bluuebunny/crossref_metadata_2025 huggingface dataset:
PENGGUNAAN DIAPERS MEMPERLAMBAT KESIAPAN TOILET TRAINNING PADA TODDLER
Authors: Kamariyah Nurul , Tukhusnah Mutmilah
Published: November 2018

Toddlers should have been done the training to use the toilet, but in fact there were many mothers who did not teach about toilet training to her children because of that her children were still not able to implementation toilet training. Therefore, the research was purposed to analyze the relationship between the diapers using and the readiness of toilet training in toddler in RW 04 Keboan Anom village Gedangan district Sidoarjo regency.

The design applied in this research was analytic cross sectional. The population involved 56 mothers having babies 18-36 months old in RW 04 Keboan Anom village Gedangan district Sidoarjo regency in which 49 respondents were taken as the samples by using the simple random sampling technique. The independent variable of this research is diapers using and dependent variable is the readiness of toilet training in toddler Moreover, the instruments used to collect the data were questionnaires. The collected data were then analyzed by applying Spearman’s Rank test with the level of significance α = 0,05.

The results of research showed that nearly half of the 49 respondents (46.9%) use the diapers for 12-24 hours / day to her children and the majority (53.1%) had poor toilet training readiness. Based on result of the statistical test, it showed that ρ = 0,000 which meant that ρ < α = 0,05 so that H0 was rejected. Thus, it also proved that there was a relationship between the use of diapers and the readiness of toilet training in toddler.

In conclusions, the higher frequency use of diapers can result in the bad effect for the child, they will have a lack toilet training readiness. The medics are expected to be more frequent for providing information about toilet training and for parents, they need to increase the guidance and the direction about toilet training to their children.
GAMBARAN SISTEM PENYELENGGARAAN MAKANAN DI PONDOK PESANTREN, KABUPATEN JEMBER
Authors: Ningtyias Farida Wahyu , Prasetyowati Irma , Astuti Ida Srisurani Wiji , Muslicha Siti , Nafi’ Ahmad , Haryono Ahmad
Published: November 2018

The good procurement of the food in a boarding school has guarantee the nutritional needs of the students. This study aims to describe the implementation of the food in the boarding school in the district of Jember. This type of research is qualitative research with descriptive approach using primary and secondary data. The informant in this study is the executive management of the boarding school and the cheff manager. The Processing and analyzing of data is using content analysis and presented in narrative form and quote. The results showed a third implementation of the boarding school was a self-managed non-commercial. The executive manager was Ning (daughter of the owner of boarding school) or coordinator of ustadzah (teacher). Only NI boarding school that has a menu cycle i.e 10 days cycle menu, budget planning is done by those responsible for food manager and Ndalem (family members of the owner of boarding house). Purchases made directly groceries every day, which storage was FIFO. Food preparation is done two times, in the morning hours of 6:00 pm and 15:00 pm. There was no calculation for nutritional adequacy andthe students consumption were still in the deficit category. Food procurement in a boarding school need to increase with planning optimizing, so it’s fulfill the students needed to have a good growth and performance.
GAMBARAN MANAJEMEN TEMPAT TIDUR RAWAT INAP KELAS 3 DI RSUD Dr. M. SOEWANDHIE SURABAYA
Authors: Firdausi Nurul Jannatul , Adriansyah Agus Aan
Published: November 2018

National Health Insurance (JKN) has encouraged utilization of Inpatient Department (IPD).The highest improvement by poor who funded by JKN-PBI scheme. Unbalancing supply and demandare potentially making queuesand effect to prolonged waiting times. The study aims to define bedmanagement in the 3rd class IPD of RSUD. Dr. M. Soewandhie Surabaya. Type of study wasobservasional-descriptive with cross sectional design. Study was conducted in The 3rd Class IPD ofRSUD. Dr. M Soewandhi beginning on June to August 2018. Sample was patients who have beendecided to discharged from IPD. Sampling technique by simple random sampling. The sample sizewere 104 patients. Data collection by observing process of patients discharge to preparation ofinpatient rooms (cleaning and put on the linen). Analysis dat in narrative and supported by graphsand tables. The results: the peak time of patient discharge and patient admission has gap about 4hour time. Room booking is centralized at Administration, but updating data is constrained due togathering information by telephone to nurses in IPD. Cycle time to provide a bed for 165 minutes(Takt Time = 52 minutes). The longest process is waiting for patient discharge and cleaning services.Provision of inpatient rooms still long, so the hospital management needs to improve patient flow,administration and information when patient discharge untill room cleaning.
KEBUTUHAN DAN PERMINTAAN TERHADAP LAYANAN KESEHATAN MATA: SEBUAH SURVEI DARI PENDUDUK SURABAYA
Authors: Khasanah Umi Nur
Published: November 2018

Healthcare institutions should take into account the needs of the community for the servicesprovided to be effective. The research aims to find out the needs and needs of the public on eye healthservices in Surabaya. A survey involved 59 respondents (from Wonokromo, Gayungsari, Jemursari,and Darmahusada) in May of 2017. The research instrument was a questionnaire. Data analysisusing descriptive statistical test. The research indicates that respondents need eye health servicesinclude good and professional services (27.10%), friendly human resources (32.20%), completelaboratory (39.00%), information system (44.10%), willingness to use (79.70%), good service system(37.30%), unreliable human resources and cost and distance factors respectively 28.80%, staffcounseling (54.20%), treatment (76, 30%), puskesmas (30.50%), clinics (16.90%), taking medicine(36.00%), Eye Hospital in Undaan (37.00%), close to home (20.00%). The study recommends thatsurvey results can be used as a reference for hospital management in developing eye health servicesin line with community expectations.
Awareness and Willingness to Pay for Community Based Health Insurance Scheme in North-Western Nigeria
Authors: Abdulganiyu Giwa , Muhammad Kabir , Ibrahim Umar , HH Suleiman , BK Lawal
Published: November 2018

