bluuebunny/crossref_metadata_2025 huggingface dataset:
Balance disorders among walk-in patients in the International Islamic University Malaysia (IIUM) Ear, Nose And Throat (ENT) clinic: An exploratory study
Authors: Aslynn W. A. Wan , Mohd Sakeri Nurul Syarida Bt. , Bt Arshad Siti Aishah
Published: January 2021

Introduction: The epidemiological studies of balance disorder symptoms in Malaysia are still understudied, therefore this research sought to explore this issue among the walk-in patients at the International Islamic University Malaysia (IIUM) Ear, Nose and Throat (ENT) clinic in Kuantan, Pahang. Methods: The study aimed to 1) observe the association of common balance disorder symptoms with factors like gender, ethnicity and age groups; 2) reveal the patterns of cases with each of the balance disorder symptom according to factors in 1); and 3) determine the pattern of balance disorders in this clinic. This study took place between February and April of 2016. The medical records of these patients were examined after services by ENT doctors. To extract the data, these documents were reviewed using a medical record review checklist. Results: A total of 92 medical records were reviewed. They consisted of 45.6% male and 54.4% female; Malay (60.8%), Chinese (27.2%), Indian (10.9%) and others (1.1%); these patients were from 3 months to 69 years old. Only 13 (14.1%) out of these cases presented with balance disorders. The findings indicated no association (p > 0.05) between each of the balance symptom and the demographic factors. Out of the 13 cases; the most frequent symptoms observed were headache (76.9%), imbalance (53.8%) and vertigo (46.2%). The peripheral vestibular disorder was found as the most common diagnosis of balance disorder; benign paroxysmal positional vertigo (BPPV) (4) and Meniere’s disease (1). Both of the disorders showed vertigo, vomiting, headache and blur vision. Conclusions: It is crucial to understand the symptoms of balance disorders, particularly for a Malaysian population as it can enhance the clinical services and its quality of treatment or rehabilitation.
Translation, adaptation and psychometric properties of Bahasa Malaysia version of the hearing handicap inventory for adult (HHIA): A preliminary study
Authors: Tengku Zam Zam Tengku Zulaila Hasma , Dzulkarnain Ahmad Aidil Arafat , Rahmat Sarah , Jusoh Masnira
Published: January 2021

Introduction: Patient self-perceived handicap inventory is an important tool for modern health care including hearing loss. The HHIA is a self-reporting outcome measurement invented to verify the hearing-impaired patients’ complaint and carry out for appropriate client-centered rehabilitation program. To the author’s knowledge, none of the self-reported questionnaire for hearing loss is available in Malay language, therefore, further research is required. The aim of this study was to translate the English version of HHIA into Bahasa Malaysia and to psychometrically validate the questionnaire. Methods: The questionnaire was initially translated using forward-backward translation techniques by four-panelists (2 panels for each level). The translated questionnaire was then reconciled and harmonized for cultural and content by the researchers and two expert panels before being piloted among 10 hearing impaired patients. At the present stage, psychometric evaluations have been conducted among 30 adults hearing-impaired participants using Cronbach’s α (for internal reliability) and Pearson’s correlation for (inter-item correlation). All participants were recruited from IIUM Hearing and Speech Clinic. Results: Cronbach’s α value was 0.96 for combined items. There were a strong correlation between the total score of the combined items with each of the sub-scale scores (social and emotional) and between each of the sub-scale scores (r=0.92-0.98, ρ<0.01). Conclusions: The preliminary finding suggests the translated version of HHIA has the potential to be a reliable and valid tool to evaluate the hearing handicaps among hearing-impaired patients in Malaysia. A large sample of subjects is needed for further evaluation to support this notion.
Integrating islamic input in undergraduate psychiatry teaching: IIUM experience
Authors: Md Rosli Najwa Hanim , Md Tahir Md Faiz , Mat Zin Nora , Mohd. Noor Hanisah , Abdullah Kartini
Published: January 2021

Introduction: Since the recognition of psychiatry as a medical specialty back in the 19th century, many theories, therapies and treatment were much influenced by Western findings and practice. In general, spirituality and religion had little input or mentioning. Recently in 2012, the Royal College of Psychiatrists (London) affirmed the value of considering spirituality and religion as a part of good clinical practice which would benefit both the patient and the psychiatrist throughout the treatment period. In the Malaysian context, the general postgraduate training of psychiatrists in Malaysia does not specifically integrate religious or spiritual values in the curriculum. Methods: At IIUM, the undergraduate students are exposed to basic and essential psychology during the first year. During their fourth year they are introduced to subject of psychiatry for a short two weeks. Later in their final year, they exposed to an extensive and comprehensive 7 weeks posting covering all major topics and disorders in psychiatry. Results: In this paper, we would like to share our experience throughout the 15 years, this program has been running and discuss the challenges, limitations and future expectation in order to realize the objective of integrating Islamic input into the psychiatry curriculum in IIUM hence producing doctors who are may then treat and heal patients holistically; physically, psychologically and spiritually. Conclusions: Studies on the outcome of the integrated Islamic input in the psychiatry curriculum among the clinical students and graduates are to be carried out further in the future.
Prevalence, clinical features and factors associated with psychosis among Idiopathic Parkinson’s Disease (IPD) patients in Universiti Kebangsaan Malaysia Medical Centre (UKMMC)
Authors: Md Rosli Najwa Hanim , Abdul Rahman Abdul Hamid , Mohamed Ibrahim Norlinah
Published: January 2021

