bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Profile and Molecular Genetic Analysis of Prader - Willi Syndrome
Authors: Sridhar Subbiah , Nazirudeen Roshan , Ramasamy Suresh , Natarajan Vasanthiy , Thiagarajan Kumanan , Karthika Lakshmanan Nivethitha
Published: August 2024

Aim:

The prevalence of childhood and adolescent obesity is increasing worldwide as well as in India. Prader–-Willi syndrome (PWS) is one of the most common causes of syndromic obesity with varied clinical manifestations across different lifespan. Herewith, we describe clinical and molecular characteristics of eight PWS who were diagnosed in an obesity clinic of tertiary care hospital.

Materials and Methods:

Clinically suspected cases of PWS were screened between January 2014 and January 2022. Detailed history and clinical examination were done to look for typical features of PWS like characteristic facial appearance, short stature, obesity, hyperphagia, delayed puberty or hypogonadism, diabetes mellitus, developmental delay, cognitive dysfunction, learning disabilities or abnormal behavior. All were evaluated, with 75 g oral glucose tolerance tests (GTT), HbA1c, Free T4, TSH, LH, FSH, testosterone, and growth hormone level. Intelligent quotient (IQ) of each patient was assessed by a psychiatrist using Binet–Kamat test. Molecular confirmation of clinically suspected PWS was done by either Methylation-specific polymerase chain reaction (MS-PCR) or Fluorescence in situ Hybridization (FISH) methods.

Results:

Based on clinical and molecular characteristics, eight were diagnosed as PWS. Except one, all were male with characteristic facies, mean age of study cohort was 12 years and mean BMI of 44.58. Obesity, short stature, hyperphagia, hypotonia, and mild to moderate mental retardation were noted in entire (100%) PWS study population. All male PWS patients had cryptorchidism, which was bilateral in six patients and unilateral (right undescended testes) in one. Apart from obesity, short stature, other endocrine associations noted were diabetes mellitus in 50% and subclinical hypothyroidism in 37% of PWS. Molecular characteristics of PWS were confirmed by Methylation-specific PCR in seven and by FISH method in one.

Conclusion:

Prader–Willi syndrome should be kept in mind in case of childhood or adolescent obesity with short stature, hypotonia, cryptorchidism, and developmental delay or cognitive dysfunction. Judicious use of molecular diagnostic testing should be made in all clinically suspected cases. Early diagnosis and appropriate management of this complex disorder by a multidisciplinary team will improve the quality of life and treatment outcome.
Variability in Sex Assignment at Birth and Etiological Diagnosis of Differences of Sex Development: A Ten-Year Institutional Experience from Assam
Authors: Nagarajaiah Praveen , Bhuyan Ashok K. , Baro Abhamoni , Saikia Uma K.
Published: August 2024

Introduction:

Differences of sex development (DSD) also known as disorders of sex development encompass a wide spectrum of conditions with varying clinical presentations across different age groups. This study aims to analyse various aetiologies of DSD in Assam and the variability of sex assignment at birth.

Methods:

This retrospective study included the records of people with DSD presenting to a tertiary centre over 10 years. The age at presentation, sex assignment, gender identity, degree of ambiguity, pertinent hormonal and radiological investigations were noted. Descriptive statistics were used for analysis.

Results:

The age of presentation varied widely, with peaks during infancy and puberty. The most prevalent DSD type was 46, XY DSD (61.2%), followed by 46, XX DSD (19.7%) and sex chromosome DSD (19.1%). Among people with 46, XY DSD, androgen biosynthesis disorders were dominant, particularly 5-a reductase 2 deficiency (46.7%). Among 46, XX DSDs, the most common subtype was androgen excess disorders (51.7%) comprising 21a-hydroxylase deficiency (48,3%) and 11β-hydroxylase deficiency (3.4%). Turner syndrome was most prevalent among sex chromosome DSD (71.4%) with others being Klinefelter syndrome, 45, XO/46, XY mixed gonadal dysgenesis and 46, XX/46, XY chimerism. The degree of ambiguity was variable depending on the type of DSD and similarly, sex assignment at birth was influenced by the level of ambiguity.

Conclusion:

The study underscores the significance of comprehensive approaches for DSD diagnosis and management, especially in regions with limited resources. The insights gained from this clinical study offer valuable understanding and aid in addressing the complexities associated with these conditions.
Botulinum toxin A as a treatment modality for acute acquired comitant esotropia – An Indian perspective
Authors: Badakere Akshay , Badrinath Vibha , Dhillon Hennaav Kaur , Valliappan Abinaya , Natarajan Viswanathan , Agarkar Sumita
Published: August 2024

Purpose:

To analyze the outcomes of botulinum toxin A injection in acute acquired comitant esotropia (AACE).

Methods:

This is a retrospective study that included cases diagnosed as AACE between January 2022 and February 2023. Patients who were treated with Botox and completed a minimum 3 months follow-up were included in the study. All the patients underwent a complete ophthalmic, orthoptic examination and neuroimaging. The effects of age, onset of esotropia, screen time, deviation pre injection, mode of injection (transconjunctival/ open sky) and whether injection was administered in one/both eyes on successful outcome were analysed.

Results:

Twenty-seven patients (20 male, seven female) were included in the study. The median age was 10 years. The median deviation for distance and near preinjection was 35 and 40 prism diopters, respectively. Complete resolution of symptoms was noted in 18 patients (66.6%). Four patients needed prisms, two required repeat injections, and one each needed surgery and divergence therapy. Six patients developed ptosis. None of the risk factors seemed to affect outcomes.