There is a need for the communities to develop their health financing system, most especially those that were not covered by the National Health Insurance Scheme (NHIS). This will give the people an opportunity to finance their medical care which in turn would alleviate financial burden at the point of treatment. Therefore, this study is aimed to determine the level of awareness for Community Based Health Insurance Scheme (CBHIS) among communities and to measure the degree of willingness to pay for the scheme in Katsina, North-Western Nigeria. Semi structured interviewer-assisted questionnaires were used to collect information from the respondents. Statistical analyses were performed using SPSS version 20.0. The results indicates that majority of the respondents attained tertiary level of education (68.3%) and 81.1% were employed. About 74.2% were earning more than the Nigerian minimum wage N18, 000 (≈$59). About 52.2% of the respondents were aware of the CBHIS. And 81% were willing to pay for premium while 62.2% will pay between N 1, 000 – 5, 000 (≈$3.3- $16.4). There was strong significant relationship between monthly income and knowledge of CBHIS (p = < 0.0001). However, gender and educational level were not significantly associated with the knowledge of CBHIS. Awareness about CBHIS was not sufficiently adequate but a significant number of the respondents were willing to pay for CBHIS after learning about the scheme. Factors such as level of education and income levels were found to have positive effect on willingness to pay.Bangladesh Journal of Medical Education Vol.9(2) 2018: 19-23
School-based educational intervention to improve children’s oral health-related behaviors in rural Bangladesh
Authors: Furukawa Yusuke , Yokota Fumihiko , Maruf Rafiqul Islam , Nishikitani Mariko , Kikuchi Kimiyo , Ahmed Ashir , Nakashima Naoki
Published: November 2018

Children in rural Bangladesh have limited access to oral health services. As a pilot project, a one-day one-time oral health educational intervention was conducted at a primary school in Tangail district in Bangladesh. This study assessed the effect of this educational intervention on the children’s oral behaviors using controlled pre- and post-intervention design. Fifty-two students at the intervention school and 37 students at a control school agreed to participate in this study. A baseline survey was conducted for children at both schools using a standardized semi-structured questionnaire. Children at the intervention school received face-to-face dental exercises and a group seminar. Six months after the intervention, a follow-up survey was conducted at both schools to compare changes in children’s oral behaviors at the two schools. The increase in the percentage of intervention-school participants who reported brushing their teeth two or more times per day between the baseline and follow-up surveys was 7.6 times greater than that in the control group (95% CI= 1.7–35.1; p<0.009). The increase in the percentage of intervention-school participants who reported brushing their teeth before bed between the two surveys was 7.3 times greater than that in the control group (95% CI=1.6–34.0; p<0.001). The findings suggest the importance of skill-based intervention, in collaboration with dentists, school teachers, parents, and community health educators. Future studies on the effectiveness of school-based educational interventions should consider longer-term sustainable behavioral changes in children’s oral health.South East Asia Journal of Public Health Vol.7(2) 2017: 27-33
Neonatal outcome of term deliveries in Sri Lanka
Authors: Gunawardane Damitha Asanga , Dharmaratne Samath D , Rowel Dhammica S
Published: November 2018

Major proportion (40-70%) of neonatal mortality is among ‘term neonates’. Even though, information on neonatal outcomes of term neonates is scarce. The high volume of term neonatal admissions to neonatal care units signify the importance of studying the neonatal outcomes among term neonates. The aim of this study is to describe the neonatal outcomes, of term neonates following term deliveries (37 completed weeks - 41 completed weeks and 6 days) at Teaching Hospital (TH) Kandy, Sri Lanka. A descriptive cross-sectional study was conducted to describe neonatal outcomes of term neonates before the initial hospital discharge point. A sample of 1,105 neonates, delivered at term were studied during the study period. Mean gestational age at delivery is 38.85 weeks and 41% of term neonates are delivered before completion of 39 weeks of Period of Amenorrhoea (POA). The mean birth weight of the term neo-nates is 2925.24 grams. Out of all term neonates, 15.84% (n=175) were admitted to Neonatal Care Unit (NCU) and 23.3% (n=257) had at least one diagnosed neonatal condition. The commonest neonatal condition was bacterial sepsis of newborn (n=138, 12.48%), followed by neonatal jaundice from other and unspecified causes (n=84, 7.6%), and respiratory distress of newborn (n=44, 3.94%). Median hospital stay of term neonates is 3 days. Majority of term neo-nates admitted to NCU are normal weight term neonates. Nearly one-fourth of term neonates had at least one diag-nosed neonatal condition. Prevention and control of infection from the time of birth to the time of discharge from the hospital should be given due attention to reducing bacterial sepsis among term neonates.South East Asia Journal of Public Health Vol.7(2) 2017: 34-39
Assimilating Oxaliplatin (Eloxatin) into the Management of Colorectal Cancer
Authors: Uddin Dayem , Kibria Syed Golam , Khan MMR , Khan Farjana
Published: November 2018

