bluuebunny/crossref_metadata_2025 huggingface dataset:
Violence against Women: Awareness, Knowledge and Attitudes of Male Civil Servants at the Ministries, Departments and Agencies in Owerri, Nigeria.
Authors: Nnebue Chimnoso , Sidney-Nnebue Queencallista , Aigbiro Efelomo , Amadi Monica , Aghaebe Collins , Ajakaiye Emmanuel
Published: July 2019

Background: Violence against women (VAW) remains a huge and protracted public health concern. Also, there is growing recognition that the role men play in changing these inequalities in gender based power relations is critical. Documenting the trends of the aforestated role is essential to developing public health interventions to tackle VAW. Objective: To determine the awareness, knowledge and attitudes to VAW among male civil servants at the state and federal government ministries and agencies (MDAs) in Owerri, Nigeria. Materials and methods: This was a cross sectional survey of 326 male civil servants at the State and Federal Government MDAs in Owerri Nigeria, selected using multistage sampling technique from August 2016 to January 2017. Data were collected using pretested self-administered semi- structured questionnaires. Data were analysed using SPSS V.22. Statistical associations between variables were tested using Chi square, at p -value < 0.05. Results: The mean age of respondents was 40.6 ± 9.8. Three hundred and two (92.6%) of them were aware of VAW. Sources of information on VAW include: 184(57.9%) television, 171(53.8%) radio, 167(52.5%) print media, 152(47.8%) social media. The form of VAW mostly cited 227(70.7%) was rape, while the mostly practiced form of VAW 201(62.4%) was physical violence. Only 65 (20%) had good knowledge, while 151 (46.3%) had a good attitude towards VAW. There were statistically significant associations between respondent’s attitudes towards VAW and (religion [p =0.000], tribe [p =0.017]). Conclusions: This study revealed high awareness on VAW, poor knowledge about VAW and poor attitude towards the practice of VAW. We recommend sustained awareness and improved comprehensive gender equity cum attitudinal change education.
Protocol for the functional evaluation of the stomatognathic system.
Authors: Ramírez-Velásquez Mariela , Molina Ana , Añez Yanira , Abad Viviana , Nava Rita
Published: July 2019

Alterations in breathing, chewing and swallowing are considered risk factors for functional disorders on the stomatognathic system. Thus, there is a need to have a protocol for functional evaluation that contributes to systematize the processes and procedures, unifying criteria for diagnosis. The objective of this study was to design a Protocol for the functional evaluation of the stomatognathic system for the Postgraduate Clinic of Orthopedics of the School of Dentistry of the University of Zulia, Venezuela. In a first stage, a situational diagnosis was made. In a second stage, the documentary analysis technique was used, using the search engines Pubmed, Redalyc, SciELO and ScienceDirect. The third stage consisted in the elaboration of the protocol according to the consensus of the resident postgraduate professionals and the evidence found in the review of the scientific literature. The protocol was drawn up, defining its objectives, population, institutional resources and a systematic and detailed ordering of the procedures and tests to be applied for the evaluation of breathing, chewing and swallowing. This protocol will improve the quality of the evaluations and obtain reliable records of the patient’s clinical condition.
The Relevance of Regional Anesthesia in Orthopaedic Surgery: Concepts and techniques.
Authors: Obalum Dike , Ibeanusi Sydney
Published: July 2019

Before the advent of anaesthesia in surgical practice, surgeons battled with patient’s maximal co-operation during surgical procedures, management of pain intra-operatively and post-operatively. Anaesthesia has greatly aided in overcoming these challenges, but a sizable proportion of reduction in these challenges but approximately 30-80% of patients complain of moderate to severe pain post-operatively indicating that post-operative pain remains a problem. Controlled epidural anaesthesia and controlled peripheral nerve block which are types of regional anaesthesia provide superior pain relief during and after surgery, making regional anaesthesia of particular relevance in orthopaedic surgery. More so, general anaesthesia has some adverse effects on the outcome of operation and the patient. These adverse effects are rare but may be disastrous and life-threatening necessitating close supervision during and after general anaesthesia. Hence, the preference should be towards regional anaesthesia with regards to the choice of anaesthesia in orthopaedic surgery. This review aims to highlight some concepts and techniques on regional anaesthesia in orthopaedic surgery.
The Relevance of Regional Anesthesia in Orthopaedic Surgery: Advantages, disadvantages and challenges.
Authors: Obalum Dike , Ibeanusi Sidney
Published: July 2019

The relevance of regional anaesthesia in orthopaedic surgery cannot be overemphasized because it has aided reduction in intra-operative and post-operative pain which has always been a challenge in surgical practice. It also reduces the risk of haemorrhage and infection. Though there are complications associated with regional anaesthesia, these complications are rare and can be anticipated; thus prompt intervention measures can be instituted. The outcome of every surgical procedure takes into consideration the risks and benefit of the method, and hence, since the benefits of regional anaesthesia in orthopaedic surgery outweighs the risks, it is highly recommended. Regional anaesthesia is of great importance in orthopaedic surgery because it offers continuous but controlled analgesia. It induces hypotension which leads to a reduction in blood loss during operation. It allows early recovery and ambulation of patients, thus reducing the risks associated with prolonged bed stay, which may, in turn, affect the overall outcome of surgery. This review aims to highlight the advantages and challenges of regional anaesthesia in orthopaedic surgery.
MEDICAL RECORD KEEPING; AN UPDATE
Authors: Gupta Dr. Naveen , Choubey Dr. R. K.
Published: July 2019

Now a day’s Medical Profession not only deals with Medical affairs it involves various aspects of Legal Profession as well. Hence it should be re- coined as Medico Legal Profession. While providing any medical services if any issue arises then Doctors has to face the legal consequences and brought under the court jurisdiction for prosecution like other criminals. 

The only thing which helps in front of court is the documents produced by the treating doctor, so keeping the Medical Records in meticulous manner,  maintaining it & keeping it safe is very important.