Conclusion:

Botulinum toxin injected into the medial rectus is a safe and viable option for AACE. Preinjection counseling about ptosis, recurrence needing prisms, reinjection, or surgery is important.
A case of coronary dissection complicating intravascular lithotripsy
Authors: Natarajan Deepak
Published: August 2024

A middle-aged male suffering from diabetes developed severe coronary artery dissection soon after 40 pulses of intravascular lithotripsy (IVL) with a 2.5 mm × 12 mm balloon inflated at 4–6 atmospheres. The patient developed chest discomfort accompanied by bradycardia. The dissection was successfully promptly treated with the insertion of a 2.75 mm × 18 mm everolimus-eluting stent. Coronary dissection following IVL, although uncommon, is not rare, and therefore, the operator should look out for this complication.
Primary testicular lymphoma: A case report
Authors: Roy Sharmistha , Soni Tej Prakash , Sharma Upendra , Sharma Anjali
Published: August 2024

Primary testicular lymphoma is a rare and aggressive form of extranodal non-Hodgkin lymphoma. It has a predilection for relapse at sanctuary sites such as the contralateral testis and central nervous system. Herein, we present a case of primary testicular lymphoma in a 62-year-old man.
Validation of the Scrub Typhus Encephalitis Assessment Tool for the Management of Acute Encephalitis Syndrome
Authors: Rath Rama Shankar , Abdulkader Rizwan S. , Srivastava Neha , Deval Hirawati , Gupta Urmila , Sharma Bhoopendra , Mittal Mahim , Singh Vijay , Kumar Manish , Kharya Pradip , Gupta Nivedita , Kant Rajni , Murhekar Manoj , Mittal Mahima
Published: August 2024

Introduction:

Acute encephalitis syndrome (AES) is one of the important causes of mortality among children in India. Active management of the cases, followed by addressing the cause of AES, is the key strategy for preventing mortality. Lack of laboratory facility and difficulty of sampling blood and cerebrospinal fluid (CSF) for assessing causes is one of the important barriers to early initiation of treatment. The main objective of the study is to validate the Scrub Typhus Encephalitis Assessment Tool (SEAT) for the management of AES.

Methods:

The study is a continuation of a study conducted in a tertiary care hospital in Eastern Uttar Pradesh. A machine learning (LightGBM) model was built to predict the probability of scrub typhus diagnosis among patients with acute encephalitis. Three models were built: one with sociodemographic characters, the second with Model 1 variables and blood parameters, and the third with Model 2 variables and CSF parameters.

Results:

The sensitivity of diagnosing the scrub typhus case was 71%, 77.5%, and 83% in Model 1, Model 2, and Model 3, respectively, and specificity was 61.5%, 75.5%, and 76.3%, respectively, in the models. In Model 1 fever duration, in Models 2 and 3, neutrophil/lymphocyte ratio was the most important predictor for differentiating the scrub and nonscrub cases.

Conclusion:

With the available sensitivity and specificity of the tool, the SEAT can be a valuable tool for the prediction of scrub typhus as a cause of AES cases in remote areas.
Is Virtual Reality Effective in Decreasing Pain during Clinical Procedures among Children: A Systematic Review and Meta-analysis
Authors: Priyadarshini Saundarya , Agarwala Sandeep , Priya Harsh , Jain Vishesh , Goel Prabudh , Dhua Anjan Kumar , Yadav Devendra Kumar , Anand Sachit , Patel Nishant
Published: August 2024

ABSTRACT

Background:

Virtual reality (VR) refers to a computer-generated simulation or environment that can be experienced and interacted with by a person through special electronic equipment, such as a headset with a screen and motion-tracking sensors. VR has been used as a distraction technique to alleviate pain and discomfort during medical procedures or as an alternative to traditional pain medication. This article explores VR’s effectiveness in reducing pain in pediatric patients undergoing painful clinical procedures.

Methodology:

This systematic review and meta-analysis was performed as per the preferred reporting item for systematic review and meta-analysis guidelines. A systematic literature search was conducted for all articles published till December 2022 in four different databases: PubMed, Scopus, Embase, and LILACS, which yielded 6886 studies. Studies showing the effect of VR on pediatric patients undergoing clinical procedures were included in the study. Risk of bias (ROB) 2.0 was used to assess the ROB. Outcome data were pooled using a random-effects model and reported as standardized mean difference (SMD) with a 95% confidence interval (CI). The meta-analysis was performed on RevMan5.4. Subgroup analysis was done for the different clinical procedures.

Results:

A total of 2477 participants from 34 studies were included in the meta-analysis. Children in whom VR was used had a significantly lower pain score as compared to the control group with an SMD of 0.87 (CI 95% −1.20, −0.53; (P < 0.00001). Subgroup analysis based on the type of intervention did not reveal any significant difference (P = 0.19). Heterogeneity for overall pain using a random effect model with I
2 was significant (P < 0.00001).

Conclusion:

This systematic review suggests that the use of VR distraction in children undergoing painful procedures is associated with significantly lower pain scores. Hence, VR can be a promising intervention for reducing pain experienced by pediatric patients during medical procedures.
Solitary Hybrid Neurofibroma–Schwannoma of the Brachial Plexus in a 4-Year-Old Child
Authors: Maddileti Varunkumar
Published: August 2024

ABSTRACT

We report the case of a 4-year-old child with a rare solitary neurofibroma–schwannoma hybrid tumor in the brachial plexus, not associated with known syndromes. Surgical management through a transclavicular approach enabled complete tumor excision with favorable postoperative outcomes. Histopathology and immunohistochemistry confirmed the tumor’s hybrid nature.
Unusual Airway Foreign Bodies in Children: Demographics and Management
Authors: Bose Sumona , Shubha Attibele Mahadevaiah
Published: August 2024

ABSTRACT

Aim:

The aim is to study the demographics and management of unusual airway foreign bodies (UAFBs) in children.