Oxaliplatin (Eloxatin) is a third-generation platinum analogue which is a novel compound with proven anti-tumor activity in colorectal cancer. That has demonstrated synergy with 5-fluorouracil (5-FU) in human tumor xenograft models. A series of phase II trials demonstrated that, as second-line therapy, oxaliplatin in combination with 5-FU/leucovorin (LV) is active and can overcome clinical resistance to 5-FU. Subsequently, two large, randomized, phase III trials demonstrated that the addition of oxaliplatin to 5-FU/LV significantly improved response rates and time to disease progression in the first-line setting, but had no statistically significant impact on survival. Oxaliplatin in combination with 5-FU/LV represents an important treatment option for patients in whom 5-FU-based therapy has failed and as first-line therapy. Oxaliplatin has also been investigated in combination with the oral Fluoropyrimidine, capecitabine. As an oral agent that exploits the high intratumoral activity of thymidine phosphorylase to generate 5-FU preferentially within tumor tissue, capecitabine may improve the efficacy and tolerability of Fluoropyrimidine/oxaliplatin combination therapy. A phase I dose-escalation study has been performed in patients with advanced/metastatic solid tumors to establish the most appropriate regimen. The study indicated that the combination is feasible and has substantial antitumor activity in patients with colorectal cancer. This article provides an overview of the clinical trial data for oxaliplatin and discusses how oxaliplatin may best be used in the future.

TAJ 2011; 24(1): 11-15
Spinal Anaesthesia Vs General Anaesthesia for Open Cholecystectomy Operation Interim Analysis of a Controlled Randomized Trial
Authors: Zahid M Abu
Published: November 2018

This is a prospective randomized clinical study was done in different clinics in Rajshahi city from September 2011 to September, 2012 to evaluate the outcome of patient undergoing cholecystectomy operation by spinal Anaesthesia. This is also a comparative study of patient undergoing cholecystectomy operation either by spinal Anaesthesia or by general Anaesthesia. For this study 100 patient of open cholecystectomy were randomly selected in to two groups (Each group contain 50 patients). Group A patient received spinal Anaesthesia with some sorts of IV anaesthetic drugs such as low dose ketamine with atropine or low dose Opioids if necessary before surgical incision. Group B patients received general Anaesthesia as usual procedure. Then these patient were monitored during per-operative and postoperative period to evaluate its outcome. After completion of the operation we seen that those patient received spinal Anaesthesia had better outcome then general Anaesthesia undergoing open cholecystectomy operation.

TAJ 2011; 24(1): 30-33
Myomectomy at Cesarean Section: Descriptive Multicentre Study
Authors: Begum Jahanara , Hossain M Aftab , Nahar Zibon
Published: November 2018

Background: In the tropics, leiomyoma are commonly encountered in women of the reproductive age group, although they are mostly asymptomatic. Surgery for uterine fibroid at caesarean section has remained controversial.

Objective: The study design was a prospective multicentre study to analyse the clinical outcome of women that had selective caesarean myomectomy in a medical college and private hospitals in Dinajpur,Bangladesh.

Method: Thirty women that had selective myomectomy at caesarean section between January 2004 and February 2012 were analysed.

Results: The patients mean age was 32.6 years with age range of 21–39 years. Of the 30 patients, 21 (70 %) were Primigravida, 27 (90%) of the patients had caesarean section at term, 2 (6.6%) and 1 (3.3%) of the patients were preterm and post term respectively. A significant number of the patients 28 (93.4%) had elective caesarean section and the remaining 2 (6.6%) patients had emergency caesarean section. The 3 leading indications for caesarean section among the patients were malpresentation/abnormal lie 23%, uterine fibroids 26.6%, and a previous caesarean section with complication in 20% of the patients. Indications for myomectomy at caesarean section were fibroid in lower uterine segment in 18 (60%) patients, pedunculated uterine fibroid in 8(26.6%) patients and anterior subserous fibroid in 4 (13.3%) patients. Intraopertively in the 30 patients, 15 (50%) had fibroid(s) removed only in the lower uterine segment; while 7 (23.3%) patients had removed in the upper uterine segment and 8(26.6%) had both upper and lower uterine segments. A total of 75 fibroids were removed in the 30 patients, of which 40 (53.3%) were subserous/pedunculated, 25 (33.3%) intramural and 10 (13.3%) were submucous. Of the75 fibroids, 51 (68%) were between 6 to 10 cm size. Sixteen (53.3%) of the 30 patients lost between 751 to 1000 ml of blood intraoperatively with an average of 860 ml of blood loss. Five (16.6%) ofthe 30 patients had blood transfusion due to anaemia. Other complications encountered were puerperal pyrexia and sepsis in 2 (6.6%) patients. There was no maternal and perinatal mortality.

Conclusion: Selection of patients for caesarean myomectomy reduces blood loss, anaemia and other complications.

TAJ 2011; 24(1): 38-42
Mucocele of Appendix – Rare Entity –A Case Report
Authors: Shah KZ , Begum N , Khan MMR , Ahmed P , Vadro SK
Published: November 2018

Appendiceal mucocele (AM) is a rare entity that can present in a variety of clinical syndrome. The prevalence is 0.2- 0.4 % among appendicectomies.1 A 48 Years old male patient came to our Centre for Nuclear Medicine and Ultrasound (CNMU), Rajshahi for abdominal ultrasound examination. He had pain with vomiting and feeling of lumpiness in right side of lower abdomen. Ultrasonography (US) showed an elongated regular outlined semi-cystic lesion in right iliac fossa. Laparotomy done, per-operative finding reveled AM. Post-operatively histopathological examination report revealed AM.