So one should be very particular while recording the details & vitals in OPD Card, Bed Head ticket, Consent Form, Admission & Discharge Ticket of the patients. Doctors should be well aware of the things to be recorded into Medical Records, as well more aware about how to keep the records & to produce them when demanded in a Legitimate manor.

Keywords: Medical Records, Record Keeping, Medico legal, Guidelines, Legetimate
A LOW GRADE TUMOR, EXTRA SKELETAL MYXOID CHONDROSARCOMA, WITH METASTATIC POTENTIAL: A CASE REPORT
Authors: Shukla Sushil Kumar , Kumar Viney , Chandra Smita
Published: July 2019

Extraskeletal Myxoid Chondrosarcoma (EMC) is a rare soft tissue sarcoma of uncertain differentiation characterized by abundant myxoid matrix located in the soft tissues. It affects mainly the soft tissues of the proximal end of long bones. EMC has a male preference, and this occurs in soft tissue area in patients who are more than 40 years old. The present case was 63 year old female diagnosed as EMC on histopathological examination with immuno–histochemical confirmation and after eight months presented with pulmonary and inguinal metastasis. EMC is a rare tumor should be considered in the differential diagnosis of myxoid soft tissue neoplasm. Therefore, a multi-modal approach, having distinct clinical, cytological, histo-pathological, immunohistochemical features and cytogenetics analysis, must be necessary in establishing a more definitive diagnosis, which may finally lead to a more targeted and specific treatment for patients.        

Keywords: Extraskeletal myxoid chondrosarcoma, Inguinal metastasis, low grade tumor, IHC
CHILD HOMICIDES IN ADANA, TURKEY
Authors: Kaya Kenan
Published: July 2019

Violence is a common and important public health problem in our country like all over the world. Homicide is the last point of no return and solution. Nearly at all communities; homicide is being accepted as most serious crime and it is being punished with severe sanctions and also they are trying to develop prevention strategies.

At this study, 5159 cases were investigated retrospectively which were medico-legally autopsied at institute of Forensic Medicine Adana Group Authority Morgue Specialty office between the years of 2009-2011. Cases were investigated according to cases’ ages, genders, the objects (weapons) causing death, localization of wounds. Besides, toxicological analyzes of all cases were reviewed. It was seen that; 79 (66%) of total 120 child victims were male, youngest was 7 months old, eldest one was 18 years old, average age was 13,5. It was detected that when we group the children according to their ages; most cases [85(70,8%) ] were between the ages of 13-18. When we look at homicide methods, it was seen that; firearms is at first place with 73 (60,8%) of cases. It was detected that; head is at first place with 50 (41,7%) of the cases and it was following by rib cage area with 21 cases. When we look at shooting ranges at the cases which were killed by firearms, shooting was done from adjacent range at 40 cases.

Even if removing the violence isn’t possible; revealing its reasons and methods provides possibility of forming strategies.

Key Words: Child; homicide; death; method.
Hiding Secret Data Using Image Steganography
Authors: Tutlani Paridhi , Priyanka Mrs.
Published: July 2019

Today’s large demand of internet applications requires data to be transmitted in a secure manner. Data transmission in public communication system is not secure because of interception and improper manipulation by eavesdropper. So, the attractive solution for this problem is Steganography, which is the art and science of writing hidden messages in such a way that no one, apart from the sender and intend recipient, suspects the existence of the message, a form of security through obscurity. Hiding Secret Data Using Image Steganography is the scheme of hiding the existence of secret information by concealing it into another medium such as image file. In this paper we mainly discuss different types of image steganographic methods, advantages and disadvantages. We focus in this paper on Hiding Secret Data Using Image Steganography, which has emerged as a prominent source of data hiding across novel telecommunication technologies such as covered voice-over-IP, audio conferencing, etc. The multitude of steganographic criteria has led to a great diversity in these system design techniques. In this paper, we review current digital image steganographic techniques and we evaluate their performance based on robustness, security and hiding capacity indicators. The primary goal of steganography is to reliably send hidden information secretly, not merely to obscure its presence. Steganography in today’s computer era is considered a sub-discipline of data communication security domain. Lately, new directions based on steganographic approaches started to emerge to ensure data secrecy. Rather than as a substitute to existing solutions, these approaches could achieve better data secrecy if combined with conventional security techniques. Modern techniques of steganography exploit the characteristics of digital media by utilizing them as carriers (covers) to hold hidden information.
Tradicionalna upotreba samoniklog i kultiviranog bilja na području grada Varaždina (Hrvatska)
Authors: Vitasović-Kosić Ivana , Kužir Mija
Published: July 2019

Zbog depopulacije ruralnog stanovništva i promjena načina života kao i nedovoljne dokumentacije, postoji velika opasnost gubitka „narodnog“ znanja o korištenju samoniklih i kultiviranih svojti koje u Hrvatskoj do desetak godina unazad nisu bile dokumentirane etnobotaničkim metodama, nego su se narodna znanja uglavnom prenosila s generacije na generaciju usmenom predajom. U ovom radu prikazani su rezultati istraživanja tradicionalnog korištenja samoniklog i kultiviranog bilja na području grada Varaždina. Ovo etnobotaničko istraživanje provedeno je intervjuiranjem tijekom 2016. godine i predstavlja prvu pismenu dokumentaciju tradicionalnog korištenja bilja na ovom području. Ukupno je zabilježeno 125 biljnih svojti (69 kultiviranih i 56 samoniklih biljaka), u prosjeku 26 vrsta po jednom intervjuu, koje se koriste kao; hrana za ljude i životinje, u medicinske svrhe, te za ostale gospodarske namjene. Zabilježeno je 43 porodice, od kojih su najzastupljenije: Rosaceae (20,63%) i Asteraceae (6,35%). Najčešće spominjane kultivirane vrste su; Prunus domestica, Vitis vinifera subsp. vinifera, Chamomilla recutita, Sambucus nigra i Tilia platyphyllos. Kao hrana za ljude i životinje najčešće se spominju Zea mays, Cucurbita maxima, Hordeum vulgare, Triticum aestivum, Fagopyrum esculentum i Urtica dioica. Karakteristika lokalne gastronomije je priprema heljdine kaše koju lokalno stanovništvo zove „hajdina“, a zanimljiva je „nova moda“ korištenje Allium ursinuma kao dodatka salatama i namazima te pohanje cvatova Robinia pseudoacacia. Vjerujemo da će ovaj rad doprinijeti edukaciji pučanstva i reintrodukciji zaboravljenih upotreba samoniklog i kultiviranog bilja u ljudsku prehranu i prehranu životinja, kao i prevenciji očuvanja zdravlja ljudi i životinja. Prikupljene biljne svojte su herbarizirane, digitalizirane i pohranjene u herbarij Agronomskog fakulteta, dostupno on-line (http://herbarium.agr.hr/).
The nutritive value of corn silage on family farms of continental Croatia in 2013 and 2014
Authors: Lukšić Božica , Vranić Marina , Božić Lucija , Kljak Kristina , Čaćić Ivana , Bošnjak Krešimir
Published: July 2019