Materials and Methods:

A retrospective observational study (2000–2020) of children with UAFBs, who underwent bronchoscopic removal. The demographics, types of foreign bodies, clinical and radiological features, management, and outcomes were collated and analyzed. Common foreign bodies, such as nuts, seeds, and vegetable aspirations, were excluded.

Results:

Among 531 children who had bronchoscopic retrieval of airway foreign bodies, 74 (59 males/15 females) had unusual foreign bodies. These included pen caps, whistles, plastic objects, pins, coal piece, stones, clay, pencil, gold ornament, and glass bangle. Thirty-one children presented within 1 day of aspiration, 37 within 1 month and 6 till 6 months. Thirty-nine were below 5 years, and the rest were between 5 and 15 years. Cough, respiratory distress, fever, choking, and noisy breathing were common presentations. Others are stridor, whistling, cyanosis, loss, and change of voice. Chest X-ray showed ipsilateral hyperinflation (23), haziness (21), radio-opaque foreign body (17) and was normal in 14. The left main bronchus, followed by the right main bronchus and trachea, were the sites of impaction. Four children required additional procedures (tracheotomy and thoracotomy). There was one mortality in the study cohort.

Conclusion:

Aspiration of unusual foreign bodies is not uncommon in children. Most aspirations are witnessed and predominant in boys. The left bronchus is the common site of impaction, and X-ray clinches the diagnosis. Presentation is delayed, and bronchoscopic retrieval, though challenging, has favorable outcome.
Accuracy of the Mincer Method for Dental Age Estimation in a Honduran Population
Authors: Cáceres-Vásquez Irma Yesenia , Palomino-Soto Mirna Mayra , Carranza-Samanez Kilder Maynor , Dulanto-Vargas Julissa Amparo
Published: August 2024

Aim:

This study aims to determine the accuracy of the Mincer method for estimating dental age (DA) using digital panoramic radiographs (PR) in a Honduran population aged 14–22 years.

Materials and Methods:

This observational, cross-sectional, retrospective study was applied in a sample of 134 digital PR from a private dental center in Comayagua (72 females and 62 males; mean age 18 ± 3 years). A calibrated observer (kappa ≥0.83) analyzed DA with the Demirjian and Mincer method in all third molars (3M) from stage D (complete crown) to H (apex closure) differentiating by sex. The decimal DA of each individual was calculated from the average of the four 3M. Estimation of chronological age (CA) according to the Mincer method was obtained with linear regression formulas.

Results:

The results revealed that the mean and standard error of the difference between CA and DA was 0.58 ± 0.13 years (male 0.5 ± 0.19 and female 0.65 ± 0.19). Age groups showed higher overestimation (>1.1) from 14 to 17 years (50%–100%), agreement (±1.1 years) at 18 years (66.7%–70%), and underestimation (<–1.1) from 21 and 22 years (42.9%–100%; P = 0.000). The prediction equations of CA according to DA were statistically significant (P = 0.000) explaining 66.5% of the total sample (error = 1.465), 84.5% in males (error = 1.367), and 79.3% in females (error = 1.548).

Conclusion:

This study concludes that the Mincer method obtained a reasonable prediction to estimate the age of the majority with improvement in the adjustments with the age estimation formula in a specific population in Comayagua, Honduras.
Electrochemical Dissolution of Stainless-Steel Files using Different Electrolytes: An in vitro Electrochemical Study
Authors: Shah Tanvi , Solete Pradeep , Sugumaran Surendar
Published: August 2024

Aim:

To evaluate the effectiveness of electrochemical dissolution of stainless-steel #15 K-files in various irrigating solutions as well as their dissolution time.

Materials and Methods:

Twenty Dentsply Maillefer single-rooted endoblocks were used. A glide path was made up to a #15 K-file, and then, a ProTaper gold rotary instrument was used for preparation up to S1. Platinum wire electrodes, connecting wires, and a 9 V battery were used to form a circuit. Saline, 3% sodium hypochlorite, 17% EDTA liquid, and acidified hydrogen peroxide (HCl 10 g/L + H2O2 100 g/L) were all used to submerge the endoblocks. The samples were assessed for dissolution time using a stopwatch, and electrochemical studies were performed for corrosion analysis of different irrigants.

Results:

The fastest dissolution of the files was observed with sodium hypochlorite (2 min 47 s), followed by acidified hydrogen peroxide (9 min 36 s). The presence of chloride ions in electrolyte solutions has been shown to be a factor directly affecting the rate of dissolution. EDTA demonstrated resilience to corrosion. The electrochemical studies confirmed a corrosion affinity with NaOCl and acidified hydrogen peroxide.