TAJ 2011; 24(1): 54-56
Development of APLAR-COPCORD Core Questionnaire for Identification of Risk Factors for Non Specific Low Back Pain
Authors: Siddiqui M Nure Alom , Islam M Nazrul , Haq Syed Atiqul , Sultana Shahnaj , Rhman MK , Khan MMR
Published: November 2018

Background: Non specific low back pain (NSLBP) has been identified as one of the commonest rheumatic disorders in prevalence surveys in Asia-PacificObjective: Development of a core questionnaire for identification of risk factors of NSLBP at community level.Methods: Following steps were followed: 1) item generation from literature survey, existing Nordic questionnaires and patient focus group discussions, 2) development of a preliminary APLAR-COPCORD English questionnaire, 3) translation into target language, back translation and development of a synthetic target language version, 4) adaptation of the synthetic target language version through tests of comprehensibility, content validity test-retest reliability, and 5) finalization of the English questionnaire. .Results: 45 items were generated. A preliminary English questionnaire was developed.Conclusion: The developed English questionnaire will serve as an efficient tool for identification of risk factors of NSLBP in Asia-Pacific communities.TAJ 2011; 24(2): 85-90
A Primary Intramuscular Hydatid Cyst of the Proximal Thigh : A Rare Case Report
Authors: Rahman M Hafizur , Hossain ASM Zakir , Islam M Saiful , Khatun Khodeza , Rahman M Anisur , Chowdhury M Sharif
Published: November 2018

Primary intramuscular hydatid cyst of thigh is a very rare parasitic disease caused by Echinococcus granulosus. We present an unusual case of primary hydatid cyst in a 21-year old male who presented with slowly growing painless lump in the anteromedial aspect of proximal right thigh. Ultrasonography of the mass revealed a multiloculated cyst in the medial compartment of right proximal thigh without detectable primary any other location. MRI clearly displayed the lesion showing cystic mass with multiple well defined daughter cysts and diagnosis of hydatid cyst was made. The patient was treated surgically and cyst was excised. Macroscopic and microscopic histopathological examination confirmed the diagnosis of muscular hydatid cyst. Primary muscular hydatidosis is kept in mind in the differential diagnosis of a cystic mass of a skeletal muscle especially in endemic areas.TAJ 2011; 24(2): 142-144
Hurler’s Syndrome - A Case Report (Mucopolysaccharidosis Type-1H)
Authors: Islam AHM Tohurul , Leema Elora A , Das Tapos K , Ali O Ibne , Rahman MH , Nahar Z
Published: November 2018

A girl named Tania, aged 5yrs was brought to Shaheed Ziaur Rahman Medical College Hospital, Bogra with the complains of swelling of both legs for 5days & low grade intermittent fever for 1month & she also had severe mental retardation, facial dysmorphism, hepatosplenomegaly, umbilical hernia, corneal clouding, large calvaria & features of dysostosis multiplex. Her clinical as well as radiological features arouse strong suspicion suffering from a rare genetic disease (autosomal recessive) hurler’s syndrome though it wasn’t confirmed by deficiency of specific enzyme or urinary excretion of GAG (glycosaminoglycan).TAJ 2011; 24(2): 148-151
Aetiological Approach to Patient with Non- Specific Chronic Cough
Authors: Majumder Samir C , Hossain MA , Hasan MR , Mahmud AM , Rahman ASMM , Hiron MM , Rahman M
Published: November 2018

Chronic cough is a problem commonly encountered by the practicing physicians. Definitive treatment depends upon identifying the cause of cough4.To develop an appropriate algorithm for diagnosis of non-specific chronic cough a Prospective case-control study was carried out in Asthma Centre,NIDCH, Mohakhali, Dhaka during the period of January,2000 to December,2001. Eighty two patients with history of cough for 3 weeks or more duration were taken in group A.The ages ranged from 11 to 68 years with mean age 35.5 ± 12.0 years. There were 43 males and 39 females. Equal number of subjects having no cough were taken as control (group B).The age of control subjects ranged from 11 to 68 years with mean age 35.6 ± 11.9 years. Diagnosis was made in all patients. PNDS was found in 41(50%), PNDS with cough variant asthma in 19(23.2%),cough variant asthma alone in 10(12.2%),GERD singly in 2(2.4%).In control group, only 5 (6.1%) persons were diagnosed as PNDS who had almost all features of PNDS except cough. In this studuy, PNDS alone and in combination with cough variant asthma were common causes of chronic cough.TAJ 2012; 25: 1-7
Study of Thyroid Hormone Status in Normal Newborn and Preterm, Low Birth Weight Baby
Authors: Ali M Obaidulla Ibne , Iqbal Tanvir , Atia Nur E , Islam Tohorul , Khanam K
Published: November 2018

