bluuebunny/crossref_metadata_2025 huggingface dataset:
Research on Rheological Disturbance Damage Laws of Rock in the Strength Limit Neighborhood
Authors: Lu Changliang , Wang Bo , Hu Shiyu , Huang Zikang
Published: April 2021

As coal mining enters deep, the rock is close to the strength limit neighborhood, and it is extremely susceptible to deformation and damage due to disturbance. In order to study the damage evolution law of rock in the strength limit neighborhood, red sandstone is selected as the research object, and the self-developed RRTS-IV rheological disturbance experimental system and nuclear magnetic resonance test equipment are used to carry out the gradual loading test of the rock rheological disturbance effect. Through the analysis of the test results, it is concluded that the instantaneous elastic modulus damage of the rock is accelerated rapidly with the increase of the number of disturbances in the strength limit neighborhood, and the disturbance becomes proportional to the instantaneous strain of the rock. At the same time, through parameter identification of the rock rheological data under different disturbance times, the rheological damage constitutive model is established, and the test results are in good agreement with the fitted curve. This shows that the establishment of this model is reasonable, and it can reflect the damage characteristics of the rock in the strength limit neighborhood under the action of different disturbance times, and the relaxation time and the disturbance times increase exponentially
Self-Directed Learning Readiness (SDLR) among Foundation Students from High and Low Proficiency Levels to Learn English Language
Authors: Razali Abu Bakar , Xuan Lim Ying , Abd. Samad Arshad
Published: April 2021

Purpose – In the field of second language education, self-directed learning is really important as it can empower students to attain optimal success in language learning by engaging students to express their ideas confidently, think reflectively and make use of language learning strategies. The main aim of the present study is to investigate students’ self-directed learning readiness (SDLR) in a foundation program in a public university in Malaysia so as to find out how they perceive this approach can improve their learning of the English language at tertiary level. More specifically, the researchers intend to find answers to these research questions: 1) Are foundation students ready to use self-directed learning strategies in English Language learning? (i.e. awareness, motivation and language learning strategies); 2) Is there a significant difference in the three attributes (i.e., awareness, motivation and language learning strategies) of self-directed learning among foundation students?; and 3) Is there a significant difference between English language proficiency (upper and lower) and the three attributes (i.e., awareness, motivation, language learning strategies) in using self-directed learning strategies?
Methodology – A set of survey questionnaires with a 6-point Likert scale were administered to 400 students attending an English proficiency course (i.e., Introduction to Academic English) in the first semester of the Foundation Studies for Agricultural Science program. The data of the questionnaire were analyzed using descriptive statistics, independent samples t-test and paired samples t-test.

Findings – Results revealed that the respondents have a rather high degree of readiness to apply self-directed learning strategies in learning English. Motivation has the highest mean scores (M=4.57), followed by language learning strategies (M=4.41) and awareness (M=4.34). Results also showed that there are no difference in terms of SDLR depending on English proficiency levels, namely lower level (MUET Bands 1,2,3) and upper level (MUET Bands 4,5) (p>.05).

Significance – The findings are beneficial for students to learn more about their readiness to apply the self-directed learning strategies. In particular, these findings also provide insights for lecturers, program administrators, curriculum developers, and policy makers to plan and implement suitable teaching methods, course outlines, and curricula for the development of the students’ English language abilities.
Improving Student Teachers’ Digital Pedagogy through Meaningful Learning Activities
Authors: Sailin Siti Nazuar , Mahmor Noor Aida
Published: April 2021

Purpose – This study aims to examine the attributes of meaningful learning that student teachers perceived as enabling them to improve their digital pedagogy. It is concerned with how the meaningful learning activities help to prepare student teachers to successfully integrate digital technologies in their future teaching practice.
Methodology – This study adopted a qualitative research design and was underpinned by a meaningful learning theory as the theoretical and analytical framework. A total of 24 final year student teachers participated in this study. Data were mainly collected through student teachers’ reflections regarding their learning experience. Thematic analysis was utilized to analyze and present the findings.

Findings –The findings offer some important insights into how the learning activities carried out in this Scholarship of Teaching and Learning (SoTL) project have directly and indirectly accelerated the acquisition of all the five attributes of meaningful learning. The findings of this study reveal that meaningful learning activities contribute to the improvement of the student teachers’ knowledge of and skills in using Web 2.0. This improvement has boosted their confidence to integrate digital pedagogy in future teaching practices. The findings also indicate that although student teachers value their experiences in meaningful learning activities, they have some concerns regarding firstly, their capacities in applying digital pedagogy and secondly, the practicality of integrating Web 2.0 tools in the school setting because of several inherent limitations.

