bluuebunny/crossref_metadata_2025 huggingface dataset:
Perbandingan Penggunaan Data Hasil Pengukuran Awal Dengan Pengukuran Kedua Menggunakan Software Autocad Landesktop 2009
Authors: Jarwanto Jarwanto
Published: August 2022

INTISARIPenelitian dilakukan pada area tambang batu split atau batuan beku ultrabasa, terletak di daerah Awangbangkal, Kecamatan Karangintan, Kabupaten Banjar, Provinsi Kalimantan Selatan. Data yang digunakan terdapat 2 data yang dapat disebandingkan. Data pertama adalah data yang telah didapatkan sebelumnya namun kurang detil bila dibandingkan data terakhir. Data yang kedua dimungkinkan adalah data yang cukup detil karena sudah menggunakan peralatan sederhana namun lebih baik daripada saat pengambilan data pertama. Entrey data untuk kedua data adalah sama mulai dari pengolahan secara manual, pengolahan menggunakan Microsoft excel, hingga ke Notepad. Pada entry data menggunakan Software Autocad Landesktop 2009, terlihat data pertama kurang detil, sehingga untuk data kedua yang lebih detil dapat dihubungkan dengan hasil potret pada googlemap. Overlay  antara data titik koordinat dengan hasil potret google map, terlihat lebih realistis karena dapat secara langsung mengetahui tinggi rendah elevasi pada lahan. Titik titik berupa point yang ditampilkan dapat dibuat kontur yang selanjutnya dapat dibuat penampang melintang atau irisan dengan visualisasi atau dapat dilihat dari samping. Hasil keseluruhan analisa dibuat skor, hasil skor menunjukkan bahwa data 2 lebih baik hasilnya dibandingkan dengan data pertama.Kata kunci — Data Pertama, Data Kedua, Autocad Landesktop 2009. ABSTRACTThe research was conducted in a split rock quarry area or ultramafic igneous rock, located in the Awangbangkal area, Karangintan District, Banjar Regency, South Kalimantan Province. The data used there are 2 data that can be compared. The first data is data that has been obtained previously but is less detailed when compared to the last data. The second possible data is data that is quite accurate because it uses simple equipment but is better than the first data collection. The input data for the second data is the same starting from manual processing, processing using Microsoft excel, to Notepad. In data entry using Autocad Landesktop 2009 software, the first data is less detailed, so the second data which is more detailed can be seen with portrait results on googlemap. The overlay between the coordinate point data and the results of the google map portrait looks more realistic because it can immediately find out the low altitude on the land. The points in the form of points that are displayed can be contoured which can then be made transverse or transverse lines with visualization or can be seen from the side. Overall results The analysis is scored, the score results show that data 2 results are better than the first data.Keyword — First Data, Data 2, Autocad Landesktop 2009.
Penerapan Data Mining Dengan Metode Naïve Bayes Dan Learning Vector Quantization Credit Rating Dalam Memprediksi Kelayakan Pemberian Kredit Oleh PT. BPR Lebak Sejahtera
Authors: Rianto Muhammad , Rusdiah Rudi , Ichwan Hidayatul
Published: August 2022

INTISARIPihak bank dalam memberikan pinjaman perlu melaksanakan credit analisis evaluasi approval terlebih dahulu supaya resiko yang timbul dari pemberian kredit kepada calon debitur tidak terlalu besar. Data mining merupakan teknik yang memanfaatkan data dengan jumlah yang besar untuk mendapatkan informasi atau data yang berharga untuk mengambil keputusan yang penting. Data mining juga telah terbukti digunakan dalam perbankan yang mengklasifikasikan data yang berguna dan berukuran besar dalam melakukan big data dan analysis. Dalam penelitian ini studikasus yang dilakukan pada data debitur Bank PT. BPR Lebak Sejahtera Kabupaten Lebak dengan menggunakan model Naive Bayes (NBC) & Learning Vector Quantization. Dengan menggunakan teknologi di bidang data mining yang mengoptimasi proses pencarian informasi prediksi dalam basis data yang besar, serta menemukan pola-pola yang tidak diketahui sebelumnya. Naïve Bayes memprediksi probabilitas di masa depan berdasarkan pengalaman di masa sebelumnya dengan mempelajari korelasi hipotesis yang merupakan label kelas yang menjadi target pemetaan dalam klasifikasi dan evidence yang merupakan fitur-fitur yang menjadi masukan dalam model klasifikasi.  Pengolahan data berbasis data mining tersebut diharapkan dapat digunakan sebagai alat bantu dalam memprediksikan kelayakan kredit yang memperkirakan layak atau tidaknya pemohon atau nasabah untuk diberikan kredit..Kata kunci— Data Mining, Naïve Bayes, Learning Vector Quantization , Bank, Kredit. ABSTRACTThe bank in providing loans needs to predict the feasibility of applying for credit in advance so that the risks arising from lending to prospective debtors are not too great. Data mining is a technique that utilizes a large amount of data to obtain valuable information or data to make important decisions. Data mining has also been shown to be used in banks that classify useful and large-sized data. In this study, the case study was conducted on the data of the bank debtors. PT. BPR Lebak Sejahtera District using Naive Bayes (NBC) Learning Vector Quantization model. By using technology in the field of data mining that optimizes the process of searching for predictive information in large databases, as well as finding previously unknown patterns. Naive Bayes predicts future probabilities based on previous experience by studying the correlation of hypotheses that are class labels that are the target of mapping in classification and evidence which are features that are input in the classification model. Data mining-based data processing is expected to be used as a tool in predicting creditworthiness that estimates whether or not the applicant or customer is eligible for credit. Keywords— Data Mining, Naïve Bayes, Learning Vector Quantization, Bank, Credit.
Implementasi K-Nearest Neighbor Untuk Prototype Sistem Pakar Identifikasi Dini Penyakit Jantung
Authors: Munandar Tb Ai , Munir Agus Qomaruddin
Published: August 2022