Cilj istraživanja bio je utvrditi i ocijeniti kemijski sastav uzoraka kukuruzne silaže (KS) (n=130) s 48 obiteljskih poljoprivrednih gospodarstava (OPG) kontinentalne Hrvatske, većih proizvođača mlijeka. Uzorci KS su analizirani tijekom 2013. i 2014. godine, a obzirom na porijeklo, podijeljeni su u 3 skupine: (i) istočna (I), (ii) sjeverozapadna (SZ) i (iii) središnja (S) Hrvatska. Obzirom na sadržaj dostavne suhe tvari (ST), u uzorcima KS je NIR spektroskopijom procijenjen sadržaj korigirane ST (KST), sirovih proteina (SP), škroba, neutralnih detergent vlakana (NDV), organske tvari (OT), metaboličke energije (ME), fermentirajuće metaboličke energije u ME (FME/ME), kiselost (pH vrijednost) i probavljivost OT u ST (D-vrijednost). Rezultati istraživanja ukazuju na prosječan visoki sadržaj ST analiziranih uzoraka KS (389,29 g ST kg-1 svježeg uzorka), poželjan sadržaj škroba (336 g kg-1 ST) i ME (11,5 MJ kg-1 ST) te visoku D-vrijednost (73,7 %). Utvrđen je signifikantno viši udio ST (P<0,01), KST (P<0,05), ME (P<0,01), FME (P<0,05) a niži udio SP (P<0,001) KS analiziranih 2013. u usporedbi s 2014. godinom. Prosječan sadržaj ST regije SZ je 2014. godine bio veći u usporedbi s regijom S (P<0,05). Za ostale kemijske parametre između regija, godina proizvodnje i unutar regija nisu utvrđene statistički značajne razlike (P>0,05).
Zaključeno je da vrijednosti kemijskih parametara analiziranih uzoraka KS ukazuju na visoku hranidbenu vrijednost te nisku varijabilnost kvalitete između godina proizvodnje, OPG-a i regija RH uključenih u istraživanje.
Stanje i gospodarske perspektive uzgoja zagorskog purana u Varaždinskoj županiji
Authors: Kurečić Vladimir , Bedeković Dalibor , Grgić Zoran , Mužic Stjepan , Janječić Zlatko
Published: July 2019

Puran se na širem području Hrvatskog zagorja uzgaja od 16. stoljeća. Nakon otkrića Novog svijeta vjerojatno je iz Srednje Amerike brodovima stigao u Europu, najvjerojatnije u Španjolsku, zatim u Englesku pa u Njemačku i Italiju, odakle se proširio i u naše krajeve. S vremenom se udomaćio, nije se križao s drugim pasminama pa je specifičan uzgoj u malim jatima koja su veći dio života provela na otvorenom u prirodi skupljajući hranu uvjetovao razvoj specifičnih morfoloških i fizioloških svojstava. Utjecao je na kvalitetu mesa, po čemu je zagorski puran poznat te se smatra specijalnom pasminom u gospodarskom smislu, a u uz to ima i veliko značenje kao vrijedan element biološke raznolikosti Hrvatske. U prošlosti se ova izvorna pasmina peradi slabo izučavala, tek nešto prije drugog svjetskog rata, iako je tada predstavljala značajan izvozni proizvod tradicionalnog uzgoja u zemlje zapadne Europe. Od drugog svjetskog rata do sredine devedesetih godina prošloga stoljeća zagorski puran gotovo je izumro i nestao. Svojom inicijativom i stručnošću, koncem devedesetih godina prošloga i početkom ovoga stoljeća spasili su ga pojedini entuzijasti i stručnjaci Agronomskog fakulteta u Zagrebu. Od tada se zagorski puran ozbiljnije istražuje, podupire i promovira, iako mu broj jedinki još uvijek varira na godišnjoj razini. U svakom je slučaju spašen, čak je u nekim inicijativama povremeno bio i ozbiljna robna marka kojoj, na kraju se pokazalo, treba stabilnost i kontinuitet uzgoja. Ovaj rad prikazuje stanje i gospodarske perspektive zagorskog purana u Varaždinskoj županiji.
Efectos económicos de la aplicación de impuestos directos e indirectos a las PYMES en la provincia de Tungurahua periodo 2014 - 2017
Authors: Flores Guamán Jonny Jesús , Padilla Martínez Mario Patricio
Published: July 2019