Conclusion:

The best solutions for dissolving stainless-steel K-files are sodium hypochlorite and acidified hydrogen peroxide. For clinical application and assessment of soft tissue effects, more studies are required. Although electrochemical dissolution has potential, it needs to be further studied before it can be used in therapeutic settings.
Evaluation of Burnout among Medical Officers and Dental Surgeons in State Health Services using Maslach’s Burnout Inventory during COVID-19: A Cross Sectional Study
Authors: Sabbarwal Bhavna , Phogat Ritu , Goel Shubhi , Bhargava Abhinav , Kumar Adarsh
Published: August 2024

Abstract

Introduction:

The Coronavirus disease 2019 (COVID-19) pandemic became a worldwide public health crisis. It leads to raised levels of burnout and anxiety among the people of the medical and dental fraternity, especially those involved in various duties related to COVID-19. The present research focused on evaluating the prevalence and predictors of burnout among medical officers and dental surgeons in Haryana’s state dental health services.

Materials and Methods:

A cross-sectional study was conducted to assess burnout among medical officers and dental surgeons involved in COVID-19-related duties in state health services. Maslach’s burnout scale was used to evaluate burnout. It is a prevalidated and self-administered questionnaire with three domains, that is, emotional exhaustion (EE), personal accomplishment (PA) assessment, and depersonalization (DP). The Chi square test, Student’s t test (unpaired), and analysis of variance (ANOVA) with post hoc analysis were done wherever applicable. Pearson’s correlation analysis was used to check the relationship among EE, DP, and PA.

Results:

A total of 200 study participants responded to the online survey. Nearly half of them (51%) were aged 25–34 years. The majority had service experience of up to 20 years (90%). Almost three-fourths (72%) of study participants performed duties for >8 h a day. Up to 86% reported that the second wave of COVID-19 caused increased burnout. Moderate-to-high degrees of occupational exhaustion (OE) and DP were reported among approximately 42% of study participants. Medical officers were reported to have statistically significantly higher levels of burnout compared to dental surgeons (P < 0.05).

Conclusion:

Moderate levels of burnout were reported among half of the study participants, suggestive of the need to address the issues related to mental health of healthcare providers.
Surface Roughness Examination of Glass Ionomer Restorative Cements Treated with Acidic and Basic Pediatric Medications: An In Vitro Study
Authors: Hasan Zainab R. , Al-Hasani Noor R. , Ibrahim Ali I.
Published: August 2024

Abstract

Background:

Consumption of different types of beverages and liquid drugs can affect of the surface properties of restorative material. This may lead to an increased probability of dental caries and periodontal inflammation.

Aim:

This study evaluated and compared the effect of amoxicillin suspension (AMS) and azithromycin suspension (AZS) on the surface roughness (SR) of silver-reinforced glass ionomer (SGI) and nano resin-modified glass ionomer (NGI).

Material and Methods:

Thirty disks (2 mm height × 4 mm diameter) of each glass ionomer (GI) type were prepared and subdivided into three groups (n = 10), which were separately exposed to AMS, AZS, and artificial saliva (AS). SR was evaluated by atomic force microscopy before and after three-immersion protocols repeated over a 3-week duration with 2-day intervals. In each protocol, the GI samples were exposed weekly to AMS three times daily, AZS once daily, and a full day to AS.

Results:

This study demonstrated, for the first time, the effect of a basic drug (AZS) on the SR of GIs. Intra- and inter-group comparisons showed significant changes (P ˂ 0.05) in the SR pattern of the GIs after immersion cycles in AZS, AMS, and AS. However, the acidic medication (AMS) exhibited significantly higher changes in SGI than in NGI.

Conclusions:

The SR of NGIs and SGIs can be significantly affected by the use of AMS and AZS suspensions. SGI demonstrated higher SR deterioration than NGI after immersion cycles in AMS.
Uterine Artery Pseudoaneurysm after Total Abdominal Hysterectomy Managed by Ultrasound-guided Percutaneous Glue Injection
Authors: Devi Yangala Sudha , Patel Ranjan Kumar , Tripathy Tara Prasad , Jena Saubhagya
Published: August 2024

Uterine artery pseudoaneurysm (UAP) following abdominal hysterectomy is an uncommon complication. However, it can cause life-threatening bleeding, necessitating early diagnosis and intervention. Imaging is vital in its prompt diagnosis and aids in planning interventions. Here, we describe a case of recurrent massive per-vaginal bleeding from a left UAP developed following total abdominal hysterectomy and bilateral salpingo-oophorectomy. Bleeding was successfully managed with percutaneous ultrasound-guided glue (N-butyl cyanoacrylate) injection into the aneurysmal sac. The patient is doing well without any recurrent bleeding.
Dissimilar Planes and Approaches with Common Neural Targets – A Cadaveric Evaluation of Three Different Ultrasound-guided Fascial Plane Blocks for Lumbar Plexus Nerves
Authors: Diwan Sandeep , Feigl Georg , Shivaprakash S. , Areti Archana
Published: August 2024

Background:

The lumbar plexus (LP) is a group of nerves located at the fourth lumbar vertebra level, between the anterior two-thirds and posterior one-thirds of the psoas muscle. In this study, the researchers aimed to investigate the spread of latex in injections of LP, suprainguinal fascia iliaca, and circum-psoas planes to assess the different regional techniques for blocking LP nerves (LPNs).

Methods:

The study involved performing ultrasound-guided injections of three different colored latexes in six cadavers. The researchers observed and compared the spread of latex in each plane by taking cross sections at the levels of L4, anterior superior iliac spine (ASIS), and sacral foramina (SF). The spread of latex and LPN staining was documented and analyzed through photography.

Results:

The results showed that the latex spread within the psoas muscle and fascia iliaca plane (FIP) during LP injections, whereas suprainguinal fascia iliaca injections showed latex dissemination in the FIP at both ASIS and SF levels. On the other hand, circum-psoas injections spread beneath the iliopsoas fascia at both levels and medially toward the external iliac vessels. Despite this spread, there was no communication between the three planes, and there was no mixing of latex from the different injections at any level.