INTISARIPenyakit jantung dapat menyerang siapa saja, di segala usia, jenis kelamin, pekerjaan maupun gaya hidup. Belum meratanya dokter spesialis penyakit jantung di berbagai wilayah, menyebabkan penyakit ini masih menjadi salah satu penyebab tingginya kematian pasien. Penelitian ini bertujuan untuk memberikan alternative lain dalam upaya identifikasi dini penyakit jantung akibat kurang meratanya dokter spesialis jantung di berbagai wilayah. Prototype system dikembangkan sebagai alat bantu sederhana identifikasi penyakit jantung. Data electrocardiogram pasien penyakit jantung digunakan sebagai data klasifikasi jenis penyakit jantung dan dianalisis menggunakan pendekatan k-nearest neighbor. Penelitian ini berhasil membuat prototype system pakar yang mampu mengkalsifikasi penyakit cardiovascular berbasis web sehingga diharapkan mampu meningkatkan layanan kesehatan khususnya untuk penanganan pasien penyakit jantung. Hasil penelitian juga memperlihatkan bahwa k-nearest neighbor memiliki tingkat akurasi sebesar 70.40%, lebih tinggi dibandingkan dengan teknik lainnya yakni naïve bayes, algoritma C45 dan multi class classifier meta..Kata kunci — penyakit jantung, electrocardiogram, k-nearest neighbor, prototype, sistem pakar ABSTRACTHeart disease can affect anyone of all ages, genders, occupations and lifestyles. The uneven distribution of specialists in heart disease in various regions has caused this disease still to be one of the causes of high patient mortality. This study aims to provide another alternative to determine the initial illness due to the uneven distribution of cardiologists in various regions. The prototype system was developed as a simple tool for heart disease. Electrocardiogram data of heart disease patients were used as data for the classification of disease types and analysis using the k-nearest neighbor approach. This study succeeded in making a prototype system capable of classifying web-based heart disease experts so that it is expected to be able to improve health services, especially for the treatment of heart disease. The results also explain that the k-nearest neighbor has an accuracy rate of 70.40%, higher than other techniques, namely naive Bayes, C45 algorithm and multi-classifier meta.Kata kunci —  heart disease, electrocardiogram, k-nearest neighbor, prototype, expert system
Analisis Dan Implementasi Metode Random Early Detection (Red) Pada Jaringan TCP/IP
Authors: Bandhaso Carla Prastika , Sutanto Yudi
Published: August 2022

INTISARIPenggunaan internet terus mengalami perkembangan yang sangat pesat. Semakin bertambahnya pengguna internet mengakibatkan semakin meningkatnya  beban pada jaringan, sehingga sering  terjadi kongesti. Seperti pada percobaan sebelum diimplementasikannya metode RED, kinerja jaringan mengalami penurunan. Hal inilah yang merupakan salah satu permasalahan yang harus diselesaikan. TCP/IP merupakan standar komunikasi data yang digunakan dalam proses tukar-menukar data dari satu komputer ke komputer lain pada jaringan internet. Pada jaringan TCP/IP ini diperlukan suatu metode pengendali antrian (congestion control) untuk meningkatkan kinerja dari QoS (Quality of Service), yaitu berupa AQM (Active Queue Management). Penggunaan router AQM menjadi salah satu cara untuk menghindari kongesti yang diterapkan dengan tujuan untuk mengatasi penurunan kinerja pada jaringan.RED (Random Early Detection) merupakan salah satu algoritma manajemen antrian queue paket data jaringan dengan menentukan ukuran panjang rata-rata antrian data sebelum masuk ke router dan membuang paket dengan probabilitas tertentu. Manajemen antrian ini menggunakan mekanisme min thresh dan max thresh untuk menghindari congestion. Dari pengujian yang dilakukan dengan menganalisa kondisi jaringan ditemukan bahwa metode RED mampu menangani kemacetan jaringan dengan mendrop paket. Pengujian lain dilakukan dengan penambahan client, nilai throughput turun sekitar 1,59% dan delay naik sekitar 2,85% seiring bertambahnya client namun masih lebih baik daripada yang metode FIFO.Kata kunci: RED, Quality of Service, AQM, TCP/IP ABSTRACTThe use of the internet continues to experience very rapid development. The increasing number of internet users results in an increased load on the network so congestion often occurs. As in the experiment before the implementation of the RED method, network performance has decreased. This is one of the problems that must be resolved. In this TCP/IP network, a queuing control method (congestion control) is needed to improve the performance of QoS (Quality of Service), namely in the form of AQM (Active Queue Management). The use of AQM routers is one way to avoid the congestion that is implemented to overcome decreased performance on the network.RED (Random Early Detection) is a queue management algorithm for network data packet queues by determining the average length of the data queue before entering the router and discarding packets with a certain probability. This queue management uses min thresh and max thresh mechanisms to avoid congestion. From the tests conducted by analyzing network conditions, it was found that the RED method was able to handle network congestion by dropping packets. Another test was carried out with the addition ofclients, the throughput value decreased by about 1.59% and the delay increased by about 2.85% as the number of clients increased but still better than the FIFO method.Keywords: RED, Quality of Service, AQM, TCP/IP
Analisis Pengaruh User Interface Dan User Experience Platform Online Menggunakan Metode Heuristik
Authors: Adinegoro Arifiyanto H , Aziza Rifda Faticha Alfa , Mufhadhal M. Faisal
Published: August 2022