Significance – Meaningful learning activities when incorporated into teacher training programmes will expose student teachers to authentic experiences which will be beneficial for their own learning and future teaching practice.
Tour Guide Simulation: A Task-Based Learning Activity to Enhance Young Thai Learnersâ€™ English
Authors: Kanoksilapatham Budsaba , Suranakkharin Todsapon
Published: April 2021

Purpose - This study aimed to explore the effects of task-based language teaching (TBLT) with a tour guide simulation as a focused activity on young Thai learnersâ€™ English speaking skill and their attitudes towards the instruction.   Methodology - Based on a three-phase framework (i.e., pre-task, during-task, and post-task), TBLT was implemented with a Grade 4 class for a period of eleven weeks. Initially, a set of English lessons developed based on the context of local tourist attractions was implemented at the pre-task stage. In the second stage, a simulated tour guide task was used to assess their ability to turn the language input into a practical and authentic use of English speaking. Subsequently, corrective feedback on each studentâ€™s performance was provided, and their attitudes towards the instruction were examined at the last stage.   Findings - The students were able to satisfactorily complete the tour guide task in English, indicating the potential of the task as a device to strengthen their speaking skill. Moreover, they generally had a favourable attitude towards the instruction.   Significance - These findings are significant for both school teachers and curriculum designers. In addition to confirming the effectiveness of TBLT, this study highlights the promising use of context specific-based lessons and class activities as an avenue for young learners to practice speaking English in a context relevant to them.
Menangani Kekaburan Kemahiran Prosedur dan Terminologi Awal Matematik: Pendekatan Leksis Berdasarkan Teori Prosodi Semantik
Authors: Sarudin Anida , Mohamed Redzwan Husna Faredza , Osman Zulkifli , Raja Maâ€™amor Shah Raja Noor Farah Azura , Mohd Ariff Albakri Intan Safinas
Published: April 2021

Tujuan- Kajian ini bertujuan mengenal pasti pedagogi guru awal Matematik dalam kalangan kanak-kanak di Pusat Anak PERMATA Negara (PAPN) dan mengenal pasti sejauh manakah pendekatan leksis berdasarkan Teori Prosodi Semantik dapat menjelaskan kekaburan kemahiran prosedur dan terminologi awal Matematik. Metodologi- Kajian ini melibatkan 20 orang guru dan 60 orang kanak-kanak yang berumur 4 tahun. Sebanyak 4 lokasi kajian dipilih, iaitu di PAPN Bercham, PAPN Sg. Siput, PAPN Teluk Intan dan PAPN Besout 1. Instrumen yang digunakan dalam kajian ini ialah soal selidik dan senarai semak pencerapan dan pemudahcaraan (PdPc). Proses pencerapan PdPc hanya melibatkan 8 orang guru yang terpilih secara rawak. Kajian ini juga mengaplikasikan korpus daripada Pangkalan data Dewan Bahasa dan Pustaka (DBP) untuk meneliti kolokasi kata dan konteks berkaitan leksikal padanan, kumpul, mengasingkan dan banding. Dapatan- Hasil kajian mendapati bahawa PdPc, guru mengajar konsep padanan dengan menjelmakan perkataan cari yang sama, pilih yang sama, sama tak bentuk, sama dengan, dan tarik, manakala konsep kumpul dijelmakan dengan leksikal seperti mengikut yang sama, dan ambil semua. Seterusnya konsep asing dijelmakan dengan leksikal kira, cuba kira, ambil, masukkan, cari dan mana. Seterusnya, konsep membanding diajarkan dengan menyebut leksikal bezakan dan yang mana. Pendekatan leksis berasaskan Teori Prosodi Semantik dapat menunjukkan konteks awal Matematik, iaitu konsep padanan, kumpul, asing dan membanding dengan tepat dari pelbagai perspektif kolokasi. Signifikan- Kajian ini mengetengahkan pendekatan leksis yang dapat menawarkan strategi baharu dalam pengajaran awal Matematik berteraskan Teori Prosodi Semantik.
Learner Autonomy of Pre-Service Teachers and its Associations with Academic Motivation and Self-Efficacy
Authors: Alkan Muhammet Fatih , Arslan Mehmet
Published: April 2021

Purpose - Learner autonomy enables an individual to learn how to cope with novelties without getting any help from others. Considering the rapid changes and transformations of the 21st century, it has become essential for teachers to possess this characteristic. Moreover, measuring learner autonomy is required to determine their levels. Thus, the purpose of this two-phased study was to adapt the Autonomous Learning Scale into Turkish and to investigate academic motivation and self-efficacy as the predictors of autonomous learning. Methodology - In the first phase, the Autonomous Learning Scale was adapted into Turkish with the participation of 335 pre-service teachers. In the second phase of the study, the autonomous learning of pre-service teachers was investigated in terms of a number of demographic variables along with academic self-efficacy and academic motivation using the data obtained from 776 pre-service teachers with a survey method. Findings - For the first phase, the confirmatory factor analysis showed that Autonomous Learning Scale was a valid and reliable tool to be used in Turkish samples. For the second phase, the regression analysis revealed that academic self-efficacy and academic motivation were significant predictors of autonomous learning of pre-service teachers. Additionally, their autonomous learning significantly differed in terms of department, high school type, and gender. Furthermore, the GPAs of the pre-service teachers were significantly correlated with their autonomous learning levels. Significance - The Turkish version of the Autonomous Learning Scale was presented to researchers. The relationships between autonomous learning and self-efficacy along with motivation have been asserted in a number of studies. However, the present study not only confirmed the correlations among these variables, but also revealed the predictive powers of these variables on autonomous learning. Therefore, teacher educators and policy makers can gain insights from these findings.
The Shadow Education System: Studentsâ€™ Responses to Private Tutorial Learning
Authors: K Jayaraman , Koon Seow Soo , Annamalai Nagaletchimee
Published: April 2021