Conclusion:

There are distinct fascial planes, for the three approaches, with no communication between them. While latex diffused from LP plane to FIP, no mixing of dye was observed and also the reverse could not be achieved. These findings suggest that different regional techniques for blocking LPNs have their unique planes of action.
Restoration of Radiosensitivity by Soya Isoflavone Genistein is Accomplished by Facilitating DNA Damage Response in Radioresistant Cervical Cancer in vitro
Authors: Salini Das , Debanjan Thakur , Debomita Sengupta , Sutapa Mukherjee
Published: August 2024

ABSTRACT

Context:

Enhancing radiotherapeutic efficacy in tumor cells and sparing the normal tissues are major clinical concerns for the betterment of cancer therapy. Genistein (GEN) being a radiosensitizer ameliorates the effectiveness of radiation-induced cell killing by inducing DNA damage. This molecule is accountable for minimizing radiation-related toxicity and protecting healthy cells. However, the explicit mechanism of action of such molecules needs exploration.

Aims:

The objective of this study is to investigate the mechanistic action of GEN in cervical cancer cell radiosensitization.

Settings and Design:

Cervical squamous carcinoma cell SiHa and a radioresistant subline SiHa/RR (developed and isolated from SiHa) were taken for this study. The experiments were performed by pretreating the cells with IC30 dose of GEN, followed by acute irradiation to detect the impact of GEN in imparting radiosensitivity.

Subjects and Methods:

Optimal dose selection of GEN was performed by MTT assay, and radiosensitizing potency was determined by pretreating the cells with IC30 dose of GEN, followed by challenging with acute incremental doses of radiation. Mechanistic parameters were checked by clonogenic assay, cell cycle analysis, DNA damage estimation, apoptosis, and wound healing-sphere-forming assay.

Statistical Analysis Used:

Statistical analysis was performed in GraphPad software by performing the Student’s t-test.

Results:

Results depicted decreased numbers of colonies, increased frequency of DNA damage and apoptotic cells, and suppressed wound healing ability along with restrained sphere-forming ability upon the intervention of cells with GEN before radiation exposure. Such observations implied that GEN pretreatment renders improved radiosensitivity in cervical cancer by increased DNA damage-mediated G2/M arrest with subsequent apoptosis.

Conclusions:

GEN by inducing DNA damage stimulates radiation-induced cell killing in vitro.
Establishing a safe pediatric surgery day unit: Process, procedures, and performance
Authors: Afaneh Osama , Almazrouei Ghanaym , Sajid Sofia , Abraham Lisa , Carasi Brian , Estandarte Jan , Jones Niall
Published: August 2024

Background:

Ambulatory surgery for babies and infants is commonly practiced worldwide. There are no reports on this special service from the UAE. A Pediatric Surgery Day Unit (PSDU) has been in operation at Danat Al Emarat Hospital Women and Children since the hospital opened in 2016.

Objective:

To describe the day-to-day structure and functioning of the PSDU, the technical aspects of the four main procedures delivered (Circumcision, Release of Tongue Tie, Excision of Umbilical Granuloma, and Excision of Accessory Digits) and the outcomes for the babies.

Materials and Methods:

The hospital’s Health Information System was interrogated for the relevant diagnostic and procedural codes for all babies operated between January 1st, 2016, and December 31st, 2019. Data were analyzed for basic demographics, biostatistics, procedures performed, and follow-up encounters.

Results:

The PSDU has a core team, including a coordinator/scheduler, one practical nurse, two staff nurses, and two surgeons. Up to 10 sessions are offered per week, and out-of-hours cover is provided for emergencies or advice on a 24/7 basis. A total of 5262 medical records were examined and data on 3891 procedures for 3801 babies were analyzed. Babies of 68 nationalities were operated and 65% were local Emirati. Circumcision was performed at a median age of 16 days and a weight of 3.5 kg. Bleeding occurred in 1.4% and retention of the ring occurred in 1%. Significant factors associated with bleeding are age, weight, and ring size. There is no difference in bleeding rates between surgeons. There is a learning curve for the technique. Retention of the ring on the glans is associated with the size of ring chosen and retention rates vary significantly between surgeons. The remaining procedures were performed without complication, giving an overall adverse event rate of 2.75%.

Conclusion:

A well-structured and consistently staffed PSDU results in a safe and effective service.
Analysis of Income Tax Revenue After Application of Single Tariff on Income Tax Payable and Its Contribution to Tax Revenue
Authors: Noviyanti Noviyanti , Husni Mohamad
Published: August 2024

The purpose of this study is to analyze the tax revenue of 2013, 2015 and 2017 that did not reach the target of tax revenue and know its contribution to tax revenue for APBN and know the amount of tax payable or tax expense paid after the application of 25% single rate to the corporate taxpayer. This research method is qualitative research method by using secondary data of tang come from financial report of the manufacturing company of chemical sub-sector from Indonesia Stock Exchange (IDX). Percentage of tax target achievement that did not meet the target in 2013, 2015 and 2017 caused by several things. The tax deductions paid due to several things typically occur due to fixed and time differences in the financial statements
The Implementation of Total Quality Management with Fishbone Method in PT. Kaliaren Jaya Plywood
Authors: Kriswanto Kriswanto , Yusuf Ayus Ahmad
Published: August 2024