INTISARIUser interface dan user experience merupakan salah satu faktor penting dalam membangun website, mengingat semakin efektif dan efisien suatu desain maka semakin betah pula pengguna untuk berlama-lama di website tersebut. Tujuan dari penelitian ini adalah untuk mengetahui hasil dari mengevaluasi desain user interface dan user experience yang diterapkan pada website Tokopedia menggunakan metode evaluasi heuristik. Metode heuristik memiliki 10 aspek yang menjadi parameter apakah user interface dan user experience tersebut berinteraksi terhadap pengguna dengan baik atau tidak. Cara kerja metode ini yaitu dengan menyebar kuisioner dengan meminta responden ahli untuk mengisinya yang mana isi dari kuisioner ini berkaitan dengan 10 aspek dari metode ini, sehingga dapat ditarik kesimpulan dan saran. Hasil dari evaluasi heuristik dengan studi kasus website Tokopedia dengan total responden ahli yang berjumlah 5 orang mendapatkan nilai severity rating rata -rata 0,46 yang berarti website Tokopedia nyaman untuk digunakan atau tidak dipermasalahkan oleh pengguna.Kata kunci— User Interface, User Experience, Evaluasi Heuristik, Website Tokopedia  ABSTRACTUser interface and user experience is one of the important factors in building a website, considering the more effective and efficient a design, the more comfortable the user to linger on the website. The purpose of this study is to find out the results of evaluating the user interface design and user experience applied to tokopedia website using heuristic evaluation method. Heuristik method has 10 aspects that become parameters whether the user interface and user experience interact with the user well or not. The way this method works is by spreading the questionnaire by asking expert respondents to fill it out which of these questionnaires relates to 10 aspects of this method, so that conclusions and suggestions can be drawn. The result of heuristic evaluation with tokopedia website case study with a total of 5 expert respondents get an average severity rating of 0.46 which means tokopedia website is comfortable to use or not in question by users. Keywords—User Interface, User Experience, Heuristic Evaluation, Tokopedia Website
RISK FACTORS ASSOCIATED WITH UPPER CROSSED SYNDROME IN FEMALES OF AGE 25-50 YEARS: A POPULATION-BASED CASE CONTROL STUDY
Authors: Khaliq Aniqa , Yaqub Shamaila , Islam Farooq , Raza Asim , Batool Aiman , Jamil Sana
Published: August 2022

OBJECTIVE: To assess the risk factors associated with upper crossed syndrome (UCS) in females of age 25-50 years. METHODS: This population based case controlled study was conducted from May to August 2019. Total of 210 females including 105 cases (participants who had upper neck pain for at least one month) and 105 controls (participants who didn't had upper neck pain), aging 25-50 years were selected through non-probability convenient sampling technique from the population of Gujrat, Punjab Pakistan. Data was collected through a pre-tested questionnaire and analyzed through SPSS software (version 21.0). Universal goniometer used to assess cervical ranges. Neck disability index (NDI) was used for functional disability and visual analog scale (VAS) was applied to assess the degree of pain. RESULTS: Majority (n=88; 41.90%) of females were in age group of 25-30 years and were housewives (n=147; 70 %). Females who used handheld devices, unsupported back chairs, read, worked, travelled for more than 3 hours had 63.91, 9.127, 3.568, 3.301, 2.068 folds risk of developing UCS respectively as compared to those who did the same for less than 3 hours. Similarly, females who were fetal sleeper had 2.032 times more risk of than front sleeper. All risk factors were statistically significant (p< 0.005). CONCLUSION: Usage of handheld devices while reading, working, and travelling for >3 hours, sleeping with curved spine and in fetal position and unsupported back chair increase the risk of UCS.
RELATION BETWEEN MATERNAL QUALITY OF LIFE WITH MOTOR FUNCTIONING OF CEREBRAL PALSY CHILDREN AFTER PHYSIOTHERAPY REHABILITATION
Authors: Fatima Noureen , Rizvi Syed Hassan Abbas , Javed Zainab , Batool Shiza , Pyarali Narmeen
Published: August 2022

OBJECTIVE: To find the relationship between quality of life of mothers of cerebral palsy children and child's motor functioning after at least 3 months of rehabilitation. METHODS: This cross-sectional study was conducted at Liaquat National Hospital, Karachi, Pakistan from August to November 2019. Total 35 cerebral palsy (CP) children and their mothers were involved. Assessment of mother’s health done through Medical Outcomes Study Questionnaire Short Form 36 Health Survey (SF-36) and children's motor functioning through Gross Motor Function Measure (GMFM-88).   RESULTS: While comparing the results of SF-36 in GMFM-88, we found that children’s mothers with low GMFM score had a general health deterioration compared to children with higher GMFM score. Mothers who are having a child with cerebral palsy, with GMFM between 1-80 had to cut down the amount of time spend on work while mothers whose child’s GMFM was between 1-20 were limited in kind of work and other activities as well as they accomplished less than she would like, and they didn’t do their work as carefully as usual. Due to low GMFM (1-20) of kids’ mothers even suffered from moderate level of body ache. Likewise, in children’s mothers with lower GMFM ratings (1-20 & 21-40) have disturbed work intervention due to affected physical and emotional health. Similarly, social interaction has also been affected. CONCLUSION: This study illustrates that mother of cerebral palsy patient deal with severe physical and mental fatigue. While paying attention only to children’s issues, the health of caregiver mothers also needs special considerations.
PRE-OPERATIVE EVALUATION AND TUMOUR-NODE-METASTASIS STAGING OF GASTRIC CARCINOMA USING 16 SLICE MULTIDETECTOR-ROW COMPUTED TOMOGRAPHY
Authors: Adil Zeenat , Saeed Sidrah
Published: August 2022