Purpose - In Malaysia, many families devote a portion of their income to private tutorial learning fees. Many parents, especially those who stay in urban areas, send their children for private tutorial learning. This research investigated the challenges of a shadow education system by analysing Malaysian secondary school studentsâ€™ reactions to private tutorial learning. Methodology - A survey instrument with a structured questionnairewas designed on a webpage and delivered via email and Virtual Learning Environment through Frog Asia, which is the first company to connect Malaysian schools through a single cloud-based learning platform. The online survey approach was chosen as a convenient and cost effectiveness means of interacting with respondents who were dispersed in various geographical locations across the country. 148 respondents from three Malaysian states, Penang, Perak and Johor, were identified using convenience sampling. Findings - The results showcase the reasons for choosing private tutoring from both studentsâ€™ and parentsâ€™ perspective. Significant findings revealed that the factors influencing studentsâ€™ choice to attend private tutorial learning were the school environment, social influence, rigidity of the school system, studentsâ€™ learning attitude and affordability for parents. The study also indicated that parents were exercising excessive force on studentsâ€™ academic choices, which increased tension and anxiety among their children. Parental influence can be stressful and have a traumatic impact on childrenâ€™s learning abilities. Furthermore, it was found that students were missing extra-curricular activities. Significance - The secondary school syllabus is too crammed and its scope is too wide, leading school teachers to complete it without in-depth teaching and learning activities. Due to peer influence, private tuition becomes a routine activity, causing school students to miss extra-curricular activities. Ultimately, a good outgoing school student is a potential candidate for higher education, and educationally qualified and skilled persons are needed for the future economy of Malaysia. It is suggested that education policy makers should not introduce a rigid curriculum as rigidity leads to rote learning and produces poorly talented children.
A study on the quality of life among stroke survivors: A cross sectional study
Authors: Sahu Rajesh Kumar , Kumar Sunil , Yadav Pankaj
Published: April 2021

Background: The World Health Organization defines - Health as a “state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”

Methodology: A cross sectional study on 96 patients with stroke aged more than 30 years was carried out NIMS Hospital, Jaipur for a period of 4 months from 1st January 2018 to 30th April 2018.

Results: Out of 96 patients, Mean quality of score of patients with stroke was 65.04±9.982 there was significant difference seen in quality of life score according to sex, side of lesion, duration of stroke, socioeconomic status, occupation and hypertension.

Conclusions: It can be said that quality of life is a multidimensional concept. As stroke cases is among the most devastating of health aspect, having multiple and profound effects upon all aspects of life, hence evaluation of quality of life is very important. Each and every effort should be made to improve these aspects and in turn to activity daily living (ADL) and improve the overall quality of stroke patients.
Incidence of Hashimoto Thyroiditis Among Libyans: A Retrospective Epidemiological Study
Authors: Atia Ahmed , Alathream Rihan , Al-Deib Abdulwahab
Published: April 2021

Background and aims. Hashimoto's disease is an autoimmune disorder in which the body produces antibodies that attack the thyroid gland, leading to chronic inflammation, destruction of the gland, and hypothyroidism. This study aimed to assess the epidemiology of this disease among Libyan patients. Methods. A cross-sectional retrospective study conducted from June 2012 to April 2020 in order to examine the anti TPO level among Libyan population. Data was collected from eastern and western part of Libya, and were analyzed from available sample for 244 apparently patients with thyroid disorders collected from different private clinic’s laboratories. The analysis for serum anti-TPO was done by electrochemiluminescence protein binding assay (ECLIA) using Roche diagnostics and Cobas e411 analyzer. Results. The current results showed that females predominate the study, and most of them were in the age group of (>40) years old. About 49.18% of these cases were suffering from Hashimoto's disease (High ATPO level). The mean value of anti-TPO status among females was (0.5±2) nmol/L, while among males it was (0.45±3) nmol/L. Significantly, more women (81.66%) had Anti- TPO Above (34 IU/ml), compared to (18.33%) of male participants. Conclusion. Hashimoto disease is common among patients with thyroid dysfunction especially females. Our findings suggest that different interventional strategies are needed to reduce the chances of developing Hashimoto’s and its associated negative health outcomes in Libya.
Formative Assessment: The Malaysian English Language Primary School Teachers’ Pedagogical Beliefs and Values
Authors: Jonglai Stephania Albert , Pike Mark , Lamb Martin
Published: April 2021

This study investigated the beliefs and practices of primary school English language teachers in eastern Malaysia with regards to the country’s School-Based Assessment (SBA) reform. The study also investigated the contextual factors affecting the teachers’ beliefs and practices, aiming to understand the effects of these beliefs on their practice of SBA in order to extend our understanding of teachers’ interpretations of SBA, the challenges influencing these interpretations and thus, what affects the implementation process. After preliminary interviews with seven teachers, the study selected three who had an understanding of and knowledge about SBA and examined their claims to be implementing it. The study conducted classroom observations and then, using post-observation interviews, explored the reasons behind the teachers’ practices. The teachers interpreted and implemented SBA using their pedagogical knowledge and beliefs and incorporating existing teaching–learning practices, and they showed awareness of the goals and aims of the SBA initiatives. However, contextual factors affected their implementation process, and thus, their practices deviated from some of the underlying principles and objectives of the SBA policy. The study pointed to a limited uptake of the SBA policy and provided evidence of the importance of studying both the teachers’ prior or existing beliefs about assessment and the contextual factors, to understand the motives behind the teachers’ actual assessment practices and their attitudes towards assessment reforms.
Filipino Adolescents’ Experiences of Abusive Parent-Child Relationship in Low Socioeconomic Status Families
Authors: Sabarre Jess , Villareal Paulo Louis H. , Arcinas Myla
Published: April 2021