Introduction: This was a cross sectional study of the prevalence of psychosis and its characteristic in patients with Idiopathic PD (IPD) attending the neurology clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM). Methods: The assessment was using a structured demographic data and clinical information questionnaire, Mini-International Neuropsychiatric Interview (MINI) 6.0.0, Starkstein’s Apathy Scale (AS), Mini Mental State Examination (MMSE), Movement Disorder Society – Unified Parkinson Disease Rating Scale (MDS-UPDRS) Q1-Q6, Hoehn and Yahr (H&Y) stages of PD and Schwab and England Activities of Daily Living (ADL) scale. Results: 112 patients were studied. Psychosis was identified in 39 (34.8 %) patients (33 patients with hallucination only, 6 with hallucination and delusion (psychotic disorder) and none with delusions only). Among patients experiencing hallucinations, 14 (35.9%) had a visual hallucination only, 12 (30.8%) had auditory hallucinations only, and 13 (33.3%) had both visual and auditory hallucinations. Psychosis were more common in IPD patients with cognitive impairment using MDSQ1 scoring (OR 0.15; 95% CI, 0.05-0.63; P = p‹0.05) while others variables were not significant. The analysis, among patients with psychotic symptoms only and patients with psychotic disorder showed education level (p<0.05), duration of illness (OR 1.8; 95% CI, (-10.7 - -3.5; p <0.01), cognitive impairment score - MDSQ1 (OR 0.2; 95% CI, 0.2-0.9; p<0.01), H&Y score (OR 0.4; 95% CI, -2.1- -0.6; p<0.01) and ADL score (OR 0.6; 95% CI, 0.3 – 2.6; p<0.05) were significant. Conclusions: Lower education level, longer duration of illness, more advance stage of Parkinson disease and less functioning in ADL were significant in psychotic disorder in IPD.
Randomized Control Trial Study On The Effect Of Wet Cupping On Lipid Profile
Authors: MH Suhaily , AA Ismail , MY Najib
Published: January 2021

Introduction: Dyslipidaemia is one of the risk factors contributing to the pathogenesis of cardiovascular   diseases (CVDs). This study was conducted to investigate the effect of wet cupping on lipid profile. Methods: This randomized controlled trial was conducted in 2012 at the School of Medical Sciences, Universiti Sains Malaysia, Malaysia. Sixty-two healthy volunteers ranging from 30 to 60 years old were randomized into control and intervention groups. Subjects in the intervention group were assigned to two sessions of wet cupping at the beginning of the study and at the third month; individuals in the control group did not undergo any cupping procedure. Venous blood sample was collected for serum lipid profile: Total Cholesterol (TC), High Density Lipoprotein Cholesterol (HDL-C), Low Density Lipoprotein Cholesterol (LDL-C), and triglycerides; measured at baseline, first, third and fourth month. Results: Subjects in the cupping group had significant improvements from baseline to third and fourth month for TC (MD=-0.56, P=0.004), HDL-C (MD=-0.22, P<0.001) and LDL-C (MD=0.58, P=0.001). There was also a significant reduction from baseline to one month for triglycerides (MD=0.38, P<0.001). Subjects in the cupping group had significantly better values in HDL-C and LDL-C as compared with the control group at the third and fourth month. Significantly lower levels of TC and triglycerides in the cupping group of the fourth month. In the control group, there were no significant changes in any serum lipid profiles. Conclusion: After two sessions of wet cupping, TC, HDL-C, LDL-C and triglycerides were significantly improved by 8.2%, 13.7%, 16.4% and 20.8% respectively.
A Pilot Study of Enhance Recovery after Surgery (ERAS) for Liver Resection
Authors: R Jarmin , IS Mohamad , AW Ahmad , H Othman , Z Zuhdi , AC Ariffin
Published: January 2021

Background: Morbidity post hepatectomy still remain persistent throughout decades compared to other surgery. Modern approach have been introduced to improve safety and reduce morbidity whilst at the same time enhance patient recovery. Thus, enhanced recovery after surgery or fast track recovery program for liver resection was initiated. Objective: The aim of this study was to achieve discharge by postoperative day 3 for minor resection and day 5 for major resection. Design and Setting: This is a prospective study conducted in Hospital Universiti Kebangsaan Malaysia (HUKM) from September 2014 till April 2015. Material and Methods: All patients undergoing open liver resection were included in the study. They were then managed post operatively according to ERAS protocol that was drawn up based on previous studies. Patient’s demographics data, intra operative parameters, postoperative complications and adherence to postoperative recovery protocol were recorded. Results: Seventeen patients (7 major and 10 minor resection) were recruited. The mean length of hospital stay for minor resection was 5.9 and major resection was 9.6 .With regards to the targets, 4 out of 10 (40%)patients in minor resection group and 4 out 7 (57.1%) in the major group were discharged on time. 9 patients had postoperative complications with no mortality recorded. In terms of the ERAS protocol targets, the PCA morphine discontinuation target was achieved in 15 patients (88.3%) ,nasogastric tube removal (13 patients -76.5%) , urinary cathether removal (6 patients - 35.3%), abdominal drains removal (9 patients-52.9%) and resumption of full diet was achieved by 82.4% (14 patients). Conclusion: From these overall achievement, most of our targets have been met and this shows that our ERAS protocol is safe to be applied to patient undergoing hepatectomy. Limitations: Some patients had achieved their target but not discharged for unknown reason.
Accuracy of Fine Needle Aspiration Cytology in Solitary or Dominant Nodular Goitre: A Single Centre Study
Authors: Rohaizak M. , Fuad Y Aman , Naqiyah I , Saladina J.J , Niza A.S Shahrun
Published: January 2021