Background : Screening for thyroid hormones in the newborn baby is extremely important to detect the newborns who are born with hypofunctional state of thyroid gland. This screening program in first few weeks of life is essential to prevent serious complications of hypothyroidism in future such as mental retardation. Objective : To assess the thyroid hormone levels in normal newborn and preterm, low birth weight babies and comparison of thyroid dysfunction between these two groups.Method : This cross - sectional analytical type of study was conducted in the department of physiology and paediatrics of Rajshahi Medical College & Hospital ( RMCH) from July 2015 to June 2016. A total of 70 newborn baby were enrolled by systematic sampling of which 40 were normal healthy newborn and 30 were preterm, low birth weight babies. Data was collected from the parents and they were filled out standard questionnaire. Then venous blood was collected from each and every neonate and blood was sent to laboratory for estimation of thyroid hormone levels. FT4 and TSH values were estimated as these two are the most important parameters for determination of thyroid function.Result : In this study, the mean (±SD) serum FT4 level in term and preterm neonates were 14.17±2.14 and 12.25±3.16 (pg/ml) respectively. This FT4 value is significantly higher in term neonates than preterm neonates (P< 0.05). The mean (±SD) serum TSH level in term and preterm neonates were 3.37±2.12 and 4.23±3.23 (μIU/ml) respectively. Statistically there was no significant difference in TSH values between these two groups (P≥0.05).Conclusion : From this study it was evident that preterm, low birth weight babies are more likely to develop hypofunctional state of thyroid gland than normal term babies. The newborns who were found hypothyroid, were informed to their parents for consultation with the concerned physicians. The physicians then took necessary steps to correct the hypofunctional state of thyroid gland.TAJ 2013; 26: 20-23
Autologus Blood Injection for Lateral Epicondylitis in Tertiary Level Hospital
Authors: Sohel DM , Dam BK , Roy D , Shamsuddin MAK , Pramanik SK
Published: November 2018

Tennis elbow is a common and well defined clinical entity. It is an extra articular affection characterised by pain and acute tenderness at the origin of the mainly extensorcarpi radialis brevis, but can involve the tendons of the extensorcarpi radialis longus and the extensor digitorum communis. It is also called lateral epicondylitis. Various types of treatment option for this disease that is conservative and operative. An injection of autologus blood might provide the necessary cellular and humoral mediators to induce a healing cascade. The purpose of the study was to evaluate result of epicondylitis treated with autologus blood injection.Total 19 patients with tennis elbow treated in this study.Among the patients 9 were male and 10 were female.Age of the patients were 25yrs – 60yrs, average 41.63yrs. All patients had failed previous non-surgical treatment. Duration of the pain 1 month to 6 months. All the patients got autologus blood injected every 21 days interval (one or three times). Before autologus blood injection average pain score was 6.2 and average Nirschi score was 5.8. After autologus blood injection pain score and Nirschi score decreases 2.2 and 2 respectively. Average follow-up period was 7 months.TAJ 2013; 26: 79-81
A Study of Drugs Causing Fixed Drug Eruptions
Authors: Rahman Md Moksedur , Abdullah Md , Nessa Moriom , Siddique Muhammad Afsar , Hossain Md Moazzem , Rahman Md Khalilur , Khan MMR
Published: November 2018

Fixed drug eruption (FDE) is a distinctive type of cutaneous drug reaction that characteristically recurs in the same site or sites each time a particular drug is taken. FDEs are among the most frequent problems encountered by the dermatologists. The present study was carried out to recognize offending drugs, to educate the patients and to avoid self-administration of drugs and re-administration of the offending drugs. The study was conducted in Skin & VD outpatient department of Rajshahi Medical College Hospital, Rajshahi over a period of one year. One hundred ten cases with established FDE were evaluated clinically. The causative drugs were identified and confirmed by provocation tests. Cotrimoxazole (25%) was the most common cause of FDE. Other drugs incriminated were NSAID (21.8%), Tetracycline (15.4%), Ciprofloxacin (10%), Amoxicillin (7.2%), Metronidazole (5.4%), Griseofulvin (2.7%) and Fluconazole (1.8%). The lesions were found to be distributed on the oro-genital mucosa, trunk and the acral regions.The main presentation of FDE was circularhyperpigmented lesion.TAJ 2014; 27(1): 29-33
Feasibility of surgical management in patients with mammary tuberculosis-study of 100 cases.
Authors: Laila RN , Islam B , Banu S , Raihan J
Published: November 2018

Tuberculous mastitis is a rare entity in patients with mammary disease even in countries where incidence of tuberculosis is high. In Bangladesh, TB is an endemic disease but breast tuberculosis is rarely reported. Its clinical patterns and treatment strategies are changing day by day. With this study, we aimed to analyze the role of surgery in diagnosis and treatment of hundred (100) cases received care for tuberculous mastitis at the Chest Disease Hospital, Rajshahi, from July’ 2012 to July’ 2016. This is a prospective nonrandomized descriptive study. Diagnosis was made in all patients initially by cytological examination from suspected lesions, which revealed typical tuberculous lesions. In all the patients the diagnosis was confirmed by biopsy of the lesion (open biopsy or core cut biopsy) with histological examination and detection of acid fast bacilli in discharge by Gene x-pert test and Z-N staining to exclude idiopathic granulomatous mastitis, malignancy and very rare concomitant malignancy. Medical therapy with anti-tubercular drugs (ATT) ranging from 9 to 12 months with follow up monthly was the mainstay of treatment. Surgical intervention reserved for selected refractory cases (36%). Extension of anti-tubercular therapy from 9 to 12 or 18 months required in fifty-eight(58) patients on the basis of slow clinical response. Complete resolution obtained in 92 patients but residual tiny mass in eight patients confirmed by repeated FNAC or biopsy to be fibrotic. Surgery play an essential role both in diagnosis and treatment of tubercular mastitis in addition with ATT but beware about unnecessary surgical intervention as majority of patients cured with only ATT.TAJ 2014; 27(1): 44-49
A Study of Ursodeoxycholic Acid for Dissolution of Gallstones
Authors: Uddin SM Afzal , Rahman MK , Khan MMR , Tarik M Hasan , Haque M Zahirul , Basak PM , Rahman M Moksedur , Islam M Akhtarul , Huda MN , Begum Shahana
Published: November 2018