This phenomenological-qualitative study aimed to describe how an abusive parent-child relationship of selected Filipino adolescents from an intact family of low socioeconomic status affects the perceptions of their potential romantic partner, marriage, and family. The study also uncovered their coping mechanisms and support system.  The seven informants were identified using a purposive sampling technique. The researchers devised an open-ended interview guide to elicit information from the informants and were conducted with a guidance counsellor. With the use of content analysis, the study revealed that their abusive experiences with one or both parents have significantly affected their perceptions. Most of them have resorted to using negative coping strategies and that their grandparents stood as their extended family support system with their friends as their non-family support system. The informants displayed a significantly entrenched position on the characteristics of their future marital partner and family. However, they have shown disapproval of marriage due to their experiences. The study also exposed that mothers have been more present in the abusive parent-child experiences than the fathers, which contradicts expectations that fathers act as strict disciplinarians and mothers being the child's protector in Philippine Culture. The study exposed the experiences of children in verbal and physical abuse in their homes from intact families with low socioeconomic status in Metro Manila, wherein expounds on the type of social support these children have been given and the kinds of coping mechanisms that are prevalent in their experiences and how these abusive parent-child experiences reflected with either positive or negative on their perception of marital partner, the concept of marriage, and concept of family, wherein provides substantial knowledge on how these experiences can be handled and faced in terms of treatment.
A Preliminary Study on the Meranaw Traditional Balod “Tie-Dye” Technique in Weaving
Authors: Alauya Casmin B.
Published: April 2021

This paper is a historical narrative study documenting two of the most ancient living Meranaw cultural heritage: kapanga-awl (weaving) and kapamalod (tie-dyeing). These century-old surviving crafts serve as a testament to a very long-standing contacts and trade relations between the Philippines and her neighboring countries such as India, China and the Asian countries, more particularly Indonesia whose Ikat (from an ancient Indonesian word mengikat which means to tie or bind) weaving style closely resembles the Meranaw balod technique in weaving. What links the Philippines with these countries and what finds the Meranaw more similar to the weaving tribes in Northern Luzon and Southern Mindanao are their weaving culture. Highlights of this paper include the origin of the balod technique in weaving, their ingenuity with regards to the use of natural and indigenous raw materials for weaving and some mythical performances, ceremonies, and ritual offerings associated with the balod craftsmanship. Significantly, the research aimed to enable the readers to appreciate and understand the said weaving cultural heritage. It addresses the issues of saving this cultural heritage; otherwise, weaving may suffer the fate of other Meranaw indigenous arts that have diminished and faded into oblivion. This paper recommends preserving such weaving cultural heritage through continuous recording or documenting, archiving, preserving them in their living form, and ensuring its transmission to the next generation.
Critically Examining Perceptions of Different Englishes in the IELTS Speaking Section: Who Decides What is Acceptable?
Authors: Michell Colin
Published: April 2021

The International English Language Testing System (IELTS) has become the worldwide benchmark for evaluating English language proficiency. However, the IELTS exam is not without its critics. It has been accused of being elitist and unaccommodating of test-takers who are not users of the prestige varieties of English, even though these people may need to take the exam for employment or immigration purposes. This study involved a focus group of experienced IELTS examiners who were given a number of listenings from non-standard yet still ‘native speakers’ of English to evaluate using the IELTS speaking bands. The focus group found that the IELTS speaking descriptors are not fit for purpose when dealing with non-standard or regional varieties of English. This study makes a case for the creators of the IELTS exam to adjust their grading criteria and examiner training to be more inclusive of all English varieties.
Separating wheat from Chaff: A dilemma for Intensivists in the age of Pandemics!!
Authors: Kulkarni Atul Prabhakar
Published: April 2021

Abstract not available

Bangladesh Crit Care J March 2021; 9(1): 1-3
Hand hygiene skills of the health care workers and the effect of training and educational intervention: A single center cross-sectional study
Authors: Shrestha Gentle Sunder , Shrestha Manjit , Sharma Roshan , KC Ramchandra , Shrestha Bibeka , Pradhan Rojika , Joshi Pankaj
Published: April 2021

Background: Hand hygiene is one of the most effective preventive measures in the transmission of infection. Proper hand hygiene strategies in health care facilities can reduce nosocomial infections and antimicrobial resistance.

Objectives: This study aims to assess the baseline hand hygiene skills among health care workers and the impact of education and training on it.

Design: Interventional cross-sectional single center study.

Method: It was conducted among 181 health care workers of Alka Hospital Pvt. Ltd. During both pre and post-test, participants were asked to perform hand hygiene with soap and water as per WHO guidelines. Pretest was conducted to assess baseline skills of health care workers regarding hand hygiene. An observer would score whether each of the steps were performed correctly, using a checklist. It was followed by intervention in the form of training, education and demonstration of hand hygiene. Post-test was conducted to assess the changes in skills after intervention.