Background: Thyroid swelling or goitre is a common condition, either asymptomatic or symptomatic. The diagnosis is usually established by ultrasound or fine needle aspiration cytology (FNAC) as a gold standard. The sensitivity of the test is inversely related to increasing size of the nodule. The objective of this study is to evaluate the accuracy of FNAC especially in cases of large goitre. Material and methods: This is a retrospective study on patients who underwent thyroidectomy between January 2000 to December 2007 for solitary or dominant nodular goitre. The analysis was made only on those patients with complete data on FNAC and histology. Result: There were 235 patients, but only 161 patients were analysed after excluding the suspicious and inadequate sample. The patients’ mean age was 42.1 year old (21 to 60). The size of the thyroid nodule ranged from 2.1 to 5.0 cm (mean = 3.9 cm). The overall sensitivity was 67.4% and the overall accuracy was 86.3%. The accuracy of FNAC according to the sizes above and below the value were as follows; 2 cm (72.2% vs. 88.1%); 3 cm (88.0% vs. 87.4%) ; 4 cm (86.6% vs. 84.4%) ; 5 cm (87.3% vs. 78.8%). This was most obvious in the sensitivity of the FNA which also showed reducing trend as the nodules increased in size. Conclusion: FNAC is an essential diagnostic tool in the management of nodular goitre. Our study showed that the accuracy of FNAC decreased as the size of the nodule getting bigger. Cautious approach should be taken in the management of large goitre and decision should not be based only on the result of FNAC.
Hypermethylation Analysis of p16INK4a and p15INK4b Promoters in Chronic Lymphocytic Leukaemia Patients and Normal Individuals
Authors: M Amira , S Sarina , H Rosline , H Azlan , J Muhammad Farid , KM Chang
Published: January 2021

Introduction: Chronic Lymphocytic Leukaemia (CLL) is a common type of leukaemia in persons of predominantly European descent but is rare in the Asian population. Disparities in CLL incidence among people of Asian and European descent may be related to the genetic make-up of the two different populations. Hypermethylation event might be one of the silencing mechanisms that inactivate the tumour suppressor genes in CLL. The aim of this study was to determine the hypermethylation status of p16INK4a and p15INK4b among CLL patients and normal individuals. Materials & Methods: A total of 25 CLL patients and 25 normal individuals were recruited for this study and their genomic DNA were extracted from the peripheral blood. The hypermethylation status of p16INK4a and p15INK4b were determined using Methylation Specific-PCR (MS-PCR) whereas DNA sequencing method was applied to selected samples for validation of the MS-PCR results. We also evaluated the association between hypermethylation of these genes with the clinical and demographic characteristics of each group of subjects. Results: Among the CLL patients, p15INK4b partialmethylation occurred in 6 (24%) subjects while methylation occurred in 1 (4%) subject. All the remaining patients were unmethylated at p15INK4b. All the samples showed unmethylation at p16INK4a. Statistically significant associations were found between p15INK4b hypermethylation with the presence of CLL (p=0.01) and with race (p=0.02). Conclusion: Further study using a larger sample size is warranted to explore the significance of DNA methylation incidence among the CLL patients of the Malaysian population. Hence, we suggest that hypermethylation at p15INK4b has a huge influence that kick-starts CLL disease among Malaysians and MS-PCR technique is applicable to be used in methylation study.
Mak Nyahs and Sex Reassignment Surgery – A Qualitative Study from Pahang, Malaysia
Authors: S Draman , S Maliya , M Syaffiq , Z Hamizah , A Abdul Hakim , Razman MR
Published: January 2021

Introduction: Mak nyahs are locally known male-to-female transgenders in Malaysia. In Western countries, medicalization of transgenderism allows strictly selected patients to undergo sex reassignment surgery. However, a standardized treatment system is not yet available in Malaysia. A number of mak nyahs underwent sex reassignment surgery at their own will. This study aimed to explore mak nyahs’ knowledge and perception on sex reassignment surgery. Materials and Methods: A qualitative research was carried out from 13th July 2016 till 31st August 2016 among 8 adult mak nyahs in Kuantan, Pahang. Snowball sampling was used. Participants who gave verbal consent were interviewed individually and in focus groups. Data obtained was transcribed and used as the primary data source. Results: All informants were Malays and Muslims. They generally had some knowledge about the standard procedures and risks in sex reassignment surgery. All informants expressed their desire to have the surgery, but chose not to. Reasons discouraging them from having the surgery were: i) religion, ii) forbiddance from family, iii) fear of regret, iv) death from surgery, and v) the lack of necessity. Factors driving them to have the surgery: i) more income from sex work, ii) pressure from sex clients, iii) securing a stable relationship, iv) self-satisfaction, and v) hope for a better future. Conclusion: Religion seemed to be the main reason refraining them from undertaking the surgery. Counselling mak nyahs should include the advantages and disadvantages of sexual reassignment surgery. Islamic religious preaching is very important to help reduce high risk behaviours, as well as teaching mak nyahs to cope with challenges in adult life. Further research is necessary to show association between religious knowledge and successful rehabilitation of the mak nyahs’ community.
Physiological and Psychological Effects of Listening To Holy Quran Recitation in the Intensive Care Unit Patients: A Systematic Review
Authors: Mat-Nor Mohd Basri , Ibrahim Noor Airini , Ramly Nur Fariza , Abdullah Fa’iza
Published: January 2021