Background: Gallstone disease one of the major health problems and causes of morbidity in Bangladesh as well as worldwide. Ursodeoxycholic acid is a bile acid which is used for dissolving gallstones.Objectives: To observe dissolution of gallstones among the patients of gallstone disease by use of ursodeoxycholic acid. Methods: It was a cross-sectional observational study carried out in the Department of Medicine, Rajshahi Medical College Hospital, Rajshahi from July, 2014 to June, 2016. According to inclusion and exclusion criteria 12 people having gallstone disease were selected whose stone size were <10mm and were treated withUrsodeoxycholic acid (Dosage of 8-12mg/kg/day). Thorough history, physical examination along with Ultrasonographical assessment were done for this study.Results: Complete gallstonedissolution with Ursodeoxycholic acid occurred in 08(66.67%) cases whereas dissolution did not occur in 04(33.33%) cases among the patients of gallstone diseases.Conclusion: In this study, complete dissolution of Gallstones (<10mm) occurred in 66.67% patients.TAJ 2014; 27(2): 27-29
Glycemic status of diabetic patients attending in a diabetic hospital
Authors: Huda MN , Islam MN , I Towfiq , Alam SM , Basak PM , Sarkar A , Bhatachariya PM
Published: November 2018

Diabetes care is now available everywhere in our country. But achievement of optimal level glycemic control and adherence to diabetic therapy is still questionable. This observational cross sectional study was done to observe the glycemic status of diabetic patients .The mean (±SD) serum HbA1c concentration of total subjects (n=100) was 7.84±2.0 with a range of 4.8-15.1%. The mean serum HbA1c concentration in group-1 subjects was 5.9±0.587% with a range of 4.8-6.9%, in group-2 subjects was 7.44±0. 304% with a range of 7.0-7.9%, in group-3 subjects was 9.55±1.52% with a range of 8.1-15.1%. Statistically significant difference (p=.001) was observed on serum HbA1c values in between the groups of subjects. Glycemic control was not satisfactory of these diabetic patients. Awareness and motivation through counseling and identifying certain factors influencing glycemic control might be able to overcome this situation.TAJ 2014; 27(2): 33-35
Association between Serum-Ascites Albumin Gradient and Esophageal Varices in Patients of Cirrhotic Ascites
Authors: Alam SM , Huda MN , Nurul MN , I Towfiq , Haque MZ , Sarker A , Sarder AH
Published: November 2018

Background: Serum-Ascitic Albumin Gradient (SAAG) can identify ascites related to portal hypertension. Esophageal varix (EV) is another feature of portal hypertension in cirrhosis. This study was done to find out the relation between SAAG and esophageal varices.Materials and methods: It was a cross- sectional descriptive study of 50 cases of cirrhotic ascites. SAAG was measured and upper gastrointestinal endoscopy was done for esophageal varices.Results: Among 50 cases, mean SAAG value 1.77 (±0.45 SD). Esophageal varices were found in 43(86%) cases. All cases with SAAG value >2.0gm/dl had EV. A significant statistical association was found between level of SAAG and the presence of esophageal varices (p=0.01).Conclusion: In patients of cirrhosis, the level of SAAG has positive association with the esophageal varices. This finding may permit us to use SAAG as a preliminary parameter of esophageal varices (EV) especially where endoscopy facilities are not available.TAJ 2014; 27(2): 36-38
Psychoanalysis under Occupation: Nonviolence and Dialogue Initiatives as a Psychic Extension of the Closure System
Authors: Sheehi Stephen
Published: November 2018

This article examines how ‘dialogue initiatives’ function as the psychic extension of Israel's Apartheid closure system and as an act of ‘extractive introjection.’ The article pays particular critical attention to the political and psychological fallacies offered by the theoretical concept (or phantasy) of ‘third space,’ which purportedly provides a possibility for ‘co-created’ space that extricates victim and victimized from their binary relationship. Rather, the author proposes that ‘third space’ facilitates Israelis’ theft of Palestinian individual and collective psychic life. In response, the author posits that sumud, or acts of refusal and ‘stalwartness,’ functions as a psychological means of defending against these assaults within the dehumanizing spatial, material, and social realities of Israel's closure system in the West Bank and Gaza.
Jihad on the Couch
Authors: Gana Nouri
Published: November 2018

