 orang (73 %). Paling banyak responden adalah berumur 47-57 tahun  sebanyak 17 orang (32,7 %). Paling banyak responden bersuku batak toba yang berjumlah 16 orang (30,7%), mayoritas responden memiliki berat badan 72-82 kg sebanyak 17 orang (32,6 %). Lama pasien menderita diabetes melitus 1-5 tahun sebanyak 22 orang (42,4%). Responden paling banyak adalah berjenis kelamin Perempuan sebanyak 31 orang (59,6%). Mayoritas responden beragama Islam sebanyak 34 orang (65,4 %),  Paling banyak pendidikan terakhir responden SMU sebanyak 18 orang (34,6%) Paling banyak responden memiliki pekerjaan sebagai Wiraswasta sebanyak 22 orang (42,4%). Dalam penelitian ini disimpulkan bahwa mayoritas pengetahuan responden akan diabetes di Puskesmas Rawat Inap Sei Mencirim Kecamatan sunggal melitus adalah baik sebanyak 38 orang (73 %).
PENGARUH PEMBERIAN AIR REBUSAN SELEDRI TERHADAP PENURUNAN TEKANAN DARAH PADA LANSIA PENDERITA HIPERTENSI
Authors: Astuti Reini , Cahya purnama Neng dian
Published: July 2024

Lansia merupakan proses alamiah berkelanjutan yang mengakibatkan perubahan fungsi baik fisik maupun fisiologi. Penuaan sering mengakibatkan penurunan fungsi dan elastisitas jantung serta kekakuan pada arteri yang mengakibatkan hipertensi. Hipertensi sering disebut silent killer (pembunuh diam-diam) karena seringkali penderitanya tidak mengalami suatu gejala, terutama pada lansia. Terapi non farmakalogi yang dapat mengatasi hipertensi salah satunya memanfaatkan air rebusan seledri. Tujuan penelitian ini untuk mengetahui pengaruh pemberian air rebusan seledri terhadap penurunan tekanan darah pada lansia penderita hipertensi di Wilayah Kerja Puskesmas Cibeber. Metode penelitiannya menggunakan Quasi Eksperimen dengan rancangan one group pre and post test with control group design. Populasi lansia penderita hipertensi di RW 01 Kelurahan Cibeber yaitu 69 lansia, dengan sampel 32 responden menggunakan Non-probability Sampling, metode pengambilan data purposive sampling. Pengumpulan data menggunakan lembar observasi tekanan darah sebelum dan sesudah intervensi pemberian air rebusan seledri. Hasil penelitian menunjukkan nilai p  pada variabel sistolik maupun diastolik sebesar 0,0001. Berdasarkan analisis uji non parametrik Wilcoxon nilai  p 0,0001 < α (0,05). Dengan demikian disimpulkan bahwa ada pengaruh air rebusan seledri terhadap penurunan tekanan darah sistolik maupun diastolik pada kelompok intervensi lansia penderita hipertensi di Wilayah Kerja Puskesmas Cibeber secara signifikan. Disarankan bagi perawat untuk menguasai terapi non farmakologis air rebusan seledri agar dapat digunakan dalam pemberian asuhan keperawatan pada hipertensi.
SENAM HAMIL DAPAT MENURUNKAN KADAR GLUKOSA DARAH IBU HAMIL TM 3
Authors: Cindi Uswatun , Asmawati Asmawati , Lestari Widia
Published: July 2024

Ibu hamil merupakan salah satu kelompok yang rentan terjadi komplikasi obstetrik seperti diabetes mellitus gestasional (DMG) yang dapat menyebabkan kematian janin/bayi, persalinan SC, dan bayi berat lahir lebih (makrosomia). Tujuan penelitian ini untuk mengetahui pengaruh senam hamil terhadap kadar glukosa darah. Desain penelitian adalah pra-eksperimen dengan pendekatan pre test dan post test one group design. Teknik sampling menggunakan consecutive sampling. Jumlah sampel 38 orang. Intervensi yang diberikan adalah senam hamil selama 1 kali seminggu selama 4 minggu. Glukosa darah sewaktu diukur sebelum dan sesudah intervensi menggunakan stick glucometer. Analisis menggunakan Wilcoxon test dengan P-value <0,05. Hasil penelitian menunjukkan kadar glukosa darah  sebelum intervensi adalah 156,61gr/d. Hasil Wilcoxon test menunjukkan ada perbedaan penurunan rata-rata kadar glukosa darah sewaktu setelah diberikan senam hamil sebesar 15,35 mg/dl (P-value 0,000). Senam hamil merupakan aktivitas fisik/olahraga yang bermanfaat menurunkan glukosa darah ibu hamil trimester tiga untuk mencegah risiko DMG.
PENGARUH PEMBERIAN ALOEVERA TERHADAP TINGKAT PRURITUS PADA PASIEN CKD YANG MENJALANI HEMODIALISA DI RSHD KOTA BENGKULU TAHUN 2024
Authors: Kurnia Septiyani Tambang , Heriyanto Hendri
Published: July 2024