OBJECTIVE: To evaluate pre-operative tumour-node-metastasis staging (TNM) staging, metastases status and detection of role of multidetector-row computed tomography (MDCT) in gastric carcinoma patients in Pakistan. METHODS: This cross-sectional study, spanned over 14 months (January 2018-February 2019), was conducted at Radiology Department of Kuwait Teaching Hospital. Sample size was 173. Patients, selected through non-probability consecutive sampling technique, irrespective of gender, aged over 18 years and having clinically and histopathologically diagnosed with gastric carcinoma were included in the study. MDCT of patients was done. SPSS Version-24 was utilized for data analysis. Chi-square test was applied with p-value ≤0.05 was considered significant. RESULTS: Out of total 173 patients with gastric carcinoma, 121 (69.9%) were males and 52 (30.1%) were females. Mean age of patients was 48.5±1.2 years. Majority of patients were in T4a stage (n=64; 37%) followed T4b, T3, T0, T1 & T2 (24.9%, 17.3%, 11% and 9.8%) respectively.  N0 stage with no nodal metastases was 40.5% followed by N1 stage (1-2 lymph nodes), N2 stage (3-6 lymph nodes), N3a stage (7-15 lymph nodes) and N3b stage (more than 15 lymph nodes) with 25.4%, 19.7%, 5.8% and 8.7% respectively. M1 stage with distant metastases was in 76 (43.9%) patients. Age and gender had insignificant association with TNM system (p>0.05). CONCLUSION: Multi detector row computed tomography was effective in pre-operative evaluation and TNM staging of gastric carcinoma. Lymph node detection on MDCT can further be utilized for fine needle biopsies if required.
EFFECT OF IRON DEFICIENCY ANEMIA ON INTELLIGENCE QUOTIENT IN SCHOOL GOING CHILDREN OF PESHAWAR KHYBER PAKHTUNKHWA, PAKISTAN
Authors: Khan Nida , Khan Zahid , Nazli Rubina , Arzeen Saima , Arzeen Naeema , Akhtar Tasleem
Published: August 2022

OBJECTIVE: To find the effect of iron deficiency anemia (IDA) on intelligence quotient (IQ) in school going children of Peshawar, Pakistan. METHODS: In this cross-sectional study a total of 153 children (male and female) of age 7-11 years were included. Socio-demographic questionnaire was designed for the collection of data. Blood specimens were collected in ethylenediaminetetraacetic acid (EDTA) and gel tubes. Complete blood count (CBC) was analyzed using fully automatic hematology analyzer (Model Sysmex XP-100, serial no.B2444) in EDTA blood. Ferritin levels were analyzed using chemistry analyzer (Model: Cobas e-6000), by Electrochemiluminescence immunoassay (ECLIA) in serum. Raven Colored Progressive Matrices (RCPM) was used for finding IQ of children. Statistical analysis was done using SPSS-22. RESULTS:  Out of 153 children 66 (43.1%) were females and 87 (56.9%) were males. The prevalence of IDA was 11.7%. The mean IQ of nuclear family (57.3±37.33) was significantly higher than joint family children (34.8±34.53). The mean IQ of male (41.7±35.0) is bit higher than female (39.0±38.62). In 153 children, 66 (43.1%) were normal, 33 (21.6%) were obese and 54 (35.3%) were underweight. IQ of below average children with the average ones shows significant difference with hemoglobin and hematocrit (HCT). IQ of iron deficient anemic children was significantly lower than the normal children. The mean IQ, hemoglobin and ferritin levels for children having IDA were 9.1±8.01 (percentile), 11.2±0.33 (g/dl), and 9.6±1.2 (ng/ml) respectively. CONCLUSION:  Intelligence of school going children is significantly affected with IDA and they have low IQ values as compared to normal children.
IMPACT OF NUTRITIONAL STATUS ON INDUCTION MORTALITY IN PAEDIATRIC ACUTE LYMPHOBLASTIC LEUKAEMIA
Authors: Tahir Muhammad , Arshed Awais , Ghafoor Tariq , Khalil Sumaira , Farah Tanzeela , Nisa Noor Un
Published: August 2022