Las empresas son el motor de la economía del país a través de sus actividades económicas generan empleo y contribuyen al crecimiento económico, en especial las PYMES que están estructuradas por organizaciones con mayor capacidad para adaptarse a los cambios tecnológicos y generar fuentes de empleo, convirtiéndose en un factor importante de política de distribución de ingresos a los estratos sociales medio y bajo; son motores del desarrollo económico que aportan con el pago de impuestos los cuales actúan como instrumentos del Estado para promover el incremento económico, e influir en los niveles de distribución de la riqueza. Las PYMES al pagar sus impuestos, directos e indirectos dependiendo de la actividad económica que realice, el tamaño,  el monto de sus ingresos y su capital carecen del conocimiento básico sobre los incentivos tributarios y el pago de impuestos, para conocer la realidad que se genera, se ha realizado una investigación sobre el impacto que genera los impuestos directos e indirectos en las PYMES en la provincia de Tungurahua en el periodo 2014 -2017, el objetivo para este estudio es determinar los efectos económicos que causan los impuestos directos e indirectos en las PYMES, mediante el análisis de fuentes teóricas, identificando la situación económica actual a través de metodologías adecuadas. Los fundamentos y elementos de discusión referentes a impuestos en las PYMES desde una perspectiva histórica, para analizar los resultados obtenidos con la encuesta aplicada conociendo la población finita de 3151, para saber sobre el tipo de actividad y la diversificación de las mismas en el sector económico primario, secundario y terciario de la provincia de Tungurahua como personas naturales o jurídicas obligadas y no obligadas a llevar contabilidad, los resultados indican que las PYMES en la provincia tienen un pago sobre impuestos en un rango entre 500 a 5000 USD, los impuestos más recaudados son el (IVA) con un porcentaje del 100%, el Impuesto y Anticipo a la Renta con un 100%, retención a la fuente con un 68%, retención al IVA con un porcentaje del 26% y la salida de divisas con un 2%; las recaudaciones de las municipalidades corresponden a: el Impuesto predial y Patentes Municipales con un porcentaje de recaudación del 100%, adicional las  PYMES con categoría jurídica tienden a pagar tributos a la Superintendencia de Compañías que asciende a un 10%. Las políticas fiscales y tributarias han afectado a través del tiempo a las PYMES con factores negativos, ya que promueven la inflación como el aumento del precio de producción lo que refleja en el precio venta de los diferentes productos y servicios, ofreciendo poca competitividad en el mercado, cierre de las PYMES y como efecto el despido de los trabajadores.
Modelo de gobierno electrónico peruano: servicios para el ciudadano en los portales de los gobiernos regionales
Authors: Alvarado Aguirre Pablo Felipe , Cevallos Vásquez Paolo Israel , Moran Villamarin Edwin Daniel , Preciado Ortiz Lenin Feliz
Published: July 2019

La investigación inicia con una parte introductoria de lo que se pretende realizar en el presente trabajo. En el segundo capítulo se incorpora la normativa relativa al servicio del ciudadano en la Administración Pública, los cuales permiten entender la legislación básica del proceso de Modernización de la Gestión del Estado, el Gobierno Electrónico, los Portales Web y los Gobiernos Regionales en el Perú. Se hace una breve contextualización de los antecedentes y avances de Gobierno Electrónico en el mundo y en el Perú. El cuarto capítulo se divide en dos partes, en el primero se realiza la selección de criterios y la metodología que permitirán evaluar de manera global el front office de los portales web de cada Gobierno Regional y en la segunda parte se exponen los resultados obtenidos, que a su vez: 1) muestra el estado actual de desarrollo de Gobierno Electrónico en los 25 gobiernos regionales del Perú, 2)  detalla las características relacionadas a la interacción, información y medio digital y 3) describe el estado actual de algunos servicios para el ciudadano como el acceso a la información, los trámites en línea y la participación.
El impacto de los estilos de liderazgo en los centros de educación media del Ecuador, su perspectiva de líderes y docentes en el año 2018
Authors: Garcia Puga Steffy Milly , Espinoza Solis Eduardo Javier
Published: July 2019

El presente artículo hace referencia a los estudios de liderazgo y su impacto en los centros de educación media del Ecuador, que de una u otra forma han progresado a lo largo de los años, transfiriéndose del ámbito empresarial hacia otros espectros de la sociedad como la educación, pese a ello, existe aún escasos aportes relacionados en países como Ecuador. El presente estudio aborda, desde una perspectiva descriptiva, los estilos de liderazgo utilizados por los líderes de centros de educación media y un comparativo con la percepción de sus docentes subordinados. A través de una metodología cuantitativa, 124 directivos y 424 de sus docentes fueron encuestados utilizando el Cuestionario Multifactorial de Liderazgo (MLQ) Avolio (1995). Los resultados presentan que las percepciones de líderes y subordinados son similares, predominando un uso mixto de los estilos transformacional y transaccional.
Use of Internet among Rural Teenagers: Pattern of Usages, Awareness and Associated Health Hazards
Authors: Jobayer Mohammad , Sultana Rabeya , Anwar Sk Serjina , Afroz Zeenat , Akter Nadira , Chowdhury Mahbuba , Rashed Asif , Farhana Nasreen , Islam Lohani Md Tazul , Hussain Dewan Azmal
Published: July 2019

Internet has become an essential tool for communication, information, and entertainment and use of internet is increasing among the teenage group. This cross sectional study was conducted among 385 teenagers from rural area of Narayanganj district in Bangladesh to evaluate the practice of internet use, their awareness about the beneficial and harmful effects and associated physical and psychological health hazards. The study reached its various findings from the view point of rural area of our country. The study population was chosen purposively; data were collected using a semi structured questionnaire regarding their knowledge and various practice of internet use relating to the objectives. Most of the respondents were students and came from lower middle class family. Majority of the study people recently started to use internet and they were mostly light or moderate user in terms of time spending. Mobile phone was used as device by 84.7% people for their internet browsing. Teenagers used internet mainly for entertainment (42.1%) and social networking (35.6%) purpose and not much for learning or education. They were aware about the beneficial and the harmful effects of internet use especially abuses. Commonly experienced physical health hazards by them were headache (11.7%), straining of eyes or blurring of vision (10.7%) and skipping meals or change in eating behavior (9.1%), and among the psychological hazards, restlessness or agitation (8%) and depression (5.2%) were stated. It may be concluded that use of internet among teenagers of rural area of our country is at modest level associated with a few health hazards but the merits of internet based networking is yet to be revealed by them.