In his most recent book, entitled Un Furieux désir de sacrifice. Le surmusulman (A Furious Desire for Sacrifice: The Super Muslim), Benslama sets himself the task of laying down on the psychoanalytic couch the jihadi figure he calls ‘le surmusulman,’ which literally means a sort of super- or Über-Muslim. In this essay, I shall not pursue a symptomatic reading of Benslama's symptomatic reading of the surmusulman, but will focus my tentative reading of his diagnostic appraisal on the psycho-affective dynamics of melancholia and jouissance – two concepts that are mentioned in passing (and are almost taken for granted by Benslama), but that seem to me to anchor the furious desire for sacrifice that is said to characterize the surmusulman. I conclude by engaging with Benslama's conception in Psychoanalysis and the Challenge of Islam of an alternative form of subjectivity (I dub l'altermusulman) that is paradoxically the product and harbinger of secular modernity, and that may need, in the final analysis, to be laid as well on the psychoanalytic couch, something Benslama hardly ponders.
Computer-Aided Analysis of Gland-Like Subsurface Hyposcattering Structures in Barrett’s Esophagus Using Optical Coherence Tomography
Authors: Wang Zhao , Lee Hsiang-Chieh , Ahsen Osman O. , Liang Kaicheng , Figueiredo Marisa , Huang Qin , Fujimoto James G. , Mashimo Hiroshi
Published: November 2018

(1) Background: Barrett’s esophagus (BE) is a complication of chronic gastroesophageal reflux disease and is a precursor to esophageal adenocarcinoma. The clinical implication of subsurface glandular structures of Barrett’s esophagus is not well understood. Optical coherence tomography (OCT), also known as volumetric laser endomicroscopy (VLE), can assess subsurface glandular structures, which appear as subsurface hyposcattering structures (SHSs). The aim of this study is to develop a computer-aided algorithm and apply it to investigate the characteristics of SHSs in BE using clinical VLE data; (2) Methods: SHSs were identified with an initial detection followed by machine learning. Comprehensive SHS characteristics including the number, volume, depth, size and shape were quantified. Clinical VLE datasets collected from 35 patients with a history of dysplasia undergoing BE surveillance were analyzed to study the general SHS distribution and characteristics in BE. A subset of radiofrequency ablation (RFA) patient data were further analyzed to investigate the pre-RFA SHS characteristics and post-RFA treatment response; (3) Results: SHSs in the BE region were significantly shallower, more vertical, less eccentric, and more regular, as compared with squamous SHSs. SHSs in the BE region which became neosquamous epithelium after RFA were shallower than those in the regions that remained BE. Pre-ablation squamous SHSs with higher eccentricity correlated strongly with larger reduction of post-ablation BE length for less elderly patients; (4) Conclusions: The computer algorithm is potentially a valuable tool for studying the roles of SHSs in BE.
Chemoresistance and the Self-Maintaining Tumor Microenvironment
Authors: Yeldag Gulcen , Rice Alistair , Del Río Hernández Armando
Published: November 2018

The progression of cancer is associated with alterations in the tumor microenvironment, including changes in extracellular matrix (ECM) composition, matrix rigidity, hypervascularization, hypoxia, and paracrine factors. One key malignant phenotype of cancer cells is their ability to resist chemotherapeutics, and elements of the ECM can promote chemoresistance in cancer cells through a variety of signaling pathways, inducing changes in gene expression and protein activity that allow resistance. Furthermore, the ECM is maintained as an environment that facilitates chemoresistance, since its constitution modulates the phenotype of cancer-associated cells, which themselves affect the microenvironment. In this review, we discuss how the properties of the tumor microenvironment promote chemoresistance in cancer cells, and the interplay between these external stimuli. We focus on both the response of cancer cells to the external environment, as well as the maintenance of the external environment, and how a chemoresistant phenotype emerges from the complex signaling network present.
Bio-Inspired Fluorine-Free Self-Cleaning Polymer Coatings
Authors: Wasser Lionel , Dalle Vacche Sara , Karasu Feyza , Müller Luca , Castellino Micaela , Vitale Alessandra , Bongiovanni Roberta , Leterrier Yves
Published: November 2018

Bio-inspired fluorine-free and self-cleaning polymer coatings were developed using a combination of self-assembly and UV-printing processes. Nasturtium and lotus leaves were selected as natural template surfaces. A UV-curable acrylate oligomer and three acrylated siloxane comonomers with different molecular weights were used. The spontaneous migration of the comonomers towards the polymer–air interface was found to be faster for comonomers with higher molecular weight, and enabled to create hydrophobic surfaces with a water contact angle (WCA) of 105°. The replication fidelity was limited for the nasturtium surface, due to a lack of replication of the sub-micron features. It was accurate for the lotus leaf surface whose hierarchical texture, comprising micropapillae and sub-micron crystalloids, was well reproduced in the acrylate/comonomer material. The WCA of synthetic replica of lotus increased from 144° to 152° with increasing creep time under pressure to 5 min prior to polymerization. In spite of a water sliding angle above 10°, the synthetic lotus surface was self-cleaning with water droplets when contaminated with hydrophobic pepper particles, provided that the droplets had some kinetic energy.
Application of an Eddy Current-Tuned Mass Damper to Vibration Mitigation of Offshore Wind Turbines
Authors: Lian Jijian , Zhao Yue , Lian Chong , Wang Haijun , Dong Xiaofeng , Jiang Qi , Zhou Huan , Jiang Junni
Published: November 2018