ABSTRAK
Toksik uremia dan hemodialisis merupakan salah satu dari penyakit Cronik Kidney Disease (CKD) yang dapat menimbulkan pruritus. Pruritus mengakibatkan luka pada kulit, infeksi dan mengganggu kenyamanan pada pasien sehingga membutuhkan terapi topikal tambahan untuk mengurangi efek dari pruritus. Aloevera merupakan salah satu terapi non farmakologis yang dapat mengurangi pruritus karena mempunyai zat aktivitas sebagai antibakteri, antijamur, peningkat aliran darah ke daerah yang terluka dan penstimulasi fibroblast yang bertanggung jawab untuk penyembuh luka. Tujuan Penelitian ini untuk mengetahui pengaruh pemberian Aloevera terhadap tingkat pruritus pada pasien CKD yang menjalani hemodialisa. Metode
 
penelitian ini yaitu Jenis penelitian yang akan dilakukan menggunakan penelitian kuantitatif dengan desain equasi eksperimen menggunakan pre-post test design with control group. Penelitian ini akan melibatkan kelompok intervensi dan kelompok kontrol. Dimana kelompok intervensi akan diberikan perlakuan berupa pemberian Aloevera sedangkan kelompok kontrol akan diberikan intervensi  Olive oil sebagai pembanding.  Hasil penelitian ini adalah Hasil analisis didapatkan bahwa pada kelompok intervensi nilai pvalue untuk 0.030 atau pvalue <0.05 yang artinya ada pengaruh dan terdapat perbedaan derajat edema kaki antara kelompok intervensi dan kelompok kontrol. Kesimpulan : Didapatkan penurunan rata-rata 0.54 dari rata-rata skala pruritus responden yaitu 2.36 menjadi 1.82
THE EFFECT OF NEBULISATION TOWARD OXYGENSATURATION AND RESPIRATORY RATE IN PRESCHOOL CHILDREN WITH ARI AT PRATAMA ABDI CLINIC IN BENGKULU CITY 2019
Authors: Yanti Septi , Prasetyo Rizki agung , Syah Idram
Published: July 2024

Infeksi saluran pernapasan akut (ISPA) umumnya mempengaruhi penyumbatan sekret pada jalan napas. Tujuan penelitian ini untuk mengetahui pengaruh nebulisasi terhadap saturasi oksigen dan frekuensi pernafasan pada anak  Prasekolah dengan ISPA di Klinik Pratama Abdi Kota Bengkulu. Desainpenelitian ini adalah studi analitik observasional dengan pendekatan Cross-Sectional yang menggunakan rancangan pre-test and post-test without control group design.Jumlah seluruh sampel penelitian adalah 30 orang.Teknik sampling adalah  Accidental Sampling. Analisis menggunakan wilcoxon pada α < 5%. Hasil penelitian menunjukkan bahwa terdapat pengaruh nebulisasi terhadap saturasi oksigen (p value = 0,001). Terdapat pengaruh nebulisasi terhadap frekuensi nafas (p value = 0,000). Pada penelitian ini metode pemberian nebulisasi mampu meningkatkan rerata saturasi oksigen setelah  pemberian nebulisasi dan mampu menurunkan rerata frekuensi napas setelah pemberian nebulisasi.
HUBUNGAN MINDFULNESS DENGAN KECEMASAN MASYARAKAT SELAMA PANDEMI COVID-19
Authors: Rakhman Arif , Prastiani Dwi Budi , Fauziyah Isni
Published: July 2024

At the beginning of 2020, the world was shocked by the Coronavirus Disease-19. This phenomenon causes changes in various aspects of life, such as health, economic, social, psychological, cultural, and more. The psychological response experienced by the community is a feeling of anxiety about their health. Anxiety can be managed properly through full awareness and attention to the conditions that are happening. Thus, it does not cause mental health problems. A state of awareness and attention in this pandemic moment called Mindfulness. This study aims to determine the relationship between mindfulness and anxiety during the Covid-19 pandemic in the community. This is quantitative research with a descriptive correlation design and a cross sectional approach. The population of this study is adult in Jatimulya Village. The sampling technique that used was simple random with a total of 288 respondents. The data collection that used was Five Facets of Mindfulness Questionnaire and the Anxiety Questionnaire during the Covid-19 pandemic. The results of the Kendall's Tau b analysis obtained that p-value is 0.000 < 0.05. It can be concluded that there is a relationship between Mindfulness and Anxiety during the Covid-19 pandemic among Jatimulya Village community. Community should have a good mindfulness in order to create awareness and attention in managing anxiety.
Keywords: mindfulness, anxiety, pandemic Covid-19
تأثير تمرينات خاصة وفق أنموذج(كارين) في التوافق الحركي وتعلم مهارة الارسال بالكرة الطائرة للطلاب
Authors: Muhammad Adel Jamal  , Asst. Prof. Dr. Fouad Abdel Latif Ghaidan
Published: July 2024