Bangladesh Med J. 2017 Sep; 46 (3): 69-73
Importance of Quality Training in Neurology Speciality: Bangladesh Perspective
Authors: Hoque Md Azharul
Published: July 2019

Abstract not available

Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 01
Surgical Outcome of Vesico-Vaginal Fistula (VVF) after Repair: Experience of 51 Cases in a Teaching Hospital of Dhaka City
Authors: Akter Shimul , Mujib Fouzia , Rahman Mohammed Masudur , Banu Dewan Shahida , Begum Taslima , Firdousi Tahmida , Mondal Dipika Rani
Published: July 2019

Background: Surgical management of vesico-vaginal fistula is very crucial regarding the outcomes among the women.

Objectives: The purpose of the present study was to see the surgical outcomes of vesico-vaginal fistula.

Methodology: This cross-sectional study was carried out from July 2013 to December 2013 for a period of 6 months in the National Fistula Centre in the Department of Obstetrics & Gynaecology at Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh. All patients who underwent surgical repair for iatrogenic VVF in National Fistula Centre of the department of Obstetrics and Gynaecology of Dhaka Medical College Hospital were included in this study. Patients who got themselves admitted to Obstetrics & Gynaecology department of DMCH with the complaints of fistula. An interview usually lasted for an hour. The entire selected patients were interviewed for detailed history. Thorough physical examination was done. The surgical outcomes were recorded among the women.

Result: A total number of 51 cases of VVF were recruited for this study. The mean age was 46.02 (±SD 6.104) years. Regarding the causes of iatrogenic vesico-vaginal fistula most of the cases (88.2%) were abdominal hysterectomy. In 4(7.8%) patients lower segment caesarean section caused the situation. Vaginal hysterectomy was responsible for 3.9% (2/51) cases of iatrogenic VVF. In more than 90% cases (46/51) the surgical outcome was successful; while in 5 patients’ fistula recurred 5 to 7 days following surgery. They were treated by re-operation later on.

Conclusion: In conclusion abdominal hysterectomy is the most common cause of iatrogenic vesico-vaginal fistula with a very good surgical outcomes.

Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 29-32
Surgical versus Conservative Management of Granular Myringitis: A single-centre Randomized Control Trial
Authors: Ahsan Ali Imam , Jamal Nasimul , Ahmad Ashfaq , Ali Syed Farhan , Haque Momenul
Published: July 2019

Background: Treatment of granular myringitis (GM) is diverse with no definitive management.

Objective: The aim of the present study was to see the effectiveness of different interventions for treating granular myringitis.

Methodology: This was a single centred, parallel, randomized control trial. This study was done at the Specialized ENT Hospital of SAHIC, Dhaka from July 2010 to June 2012. Patients presenting with granular myringitis of 18 years of age or more with both sexes were included. All patients were divided into two groups by simple random sampling method of which patients of group A were treated by surgical treatment and that of group B were treated by medical treatment. Medical treatment was given in the form of topical ear drops and surgical treatment was performed by surgical debridement of granulation tissue followed by chemical cauterization. Repeated follow up was performed up to 6 months in both groups of treated patients. The primary outcome was the resolution of granulation tissue. During follow-up the secondary outcome variables were recurrence, perforation of the TM and any other complications or complain from the patients.

Results: A total number of 60 patients were studied of which 30 patients were treated medically and 30 patients were treated surgically. The cure rate was higher in surgical treatment (80%) than conservative (16.7%) (p=0.011). The recurrence rate (17.24%) is also less in surgical group compared to medical treatment group (77.27%) (p=0.001).

Conclusion: Surgical treatment is a more successful treatment modality for granular myringitis.

Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 64-68
Association of HbA1c Level with Lipid Profiles among Type 2 Diabetic Patients attended at Medical University of Bangladesh
Authors: Majumder Moitreyee , Mollah Forhadul Hoque , Ferdous Shamim Ara
Published: July 2019

Background: Type 2 diabetic patients are presented with dyslipidemia.

Objective: The objective of this study was to see the association between the HbA1c and lipid profiles among the diabetic subjects.

Methodology: The cross-sectional study was carried in the Department of Biochemistry at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh on type 2 diabetic individual attending the endocrine OPD of BSMMU. In this study estimation of HbA1c level and lipid profiles in diabetic subjects were performed and was compared the lipid profiles between the controlled (HbA1c <7%) and uncontrolled (HbA1c >7%) groups.

Result: A total number of 95 patients were recruited for this study. The mean age of the respondents was 42.63 ±5.56 years. Female (8.21± 1.88) had lower HbA1c than male (8.42±2.21) in the study. TC: HDL (6.07±1.02:1) and LDL: HDL (3.88±1.58:1) were also higher. Among the study population 30 had good (HbA1c<7 mg%) glycemic control and 14 of them were male and 16 were female. Those having good glycemic control had lower TG and HDL (176.72±88.83 vs 206.84±124.77mg/dl) and (32.84±7.78 vs 34.88±8.48 mg/dl); however, higher TC and LDL (201.56±34.73 vs 197.19 mg/dL) and (133.04±33.71 vs 124.30±35.97 mg/dL) than those having poor glycemic control. No statistically significant difference between these two groups were observed.

Conclusion: Thus there is no statistical significant difference between HbA1c and lipid profile among type 2 diabetes mellitus patients.

Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 72-75
Pattern of Periodontitis among Adult Patients Attending at Medical University of Bangladesh
Authors: Alam Md Rajaul , Abid Mohammad , Biswas Utpalendu , Islam Syed Shariful , Banik Rajib Kumar , Bithi Sonia Jahan
Published: July 2019

Background: Periodontitis is one of the most common oral diseases and is one of the widest spread chronic diseases all over the world. If a person maintains a good oral hygiene, he/she can control periodontitis easily. Periodontitis is a preventable disease.