OBJECTIVE: To study the impact of nutritional status on induction mortality among pediatric patients suffering from acute lymphoblastic leukemia (ALL). METHODS: This descriptive analytical study was conducted on pediatric ALL patients who completed induction chemotherapy in Pediatric Oncology Department Combined Military Hospital, Rawalpindi, Pakistan from 1st January 2012 to 30th June 2021. All patients of ALL diagnosed on basis of National Comprehensive Cancer Network Clinical Practice Guidelines, aged 1-18 years were included. Patients who left before completion of induction chemotherapy or refused to participate were excluded. Cases were divided into three groups based on nutritional status. Induction chemotherapy was given as per UKALL 2011 protocol. RESULTS: Out of 926 patients diagnosed with ALL, 586 (63.3%) were males and 340 (46.7%) were females. Mean age of patients was a 5.83±3.627 years. Majority of the patients (n=679, 73.3%) were well-nourished; and 161 (17.4%) and 86 (9.3%) were moderately and severely malnourished, respectively. About 49.8% (n=461) patients received standard risk chemotherapy protocol with three-drug induction and 50.2% (n=465) received four-drug induction chemotherapy. Infection was the most common complication in 742 (80.1%) patients. Overall induction mortality was 12.9% (n=119/926) in all patients including 9.54% (n=44/461) in standard-risk and 16.12% (n=75/465) in high-risk patients (p=0.003). Induction mortality was significantly high in malnourished-group (17.8%) and 12.2% in normally-nourished children (p=0.008). CONCLUSION: Nutritional status and risk group at time of diagnosis emerged as predictors of induction mortality among ALL patients. Considerable number of patients died during induction phase of treatment. Malnourished children have a high mortality rate.
SCREENING OF PRE-DIABETES IN PATIENTS PRESENTING WITH POLYCYSTIC OVARIAN SYNDROME: A TERTIARY CARE EXPERIENCE
Authors: Hussain Akhtar , Ali Sobia Sabir , Ahmad Ibrar , Khan Muhammad Nawaz , Tahir Syeda Hira
Published: August 2022

OBJECTIVE: To screen the females presenting with Polycystic Ovarian Syndrome (PCOS) for underlying pre-diabetes and to correlate pre-diabetes with the various diagnostic criteria of PCOS. METHODS: This descriptive cross-sectional study was conducted at Lady Reading Hospital Peshawar, Pakistan from March, 2020 till December, 2020. One hundred & fifty one cases of PCOS, ranging in age from 17-40 years, were selected through purposive sampling. The Rotterdam criterion was used to diagnose PCOS, the details of history, physical examination and biochemical investigations like luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone, thyroid stimulating hormone (TSH), glycosylted hemoglobin (HBA1c), prolactin and pelvic ultrasound were recorded on a structured questionnaire. RESULTS: Mean age of the patients was 23.42±4.88 years. Mean BMI was 33.27±26.98 kg/m2. Pre-diabetes was detected in 19.2% (n=29) and overt diabetes in 4.0% (n=6) of the women with PCOS.  Hypertension, dyslipidemia and hypothyroidism were reported by 11 (7.2%), 9 (5.9%) and 4 (2.6%) patients respectively. Delayed menstrual cycle was reported by 44.8% (n=52); 27.6% (n=8) & 33.3% (n=2) cases of normoglycemic, prediabetes and diabetes mellitus respectively. Oligomenorrhoea was present in 69.0% (n=20) of pre-diabetics. Moderate and severe hirsutism was present in 44.8% and 10.3% PCOS patients with pre-diabetes. There was no significant correlation between pre-diabetes and the criteria of PCOS diagnosis. CONCLUSION: Women with PCOS are at increased risk of pre-diabetes and other metabolic complications like obesity, hypertension and dyslipidemia at an earlier age. However, there was no significant correlation between pre-diabetes and the criteria of PCOS diagnosis.
SAFETY OF SODIUM-GLUCOSE COTRANSPORTER 2 INHIBITORS DURING THE MONTH OF RAMADAN IN PATIENTS WITH TYPE 2 DIABETES MELLITUS FROM A TERTIARY CARE CENTRE IN KARACHI, PAKISTAN
Authors: Sheikh Aisha , Das Bhgawan , Sattar Saadia , Islam Najmul
Published: August 2022

OBJECTIVES: To assess the safety of Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2-I) during the fasting month of Ramadan, in a real-life scenario, by finding the frequency and severity of severe hypoglycemia, hyperglycemia, dehydration, or diabetic ketoacidosis (DKA). RESULTS: Total of 101 participants were enrolled and because of pandemic, we were able to collect complete data on 84 (83.2%) participants. Majority (n=44; 52.4%) of participants were males. Mean age of patients was 52.4±9.5 years with an average duration of T2DM was 11.5±6.5 years. Most of the study participants (n=54; 64.3%) were on Empagliflozin (mean-dose=14.7±7.1 mg/day) and 30 (35.7%) participants were on Dapagliflozin (mean-dose=8.2±2.7 mg/day). Only six patients (7.1%) reported having mild hypoglycemia. No study participant had any severe hypoglycemia, hyperglycemia, dehydration or DKA that would have required hospital admission. Changes observed were in the HbA1c (7.6±1.2% from 7.9±2.4%, p=0.34), weight (78.1±13.1 Kgs from 78.7±13.4 Kgs, p=0.23) and in creatinine (0.9±0.2 mg/dl from 0.9±0.4 mg/dl, p<0.09) within six weeks post Ramadan. CONCLUSION: SGLT2-I agents are safe and effective during the month of Ramadan in Pakistani patients with T2DM, without any additional adverse events.
TSHOMA: A RARE PITUITARY TUMOR
Authors: Aamir Muhammad Salman , Ghaffar Tahir , Qasim Muhammad , Ahmed Mian Sameer , Khalil Afrasiyab , Sibtain Ali
Published: August 2022