Results: There was an overall improvement in the hand washing skills post intervention indicated by an increase in median score, which was 8 for pre-intervention and 9 for post-intervention. Doctors and nurses had better practice regarding hand hygiene in comparison to other participants. Those participants who had prior training on infection prevention and control, were found to have better hand hygiene skills post-intervention.

Conclusion: Training and educational interventions are the effective tools to improve hand hygiene skills of the health care workers. Performing such interventions at regular intervals can be helpful.

Bangladesh Crit Care J March 2021; 9(1): 12-15
Evaluation of Percutaneous tube Thoracostomy Performed by Trainee in both Trauma and non-Trauma Patients
Authors: Maula Kulsum , Alam Md Kamrul , Khalil Md Ibrahim , Hasan Md Nazmul , Faruq Mohammad Omar
Published: April 2021

Background: Percutaneous Tube Thoracostomy (PTT) is an invasive procedure that can save life now and then in different traumatic and non-traumatic conditions. But still it is an enigma; how our trainee surgeons are at home in this procedure.

Objectives: To evaluate the outcome of the percutaneous tube thoracostomy performed by trainee in both trauma and non-trauma patients.

Study design: Prospective, Observational study. Duration of study was September, 2019 to February, 2019.

Methods: All patients who need PTT in traumatic and non-traumatic conditions were selected by purposive sampling. Thereafter, they were scrutinized according to eligibility criteria and 96 patients were finalized. A pre-tested, observation based, peer-reviewed data collection sheet was prepared before study. Data regarding clinical and surgical outcome profile were recorded. Data were compiled, edited, analyzed.

Results: Among 96 patients, the highest 32.29% belonged to age group 31-40 years and lowest 9.37% belonged to age group ≤20. The mean age of the respondents was 29.19±9.81. We found out of 96 patients, 70(72.91%) were indicated PTT for traumatic conditions and rest 26(27.08%) were indicated PTT for non-traumatic chest condition where 36(37.5%) had simple penumothorax, 21(21.87%) haemothorax, 14(14.58%) massive pleural effusion, 13(13.54%) tension pneumothorax, 10(10.41%) haemopneumothorax, and 2(2.08%) had pyothorax respectively. In 53.12% patients had right sided intercostal chest tube (ICT) insertion whereas 46.87% had left sided ICT insertion. In our study, 89.55 % tube was placed at normal anatomical position. Besides, 10.41% tube thoracostomy were performed deviated from anatomical site. Among 96 patients 62.5% patients had length of incision 2-3cm, 35.41% had >3cm and 2.08% had <2cm respectively. Out of 96 patients 75(78.13%) showed uneventful outcome whereas 21(21.87%) had complications including 11.15%(11) each had wound infection, 4.46%(4) subcutaneous emphysema, 4.28%(3) drain auto expulsion, 2.85%(2) hemorrhage, 1.45%(1) had non-functioning drain and empyema with ascending infection respectively (p=<0.05).

Conclusion: PTT is a life saving procedure that is most frequently implemented in chest trauma patients of our country. In majority cases, outcome of PTT were uneventful (78.13). Besides this more than one third of patient had length of incision more than 3 cm that needed extra stitches and 10.41% cases PTT were placed other than the normal anatomical site. Trainees of Dhaka Medical College Hospital are doing well in their performance of PTT insertion but still some anatomical orientations are necessary to avoid operative and post-operative complications

Bangladesh Crit Care J March 2021; 9(1): 28-33
Effect of low dose Methotrexate in newly diagnosed Rheumatoid arthritis case
Authors: Sobhan Fauzia , Moiz Khaza , Siddiquee Naima , Debnath Aditi , Haque Fazlul , Rahman Zanifar
Published: April 2021

Rheumatoid arthritis is a painful debilitating joint disease with the proliferation of the synovium and progressive erosion of cartilage and bone. Methotrexate (MTX) has been used for the treatment of Rheumatoid Arthritis (RA) for about 3 decades. It is most effective and commonly used Disease Modifying Antirheumatic Drugs (DMARDS) because it improves symptoms, signs, disease activity and functions. This study was done from January 2016 to December 2016 for a period of 1 year under Physical Medicine and Rehabilitation department, Jalalabad Ragib-Rabeya Medical College (JRRMC), Sylhet. Here we treated the patients with low dose methotrexate. Study was done to see the effect of low dose MTX in newly diagnosed RA patients by clinical examination and DAS 28. DAS stands for disease activity score and 28 joints that are examined in this assessment. The result concluded low dose MTX improves the symptoms, signs, disease activity and functions of the patients.

Bangladesh Crit Care J March 2021; 9(1): 34-37
Sudden Cardiac Death and Catecholaminergic Polymorphic Ventricular Tachycardia: What Genetic Medicine could offer
Authors: Bhuiyan Zahurul A
Published: April 2021

Abstract not available

Cardiovasc. j. 2021; 13(2): 106-111
Early Outcome of Minimally Invasive Direct Coronary Artery Bypass Surgery- A hospital based study
Authors: Akhter SM Quamrul , Rahim AM Asif , Azad Quazi A , Maruf MF , Ahsan NA Kamrul
Published: April 2021

Background: coronary artery bypass surgery (CABG) is expensive, uses disposable appliances and patients require more perioperative intensive care, long stay in hospital and often have a lengthy recovery time. These complications, together with the growing trend towards less invasive techniques in other areas of surgery, have encouraged cardiac surgeons to see if minimally invasive cardiac surgery can become a reality with improved outcomes and costs.