Stress and anxiety are common among intensive care unit (ICU) patients especially those who are on mechanical ventilation. Non-pharmacological interventions such as music and prayer are recommended because they are opioid sparing, easy to provide, cheap and safe. There is a growing body of evidence on the effects of Holy Quran Recitation (HQR) in reducing stress and anxiety in critically ill Muslim patients. The aim of this review is to evaluate the physiological and psychological effects of HQR specifically in ICU setting. This review was performed on articles published between 2007 and 2018. Extensive search was done using PubMed, ISI Web of Knowledge, Scopus and Google Scholar. Systematic review articles are also assessed and relevant literatures are hand searched based on reference lists and citations made in key publications. Studies related to HQR which were done outside adult ICU setting were excluded. A total of nine articles are included in the final list for detail analysis. Findings of this review revealed six studies with significant results in improving stress responses, hemodynamic stability and conscious levels. HQR is a potential nonpharmacological tool to reduce stress and can also be used as auditory stimulus to improve conscious level in comatose patients. More studies in this area are recommended aiming for low risk of bias, appropriate calculation of sample size and adequately powered to detect significant outcomes.
Sacral Marjolin's Ulcer: A Case of Delayed Diagnosis in a Paraplegic Patient
Authors: Ahmad Wafiuddin , Liang Goh Kian , Yi Kow Ren , Taufik Taufik
Published: January 2021

Marjolin's ulcer is a rare and aggressive malignancy ulcerating squamous cell carcinoma of the skin presenting in a previously injured or chronically inflamed area. However, the diagnosis may be delayed particularly in chronic sacral sores due the insidious onset and low index of suspicion, resulting in suboptimal management and poor outcome.A 42-year-old Malay gentleman sustained complete spinal cord injury in 1998 and consequently paraplegic. Five years prior to presentation in 2019, he noted a small ulceration at the sacral area. Despite regular dressing and multiple hospitalization for wound debridement, the wound condition worsened and involved gluteus and right thigh,associated with loss of weight and appetite. The patient also had rectocutaneous fistula and subsequently underwent diversion colostomy. Upon presentation at our hospital, he was in septic shock requiring prolonged inotropic support. Local examination revealed a 20x40cm sacral and gluteal sores with copious purulent discharge and presence of slough intermixed with granulation tissue and irregular looking mass. Diagnosis of septic shock secondary to infected Marjolin's ulcer was made. Four quadrant biopsies were taken, and the histopathological examination revealed well-differentiated squamous cell carcinoma. CT thorax, abdomen and pelvis revealed multiple calcified lung nodule, local spread of squamous cell carcinoma and invasion into whole rectum, posterior part of bladder , prostate gland ,and posterior part of penis . In view of the extensive local disease and lung metastases, patient opted for palliative treatment.The sepsis was unresolved and the wound remained infected, the patient succumbed and died due to the sepsis.A high index of suspicion and prompt oncologic management is required in managing chronic non- healing ulcer. An early referral to oncologic centre will improve the prognosis of patients with Marjolin's ulcer. Late diagnosis and superimposed infection will ultimately result in very poor outcome.
Phenotypic and Genotypic Characterization, and Detection of PVL Encoding Gene in Methicillin Resistant Staphylococcus Aureus Strains Isolated From Patients Admitted to a Tertiary Hospital In Kuantan, Malaysia
Authors: Bariman Mohammad Hanif , A. Mustafa Mahmoud Mohammed Imad , Binti Hamzah Hairul Aini
Published: January 2021

Introduction: Methicillin-resistant Staphylococcus aureus is globally a major public health threat. Resistance to methicillin originates from a modified protein (PBP2a) encoded by the mecA gene. The PVL gene as an important virulence factor increases the pathogenicity of MRSA. Epidemiology and characteristics of MRSA differ in different geographical regions. This study was conducted to characterize and determine the antibiotic susceptibility profile of MRSA strains isolated from patients in Hospital Tengku Ampuan Afzan, Pahang, Malaysia and to detect the presence of the mecA and PVL genes in the isolates. Materials and methods: In this study a total of 36 isolates of MRSA have been collected during a period of three months (1stFebruary –30thApril 2018). The susceptibility pattern of the isolates to ten different commonly used antibiotics were determined and the target genes were addressed by real-time PCR experiment. Results: Based on the identifying criteria, 44.4% of the isolates were CA-MRSA, and 55.5% were HA-MRSA. Resistance to oxacillin, cefoxitin and penicillin was 100%, gentamicin 88.8%, erythromycin 33.3%, tetracycline 77.7%, trimethoprim-sulfamethoxazole 61.1%, clindamycin 13.8%, chloramphenicol 11.1%, but no resistant strain of vancomycin was detected. Most of the isolates were resistant to more than three groups of antibiotics. Realtime PCR revealed that all the isolates were mecA positive and 4 isolates were PVL-positive. PVL-positive strains were CA-MRSA and susceptible to clindamycin. Conclusion: The study confirms multi-drug resistant MRSA in the study area, and shows that resistance to methicillin is mecA mediated. PVL carrier strains were present and related to CA-MRSA strains of the isolates.
Medicinal Properties Screening of Mallotus paniculatus Extract
Authors: Bahaman NA , Ahmad Raus R , Ahmad Nor Y , Mamun AA , Adzahar NS , Basri DF
Published: January 2021

Introduction: Traditionally, Mallotus paniculatus (Balik Angin) plant is used in the treatment of various diseases in rural areas such as remedy after childbirth, wound healing and fever. In this present study, four medicinal properties of the plant were investigated which included antibacterial, antifungal, anticancer and antioxidant activities. Materials and Methods: Potential medicinal compounds were extracted from the plant leaves by sonication with 3 different solvents namely ethanol, ethyl acetate and hexane respectively. The antibacterial and antifungal properties were determined using disc diffusion agar and broth dilution assay, the antioxidant activity by DPPH scavenging assay and the anticancer effect by MTT assay. Results: From the screening of the medicinal properties, M. paniculatus leave extracts were shown to possess antibacterial, antioxidant and anticancer properties but not antifungal properties. Ethanolic and ethyl acetate extracts of the leave were active against gram positive bacteria (Staphylococcus aureus and Bacillus subtilis) but not gram negative bacteria (Pseudomonas aeruginosa and Escherichia coli). The antioxidant activity of the ethanolic crude extract was high; with IC50 of 30 μg/ml comparable with the positive controls; ascorbic acid and butylated hydroxytoluene (BHT). Both ethanolic and ethyl acetate extracts were cytotoxic against breast cancer (MCF7), colon cancer (HT-29), cervix cancer (Hela) cell lines. Conclusion: M. paniculatus leave extract has many potential medicinal values for further studies.
Surgical Antibiotic Prophylaxis: Incidence and Risk of Surgical Site Infection
Authors: B. Fadzwani , A.R. Raha , M.N. Nadia , WM. Wan Rahiza , J. Razman , A.J Nordiah
Published: January 2021