The problem in this study is the Expansion of Total Quality Management with the Fishbone Method at PT. Kaliaren Jaya Plywood. Implementation of Total Quality Management by using the Fishbone method at PT. Kaliaren Jaya Plywood, obstacles faced in implementing Total Quality Management by using the Fishbone method at PT. Kaliaren Jaya Plywood, the efforts made in overcoming barriers in the Implementation of Total Quality Management by using the Fishbone method at PT. Kaliaren Jaya Plywood. The study results are: In the application of Total Quality Management using the Fishbone method at PT. Kaliaren Jaya Plywood has been very well such that production is the main thing in implementing company activities. Quality is the primary concern of both the product and its management. Continuous improvement to improve company performance. The obstacles encountered from the implementation of Total Quality Management by using the Fishbone method at PT. Kaliaren Jaya Plywood, namely: Lack of attention from production equipment which is still inadequate. Then the placement of production materials is still not following operational standards that have been previously determined. The effort felt by PT. Kaliaren Jaya Plywood is thought because the implementation of Total Quality Management is beneficial in the performance of company activities, especially for: Production must be further optimized so that the company becomes more advanced so that it can extend business cooperation with other companies. The company can optimize the performance of all departments to provide the best quality and increase the company's competitiveness. The research method used is qualitative. Whereby interviewing the president, director, head of the production, and employees. The research results using the fishbone method show that the implementation of total quality management is the main thing for companies and employees
The Role of Motivation and Work Discipline on Employee Performance in the Operator Section At PT. Sigma Mitra Sejati Cilegon
Authors: Saleh Muhammad , Sunardi Sunardi , Hartoko Gatot , Shella Nurul , Listiawati Listiawati
Published: August 2024

This study aims to determine the role of motivation and work discipline on the performance of production operator employees at PT. Sigma Mitra Sejati Cilegon City. The method used in this research is the associative descriptive method. Data analysis techniques used include Normality Test, Classical Assumption Test, Determination Test and Hypothesis Testing. This study indicates that motivation has a significant effect on performance, work discipline has a substantial impact on performance, and motivation and work discipline substantially impact performance
The Effect of Services and Prices On Customer Satisfaction
Authors: Asfar Andi Hasryningsih , Suripto Puji
Published: August 2024

The orientation of the marketing world has changed from profit orientation to satisfaction orientation. Many companies implement strategies to improve service quality, increase customer satisfaction, and win the competition to increase profits. The researcher tries to prove that there is a positive and significant influence on the quality of service and that it can increase customer satisfaction and increase profits. This research was conducted at PT. Anugrah Argon Medica Branch Serang Banten, from the total population of 200 active customers taken samples from Slovin formula as many as 67 respondents. This researcher uses associative research methods with a quantitative correlational approach. Associative research is a research method. Based on the results of hypothesis testing that has been carried out, the t-test variable Service Quality (X1) 1.040 <1.997 and significance level of 0.302> 0.005, it turns out that service quality has no significant effect on customer satisfaction. From the results of the variable t-test Price (X2) 5,284> 1,996 and the significance level of 0,000 <0.05, it turns out the price has a positive and significant effect on Customer Satisfaction, the results of the F test results obtained 23,103> 3.14 and the significance level of 0,000 <0.05 turned out to be Service Quality, and Simultaneous prices have a positive and significant influence on customer satisfaction. From the results obtained, the value of R 0.648 while Adjusted R Square has amounted to 0.419 so that it can be concluded that the contribution of service quality and price to the dependent variable customer satisfaction simultaneously is 41.90%
ANALISIS KORELASI ANTARA SUDUT SIMPANGAN DAN WAKTU RATAAN PADA BANDUL FISIS DENGAN LATIN SQUARE DESIGN
Authors: Putri Adellia Purnomo , Sofro A’yunin
Published: August 2024

This study aims to examine the relationship between the angle of deviation and the average time length of a physical pendulum. This study uses primary data, namely practicum report data in a physics laboratory. Data collection was conducted under closed conditions with control variables (shaft length, number of oscillations, and radius of gyration) and dependent variables (angle of deviation and average time). The analysis technique used is a statistical approach technique, namely Latin Square Design analysis. The findings of this study indicate that the variables of deviation angle and average time on the physical pendulum have a strong and unidirectional correlation relationship. This result is evident from the value of F0 > Fcritical and the value of Pr (> P) > 0, 05(significant level) where both of these prove that there is a strong reason to reject H0 which means that there is at least 1 difference in the effect of the angle of deviation on the average time. It shows that the angle of deviation affects the average time of the physical pendulum
PENERAPAN MODEL PEMBELAJARAN TWO STAY TWO STRAY PADA PEMBELAJARAN PERSAMAAN LINEAR DUA VARIABEL SISWA KELAS 8 SMP N 3 MOTOLING TIMUR
Authors: Tewu Vernando , Sumarauw Sylvia Jane Annatje , Wenas John R
Published: August 2024

The two stay two stray learning model is a cooperative learning model that provides opportunities for groups to share knowledge and learning experiences with other groups, where in the group there are group members who stay to share the material obtained and group members who visit other groups to find information about the material obtained in the group. This study was conducted to determine whether using the two stay two stray learning model can improve student learning outcomes, especially in the material of Two Variable Linear Equations. The posttest type experimental design used in this study was posttest only control group design. The sampling technique is simple random sampling (simple random technique). The subjects in this study were class VIIIB students as an experimental class consisting of 22 students and class VIII A students as a control class consisting of 22 students at SMP Negeri 3 Motoling Timur, these two classes were randomly selected. Data were obtained from the learning outcomes of experimental and control class students. With the average learning outcomes of experimental class students 81.046 and the average learning outcomes of control class students 71.27. The data normality test is fulfilled so that the data is normally distributed. In the results of data analysis with a real level of 0.05 obtained 0.100 in the experimental class and 0.999 in the control class. Also obtained the result that the variance is homogeneous
ANALISIS KEMAMPUAN PEMECAHAN MASALAH MATEMATIKA MATERI BANGUN DATAR SISWA KELAS V SEKOLAH DASAR
Authors: Rahayu Salamah Tri , Pramudyanti Pramudyanti , Perdana Ryzal
Published: August 2024