يهدف البحث الى اعداد تمرينات خاصة وفق انموذج كارين في التوافق الحركي وتعلم مهارة الارسال بالكرة الطائرة للطلاب والتعرف على تأثير تمرينات خاصة وفق انموذج كارين في التوافق الحركي وتعلم مهارة الارسال بالكرة الطائرة للطلاب كذلك التعرف على الفروقات بين الاختبارات القبلية والبعدية. وأستخدم الباحثان المنهج التجريبي وهذا ما يراه منسجما ومتطابقا مع مواصفات الدراسة وتحقيق اهداف البحث، وتم تحديد مجتمع البحث بطلاب السنة الثانية في كلية التربية البدنية وعلوم الرياضة جامعة/كركوك  للعام الدراسي (2023-2024) والبالغ عددهم (91) طلاب والموزعين على (2) شعب، وقد اختار الباحثان عينة البحث بالطريقة العمدية قد تم الاستبعاد الطلاب الراسبون والمؤجلون وطلاب غير ملتزمين بالدوام والنقل ولاعبون، وقد تم الاختيار شعبة (أ) هي المجموعة الضابطة وشعبة (ب) في المجموعة التجريبية وبالغ عدد كل شعبة (15) طالب، اما عينة التجربة الاستطلاعية والبالغ عددهم (5)  قد تم استبعادهم من الاهتمام بتطبيق نماذج جديد التي تحمل في طياتها من الاساليب القائمة على النظريات السلوكية والبنائية والتعلم ذي المعنى والتي تسهم في رفع مستوى الطلاب وتطوير العملية التعليمية.
A case of reversible cytotoxic lesion of corpus callosum (CLOCCs) secondary to septic encephalopathy caused by suspected enteric fever
Authors: Tamanna Yasmin Shena  , Umme Kulsum Chy  , Amina Sultana  , Mohammad Omar Faruq
Published: July 2024

Abstract not available
Bangladesh Crit Care J September 2023; 11 (2): 140-141
A Case Study on Pemphigus Vulgaris
Authors: Rabita Nur Mannan  , Afsana Chowdhury  , Afia Mahmuda Khan  , Fannana Nowshin  , Alam Md Tarek
Published: July 2024

Pemphigus vulgaris is a chronic autoimmune mucocutaneous disease that is primitively demonstrated in the form of intraoral lesions extending to other mucous membranes and the skin. The origin of pemphigus vulgaris is unknown, even though the disease has prompted considerable interest. It is marked by the existence of circulating IgG antibodies directed against desmosomes, which are skin components that retain particular layers of skin bound to one another. When desmosomes are attacked, the skin layer separates, and the clinical presentation resembles a blister. Oral lesions are vesiculobullous at first but easily rupture, with new bullae attempting to form as the older one’s rupture and ulcerate. A biopsy of perilesional tissue and histological and immunostaining examination is required for a correct diagnosis. The current standard of treatment relies mainly on systemic immunosuppression with corticosteroids, azathioprine, or other adjuvants, but newer therapies with possibly fewer adverse effects also seem promising.
Bangladesh Crit Care J September 2023; 11 (2): 137-139
Clinicopathological profile & outcome of critically ill patients suffering from Dengue: Single Centre Experience during COVID Pandemic
Authors: Kaniz Fatema  , Alimul Haque  , ASM Areef Ahsan  , Ahmed Fatema , Debasish Kumar Saha  , Madhurima Saha  , Suraiya Nazneen  , Rozina Sultana  , Ishrat Jahan  , Taslima Begum  , Khandaker Sabbir Ahmed
Published: July 2024