Objectives: This study was aimed to know the current pattern, the possible causes and the attitude towards periodontitis among adult patients attending at outdoor of dental faculty of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

Methodology: This cross-sectional study was carried out in the OPD of Dental faculty of BSMMU, Dhaka fromJanuary 2013 to December 2013 over a period of one year. One hundred twenty patients with any sort of dental problem were enrolled in this study.

Results: The current study depicted that 68.3% of the patients were from age group of 18 to 40 years and 59.2% were male while 40.8% were female. Most of the respondents (65.8%) lived in urban area. This study showed that 80.8% experienced bleeding from gums and 59.2% had knowledge about cleaning teeth before going to bed and after breakfast. It was found that 77.5%of the respondents used tooth brush and tooth paste for cleaning their teeth. Only 15.8% of the respondents visited dentist for oral and dental check-up regularly. According to life style related habit, 53(44.2%) respondents were smoker, 55 (45.8%) respondents chewed betel leaf and 30 (25%) of the respondents hewed betel leaf with Jarda or SadaPata. Majority 104 (86.7) had calculus, defective margins and restorations. Most of the respondents (95.0%) had bleeding on probing.

Conclusion: In this study a significant number of respondents have periodontitis who have attended outdoor of dental faculty. Older age, smoking, betel, jarda/sadapata, diabetes mellitus and presence of calculus and restorations are the risk factors for developing periodontitis.

Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 76-80
Headache as anUnusual Presentation of Ischemic Heart Disease: A Case Report
Authors: Chowdhury Abdul Wadud , Sarker Sudhakar , Ali Mohammad , Hasan Pratyay , Rahman Sazedur , Islam Md Rafiqul , Mohammad Quazi Deen
Published: July 2019

The clinical features of coronary artery disease vary, and patients may present with symptoms other than chest pain, such as headache. Rarely, the headache may be theonly presenting feature without any chest discomfort, and may be confused with migraine. Failure to distinguish such headache, caused by CAD, from migraine may result in wrong treatment with disastrous fate. Elderly patient with the presence of cardiovascular risk factors having recent onset exertional headache should be evaluated for the presence of cardiac cephalgia.We intend to report a 60-year-old hypertensive, diabetic patient with a 6-months history of episodic exertional headaches, who turned out to be a case of headache angina (cardiac cephalgia).

Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 81-86
Economic and institutional framework for environmental safety
Authors: Gusev Andrey A.
Published: July 2019

The current state of environmental safety in Russia is described in the article. It is shown that the regulatory documents related to environmental safety are not fully harmonized. The article analyzes the results of social surveys of the population, reflecting the importance of the environmental situation in their places of residence. The shortcomings in the implementation of economic and institutional policies affecting environmental safety are considered. Based on the current environmental situation, the goal and priorities in the field of environmental safety are formulated. It is proposed to improve the legislation in the field of environmental protection and environmental management, taking into account the support for the development of environmentally friendly technologies and products. The economic stimulation of environmental safety, including the rationale for the use of ecological and economic criteria for economic decisionmaking is considered. The ways of creating the industry of utilization of harmful waste taking into account the union of the enterprises for production of the equipment for waste processing, the enterprises for waste processing and also the subjects applying waste and products of their processing as raw materials in technological processes are offered. The article considers the ways of increasing the energy efficiency of buildings and the impact of this increase on environmental safety, including the rationale for improving the energy efficiency of buildings by reducing the need for electricity and heat. The organizational measures of ecologically safe “green” economic growth are proposed taking into account the analysis of the best foreign practices. It is shown that the success of “green” growth in South Korea is due, in particular, to the political will of the country's leadership. It is proved that progressive provision of ecological safety is possible only on the way of system transformations in ecological and economic development of Russia.
Influenza vaccination coverage in a population-based cohort of Australian-born Aboriginal and non-Indigenous older adults
Authors: Dyda Amalie , Karki Surendra , Kong Marlene , Gidding Heather F , Kaldor John M , McIntyre Peter , Banks Emily , MacIntyre C Raina , Liu Bette
Published: July 2019

Background: There is limited information on vaccination coverage and characteristics associated with vaccine uptake in Aboriginal and/or Torres Strait Islander adults. We aimed to provide more current estimates of influenza vaccination coverage in Aboriginal adults.

Methods: Self-reported vaccination status (n=559 Aboriginal and/or Torres Strait Islander participants, n=80,655 non-Indigenous participants) from the 45 and Up Study, a large cohort of adults aged 45 years or older, was used to compare influenza vaccination coverage in Aboriginal and/or Torres Strait Islander adults with coverage in non-Indigenous adults.

Results: Of Aboriginal and non-Indigenous respondents aged 49 to <65 years, age-standardised influenza coverage was respectively 45.2% (95% CI 39.5–50.9%) and 38.5%, (37.9–39.0%), p-value for heterogeneity=0.02. Coverage for Aboriginal and non-Indigenous respondents aged ≥65 years was respectively 67.3% (59.9–74.7%) and 72.6% (72.2–73.0%), p-heterogeneity=0.16. Among Aboriginal adults, coverage was higher in obese than in healthy weight participants (adjusted odds ratio (aOR)=2.38, 95%CI 1.44–3.94); in those aged <65 years with a medical risk factor than in those without medical risk factors (aOR=2.13, 1.37–3.30); and in those who rated their health as fair/poor compared to those who rated it excellent (aOR=2.57, 1.26–5.20). Similar associations were found among non-Indigenous adults.