INTRODUCTION: TSH-secreting pituitary adenomas (TSHoma) or thyrotropinoma are rare pituitary tumors that secrete an abnormal Thyroid Stimulating Hormone (TSH) which constitutes up to 1%–2% of all pituitary adenomas. Patients often remain misdiagnosed for years. This case is reported to emphasize the importance of diagnosing it early and accurately to ensure timely management and relief of symptoms before perpetual damage is done. CASE DESCRIPTION: We report a case of a 29 years old patient from Peshawar, Pakistan who was referred to Endocrine unit Hayatabad Medical Complex Peshawar for the review of his persistently raised TSH despite optimal dosing of thyroxine for 2 years. He was initially diagnosed and treated for hyperthyroidism with Neomercazole and then with radioactive iodine (RAI). Post-RAI he developed Hypothyroidism and was subsequently treated with optimal doses of Thyroxine. Despite optimal doses of thyroxine, TSH remains elevated. Previous thyroid function tests also showed persistently raised T3, T4 and raised TSH. Patient was clinically thyrotoxic. MRI findings reveals macro adenoma and was resected by neurosurgeon and advised Endocrine follow up visit in OPD after surgery. CONCLUSION: TSHoma is highly under diagnosed. It is important to consider the pitfalls in diagnosis where normal or low alpha sub unit levels could lead to dubious differentials. The use of advance technology i.e. functional MRI scans to confirm diagnosis should be carried out early on leading to timely treatment options including radiotherapy and surgery.
FANCONI SYNDROME SECONDARY TO CYSTINOSIS IN YOUNG MALE: A CASE REPORT
Authors: Bibi Samina , Ahmed Mian Sameer , Babar Bakht , Ghaffar Tahir , Aamir Azizul Hassan , Aziz Sana
Published: August 2022

INTRODUCTION:  Nephropathic cystinosis is a rarely occurring inherited metabolic disorder, leading to Fanconi syndrome, progressive renal failure and a range of extra-renal manifestations including endocrinopathies. There is no definitive cure for Cystinosis. Never the less, early introduction of cysteamine treatment and other supportive measures can adequately retard the occurrence of complications and improve prognosis. CASE DESCRIPTION: An 18-year-old boy who presented with complaints of abdominal pain, vomiting, polyuria and episodes of periodic paralysis for the last 01 year to the Endocrine Unit, Medical Teaching Institution Hayatabad Medical Complex, and Peshawar, Pakistan. He was lean and wasted with a BMI of 12.9kg/m2 (weight=32.59kg, height=159cm) having frontal bossing and splaying of bones at wrist joint with normal to low blood pressure. Investigations revealed hypokalemia, alkaline urine and metabolic acidosis on arterial blood gas analysis. Consequently, his symptoms were attributed to underlying renal tubular acidosis. Later, slit lamp examination revealed Cysteine crystals in the cornea confirming the diagnosis of Cystinosis as the underlying cause. He was started on supportive therapy including potassium chloride and citrate supplements, intravenous fluids, calcium and vitamin D supplements and Indomethacin. Senior nephrologist and Nutritionist were also taken on board regarding his management. Follow up at 02 months was suggestive of marked symptomatic and biochemical improvement. CONCLUSION:       Data regarding the definitive cure for Cystinosis is scarce. Never the less, early introduction of cysteamine therapy and other supportive measures can adequately retard the occurrence of complications and improvise prognosis.
OUTCOME OF SEVERE/CRITICAL COVID-19 INFECTION IN PATIENTS WITH AND WITHOUT DIABETES MELLITUS
Authors: Saeed Bilal , Arshad Abdul Rehman
Published: August 2022

OBJECTIVES: To compare outcomes of COVID-19 infection in patients with and without diabetes mellitus (DM). METHODS: This retrospective chart review study was conducted on patients with COVID-19 infection admitted in Department of Medicine, Combined Military Hospital, Peshawar, Pakistan from Jan 2020 to August 2021. Diagnosis of COVID-19 infection was based on a positive PCR for SARS-CoV-2. Using consecutive sampling technique, medical records of all patients with severe/ critical disease were scrutinized. Patients with incomplete data and those with a negative PCR despite suggestive radiological findings were excluded. Duration of hospital stay and in-hospital mortality were compared amongst patients with and without DM. RESULTS: There were a total of 279 patients including 216 (77.42%) males. Of these, 92 (32.97%) had DM. Their mean age was 52.53±11.31 years. Duration of hospital stay was 10.18± 3.13 days in the overall cohort. There was a trend towards longer stay (10.70±3.51 days) in patients with DM as compared to 9.92±2.91 days in patients without DM (p= 0.052). In-hospital mortality was 46.74% (n=43/92) in patients with DM as compared to 28.34% (n=53/187) patients without DM (p=0.002). Hazard ratio for death in patients with DM was 1.673 (95% CI 1.207, 2.319). CONCLUSION: Pre-existing diabetes is associated with higher mortality rates in COVID-19 infection.
COVID INDUCED THYROIDITIS: A CASE REPORT
Authors: Ghaffar Tahir , Babar Bakht , Ahmed Mian Sameer , Rehman Adnan , Zia Sabeena , Aamir Azizul Hasan
Published: August 2022

INTRODUCTION: Thyroiditis is one of the manifestations of novel Covid-19 virus. Thyroid function test (TFTs) shows typical features of hyperthyroidism. Inflammatory markers [erythrocyte sedimentation rate (ESR), C reactive protein (CRP) and serum ferritin] and thyroid scan give clue to the diagnosis. Up till now very few cases of subacute thyroiditis (SAT) due to Covid-19 have been reported CASE DESCRIPTION: We present a case of 39-year-old female with no personal or family history of thyroid disorder presented with features suggestive of thyrotoxicosis along with pain in the neck, odynophagia and intermittent fever after recovering from covid-19 recently i.e. 2 weeks before the onset of symptoms. TFTs revealed high triiodothyronine-T3 (1.8 ηg/ml) and thyroxine-T4 (2.66 ηg/dl) and low TSH (<0.04 uIU/ml). Thyroid scan revealed decrease uptake, ESR was 115 mm/hour, CRP was 48 mg/L and serum ferritin was 740ηg/ml. She was started on non-steroidal anti-inflammatory drugs, steroids and beta blocker. Four weeks later she reverted back with the resolution of symptoms and normal TFTs. CONCLUSION: Early recognition and timely management of SAT with anti-inflammatory therapy can help in successful management of the disease.
MEDULLARY THYROID CANCER, AN EXPERIENCE FROM A TERTIARY CARE HOSPITAL OF A DEVELOPING COUNTRY
Authors: Khan Sajjad Ali , Aziz Abdul , Esbhani Umer Arif , Masood Muhammad Qamar
Published: August 2022