Introduction: Dengue is endemic in our country contributing significantly in morbidity & mortality. This study was conducted to observe the clinic-pathological profile, presentation & outcome of critically ill dengue patients who required Intensive Care Unit admission.
Methods: This observational study was conducted in ICU of a tertiary care hospital in Dhaka city from July 2021 to September 2021. Laboratory confirmed cases of Dengue patients admitted in ICU were included in the study.
Results: Total patients were 40 with equal male-female distribution. Mean age of the patients was 39.17 ± 13.83 years with most of them (70%) in age group of 18-40 years. Direct admission through Emergency Room (42.5%) was more than transfer-in from indoor of same hospital & other hospitals (35% & 22.5% respectively). There were multiple reasons for ICU admission including hypotension (commonest reason), breathlessness, diarrhoea, abdominal distension, altered level of consciousness etc. Only 13 (32.5%) patients had co-morbidities like DM, HTN etc, and mean age of them was significantly higher than patients without co-morbidities (50.3 ± 13.31, vs 32.23 ± 6.88). Biochemical parameters showed that TWBC count was normal in most patients (n=27, 67.5%), thrombocytopenia was present in 35 (87.5%) patients during admission, hypocalcaemia was present in most patients (90%), liver enzymes were raised in most patients (87.5% & 95% respectively for AST & ALT) and three patients had AKI. Twenty percent patients needed vasopressor support for shock & 5% needed mechanical ventilator support for respiratory failure. Clinical condition was improved in 38 patients & most of them (82.5%) were transferred out from ICU within 6 days. Only two among forty patients expired despite resuscitative efforts. There was no significant difference in the biochemical parameters between survivors & non-survivors.
Conclusion: As dengue specific treatment is not yet available, early recognition of the critically ill patients and immediate supportive treatment along with close monitoring in Intensive Care Unit is life-saving for the patients.
Bangladesh Crit Care J September 2023; 11 (2): 68-74
Palliative care in ICU: Scope and Limitations that ICU physicians need to know
Authors: Mehnaz Ferdous  , Mohammad Omar Faruq
Published: July 2024

Abstract not available
Bangladesh Crit Care J September 2023; 11 (2): 66-67
Premature rupture of membrane - Evaluation of incidence and risk factors in a tertiary Medical College Hospital
Authors: Ummul Nusrat Zahan  , Nigger Most Nasrin , Sheuly Akter
Published: July 2024

Background: Premature rupture of membrane (PROM) is defined as rupture of membrane before onset of true labour pain and one of the most common complications of pregnancy. It is associated with maternal morbidity and perinatal morbidity and mortality. Objective of this study is to determine the incidence and risk factors of pregnant woman with PROM admitted in a tertiary medical college in Bangladesh.
Materials and methods: This prospective observational study was conducted in the Department of Obstetrics and Gynaecology at Khawaja Younus Ali medical college, Sirajgonj from 1st January 2021 to 31st December 2021. In this period total admitted antenatal patients were 8117. Among the pregnant patients with PROM were 665 and their weeks of gestation were > 28 weeks. Data was collected by an interviewer with semi structured questionnaire & check list.
Results: Incidence of PROM was 9.3%. PROM was found to be frequent (39.1%) in younger age group between 21-25 years. Majority of the patients were housewife (71%). Maximum (61%) patient’s education level was up to secondary. PROM is extremely influenced by low socioeconomic status which was (49.1%) of cases in our study. It was also common in multigravida (67.2%) and term PROM was higher (56.4%) than preterm PROM (43.6%). Analysis of risk factors revealed etiology was unknown in 53 (48%) cases, anemia (16 %), lower genital tract infection (7.2%), UTI (19%), previous history of PROM (26.3%), malpresentation (15%) multiple pregnancy (6.7%) DM and GDM (10.5%) were commonly associated with PROM.
Conclusions: Early identification of various risk factors causing PROM and their management can prevent premature deliveries and its complications to some extent as well as serious maternal complication like Chorioamnionitis.
Bangladesh Crit Care J September 2023; 11 (2): 109-112
Role of Neutrophil to Lymphocyte Ratio (NLR) and C-Reactive Protein to Albumin Ratio (CAR) as Early Predictors of Severity in Acute Pancreatitis
Authors: Nikhil Chandra Roy  , Md Golam Azam  , Riad Mohammad Moshaed Hossain  , Sarker Mohammed Sajjad  , Indrajit Kumar Datta  , Shireen Ahmed  , Md Abdullah Al Mamoon  , AHM Rowshon
Published: July 2024