Introduction: This prospective cross sectional study assessed surgical antibiotic prophylaxis (SAP) practice, the incidence of surgical site infection (SSI) and its associated risks in Universiti Kebangsaan Malaysia Medical Centre. Methods: Patients for elective colorectal, hepatobiliary, upper gastrointestinal, breast and endocrine surgery, who received SAP were included and followed up until day-30 postoperatively. Types of antibiotic, preoperative–dose timing, intraoperative re-dosing and its duration were recorded. The incidence of SSI was calculated and its associated risks expressed in odds ratio. Results: Out of 166 patients recruited, 121 (72.89%) patients received SAP preoperatively, and 91 (75.21%) of them were prescribed the appropriate antibiotic as per our institutional guideline. Three patients who continued to receive therapeutic antibiotic postoperatively were excluded from statistical analysis. Eleven (9.10%) patients received SAP beyond the preoperative–dose timing of 60 minutes (p=0.001), which was an independent risk factor for SSI (adjusted OR 4.527, 95% CI; 1.058-19.367, p=0.042). The risk of SSI also remained in patients who continued to receive SAP beyond 24 hours (OR 4.667, 95% CI; 1.527-14.259, p=0.007). The overall rate of SSI was 17.18%. Conclusion: We found that the choice of antibiotic prescribed for SAP was in accordance to institutional guideline and the relatively high SSI incidence was similar to a recent local report. Although the number of patients receiving preoperative dose-timing of > 60 minutes was low, it was nonetheless an independent risk factor for SSI. The postoperative continuation of SAP for more than 24 hours showed no benefit in reducing SSI.
The Effects of Chronic Low Dose Exposure of Chlorpyrifos on the Rat Kidney
Authors: S Aung , AT Norlelawati , A Nor Zamzila , MZ Zamzuria , H Norra , MN Noriah , AR Tariq
Published: January 2021

Introduction: An increased incidence of chronic kidney disease (CKD) was reported among agricultural workers who were exposed to organophosphates (OP). There is little information on the effects of chronic low OP exposure on kidney in experimental animals. Chlorpyrifos (CPF) is a common type of OP used in agriculture. Thus, the aim of this study was to assess the effects of chronic low subcutaneous exposure of CPF on the kidney. Methods. Eighteen male Sprague Dawley rats were divided into three groups, with six rats in each group. Group 1 served as a control group, and groups 2 and 3 received a subcutaneous vehicle (3% dimethyl sulfoxide + 97% v/v soy oil) or CPF (18.0 mg/kg) respectively, every other day for 180 days. Serum urea, creatinine, uric acid, cystatin C, electrolyte levels, acetylcholinesterase (AChE), and arylesterase (ArE) activities were measured. Histopathological changes in the kidney tissues were examined. Results. Urea, creatinine, uric acid, and cystatin C levels were significantly increased (p < 0.05), while electrolytes were reduced (p < 0.05) in the CPF-treated rats. Both AChE and ArE activities were depressed in the CPF group (p < 0.01 and p < 0.001, respectively). Diffuse necrosis of proximal tubules and glomerular hypercellularity were observed in the kidney in the CPF group. Conclusion. A chronic low dose of CPF via subcutaneous exposure caused considerable renal tubular necrosis and derangement of glomerular function. These findings suggest that chronic occupational OPs exposure can cause kidney damage.
Dextranomer/Hyaluronic Acid Copolymer (Dx/HA) Has no Effect on Bacterial Growth in Culture Media With or Without Antibiotic Discs
Authors: R Karabulut , F Doğruman-Al , Z Türkyılmaz , K Sönmez , F Demirel , N Sultan , AC Başaklar
Published: January 2021

Introduction: Endoscopic treatment of vesicoureteral refl ux (VUR) by subureteral injection of biocompatible polymers is an established treatment option for refl ux. Dextranomer/hyaluronic acid copolymer(Dx/HA) has gained wide popularity for treating VUR. We decided to investigate the antibacterial activity of Dx/HA and its interaction with antibiotics in in-vitro conditions. Materials and Methods: Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Proteus mirabilis suspensions were inoculated into Mueller-Hinton agar media and 30 μl of Dx/HA was inoculated in 5 mm diameter pits and the plates were incubated at 37°C for 24 hours. At the end of the incubation period, inhibition zones around the discs were measured. Expansion of the inhibition zones towards the pits which contained Dx/HA was considered as synergism. Dx/ HA was inoculated into pits made in Mueller-Hinton agar medium without antibiotic discs but containing suspensions of bacteria. These media were incubated under the same circumstances and same measurements were done. All experimental procedures were performed twice. Increase in bacterial zone diameters for ≥ 5 mm was inoculated was regarded as signifi cant for each agent. Results: Dx/HA caused no difference in bacterial growth either with or without antibiotic discs as determined by inhibition zones in the culture media. Conclusion : Dx/ha will not contribute to UTI if it is used for the treatment of VUR in cases either with or without infection.
Validation of Noise Induced Hearing Loss Questionnaire Among Malay Sawmill Workers in Kelantan Malaysia
Authors: MR Razman , L Naing , D Aziah , IM Kamarul
Published: January 2021