Conclusions: In this sample of adults ≥65 years, self-reported influenza vaccine coverage was not significantly different between Aboriginal and non-Indigenous adults whereas in those <65 years, coverage was higher among Aboriginal adults. Overall, coverage in the whole cohort was suboptimal. If these findings are replicated in other samples and in the Australian Immunisation Register, it suggests that measures to improve uptake, such as communication about the importance of influenza vaccine and more effective reminder systems, are needed among adults.
Aplikasi Principle Component Analysis dan Directed Principal Component untuk Pemetaan Alterasi Hidrotermal menggunakan Citra ASTER di Kecamatan Kokap, Kulon Progo
Authors: Raharja Bayu , Setianto Agung , Titisari Anastasia Dewi
Published: July 2019

Endapan emas di daerah Kokap, Kabupaten Kulon Progo yang berasosiasi dengan endapan tipe epitermal terbentuk akibat adanya proses alterasi hidrotermal. Pemanfaatan data penginderaan jauh untuk pemetaan alterasi telah berhasil dilakukan diberbagai lokasi. Penelitian ini bertujuan untuk mengkaji kemampuan citra ASTER saluran visible near infrared (VNIR) dan saluran shortwave infrared (SWIR) dalam memetakan jenis alterasi menggunakan metode Principle Component Analysis (PCA) dan Directed Principal Component (DPC). Klasifikasi multispektral selanjutnya dilakukan untuk membedakan tipe alterasi hidrotermal menggunakan kombinasi saluran hasil PCA dan DPC. Keberhasilan pemetaan alterasi hidrotermal dievaluasi secara statistik menggunakan confusion matrix. Tingkat akurasi yang dapat diterima adalah sebesar 85% dengan koefisien kappa lebih besar dari 0.8. Hasil penelitian menunjukkan metode DPC memiliki akurasi lebih baik dari PCA dalam memetakan tipe alterasi meskipun tingkat akurasi keduanya dibawah batas yang ditentukan. Saluran ASTER yang paling baik digunakan untuk memetakan tipe alterasi hidrotermal di lokasi penelitian adalah 1, 2, 4, dan 6.
Penerapan C4.5 pada Keaktifan Mahasiswa dalam Pengumpulan Berkas di Biro Akademik
Authors: Irawan Eka , Gunawan Indra
Published: July 2019

Keberhasilan dan kegagal mahasiswa dalam menyelesaikan perkuliahan merupakan gambaran dari suatu perguruan tinggi. Mahasiswa aktif  adalah mahasiswa yang  melakukan pendaftaran ulang pada awal semester dan memberikan hasil registrasi berbentuk foto copy di pendidikan sebagai syarat keaktifan mahsaiswa di lihat dari berkas yang telah di kumpulkan. Selain mahasiswa aktif ada juga  mahasiswa non-aktif ini sangat berpengaruh terhadap keberlangsungan perguruan tinggi dan mahsiswa nonaktif dapat menyebabkan mahsiswa drop out. Hal ini dapat menjadi lebih menarik jika di lakukan penelitian dengan teknik data mining metode C.4.5 untuk mencari karakteristik mahasiswa aktif berdasarkan   berkas yang di kumpulkan ke Biro Akademik. Data penelitian menggunakan data mahasiswa Semester V (lima) S1 STIKOM TUNAS Bangsa Pematangsiantar. Hasil menunjukan nilai accuracy yang mencapai 97,28 % dan recall 99,27%.
PENGARUH TEKNIK OUTLINE (KERANGKA KARANGAN) TERHADAP KETERAMPILAN MENULIS KARANGAN NARASI SISWA KELAS V SD NEGERI 161 PEKANBARU
Authors: Sari Desi Permata
Published: July 2019

Penelitian ini dilatarbelakangi oleh rendahnya keterampilan menulis karangan narasi siswa kelas V SD Negeri 161 Pekanbaru. Hal ini dikarenakan dalam pembelajaran Bahasa Indonesia, guru kesulitan menemukan metode/teknik pembelajaran yang tepat dalam menyampaikan materi menulis karangan narasi. Penelitian ini bertujuan untuk mengetahui perbedaan keterampilan menulis karangan narasi siswa kelas kontrol dan kelas eksperimen dengan pembelajaran menggunakan teknik outline (kerangka karangan) kelas V. Metode penelitian ini menggunakan kuasi eksperimen nonequivalent control group design. Penelitian ini dilakukan di dua kelas V SD Negeri 161 Pekanbaru yaitu kelas VA sebagai kelas kontrol dan kelas VB sebagai kelas eksperimen, yang setiap kelas berjumlah 30 siswa. Berdasarkan hasil posttest diperoleh bahwa rata-rata keterampilan menulis karangan narasi pada siswa dengan teknik outline (kerangka karangan) (kelas eksperimen) lebih tinggi dibandingkan rata-rata keterampilan menulis karangan narasi pada siswa yang tidak menggunakan teknik outline (kerangka karangan) (kelas kontrol). Rata-rata nilai pretest yang diperoleh kelas eksperimen yaitu 53,33. Rata-rata nilai pretest kelas kontrol yaitu 64,16. Setelah dilakukan tindakan pada kedua kelas, maka diperoleh rata-rata posttest kelas eksperimen yaitu sebesar 75 atau memiliki rata-rata gain yaitu 0,45 kategori sedang yang berarti terjadi peningkatan di atas rata-rata dan kelas kontrol sebesar 64,16 atau memiliki rata-rata gain yaitu 0,12 kategori rendah yang berarti memiliki terjadi peningkatan dibawah rata-rata. Perhitungan hipotesis dengan menggunakan Uji-t diperoleh  memenuhi kriteria  atau 2,913 2,0118. Hal ini membuktikan bahwa teknik outline (kerangka karangan) dapat lebih meningkatkan keterampilan menulis karangan narasi siswa dibandingkan dengan tanpa teknik outline (kerangka karangan) pada siswa kelas V di SD Negeri 161 Pekanbaru.
Penentuan Strategi Mitigasi Risiko Kritis Aset IS/IT Perkara Berdasarkan ISO/IEC 27002:2013
Authors: Sofiyani Fania , Rohmani Asih
Published: July 2019