The purpose of this study is to characterize and understand the mathematical problem-solving skills of fifth-grade students at SDN 1 Tanjung Sari, particularly with regard to narrative problems with flat forms. This study employs a qualitative descriptive methodology that focuses on close observation and in-depth examination of the research participants, who are SDN 1 Tanjung Sari fifth-grade pupils. Two primary methods were used in this study to gather data: assessments of students' mathematical problem-solving skills and interviews. The Miles and Huberman Model, which has three primary stages data reduction, data presentation, and conclusion drawing was used to conduct the data analysis. The technique of eliminating extraneous or useless data is known as data reduction. Data presentation is the process of arranging and displaying information in a way that is simple to understand. Drawing conclusions from study results entails analyzing data and drawing judgments. The study's findings indicate that pupils' average proficiency in solving mathematical problems involving flat shapes is 75.78, falling within the middle range. This indicates that although there is still need for development, pupils' grasp of the notion of flat forms is adequate. The study indicated that, when considering learning interest, students' average mathematical problem-solving skill was 87.22 for high learning interest students, 74.85 for moderate learning interest students, and 57.80 for low learning interest students. This demonstrates that students' aptitude for solving mathematical puzzles is greatly influenced by their learning interests. Overall, this study offers significant new information on how learning interests might influence students' ability to solve mathematical problems. Future instructional materials for more efficient learning can be developed using these findings as a foundation
ANALISIS KEMAMPUAN PEMECAHAN MASALAH MATEMATIKA PADA MATERI PERSAMAAN DAN PERTIDAKSAMAAN LINEAR SATU VARIABEL
Authors: Alfiansah Saeful , Sutiarso Sugeng
Published: August 2024

This study was conducted with the primary aim of evaluating and deeply understanding students' abilities in solving mathematical problems, specifically focusing on Linear Equations and Inequalities with One Variable (SPLSV). A qualitative approach was chosen because it allows researchers to delve deeper into students' thought processes and how they approach given mathematical problems. Descriptive analysis was used to interpret data systematically and in detail, enabling researchers to identify specific patterns in test data and interviews. Adab Kesuma Bangsa Junior High School in Natar, South Lampung, was selected as the research site because it was considered representative of the student population being studied. A total of 32 students participated in this study, selected through Purposive Sampling method. The research instruments used included written tests and in-depth interviews. The main indicators focused on in this research were: (1) understanding of the problem, which measured how well students could identify and comprehend key elements of mathematical problems; (2) solution planning, which assessed students' ability to formulate effective strategies or steps to solve problems; (3) solution implementation, which observed to what extent students could apply their plans in practice and achieve correct solutions; and (4) re-evaluation, which evaluated students' ability to reflect on their processes and outcomes, identifying errors or areas for improvement. The research findings indicated that only a small proportion of students (21.5%) demonstrated high problem-solving abilities. Approximately 11.5% were at a moderate level, while the majority of students (67%) exhibited low problem-solving abilities. These findings provide valuable insights for educators and policymakers regarding the need for more effective educational interventions to enhance students' mathematical problem-solving abilities
EFEKTIVITAS MODEL PEMBELAJARAN RELATING, EXPERIENCING, APPLYING, COOPERATING, AND TRANSFERRING (REACT) DENGAN PENDEKATAN MATEMATIKA REALISTIK (PMR) TERHADAP LITERASI MATEMATIKA SISWA
Authors: Maulana Mukhamad Riziq , Mariani Scolastika , Wijayanti Kristina
Published: August 2024

Mathematical literacy is a very important ability that students must have because mathematical literacy supports students' mathematical abilities in many contexts that will be used in everyday life. This research aims to analyze the effectiveness of REACT learning with a realistik mathematics approach (PMR) on students' mathematical literacy. The method used in this research is quasi-experimental research with a pretest-posttest design. The sample used was students of Class IXA and IXB Mts Miftakhul Khoirot Branjang, Ungaran, Semarang Regency. The data used is the results of the mathematics literacy test before learning (pretest) and the results of the mathematics literacy test after learning (posttest). The data that has been collected is analyzed using statistical analysis in the form of a t-test, z-test, paired sample t-test, and N-gain test. The results of this research showed that the average value of students' mathematical literacy in the REACT learning model with PMR achieved minimum completeness, the proportion of students who achieved the average value in the REACT learning model with PMR was more than 75%, the average value of mathematical literacy in classes using the model REACT learning with PMR is higher than the average value of the class using the direct learning model, the increase in the average value of mathematics literacy for the class using the REACT learning model with PMR is higher than the increase in the average value of the class using the direct learning model. These results can be concluded that the REACT learning model with PMR is effective for students' mathematical literacy
MODEL PENJADWALAN BACKWARD HYBRID FLOW SHOP 2 STAGE UNTUK MEMINIMASI MEAN FLOWTIME
Authors: Anwar Asep , Ferdian Rendiyatna , Rochman Didit Damur
Published: August 2024