OBJECTIVES: To study the characteristics of medullary thyroid carcinoma (MTC) in Pakistani population. METHODS: This retrospective study analyzed data of past 20 years in Aga Khan University Hospital, Pakistan. Data of 32 patients was analyzed after fulfillment of the inclusion criteria. Their clinical, pathological, biochemical and treatment outcomes were recorded through retrospective review of their medical record files. RESULTS: Mean age of patients was 42.88±2.67 years, with male to female ratio of 2:1. Majority (68.8%) of MTC patients were sporadic. Common presentations were neck swelling (81.3%), palpable lymph nodes (43.8%) and distant metastasis (25%). Histologically, mean tumor size was 7.62±3.64 cm. Majority (68.7%) of carcinomas were unifocal, followed by bifocal (21.9%) and multifocal (9.4%). Mean pre-surgery calcitonin was 11225.7±4043.57 ρg/ml (0.0-18.2) which then decreased to 244.43±113.48 ρg/ml after surgery (subsequent visits). Mean pre-surgery carcinoembryonic-antigen (CEA) level was 25.08±7.23ηg/ml (0-10) which then decreased to 0.0645±0.044ηg/ml post-surgery. Hyperparathyroidism was found in two patients while pheochromocytoma was found in one patient only. Two patient were positive for rearranged during transfection gene mutations. Total thyroidectomy was done in 26 (81.2%) while one patient had subtotal-thyroidectomy followed by complete-thyroidectomy as initial fine-needle-aspiration-cytology was Bethesda category 3. Surgery was not performed in five patients due to distant metastasis or palliative intent. Chemotherapy was given to only one patient while radiotherapy in two patients. CONCLUSION: MTC usually presents in fourth decade of life with male predominance and mostly sporadic occurrence. Total thyroidectomy with subsequent serial calcitonin and CEA levels thereafter are the mainstay of treatment and follow-up.
FUNCTIONAL PITUITARY GONADOTROPHIC ADENOMA IN MALE PATIENTS: CASE REPORTS
Authors: Ram Nanik , Khan Sajjad Ali , Das Bhagwan , Islam Najmul
Published: August 2022

INTRODUCTION: Pituitary gonadotrophic adenomas (FGA) are common but only minority of them secrete Luteinizing hormone (LH) and Follicle Stimulating hormone (FSH). These hormones are biologically inactive as they do not affect the secretion of sex hormones. Few case reports showed high testosterone/estrogen levels with elevated or normal LH and FSH. CASE DESCRIPTION: We report two cases aging 61 years and 52 years, presented with visual disturbance and headache at Aga Khan University Hospital, with gradual onset of symptoms over months with no history of weight change, broadening of hands or abdominal striae. Examination revealed bitemporal hemianopia, normal vitals and testicular sizes. Case 1: Investigations revealed elevated FSH [36.66 mIU/ml (Normal=1.4-15.4)], testosterone [952.7 mlU/ml (Normal=193-740)], high normal LH [7.09 mlU/ml (Normal=1.2-7.8)], insulin-like-growth factor 1 (IGF-1) [34 ng/ml (Normal=54.6-185.7), free-thyroxine (FT4) [0.69 ng/dl (Normal=0.89-1.76)], prolactin [12.4 ng/ml (Normal=3-14.7)] and 8AM-cortisol [2.6 ug/dl (Normal=4.3-22.4)]. Case 2: Investigations revealed high normal FSH of 13.61 mIU/mL and high testosterone level of >1500 ng/dL but normal LH 4.45 mlU/mL, 8AM-cortisol=12.60 ug/dl, FT4=0.88 ng/dl and prolactin=36.80 ng/ml. Magnetic resonance imaging brain revealed mass lesion measuring 27.5×25.4×3 mm (case-1) and 45×39 mm (case-2) arising from pituitary gland and extending in to surround structures. Thyroxine and steroids were started for case 1 preoperatively. Both patienst underwent transsphenoidal resection of tumor. Postoperatively, a significant decrease in testosterone, FSH and LH level and resolution of symptoms were observed. CONCLUSION: FGA should be considered in presence of elevated testosterone/estrogen and normal or elevated FSH/LH. Early diagnosis leads to a better outcome.
PRIMARY THYROID LYMPHOMA: A CASE SERIES
Authors: Khan Sajjad Ali , Aziz Abdul , Ali Dani , Islam Najmul
Published: August 2022