Offshore wind turbine (OWT) structures are highly sensitive to complex ambient excitations, especially extreme winds. To mitigate the vibrations of OWT structures under windstorm or typhoon conditions, a new eddy current with tuned mass damper (EC-TMD) system that combines the advantages of the eddy current damper and the tuned mass damper is proposed to install at the top of them. In the present study, the electromagnetic theory is applied to estimate the damping feature of the eddy current within the EC-TMD system. Then, the effectiveness of the EC-TMD system for vibration mitigation is demonstrated by small-scale tests. Furthermore, the EC-TMD system is used to alleviate structural vibrations of the OWT supported by composite bucket foundations (CBF) under extreme winds at the Xiangshui Wind Farm of China. It is found that the damping of the EC-TMD system can be ideally treated as having linear viscous damping characteristics, which are influenced by the gaps between the permanent magnets and the conductive materials as well as the permanent magnet layouts. Meanwhile, the RMS values of displacements of the OWT structure can be mitigated by 16% to 28%, and the acceleration can also be reduced significantly. Therefore, the excellent vibration-reducing performance of the EC-TMD system is confirmed, which provides meaningful guidance for application in the practical engineering of OWTs.
Phase Balancing Home Energy Management System Using Model Predictive Control
Authors: Rao Bharath Varsh , Kupzog Friederich , Kozek Martin
Published: November 2018

Most typical distribution networks are unbalanced due to unequal loading on each of the three phases and untransposed lines. In this paper, models and methods which can handle three-phase unbalanced scenarios are developed. The authors present a novel three-phase home energy management system to control both active and reactive power to provide per-phase optimization. Simplified single-phase algorithms are not sufficient to capture all the complexities a three-phase unbalance system poses. Distributed generators such as photo-voltaic systems, wind generators, and loads such as household electric and thermal demand connected to these networks directly depend on external factors such as weather, ambient temperature, and irradiation. They are also time dependent, containing daily, weekly, and seasonal cycles. Economic and phase-balanced operation of such generators and loads is very important to improve energy efficiency and maximize benefit while respecting consumer needs. Since homes and buildings are expected to consume a large share of electrical energy of a country, they are the ideal candidate to help solve these issues. The method developed will include typical distributed generation, loads, and various smart home models which were constructed using realistic models representing typical homes in Austria. A control scheme is provided which uses model predictive control with multi-objective mixed-integer quadratic programming to maximize self-consumption, user comfort and grid support.
Origin of Knickpoints in an Alpine Context Subject to Different Perturbing Factors, Stura Valley, Maritime Alps (North-Western Italy)
Authors: Marrucci Monica , Zeilinger Gerold , Ribolini Adriano , Schwanghart Wolfgang
Published: November 2018

Natural catchments are likely to show the existence of knickpoints in their river networks. The origin and genesis of the knickpoints can be manifold, considering that the present morphology is the result of the interactions of different factors such as tectonic movements, quaternary glaciations, river captures, variable lithology, and base-level changes. We analyzed the longitudinal profiles of the river channels in the Stura di Demonte Valley (Maritime Alps) to identify the knickpoints of such an alpine setting and to characterize their origins. The distribution and the geometry of stream profiles were used to identify the possible causes of the changes in stream gradients and to define zones with genetically linked knickpoints. Knickpoints are key geomorphological features for reconstructing the evolution of fluvial dissected basins, when the different perturbing factors affecting the ideally graded fluvial system have been detected. This study shows that even in a regionally small area, perturbations of river profiles are caused by multiple factors. Thus, attributing (automatically)-extracted knickpoints solely to one factor, can potentially lead to incomplete interpretations of catchment evolution.
Association between Problematic Internet Use and Sleep Disturbance among Adolescents: The Role of the Child’s Sex
Authors: Yang Jiewen , Guo Yangfeng , Du Xueying , Jiang Yi , Wang Wanxin , Xiao Di , Wang Tian , Lu Ciyong , Guo Lan
Published: November 2018

Use of the Internet has become an integral part of daily life. Adolescents are especially at a higher risk of developing problematic Internet use (PIU). Although one of the most well-known comorbid conditions of PIU is sleep disturbance, little is known about the sex disparity in this association. This school-based survey in students of grades 7–9 was conducted to estimate the prevalence of PIU and sleep disturbance among Chinese adolescents, to test the association between PIU and sleep disturbance, and to investigate the role of the child’s sex in this association. A two-stage stratified cluster sampling method was used to recruit participants, and two-level logistic regression models were fitted. The mean Internet addiction test score was 37.2 (SD: 13.2), and 15.5% (736) met the criteria for PIU. After adjusting for control variables, problematic Internet users were at a higher risk of sleep disturbance (adjusted odds ratio = 2.41, 95% confidence interval (CI) = 2.07–3.19). Sex-stratified analyses also demonstrated that association was greater in girls than boys. In this respect, paying more attention to the sleep patterns of adolescents who report excessive Internet use is recommended, and this early identification may be of practical importance for schools, parents, and adolescents themselves.
Social Network Analysis of Factors Influencing Green Building Development in China
Authors: Huang Ning , Bai Libiao , Wang Hailing , Du Qiang , Shao Long , Li Jingtao
Published: November 2018

Green buildings have been viewed as one of the most effective solutions to the negative environmental impacts of construction activities. For the sustainable development of the economy and the environment, many governments in the world have launched a variety of policies to encourage the development of green buildings. However, green targets achieved during the operational stage of green buildings are far below the expectations from the design stage. In addition, the development of green buildings is unevenly distributed in different cities. To help resolve these issues, this paper identifies 28 green building influencing factors from two perspectives, the life cycle and stakeholders. Then, a social network analysis is used to analyse their interactions and identify the critical factors. Our results show that government supervision, incremental cost, property management experience, and the awareness of environmental protection in green buildings are the critical influencing factors in promoting green building development. However, some factors related to contractors, designers and suppliers are not as important as perceived. Finally, some policy recommendations are proposed to promote green buildings in China.