Background: Acute pancreatitis (AP) is a life-threatening disease caused by a variety of factors, and once it progresses to severe acute pancreatitis, the prognosis is poor. Different modalities are available for predicting severity in acute pancreatitis. A single, cheap, widely available marker with high sensitivity and specificity is yet to be identified.
Aims and objectives: The present study was aimed to determine the relation of the neutrophil-lymphocyte ratio (NLR) and CRP-Albumin ratio (CAR) in early prediction of severity in acute pancreatitis.
Materials and methods: This cross-sectional study was conducted at the Department of Gastrointestinal, Hepatobiliary and Pancreatic Disorders (GHPD), BIRDEM General Hospital, Shahbagh, Dhaka, Bangladesh, from April, 2020 to March, 2022. Diagnosis of acute pancreatitis was made by clinical findings, serum amylase and lipase levels (>3 times the upper limit of normal values), evidences of acute pancreatitis by ultrasonography and computed tomography (CT). Severity of acute pancreatitis was classified according to the revised version of Atlanta classification. Data collection was done through a structured questionnaire. Data were analyzed by SPSS 23. Receiver operating characteristic (ROC) curve was constructed to estimate the sensitivity and specificity of NLR and CAR.
Results: A total of 120 patients with acute pancreatitis were enrolled in this study. Age of the patients was 45.20±13.93 (mean ±SD) years, male predominance was observed (54.2%). Majority of the cases were mild 52.5% (n=63) compared to moderate 28.3% (n=34) and severe 19.2% (n=23). The NLR was 6.63±3.344 (Mean ± SD) with a range of 1.32 to 18.75. The CAR was 3.20±2.23 (Mean ±SD) with range of 0.14-7.20. The area under the curve (AUC) of NLR and CAR were 0.865 and 0.949 for severity of AP respectively. Sensitivity, specificity, PPV, NPV and accuracy of NLR at cut-off ≥5.72 were 80.7%, 76.2%, 75.4%, 81.4% & 78.3% and that of CAR at cut-off ≥2.07 were 96.5%, 76.2%, 78.6%, 96.0% & 85.8%.
Conclusion: This study revealed that NLR and CAR are good predictors in the assessment of severity of AP. These easily accessible and low-cost inflammatory markers can be used for the management of acute pancreatitis.
Bangladesh Crit Care J September 2023; 11 (2): 83-89
Treatment of Thyroid Storm in ICU
Authors: SM Ashrafuzzaman
Published: July 2024

Among endocrine emergencies thyroid storm is a very devastating disease. Sometimes patient presents with cardiovascular or neurological disorder, admits in general medical unit other than ICU. But all Thyroid storm patients should be treated in medical ICU. Delay in diagnosis and/or treatment increases morbidity and mortality. Presentation usually with severe hyperthyroid with other systemic dysfunction. Liver function test usually altered. It has got definite diagnostic criteria. Burch HB, Wartofsky L has a scoring scale. Temperature, involvement of central nervous system, Gastro-intestinal or Liver, Heart rate, Atrial fibrillation and precipitating factors give definite scoring system and ideas for prognosis. Treatments depend on severity and associated co-morbidities. Propylthiouracil or Carbimazole or Methimazole should be started early. Propranolol/beta blocker, Digoxin, Saturated Solutions of Potassium Iodide, Hydrocortisone, Antibiotics and IV fluids are essential. Rarely treated with Cholestyramine, Lithium etc. Plasmapheresis is a lifesaving procedure.
Bangladesh Crit Care J September 2023; 11 (2): 121-126
Effectiveness of Plasmapheresis and IVIG in the Treatment of Guillain-Barre Syndrome: A Cross-Sectional Observational Study
Authors: Md Hasibuddin Khan  , Md Khairul Islam  , Sonia Rahman  , AKM Ferdous Rahman  , Subroto Kumar Sarker  , Mohammad Mohsin  , Mohammad Salim  , Sardar Mohammad Tanvir  , Md Habibullah  , Md Mozaffer Hossain
Published: July 2024

Background: Plasma exchange and intravenous immunoglobulin (IVIG) are the most effective treatments for Guillain-Barre syndrome; both can improve patients' symptoms. However, limited clinical research is available in Bangladesh to compare the effectiveness of both treatment modalities.
Aims: This study aimed to compare the effectiveness of plasmapheresis and IVIG in the treatment of Guillain Barre Syndrome.
Method: It is a prospective analytical study carried out in the ICU at the Department of Anesthesia, Analgesia, Palliative & Intensive Care Medicine, Dhaka Medical College Hospital, Dhaka, and Transfusion Medicine Department, NINS. Study subjects were patients with GBS, irrespective of gender, race, ethnic group, and age. For this study, they were divided into Group A (treated by IVIG) and Group B (treated by plasmapheresis). The clinical outcome & disability grade were evaluated and compared between groups.
Result: In this study plasmapheresis was associated with more improvement compared to IVIg, moreover there was a significant difference in the disability scores between the two groups after 12 weeks of treatment. Group B with plasmapheresis had a significantly lower mean disability score (1.26 ± 0.06) compared to Group A with IVIg (3.05 ± 0.17) with a p-value of 0.011 At presentation and immediate post-therapy, there was no statistically significant difference between the two treatment groups in terms of MRC grade. However, at the later time points (6 and 12 weeks), Group B (plasmapheresis) was associated with a statistically significant improvement in MRC grade compared to Group A (IVIg). Specifically, at six weeks, the mean MRC grade was 3.18 for Group A and 4.04 for Group B (p=0.038), and at 12 weeks, the mean MRC grade was 3.52 for Group A and 4.87 for Group B (p=0.019). The mechanical ventilation rate was higher in IVIg (51.4% vs 14.2%, respectively) group. The difference was statistically significant (p=0.017). The proportion of individuals with complete recovery was significantly higher in Group B (60%) compared to Group A (22.8%) with an odds ratio of 5.06 (95% CI: 1.79-14.31) and a risk ratio of 1.959 (95% CI: 1.24-3.01). The proportion of individuals with residual deficit was significantly lower in plasmapheresis (25.71%) compared to Group A (57.1%) with an odds ratio of 3.85 (95% CI: 1.40-10.59) and a risk ratio of 2.22 (95% CI: 1.18-4.18), and this was statistically significant. There was no statistically significant difference in the proportion of individuals who died between the two groups, with a p-value of 0.530.
Conclusions: In point of comparison, plasmapheresis has a potential benefit over intravenous immunoglobulin.
Bangladesh Crit Care J September 2023; 11 (2): 95-102
Two Cases of Hypokalaemic Periodic Paralysis due to Conn’s Syndrome
Authors: Chowdhury Md Imdadul Hoque , Mostofa Monwar Kowshik  , Partha Pratim Das  , Muhammad Habibul Hasan Sourav  , Sorowar Hossen  , Md Kamal Uddin  , AKM Ferdous Rahman  , Mohammad Mohsin  , Subroto Kumar Sarker  , Mohammad Salim
Published: July 2024