Introduction: Exposure to excessive noise is the major avoidable cause of permanent hearing impairment. Sawmill is one of the workplaces where workers are exposed to hazardous noise level. This study was conducted to determine the reliability and validity of noise-induced hearing loss questionnaire among sawmill workers. Materials and Methods: This cross sectional study was conducted in March 2007 among 35 consented sawmill workers. A total of 40 items; 10 items for knowledge (8 areas), 20 items for attitude (7 areas) and 10 items for practice (2 areas) were assessed. Statistical analysis for reliability analysis was test by internal consistency and construct validity by exploratory factor analysis using principal components and Varimax rotation method. Results: Cronbach’s alpha coefficients were acceptable for attitude (0.90) and practice (0.75). However, it was low for knowledge (0.67). Exploratory factor analysis showed three meaningful exploratory factors that could explain the three dimensions in the questionnaire. Conclusion: The results of the validation study suggested that the noise-induced hearing loss questionnaire is reliable and valid tool for assessing knowledge, attitude and practice among sawmill workers.
Hepatic Adenomatosis: Diagnosis and Management Dilemma
Authors: S Norly , J Razman
Published: January 2021

Hepatic adenomatosis is a rare, benign tumour of the liver. It was first described by Flejou et al as multiple adenomas in an otherwise normal liver parenchyma. Although benign, it can present as a diagnostic challenge because the lesions can be difficult to distinguish from other hepatic tumours. Patients can be asymptomatic and the diagnosis may only be made incidentally. We describe the case of 40-year-old Malay lady who was incidentally found to have hepatomegaly. Radiological examinations revealed a complex left ovarian cyst with multiple liver lesions. Biopsy of the liver lesion showed features of hepatic adenomatosis. Literature review was done and the dilemma in managing her was discussed.
Скарби Поділля XIV – XVII ст. Документи і матеріали
Authors: Boiko-Gagarin Andrii
Published: January 2021

Бойко-Гагарін Андрій Рецензія на монографію Олексія Бакальця "Скарби Поділля XIV – XVII ст. Документи і матеріали"
KAJIAN KONSEPTUAL DAYA SAING IKM BATIK DI INDONESIA
Authors: Hamdani Nizar Alam
Published: January 2021

Industri batik di indonesia umumnya merupakan industri kecil menengah yang menjadi sebagian besar pencaharian masyarakat di berbagai daerah di indonesia. sebelum krisis moneter tahun 1997 industri kecil menengah ini sempat mengalami kemajuanyang pesat. Tujuan penelitian ini adalah untuk mengkaji secara teoritis hubungan antar variabel untuk menciptakan daya saing ikm. Metode yang digunakan adalah studi kepustakaan dengan tujuan menemukan landasan teori dalam  pendekatan solusi masalah untuk  perumusan hipotesis yang bakal diuji dalam penelitian. Hasil dari kajian tersebut adalah pertama kepemimpinan, teknologi, organisasi dan organisasi pembelajaran secara simultan dan parsial berpengaruh terhadap knowledge management, kepemimpinan, teknologi, organisasi dan organisasi pembelajaran mempunyai hubungan antar variabel, kepemimpinan, teknologi, organisasi dan organisasi pembelajaran berpengaruh secara simultan dan parsial terhadap inovasi, knowledge management berpengaruh terhadap inovasi, inovasi berpengaruh terhadap daya saing, knowledge management berpegaruh secara simultan dan parsial melalui inovasi terhadap daya saing dan knowledge management berpegaruh secara simultan dan parsial melalui inovasi terhadap daya saingKata Kunci : Daya Saing, Inovasi, IKM Batik, Manajemen Pengetahuan
APPLICATION OF ISCHEMIC COMPRESSION TECHNIQUE AND MYOFASCIAL RELEASE TECHNIQUE IN LUMBAL SPONDYLOSIS PATIENTS IN RATULANGI MAKASSAR MEDICAL CENTER
Authors: Suharto Suharto , Suriani Suriani
Published: January 2021

Lumbar spondylosis is a condition of lower back pain caused by disc degeneration and facet joint which is characterized by osteophyte growth in the vertebral body precisely at the inferior and superior corpus edges, causing problems of pain, spasm, and impaired lumbar flexibility. The purpose of this study was to determine the difference in effect between the Ichemic compression technique (ICT) and Myofascial Release Technique (MRT) on the improvement of Lumbar Flexibility in patients with lumbar spondylosis, which was carried out at the Physiotherapy Clinic of TK II Pelamonia Hospital Makassar. The number of research subjects obtained as many as 20 people who meet the research criteria Then randomized into 2 groups: the treatment group I with ICT as many as 10 people and the treatment group II as many as 10 people with MRT. The research results show that the administration of Ichemic Compression Technique can increase lumbar flexibility with a mean difference 1,250. Whereas MRT administration can increase lumbar flexibility with a mean difference of 1,950. Wilcoxon test results of the treatment group I on the flexibility component obtained p value = 0.004 (p <0.05) while the treatment group II on the lumbar flexibility component obtained p value = 0.004 (p <0.05) which means that the provision of ICT with MRT can produce significant effect on increasing lumbar flexibility in patients with lumbar spondylosis. Mann Whitney test results on the lumbar flexibility component for treatment groups I and II p value = 0.035 (p <0.05). If seen from the mean values above, it can be concluded that the administration of Myofascial Release Technique (MRT) can result in a greater increase in lumbar flexibility compared to the Intermitten compression technique.  Keywords: Ichemic compression technique., Lumbar flexibility, Myofascial Release Technique, Lumbar Spondylosis
人本主义视角下的多元定制式教学法在幼儿早期教育中的应用：以言语教育为例
Authors: 朱 文婕
Published: January 2021