The scheduling problem is a common challenge when it comes to executing tasks, making the resolution of this issue crucial for decision-making in production activities. The problem addressed in this research is the company's desire to conduct production without waiting times between stages to maintain the quality of pharmaceutical raw materials. Additionally, the production results must meet predefined due dates. The production system formed is a Hybrid Flow Shop system, which is an extension of the Flow Shop concept where one or all stages have identical parallel machines. The objective of this study is to minimize the time between job start and job completion, defined in scheduling problems as the minimization of mean Flow time. The research collected data from 5 products in the company to model according to the research objectives. Process times for each stage and due dates for each product have been predetermined. After modeling and processing using the LINGO application, the optimal result obtained is backward scheduling with an average flow time of 12.6. This demonstrates that the model in this research effectively addresses the Hybrid Flow Shop problem using backward scheduling to minimize mean flow time
MATHEMATICAL MODELING AND CORRUPTION-FREE FIXED-POINT STABILITY OF CORRUPTION DYNAMIC WITH CONTROL STRATEGY
Authors: Hanan Hafizhah Atrya , Putri Arrival Rince , Muhafzan Muhafzan
Published: August 2024

The given work presents a Susceptible Corrupt Jailed Reformed (SCJR) model on corruption spread with a control strategy: encouragement of punishment (in the form of law enforcement). In this mathematical model, it is assumed that corruption spreads like an infectious disease because corrupt individuals can influence susceptible individuals if they interact frequently. This model also assumes that corruption can occur due to personal desires without influence from other individuals. The study shows that the corruption-free fixed point stability depends on the basic reproduction number. The corruption-free fixed point is asymptotically stable if R0<1. The numerical simulations of the corruption-free fixed point and the difference between the model with and without the control strategy are given to demonstrate the validity of the theoretical analysis using Maple software. software Maple
FORMULASI DAN EVALUASI SEDIAAN GEL EKSTRAK DAUN KEMANGI (Ocimum bacilicum L.)
Authors: Budiman Hendra , Tantiningrum Sumeita
Published: August 2024

Kemangi di Indonesia umumnya dimanfaatkan untuk sayur atau lalap sebagai pelengkap makanan. Manfaat lain tanaman kemangi dalam pengobatan sudah banyak diteliti sebagai antibakteri. Daun kemangi (Ocimum bacilicum L.) memiliki kandungan flavonoid yang mampu memberikan efek antibakteri.Pada penelitian ini daun kemangi dimanfaatkan untuk pembuatan gel antiseptik tangan. Pemakaian antiseptik tangan dalam bentuk sediaan gel di kalangan masyarakat menjadi suatu gaya hidup. Pembuatan antiseptic sangat dipengaruhi oleh gelling agent.Penelitian ini bertujuan untuk mengetahui formulasi optimum sediaan gel dari ekstrak daun kemangi dengan Na-CMC sebagai gelling agent. Metode ekstraksi yang dipilih yaitu metode maserasi dengan pe,larut yang digunakan yaitu etanol 96%. Formulasi sediaan gel ekstrak daun kemangi dibuat dengan variasi konsentrasi gelling agent Na-CMC sebesar 1%, 2% dan 3%. Evaluasi sediaan gel meliputi uji organoleptis, uji homogenitas, uji pH, uji daya sebar dan uji daya lekat. Hasil penelitian menunjukkan bahwa seluruh formula mempunyai hasil evaluasi fisik gel yang baik. Namun formula dengan konsentrasi Na-CMC 1% (F1) secara oprganoleptis mempunyai bentuk lebih encer disbanding formulasi lain sesuai dengan bentuk gel antiseptik tangan pada umumnya.
PENGARUH pH TERHADAP KADAR FLAVONOID PADA GEL EKSTRAK DAUN KITOLOD (Hipobroma longiflora (L) G.Don)
Authors: Nugroho Praptanti Sinung Adi , Syaifudin Ahmad
Published: August 2024

Tumbuhan kitolod (Hipobroma longiflora (L) G.Don) mengandung senyawa flavonoid,alkaloid, dan saponin. Kandungannya dipercaya sebagai obat tetes mata, padahal obat herbal dilarangpemerintah apabila dijadikan sebagai obat tetes mata. Oleh karena itu, penelitian ini memberi alternatifsediaan obat yang dapat dipakai sebagai antibakteri topikal. Penelitian ini bertujuan untuk mengetahuipengaruh perbedaan pH terhadap kadar flavonoid gel ekstrak daun kitolod. Penelitian berbentukdeskriptif eksperimental. Ekstrak etanol daun kitolod diperoleh dengan soxhletasi menggunakanpelarut etanol 96%. Ekstrak kental daun kitolod digunakan sebagai zat aktif sediaan gel dengankonsentrasi ekstrak 5%. Pengukuran kadar flavonoid dalam sediaan gel digunakan kurva bakukuersetin dengan konsentrasi 0,5 ppm; 1 ppm; 1,5 ppm; dan 2 ppm. Larutan baku kuersetin diukurserapannya dengan Spektrofotometer UV-Vis pada panjang gelombang maksimal (λmax) = 442 nm,didapatkan persamaan regresi linier y = 0.175x + 0.317. Kandungan flavonoid pada masing-masingsediaan gel yaitu F1 = 0,0090%, gel F2 = 0,0062%, dan gel F3= 0,0002%. Hasilnya pH dapatmempertahankan kadar flavonoid pada sediaan gel ekstrak daun kitolod yaitu kadar flavonoid tertinggipada F1 dengan pH 5,4