Aset teknologi informasi dan sistem informasi perkara pada Pengadilan Negeri Slawi memiliki beberapa kelemahan sehingga menimbulkan beberapa permasalahan, seperti server down, kehilangan data dan peretasan website milik Pengadilan Negeri Slawi. Apabila permasalahan tersebut tidak segera ditangani maka dapat menimbulkan dampak yang lebih buruk bagi PN Slawi, misalnya terganggunya proses bisnis, kehilangan data yang krusial bahkan pencurian data perkara untuk dijual ke ranah publik sebagai konsumsi publik. Perlu dilakukan tindakan pencegahan agar tidak terjadi permasalahan tersebuti. Tidak hanya berfokus kepada aset  teknologi yang bermasalah saja, tetapi juga pada semua aset teknologi informasi yang digunakan dalam sistem informasi terkait perkara. Maka dari itu  tujuan dilakukannya penelitian ini adalah untuk mengidentifikasi semua aset teknologi informasi terhadap penggunaan sistem informasi terkait proses bisnis perkara, menganalisa aset, mengevaluasi risiko, melakukan penilaian terhadap risiko dan mengetahui strategi mitigasi sebagai tindakan untuk merespon risiko kritis. Metode penelitian yang digunakan sebagai kerangka penelitian untuk mengolah hasil yang diperoleh dari wawancara menggunakan metode OCTAVE, sedangkan metode penilaian terhadap risiko menggunakan metode Risk FMEA. Hasil penilaian dari 75 risiko diperoleh 34 risiko kritis yang harus diperhatikan untuk memperoleh tindakan mitigasi berdasarkan standar ISO/IEC 27002:2013. Penentuan risiko kritis tersebut didasarkan pada nilai batas yang telah ditetapkan pada skor risiko dan nilai RPN.Kata kunci— Mitigasi Risiko, OCTAVE, Risk FMEA, ISO 27002:2013, Aset IS/IT
PENGARUH AROMATERAPI LAVENDER TERHADAP PENURUNAN INTENSITAS NYERI PADA PASIEN POSTPARTUM NORMAL DI RSUD KOTA SEMARANG
Authors: Pambudi Angki Bagus , Supriyanti Endang
Published: July 2019

ABSTRAK

Postpartum adalah masa sesudah persalinan dan kelahiran bayi, plasenta, serta selaput yang diperlukan untuk memulihkan kembali organ kandungan seperti sebelum hamil dengan waktu kurang lebih enam minggu. Hal ini akan berdampak pada ibu setelah melahirkan salah satunya yaitu nyeri karena kontraksi uterus. Perawat atau bidan memiliki peran penting dalam penanggulangan nyeri melalui pendekatan non farmakologi, salah satunya dengan pemberian aromaterapi lavender. Akses aroma lavender melalui hidung merupakan rute yang jauh lebih cepat dibanding cara yang lainnya, ketika minyak lavender dihirup molekul yang mudah menguap (volatile) dari minyak tersebut dibawa oleh arus udara dan ditransmisikan ke dalam sistem limbic. Hal ini akan merangsang memori dan respons emosional. Hipotalamus berperan sebagai relay dan regulator, memunculkan pesan – pesan yang harus disampaikan ke bagian lain otak serta bagian badan yang lain. Pesan yang di terima itu kemudian diubah menjadi tindakan yang berupa pelepasan senyawa elektrokimia yang menyebabkan euporia, relaks, atau sedatif. Tujuan dari penelitian ini adalah mengetahui pengaruh aromaterapi lavender terhadap penurunan intensitas nyeri pada pasien postpartum normal. Metode pada penelitian ini menggunakan jenis studi kasus dengan metode pendekatan deskriptif. penelitian ini menggunakan Pretest – Posttest Desain. Sampel penelitian ini sebanyak 5 orang diambil dengan teknik Purposive Sampling. Hasil penelitian ini menunjukan bahwa sebelum dilakukan pemberian aromaterapi lavender secara inhalasi rata – rata intensitas nyeri pada skala 5.4 sedangkan sesudah pemberian aromaterapi lavender intensitas nyeri mengalami penurunan yaitu rata – rata skala 2.8. Ada pengaruh aromaterapi lavender terhadap penurunan intensitas nyeri pada pasien postpartum normal, sehingga dengan adanya hasil penelitian ini diharapkan tenaga kesehatan khususnya perawat dan bidan dapat mengaplikasikan aromaterapi lavender ini untuk mengurangi intensitas nyeri postpartum atau nyeri akibat hal lainnya.
EFEKTIFITAS TEKNIK RELAKSASI NAFAS DALAM UNTUK MENURUNKAN SKALA NYERI PADA PASIEN POST OPERASI SECTIO CAESAREA
Authors: Astuti Marsela Tri , Sukesi Niken
Published: July 2019

ABSTRAK

 

Post section caesarea memberikan komplikasi seperti nyeri. Untuk penanganan nyeri dapat dilakukan berupa teknik relaksasi nafas dalam yang merupakan penatalaksanaan secara non farmakologi. Tujuan penelitian ini adalah untuk mengetahui efektifitas teknik relaksasi nafas dalam terhadap penurunan skala nyeri pada pasien post operasi section caesarea. Desain dalam penelitian ini adalah studi kasus. Subjek penelitian ini dilakukan pada pasien yang mengalami nyeri post operasi section caesarea yang berada di ruang Bougenville di RSUD Tugurejo Semarang. Teknik sampling penelitian adalah mengunakan non probability sampling dengan pendekatan purposive sampling yaitu sebanyak 5 responden. Berdasarkan hasil penelitian ini dapat diketahui dari 5 responden sesudah dilakukan teknik relaksasi nafas dalam yang mengalami nyeri ringan sebanyak 4 dan responden yang mengalami nyeri sedang sebanyak 1. Kesimpulan dari penelitian ini bahwa teknik relaksasi nafas dalam mampu menurunkan intensitas nyeri pada pasien post operasi section caesarea.