早期教育是全民终身教育的开端。0-6岁是儿童的重要阶段,根据人的生理、心理和敏感期的发展特点,进行有针对性的指导和训练,为儿童发展健康人格打下良好的基础。“多元定制式教学法”不同于一般的早期教育模式,具有“高度针对性”和“跨学科整合”的特点,在开发儿童潜能、塑造儿童人格方面具有不可替代的优势。
Peran Modal Intelektual dalam Memoderasi Risiko Investasi dan Struktur Modal Terhadap Nilai Perusahaan pada Perusahaan Manufaktur Sub-Sektor Makanan dan Minuman Yang Terdaftar di Bursa Efek Indonesia
Authors: Widhiastuti Susanti , Sukarya Bilqis Zamzamiria Putri , Ahmadi Slamet
Published: January 2021

Penelitian ini bertujuan untuk menguji peran modal intelektual dalam memoderasi risiko investasi dan struktur modal terhadap nilai perusahaan. Modal Intelektual diukur dengan value added intellectual capital coefficient (VAIC), Risiko investasi diukur menggunakan standar deviasi (SD) dan struktur modal diukur dengan menggunakan debt to equity ratio (DER) dan nilai perusahaan diukur menggunakan price to book value (PBV).  Populasi dalam penelitian ini adalah perusahaan manufaktur.Tbk yang terdaftar di Bursa Efek Indonesia (BEI) periode 2017-2018 sub sektor makanan dan minuman. Sampel penelitian berjumlah 12 perusahaan. Metode sampel menggunakan purposive sampling. Hasil penelitian menunjukkan bahwa R Square sebelum adanya moderasi peran modal intelektual, struktur modal dan resiko investasi terhadap nilai perusahaan memberikan masukan sebesar 24,6% dan pada saat modal intelektual memoderasi struktur modal terhadap nilai perusahaan dan resiko bisnis terhadap nilai perusahaan R square sebesar 25,8 %. Hasil penelitian model tanpa moderasi menunjukkan bahwa modal intelektual berpengaruh positif signifikan sebesar 25 %, resiko investasi berpengaruh negative signifikan sebesar -1,063 dan struktur modal berpengaruh negative tidak signifika sebesar -2,121 terhadap nilai perusahaan. Peran modal intelektual dalam memoderasi resiko invesatasi dengan nilai perusahaan berpengaruh positif tidak signifikan sebesar 40,1 % dan antara struktur modal dengan nilai perusahaan berpengaruh negative dan tidak signifikan sebesar -52,7 %.
Analisis Prediksi Kebangkrutan dengan Model Altman, Springate, Ohlson dan Zmijewski Pada Perusahaan Food and Beverage di Bursa Efek Indonesia (BEI)
Authors: Munjiyah Munjiyah , Artati Dwi
Published: January 2021

The purpose of this study was to determine and analyze the prediction of bancrupty are most appropriate for use in its application to the food and beverage company listed on the Indonesia Stock Exchange (BEI) period 2015-2018. The study compared four models of prediction of bancrupty, the Altman, Springate, Ohlson and Zmijewski. Comparisons were made by analyzing the accuracy of each models. Data used in the form of annual financial statements published by the company on the website www.idx.com. The sampling technique is purposive sampling with total sample acquired nine companies. The results of one way ANOVA test is significant as 0,000. So, there are the difference results of bancrupty prediction of food and beverage company using Altman, Springate, Ohlson and Zmijewski. The survey result revealed that the model Ohlson is a prediction models with the highest level of accuracy of 100%, with the type of error at 0%. The model of Zmijewski has an accuracy rate of 92,31% with the type error by 7,69%. While the model of Altman has an accuracy rate of 69,23%, with the type of error by 23,08% and the model of Springate has an accuracy rate of 69,23%, with the type error at 30,77%. Thus the accurate prediction models for food and beverage company registered in BEI is the Ohlson model, because have the best accuracy rate compared Altman, Springate and Zmijewski models.
Análisis de la rentabilidad aplicando el modelo DUPONT en empresas de transporte de carga pesada en la provincia del Carchi
Authors: Rodriguez Rivera Henry Francisco
Published: January 2021

El objetivo de esta investigación es analizar la rentabilidad de las empresas del sector de transporte de carga pesada en la provincia del Carchi, durante el período 2013 al 2018, y compararla con el promedio de la industria, a través de un análisis financiero técnico, empleando como herramienta de medición el Modelo Dupont.  Esta investigación es de tipo cuantitativa con dos alcances: exploratorio y descriptivo. El diseño de la investigación es de tipo longitudinal y el tipo de muestra es no probabilística. Para el análisis financiero se tomó en consideración la información estadística agregada multidimensional del Servicio de Rentas Internas, empleando los datos del Formulario 101 relacionados con las declaraciones del Impuesto a la Renta de las Sociedades domiciliadas en la provincia del Carchi. Como resultado de esta investigación se concluyó que el sector empresarial de transporte de carga pesada por carretera en la provincia del Carchi no es atractivo para el inversionista. A pesar de que las empresas del Carchi son más eficientes en el uso de sus activos para generar ingresos, aún existen problemas en el manejo del Margen Neto de Utilidad, por lo que el Rendimiento Operativo sobre los Activos ROA es del 2,02% menor al promedio de la industria que es de 3,83%. En los últimos seis años el ROE, ha tenido una tendencia fluctuante, en promedio los inversionistas por cada 100 dólares invertidos están recuperando a nivel de utilidades 4,38 dólares mientras que en el promedio de la industria se genera una utilidad de 9,99 dólares.
Influencia de los sistemas silvopastoriles en la conducta alimentaria de vacas lecheras Holstein
Authors: Benavides Rosales Hernán Rigoberto , López Cevallos Evelyn Nathaly , López Cevallos Franklin Ernesto , Vivas Peñafiel Gina Valeria
Published: January 2021