Methods: This is a prospective nonrandomized comparative clinical study done at the Department of Cardiac Surgery in National Institute of Cardiovascular Diseases (NICVD) Sher-E- Bangla Nagar, Dhaka from July 2006 to June 2008 among routine CABG patients. Purposive sampling was done with 26 patients in group A selected for MIDCAB and 24 patients in Group B selected for conventional CABG surgery. Patients were followed up for three months. Postoperative outcomes were assessed to evaluate the safety and efficacy of MIDCAB in relation to conventional CABG.

Results: Mean age were 54.19 vs 53.87 in group A and Group B. 92.3% vs 87.5% were male respectively. Mean duration of operation, per operative blood loss transfusion and arrythmia were lower in MIDCAB group (p<0.05) number of grafts were also statistically significant (p< 0.001). Regarding post-operative outcome ventilation time in hours ICU stay post-operative hospital stay in days, postoperative MI and stroke rate were lower in favor of group A MIDCAB patients (p<0.001). Three months postoperatively six-meter walking distance is also statistically significant in favor of Group A MIDCAB (p<0.01) patients. However, pain score in early post-operative period was higher in group A significantly but it decreased significantly in late post-operative period which is also highly statistically different (p<0.001). However, mortality and quality of life at three months were similar in both groups.

Conclusion: No difference in mortality rates detected between MIDCAB and CCABG group. But there was evidence that MIDCAB is associated with less perioperative and early postoperative morbidity and improved quality of life. The MIDCAB surgery is an effective procedure of complete revascularization in ischemic heart diseases like CCABG. The procedure is associated with shorter operating time, shorter ICU stay time, shorter hospital stays and better quality of life than for CCABG.

Cardiovasc. j. 2021; 13(2): 135-143
Study on Heart Failure Patients Admitted in National Institute of Cardiovascular Diseases
Authors: Alam Nur , Majumder Abdullah Al Shafi
Published: April 2021

Background: Heart failure is a complex clinical syndrome that arises secondary to abnormalities of cardiac structure and/or function (inherited or acquired) that impair the ability of the left ventricle to fill or eject blood. There is a paucity of data on characteristics of the patients of heart failure admitted in hospitals in terms of demographic and etiological information. So, this study aimed to see the disease burden of heart failure patients and the age and sex specific prevalence of heart failure among patients admitted into NICVD and to identify the etiological pattern of diseases leading to heart failure with associated comorbid factors.

Methods: It was a cross sectional study carried out at National Institute of Cardiovascular Diseases (NICVD) Dhaka Bangladesh and was conducted from January 2015 to December 2015. Total 400 heart failure patients were taken.

Results: The mean age of the patients were 54 ± 14 years ranging from 16 to 95 years with a high preponderance of male. Most the patient population was in the age group of 51- 60 years (29.5%). 79% of the cases were male & 21% female by gender specification. Ischaemic cardiomyopathy (ICM) was found to be the common cause of heart failure (n=153, 40.75%) followed by Acute coronary syndrome (32.5%) and Valvular heart disease (18.25%). The patients with heart failure having acute coronary syndrome (n=107) had hypertension (46.8%) as the most prevalent major risk factor. In the present study only 11% patient had heart failure with preserved ejection fraction. Mortality rate of the study population were 6.3%.

Conclusion: In this study, the most common cause of heart failure is ischaemic heart disease. So, patients of acute and chronic ischemic heart disease patients should be treated and follow up with care. Clinical and epidemiological studies are needed to explore further.

Cardiovasc. j. 2021; 13(2): 172-176
Early Outcome of Mitral Valve Replacement in Patient Having Mitral Stenosis with Moderate Pulmonary Hypertension
Authors: Zaman MH , Rahim AM Asif , Rashid MZ , Hasan MK , Islam MS , Sharker MK
Published: April 2021

Background: Mitral valve replacement (MVR) plays a central role in the management of patients with mitral stenosis with moderate to severe pulmonary hypertension. Pulmonary hypertension has an impact on short term outcome of MVR. It can influence left ventricular function (low output syndrome), incidence of arrhythmia, ARDS leading to respiratory failure and right ventricular failure which may be irreversible.

Methods: The immediate postoperative hemodynamics in 40 patients with moderate to severe pulmonary arterial hypertension who underwent mitral valve replacement (BLMV) between July 2010 and June 2012 were studied prospectively. Patients were divided into two groups: Group A (n=20): Patient having MS with moderate pulmonary hypertension (PASP: 40-59 mm-Hg) and Group B (n=20): Patient having MS with severe pulmonary hypertension (PASP e” 60mm-Hg). Total two follow up were done- 1st follow up after 10 days and 2nd follow up after 1 month of MVR. Each patient was assessed by medical history, clinical examination & color doppler echocardiogram.