Aldosterone producing adenoma, also known as Conn’s syndrome, is the most common secondary form of hypertension. Conn’s syndrome is characterized by hypertension with increased aldosterone, low renin, hypernatremia and hypokalaemia. Clinical manifestations include hypertension in young or resistant hypertension, generalized weakness and fatigue. Here we report two cases presenting with hypokalaemic periodic paralysis and ultimately diagnosed as primary hyperaldosteronism due to Conn’s syndrome.
Bangladesh Crit Care J September 2023; 11 (2): 130-132
A Case of Delayed Right Ventricle Perforation following Permanent Pacemaker Insertion complicated with Sepsis
Authors: Shena Tamanna Yasmin , Umme Kulsum Chy  , Amina Sultana  , Mohammad Omar Faruq
Published: July 2024

Bangladesh Crit Care J March 2024; 12 (1): 75-78
Abstract not available
Severe Acute Pancreatitis Complicated by Acute Pulmonary Embolism: a case report
Authors: Ehteshamul Hakim  , Md Motiul Islam  , Tarikul Hamid  , Mohammad Rabiul Halim  , Kazi Nuruddin Ahmed  , Rajib Hassan  , Rahatul Jannat Nishat  , Hafizur Rahman  , Md Atikuzzaman  , Md Mazharul Haque  , Sami Nazrul Islam
Published: July 2024

Acute pancreatitis is a painful condition in which the pancreas becomes inflamed and edematous usually for a short period of time. Pulmonary embolism due to severe acute pancreatitis is a rare but serious condition. A 68-year-old patient got admitted in gastroenterology department of a tertiary care hospital of Dhaka, Bangladesh with chief complaints of severe abdominal pain for 5 hours and several episodes of vomiting for same duration. After admission relative investigation and examination were done. His USG revealed swollen oedematous pancreas with peripancreatic fluid collection, bilateral renal parenchyma changes with cortical cyst. Patient’s Glasgow Imrie score was 3, Numeric pain score (NRS) was 4, Urine output was normal. The patient was categorized into severe acute pancreatitis. The patient was treated with antimicrobials, proton pump inhibitors, analgesic, and fluid resuscitation. But patient’s medical condition deteriorated and oxygen demand increased. Due to susceptibility of pulmonary embolism and worsening of patient’s condition a thrombolysis was done. Severe acute pancreatitis complicating with pulmonary embolism is a fatal condition.1 Early diagnosis and treatment are fundamental for treating this dreadful condition. When Patient with acute pancreatitis exhibits dyspnoea, leg oedema and thromboembolic events, pulmonary embolism should be suspected. Following early diagnosis, thrombolysis is necessary to combat this situation.
Bangladesh Crit Care J March 2024; 12 (1): 50-54
A Case of Post Viral Acute Longitudinal Extensive Transverse Myelitis (LETM): MOGAD- A New Horizon
Authors: Gomes Richmond Ronald
Published: July 2024

Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a recently identified autoimmune disorder that presents in both adults and children. It is a group of central nervous system demyelinating diseases caused by auto antibodies against myelin oligosaccharide protein, a myelin sheath component protein, and present with a variety of symptoms, including optic neuritis, longitudinal extensive transverse myelitis (LETM), acute disseminated encephalomyelitis (ADEM), brainstem encephalitis, and corticobasal encephalitis. Although there are clinical phenotypic overlaps between MOGAD, multiple sclerosis, and aquaporin-4 antibody-associated neuromyelitis optica spectrum disorder (NMOSD) cumulative biological, clinical, and pathological evidence discriminates between these conditions. Here, we present a case of a young male with acute onset of spastic paraplegia with sphincters involvement and patchy loss of pinprick sensation with positive Anti-MOG Antibody shortly after viral febrile illness.
Bangladesh Crit Care J March 2024; 12 (1): 62-67
Hypertriglyceridemia induced acute pancreatitis and efficacy of therapeutic plasma exchange
Authors: Ehteshamul Hakim  , Motiul Islam  , Tarikul Hamid  , Mohammad Rabiul Halim  , Kazi Nuruddin Ahmed  , Rajib Hassan  , Rahatul Jannat Nishat  , Hafizur Rahman  , Md Atikuzzaman  , Momtazur Rayhan Shumit
Published: July 2024

Acute pancreatitis is a condition in which the pancreas becomes inflamed suddenly within a short period of time. Typically, this condition lasts less than 6 weeks, with most cases resolving within 1-2 weeks. The major causes of acute pancreatitis are ethanol, gallstones, and hypertriglyceridemia. Acute pancreatitis that is caused by hypertriglyceridemia can be severe and life-threatening. Compared to other causes of pancreatitis, studies have shown that the acute pancreatitis induced by hypertriglyceridemia is more serious and can lead to recurrent episodes of pancreatitis, eventually leading to chronic pancreatitis. Here, we report a clinical experience with a patient of high triglyceride induced pancreatitis. He was treated with two sessions of Therapeutic Plasma exchange along with intravenous insulin, statins, and fibrates. In recent times, plasmapheresis has been used to treat severe cases of hypertriglyceridemia-induced acute pancreatitis with success. Early initiation, along with appropriate supportive measures, may lead to favourable outcomes and reduce the risk of complications. However, further research is needed to determine the exact role and timing of plasmapheresis in managing acute pancreatitis caused by hypertriglyceridemia.
Bangladesh Crit Care J March 2024; 12 (1): 58-61
Correlation of Caval Index and Central Venous Pressure in Non-ventilated Critically ill Patients
Authors: Mohammad Asrafuzzaman  , Md Mahabub Morshed  , Rumana Sultana  , Moffijul Haque Khan
Published: July 2024

Background: Determination of intravascular volume status can sometimes be challenging part of critically ill patient’s management in ICU. Invasive haemodynamic monitoring of central venous pressure is a useful guide in directing early resuscitative efforts and assist in reducing the morbidity and mortality of ICU patients with severe sepsis/septic shock. Obtaining invasive hemodynamic monitoring can lead to complications and time consuming. Sonographic measurement of the inferior vena cava (IVC) diameter and IVC collapsibility, termed the caval index is a non-invasive method of estimating the fluid status in critically ill patients. The study was designed to see the correlation between caval index and central venous pressure (CVP) in non-ventilated critically ill patients. Objectives: The aim of the study was to evaluate the correlation of caval index and central venous pressure in non-ventilated critically ill patients. Methods: It was a hospital based descriptive type of cross-sectional study, carried out in the ICU at the Department of Anaesthesia, Analgesia, Palliative & Intensive Care Medicine, Dhaka Medical College Hospital, Dhaka from the period of May 2017 to October 2018. A total number of 86 patients were enrolled in this study. Study subjects were patients (age >18 years) with critically-ill non-ventilated and whom central venous catheter inserted for CVP monitoring. Central venous pressure was measured first by CVP manometer. Then IVC diameter and caval index were measured with curvilinear probe of the Sonosite ultrasound device. The correlation of CVP and CI was calculated. Statistical analyses of the results were obtained by using window-based Microsoft Excel and Statistical Packages for Social Sciences (SPSS-24). Results: In this study, according to CVP 33.7% (29) of patients were hypovolemic with mean (±SD) CVP 5.3±1.2 cm H20, euvolemic were 38.3% (33) with mean (±SD) CVP 10.6±1.7 cm H20 and hypervolemic were 27.9% (24) with mean±SD CVP 16.1±1.5 cm H20. Mean caval index (CI) (%) mean (±SD) was found 57.1±7.23 in hypovolemic patients, 39.5±2.65 in euvolemic & hypervolemic patients. So, the result shows >50 % CI is associated with CVP < 8 mm of Hg and < 50% CI is associated with CVP > 8 mm of Hg. Pearsons correlation coefficient test used to assess the strength and nature of correlation between two variables. There was a statistically significant correlation between the mean CVP and the caval index (p < 0.001). So findings revealed that there is an inverse relationship between the caval index and CVP. Conclusion: The caval index had acceptable correlation with CVP at the level of IVC entry into the right atrium. It was concluded that there is an inverse relationship of CVP with the caval index.
Bangladesh Crit Care J March 2024; 12 (1): 29-34
A Clinicopathological study of Guillain-Barrḗ Syndrome in a Tertiary Level Hospital
Authors: A K M Ferdous Rahman  , Mohammad Salim  , Saifullah Al Kafi  , Saudia Akter Gulshan  , Md Imdadul Hoque Chowdhury
Published: July 2024