El papel que tienen los árboles en los sistemas silvopastoriles ha evidenciado múltiples beneficios en la producción pecuaria, por lo que se planteó evaluar la conducta alimentaria de vacas lecheras en agro-ecosistemas con Aliso (Alnus acuminata Kunth) más pasto, Acacia (Acacia melanoxylon R. Brown) más pasto y solo pastizal, en un periodo de seis meses, usando siete vacas Holstein por Jersey en cada agro-ecosistema, y evaluando las siguientes actividades: tiempo de consumo de pasto, rumia y descanso. De igual manera, se determinaron las diferencias de la conducta alimentaria con el tiempo y los diferentes agro-ecosistemas; los datos recopilados fueron analizados empleando un diseño completamente aleatorizado, prueba estadística de Kruskal Wallis y la Mediana de Mood. Así se logró demostrar que los animales dedican mayor tiempo al consumo de pasto (50,87 %) en el bimestre julio - agosto, seguido del descanso (29,30 %) en el bimestre marzo - abril y la rumia (28,40 %) en el bimestre mayo - junio, siendo estadísticamente significativos (p<0,05) entre bimestres. En cuanto al efecto del agro-ecosistema, se demostró que existió mayor tiempo de consumo de pasto en combinación con Aliso más pasto (46,79 %), seguido del descanso en el sistema de Acacia más pasto (28,36 %) y la rumia en el Testigo de solo pastizal (27,33 %), siendo estadísticamente no significativos(p<0,05) entre agro-ecosistemas. Se concluye que los efectos de bimestre fueron decisivos para ayudar a mejorar la conducta alimentaria; sin embargo, se recomienda realizar la investigación para evaluar en un periodo más prolongado en la conducta alimentaria de los bovinos.
Depresión como consecuencia del maltrato femenino entre 15-30 años en la Parroquia Mariscal Sucre 2019
Authors: Guillen Godoy Mauricio Alfredo , Guallo Neira Mayra Alejandra , Guacho Gualli Flor Abigail , Benítez Reinoso Allison Meliza
Published: January 2021

La integridad de la mujer siempre ha sido catalogada como el sexo más débil y por ende la constancia de la violencia hacia las mismas se ha considerado como un problema de salud pública que afecta a la situación social, psicológica y física, obstaculizando su verdadero desempeño en la sociedad característico de la depresión. Es por ello que el objetivo del presente artículo fue relacionar la influencia de la depresión en la vida cotidiana de mujeres a partir del estrès postraumático como resultado de la violencia en sus diferentes formas. En este contexto, la distensión social por falta de apoyo emocional permitió conocer de manera cualitativa el enfoque de la investigación descriptiva; por otra parte, la cuantificación de las encuestas se realizó a una muestra de 101 mujeres pertenecientes a la Parroquia Mariscal Sucre a partir del Test de Yesavage y preguntas adyacentes se observó que el 40% de las encuestadas resultaron positivo al test. Asimismo, la continuación de las preguntas concluyó la naturaleza de la mujer tiende a deprimirse fácilmente pero cuando existe compromiso sentimental como son las parejas de unión libre y la violencia de por medio la estabilidad emocional se quiebra hasta el punto de ser atemorizadas al compartir dichas experiencias con otros de confianza.
Development of moral and ethical qualities of primary schoolchildren through a reflective environment (through the example of mathematics and music lessons)
Authors:   State Humanitarian and Technological University, Kolycheva Galina Yu. , Kalinina Irina G. ,   State Humanitarian and Technological University, Zavarina Svetlana Yu. ,   State Humanitarian and Technological University
Published: January 2021

Introduction. The development of pedagogical science requires the introduction of new technologies, forms, and methods of influencing children’s microcommunity. At the present stage of social development, the need for moral and ethical education of the younger generation increasingly arises as the assimilation of external requirements for behavior in accordance with their own convictions, which are actively developing in primary school age. In this regard, it is relevant to study the possibilities of using the reflective environment in multidirectional mathematics and music lessons. The purpose of the study was to study the development of moral and ethical qualities as a result of the organization of a reflective environment at mathematics and music lessons for children of primary school age. Materials and methods. The experimental study was conducted from September 2016 to May 2020. The study was conducted in the Municipal Educational Institution “General Secondary School No. 22” and the Municipal Budgetary General Education Institution “General Secondary School No. 28” in Orekhovo-Zuevo, Moscow Region. Two hundred and twelve schoolchildren studying at these schools took part in the study. The χ2-Pearson statistical test was used for statistical processing. Results. The results obtained during the ascertaining stage of the experiment made it possible to identify and characterize a number of shortcomings in the cognitive, emotional, and behavioral components of the moral and ethical development of primary schoolchildren. In accordance with the need to develop moral and ethical qualities, an appropriate reflective environment was organized in the experimental classes of both schools. The development of moral and ethical qualities of primary schoolchildren through the reflective environment was successful, which is confirmed by statistically significant differences at the control stage of the experiment (χ2 = 42.27>χ20.05). Discussion of results and conclusion. The need for the formation of reflexive abilities in primary school age necessitates the creation of a special environment, the use of effective author’s techniques. It is advisable to include the use of reflective practice-oriented situations in the structure of mathematics and music lessons.