Results: It was shown that surgery can be beneficial for the patients if MVR is done in the state of mild PAH irrespective of age but beyond this level of PAH, the patients may still remain with mild pulmonary hypertension which may trigger the cascade of pulmonary vascular Disease may be the cause of unsatisfactory outcome. So, early surgical outcome of mitral stenosis with moderate pulmonary hypertension is better than mitral stenosis with severe pulmonary hypertension.

Conclusion: We conclude that MVR in patients having MS with moderate PAH is a safe and effective measures for preventing pulmonary hypertension related complications.

Cardiovasc. j. 2021; 13(2): 177-182
Vitamin D Status and Acute Coronary Syndrome – A Single-Centre Study
Authors: Rahman Mohammad Saidur , Alam Muhammad Badrul , Islam AKM Monwarul , Ahmad Tanveer , Md Wareshuzzaman - , Shimu Ishrat Jahan
Published: April 2021

Background: Vitamin D are needed for normal functioning of cardiovascular system, and its deficiency has been linked to different cardiovascular disorders, including hypertension. However, the relationship between vitamin D deficiency and ischaemic heart disease is not yet clear. The present study was intended to find out the association between serum vitamin D level and acute coronary syndrome (ACS).

Methods: The cross-sectional analytical study was carried out in a tertiary care hospital of Dhaka, Bangladesh. Fifty-one consecutive ACS patients admitted into the Department of Cardiology of the hospital were considered as the cases and 51 apparently healthy subjects were considered as the controls. The exposure and outcome variables were serum vitamin D and ACS respectively. Vitamin D insufficiency and deficiency were defined as serum 25(OH) D <30-20 ng/ml and <20 ng/ml, respectively. Severe vitamin D deficiency was defined as serum 25(OH) D <10 ng/ml.

Results: Hypovitaminosis D was prevalent in both cases and controls; however, the mean serum 25(OH) D was significantly lower in the former than the latter (14.2 ± 5.9 ng/ml vs. 18.2 ± 6.3 ng/ ml, respectively; p <0.001). Vitamin D insufficiency and moderate deficiency (serum 25(OH) D <20- 10 ng/ml) did not differ significantly between the groups, but severe deficiency (<10 ng/ml) was significantly more common in patients with ACS compared to the healthy controls. The risk of having moderate and severe vitamin D deficiency was 1.9-fold (95% CI = 0.8 – 4.7) and 22.8-fold (2.9 – 180.4) higher for ACS patients than for healthy subjects (p = 0.173 and p <0.001, respectively).

Conclusion: Vitamin D deficiency is more common in patients with ACS compared to those without ACS. However, the independent association between vitamin D deficiency and ACS needs further evaluation.

Cardiovasc. j. 2021; 13(2): 183-188
Echocardiographic Evaluation of Pulmonary Haemodynamics - A Review
Authors: Kabir MS , Majumder AAS , Ahmed AFKU , Rubaiyat KA , Jhan A , Rabbani ASMG , Haque SMS
Published: April 2021

Pulmonary haemodynamic status has got significant clinical and prognostic significance both in structural and nonstructural heart diseases. But diagnostic accuracy depends on much care in evaluation and logical correlation of different echocardiographic parameters. Though the Doppler studies play crucial role in estimating Pulmonary haemodynamics, careful observation of 2-D measurements of different structures as well as RV systolic and diastolic function are vital issues to be addressed and correlated for diagnostic accuracy. Tricuspid Valve, RVOT and Pulmonary valve pathologies also demand vivid correlation while estimating PA pressures and pulmonary vascular resistance. Mere presence of elevated pulmonary artery systolic pressure is not enough to define pulmonary hypertension (PH). Before declaring a patient having PH a comprehensive evaluation of right heart haemodynamics is to be performed carefully to avoid unnecessary cardiac catheterization or to avoid inadvertent initiation of PH therapy.

Cardiovasc. j. 2021; 13(2): 200-216
Patent Foramen Ovale Device Closure in a 27 Years Old Young Lady with Cryptogenic Ischaemic Stroke - First Case Report from Bangladesh
Authors: Reza AQM , Karim Aparajita , Khan Mahmood Hasan , Rahman Kazi Atiqur , Joarder Md Aliuzzaman , Talukder Shahab Uddin , Munwar Shams , Ali M Atahar , Ahmed Tamzeed , Islam AHM Waliul
Published: April 2021

A patent foramen ovale (PFO) is highly prevalent in patients with strokes of unknown cause or cryptogenic strokes (CSs). It has been remained an unsolved question as to whether a PFO should be closed or not to prevent recurrent strokes in patients diagnosed with cryptogenic stroke (CS). A paradoxical embolism through a PFO is pointed as a leading cause of CS, especially in younger patients with low risk factors for stroke. It also remains an unsolved matter on type of anti-coagulation therapy, which would be better for patients with CS and a PFO. In addition, surgical and transcutaneous closure of a PFO has been proposed for the secondary prevention of stroke in patients with CS with PFO. Several randomized controlled trials have been conducted in recent years to test whether a PFO closure gives a significant benefit in the management of CS. Many investigators believed that a PFO was an incidental finding in patients with CS. However, meta-analyses and more recent specific trials have eliminated several confounding factors and possible biases and have also emphasized the use of a shunt closure over medical therapy in patients with CS. Therefore, these latest studies can possibly change the treatment paradigm in the near future. We are reporting a case of cryptogenic ischaemic stroke in middle cerebral artery territory due to paradoxical embolism through a PFO which was successfully closed with a device solely by a Bangladeshi Consultant & his team first time in Bangladesh.