Background: Guillain-Barre syndrome (GBS) stands out as the most prevalent autoimmune neurological disorder. This investigation involves a comparative analysis of clinical observations, neurophysiological assessments, and cerebrospinal fluid examination, outcomes among patients with GBS. Method: A retrospective review of medical records constituted the methodology for this study, spanning from July 1, 2023, to December 31, 2023. Sociodemographic traits, antecedent illnesses, clinical progression, laboratory results, therapeutic interventions, and ultimate outcomes were assessed and compared among the study participants. Results: The study encompassed 8 patients, with an average age of 42.75 years. Respiratory complications were evident in 87.5% of the patients. In CSF analysis, 62.50% exhibited a normal cell count, while 37.50% displayed an elevated count. Elevated CSF protein levels were observed in 50% of patients, with a corresponding 50% revealing normal CSF protein levels. Increased CSF protein was associated with delayed lumbar puncture, demyelinating nerve conduction study subtype, and sensory motor variant. Regarding treatment modalities, 37.5% received intravenous immunoglobulin, and 25% underwent plasma exchange therapy. The acute phase of the disease resulted in a 25% mortality rate among patients. Conclusion: Guillain-Barre syndrome manifests diverse clinical presentations and laboratory findings. Notably, a high cerebrospinal fluid cell count challenges the widely accepted Brighton criteria for GBS diagnosis. Further investigations are warranted to elucidate the correlation between elevated CSF cell count and other factors influencing pathogenesis and outcomes in GBS patients.
Bangladesh Crit Care J March 2024; 12 (1): 25-28
Association Between Serum Uric Acid Level and the Severity of Parkinsons Disease: A cross sectional study
Authors: Muhammad Shamsul Islam  , Khan Md Nazmus Saqeb
Published: July 2024

Background: Parkinson’s disease is a chronic, progressive, neurodegenerative disease. Various factors have been attributed to the development and progression of the diseaseover the years. Uric acid is the final oxidation product of purine metabolism with potent antioxidant properties, which could play an important role in reducing the risk of development of Parkinson’s disease (PD) as well as it could have a role in delaying the progression of Parkinson’s disease (PD). Aim: This study aims at evaluating the role of serum uric acid level in clinical progression of Parkinson’s disease. Methods: This cross-sectional study was conducted among 70 patients of Parkinson’s disease attending the outpatient department and meeting the inclusion criteria. All the clinical and biochemical data were collected and analyzed by SPSS. Mean serum uric acid levels were compared between different stages of Parkinson’s disease. A p value of less than 0.05 was considered as significant. Result: Mean age of the patients with Parkinson’s disease was 62.25 ± 8.56 years with a male to female ratio of 1.12:1. Regarding the clinical presentation of the patients, it was observed that 16 (22.9%) patients had combination of tremor, hypokinesia, rigidity and postural imbalance, 18 (25.7%) had tremor, hypokinesia & rigidity and 36 (51.4%) had tremor and rigidity. It was observed that 24.3% of the patients had sensory, sleep and cognitive disorder, 21.4% patients had sleep and cognitive disorder, 2.9% patient had disorder in sleep and anosmia, 8.6% patients had only sleep disturbance, 17.1% had only cognitive disturbance but 25.7% had no non-motor symptoms. Majority (61.4%) patient’s disease duration was 1-5 years. The mean duration of disease was found 6.34±5.53 years. Majority 34 (48.6%) patients were in stage II, 19 (27.1%) were in stage III, 5 (10.0%) were in stage IV and 12 (17.1%) were in stage V. Mean serum uric acid was found to be 3.45±1.26mg/dL (2.0-5.8) in male and 3.36±0.81mg/dL(2.1-5.8) in female patients.Serum uric acid level steadily reduced with the severity of PD which is statistically significant. Advanced stages of parkinson’s disease were associated with significantly lower levels of serum uric acid. The difference between the stages were statistically significant (p=0.007). Conclusion: This study shows a negative association between serum uric acid level and the severity of Parkinson’s disease. The level of serum uric acid decreased with the disease progression. This study added evidence consistent with an association between serum uric acid level and the severity of Parkinson’s disease. This finding pushes us to emphasize on the role of uric acid levels on the Parkinson’s disease.  
Bangladesh Crit Care J March 2024; 12 (1): 18-24