Cardiovasc. j. 2021; 13(2): 227-234
Atitudes relacionadas a colaboração interprofissional entre os profissionais da Atenção Primária em Saúde
Authors: Durans Keyla Cristina Nogueira , Silva Mayara Cristina Pinto da , Miranda Aline Ferreira , Sousa Heloisa Ferreira de , Lima Sara Fiterman , Pasklan Amanda Namíbia Pereira
Published: April 2021

O estudo buscou caracterizar as atitudes relacionadas à colaboração interprofissional entre os profissionais de saúde da Atenção Primária em Saúde de um município no Maranhão. Para isso, foi realizado um estudo transversal com 173 profissionais de saúde. Foram aplicados questionários sobre a colaboração interprofissional, com a Escala Jefferson de Atitudes Relacionadas à Colaboração Interprofissional, e sobre aspectos demográficos, de formação e atuação profissional deles. Os dados foram organizados em planilhas no Microsoft Excel, em formato de percentual e analisados por meio do programa Stata versão 14. A maioria pesquisada era do sexo feminino, com média de idade de 36,3 anos, profissão agente comunitário de saúde. Identificou-se que os atributos tempo de exercício da profissão, tempo de Atenção Primária em Saúde e especialização configuraram-se como aspectos ligados a atitudes relacionadas à colaboração interprofissional. Nossos achados demonstram que os profissionais da Atenção Primária em Saúde possuem atitudes relacionadas à colaboração interprofissional sendo que é necessário ferramentas de educação continuada para que as competências colaborativas sejam melhor compreendidas e praticadas por esses profissionais.
Portfólio E-V eficiente: Bibliometria das evoluções considerando simulação ou métricas do risco com espaço objetivo aumentado
Authors: Mendes Marcos Huber , Souza Reinaldo Castro , Sanfins Marco Aurélio , Silva Tuany Esthefany Barcellos de Carvalho , Martins Lucas Mattos
Published: April 2021

A produção científica e a necessidade de indicadores que a quantifique se fortaleceu e cresceu nas últimas décadas, como também a de ferramentas que auxiliem na sua mensuração e a busca por técnicas para analisar de forma temporal, entre outras, o volume de publicações, autores, citações e citações das referências. A bibliometria é uma importante técnica quantitativa e estatística para medir índices de produção e conhecimento científico utilizando softwares, palavras chaves de interesse e títulos para realizar levantamentos bibliométricos em plataformas de repositórios de artigos científicos, teses e livros. O trabalho objetiva analisar a veracidade de duas suposições sobre as evoluções, até a presente data, do modelo da teoria de portfólio E-V eficiente de Markowitz. A primeira se existe evoluções do modelo, com simulação pelo método de Monte Carlo, que utilizem a simulação como um fim para obter a distribuição de probabilidade empírica de todos os resultados ótimos inerentes à simulação e não, pelo usual método de concentração de dados, sendo apenas um meio para se obter melhores resultados e modelos, para comparação entre modelos ou para análise de resultados dos modelos ou ainda para projeção dos resultados dos modelos em janelas de holdout. A segunda se existe evoluções do modelo utilizando métricas do risco com espaço objetivo aumentado, possibilitando a estimação de um maior número de parâmetros. A partir de softwares para análise bibliométrica se conseguiu chegar à conclusão de que na teoria analisada, e nas suas evoluções até a presente data, as duas suposições não são verdadeiras.
A influência da família na autonomia e participação do cuidado do sujeito diagnosticado com Diabetes mellitus
Authors: Souza Yara Ribeiro Santos de , Silva José Adailton da , Silva Ilisdayne Thallita Soares da , Souza Talita Araújo de , Medeiros Marília Rute de Souto
Published: April 2021

O diagnóstico da Diabetes mellitus exige participação no tratamento, e mudanças na vida de quem com ela convive, e afeta não apenas o sujeito, mas também sua família. Este estudo teve como objetivo compreender a influência da família na autonomia e participação do cuidado do sujeito diagnosticado com diabetes mellitus tipo 2. Trata-se de uma pesquisa de campo do tipo participativa, sustentada na teoria da reflexividade e com abordagem qualitativa. Dezesseis sujeitos que convivem com a diabetes participaram de encontros de um grupo de promoção da saúde. Estes participaram de oito encontros para a produção de dados, em um grupo do tipo fechado, entre os meses de maio e agosto do ano de 2017.  Os resultados obtidos mostraram que os fatores que influenciam na adesão ao tratamento são multifatoriais e que nem sempre estão diretamente associados à síndrome, mas também à maneira como as pessoas vivem e se relacionam com os outros. Entre as conclusões do estudo, o apoio da família da pessoa que convive com a síndrome é essencial nesse processo, contudo, constatou-se que os participantes identificaram aspectos negativos no zelo que os familiares assumem em relação ao tratamento. Desse modo, o grupo proporcionou reflexões acerca do autocuidado dos indivíduos e da importância destes se tornarem responsáveis pelo tratamento e pela busca da autonomia para seus estilos de vida.