OBJECTIVE: To find out about the disease characteristics of primary thyroid lymphoma in Pakistani patients. METHODS: In this retrospective study of 20 years duration, we reviewed five diagnosed and/or treated cases of primary thyroid lymphoma at the Aga Khan University Hospital (AKUH), Karachi, Pakistan. Each patient’s medical records were reviewed and studied.   RESULTS: Mean age of the participants was 62.8±10.2 years with 3 males and 2 females. Two patients presented at the age of 69 and 70 years, and two patients presented at ages of 47 and 58 years. All our patients presented with a rapidly progressing neck mass and dysphagia. Other common presenting complaints in our study subjects included dyspnea, hoarseness of voice, stridor and feeling of globus in the throat. Average duration of presentation of our cases was 3 months, with 2 patient’s presenting after a month of development of symptoms, while the remaining two participants presented at four and six months after onset of signs and symptoms. All patient’s histopathology was consistent with Diffuse B cell Lymphoma subtype. Out of the five patients, one patient died as a result of complications, one patient opted out of treatment at AKUH due to financial constraints and three patients are doing well with no active complaints and followed-up regularly. CONCLUSION: Primary thyroid lymphoma is a rare condition and can present with neck swelling and compressive symptoms. Diagnosis is based on the histological findings. Larger studies are needed to study the prognosis of the patients.
Characterization of peripheries of n-GaN Schottky contacts using scanning internal photoemission microscopy
Authors: Imabayashi Hiroki , Yasui Yuto , Horikiri Fumimasa , Narita Yoshinobu , Fukuhara Noboru , Mishima Tomoyoshi , Shiojima Kenji
Published: August 2022

We applied scanning internal photoemission microscopy (SIPM) to clarify the electrical characteristics on the electrode periphery of Ni/n-GaN Schottky contacts. Two types of Schottky contacts with different electrode formation methods were prepared. For the samples in which the Ni contacts were evaporated through a metal shadow mask, in the scanning electron microscopes (SEM) observation, the electrode edges were tailed and the tail was divided into two contrasts, a bright region with a width of 15.5 μm from the electrode edge followed by a dark region with a width of 32 μm. The SIPM signal was obtained from the first 16 μm tailing region, and corresponded with the SEM images. For the photolithography sample, a sharp edge less than 1 μm wide was obtained and no increase in SIPM signal was detected on the edge. These results indicate SIPM is able to characterize the electrical properties of electrode periphery in conjunction with the structural characteristics.
Evaluating English Textbooks by Using Bloom’s Taxonomy to Analyze Reading Comprehension Question
Authors: Stevani Margaret , Tarigan Karisma Erikson
Published: August 2022

The use of Bloom’s taxonomy to form knowledge, comprehension, application, analysis, synthesis, evaluation, and creation in choosing the type of reading test was to consider the role of higher and lower-order thinking skills in reading comprehension questions in English textbooks. The conceptual aspects of the reader's mental and visual response to the purpose of reading comprehension needs were the ability to generate new thoughts, separate ideas into parts, and judge the values of ideas by using appropriate criteria based on the text. This research contributed to the following questions: (1) the representation of Bloom’s taxonomy levels in English textbooks, and (2) the calculation of reading comprehension questions in each level of Bloom’s taxonomy. Using a qualitative approach with content analysis, the results showed that the types of reading comprehension questions could foster the student’s critical thinking regarding acquiring learning objectives in the English curriculum. Most of the question was focused on comprehension level (26%), knowledge/remember level (17%), application level (16%), synthesis level (14%), analysis level (13%), evaluation level (11%), and creation level (3%). By applying Bloom's taxonomy, English teachers were suggested to classify their instructional objectives and learning goals.
Lexical Relation used in Newspaper Headline of the Jakarta Post: Jokowi Highlights Tolerance at Cultural Congress Conclusion
Authors: Nurmayana Nurmayana , Nasution Nazlah Syahaf
Published: August 2022

The lexical meaning was the smallest meaning unit in the meaning system of language that could be distinguished from other similar units. A lexeme was an abstract unit that occurred in many different forms of spoken or written sentences. Lexical associations were considered more important in the headline in the newspaper because they formed a semantic relationship and related to the most problematic coherence as open-word in the form of noun and verb since the lexical meaning of the words had the same meaning in the context. This research aimed to examine the use of lexical meaning in the headline newspaper of the Jakarta Post. The result found that there were few words whose lexical meaning correlated to certain semantic roles. As two semantic roles were used in analyzing the data, it was obtained that synonym words existed in 13 words, its percentage toward the article was 3.01%; and hyponymy words existed in 10 words, its percentage toward the article was 2.32%. This result indicated that lexical relations such as synonymy and hyponymy might vary to perform functions between sentences and clauses. Choosing the correct definition of a lexical word could avoid misinterpreting the proposition of the reader’s interpretation. It was determined that the Jakarta Post, especially in the headline entitled “Jokowi highlights tolerance at cultural congress conclusion,” contained mostly synonym words, which meant most of the lexical meaning of the words had the same meaning in the context.
Pharmacy 4.0—The Potential of Integrating Digital Technologies into Daily Healthcare Processes at Pharmacies
Authors: Liebenspacher Fabio , Siegfried Patrick
Published: August 2022

This scientific paper aims to collect and analyze various digital technologies connected to pharmacies and Health 4.0. Thus, the goal is to give basic recommendations for actions for pharmacies to remain successful businesses in the digital future of healthcare. While the total health sector is growing continuously, the total number of pharmacies is shrinking. To be able to face the competitive pressure on the pharmaceutical market, pharmacies have to integrate more efficient digital technologies to be able to increase customers’ experience. Hence, the acceptance and attitude of the German society towards digital health solutions are examined using a short survey and a precise questionnaire. After a detailed analysis of the survey results and the questionnaire answered by a pharmacist, specific digital methods and technologies which make sense for pharmacies can be elaborated. As the future of pharmacies is still quite unexplored, while the health market is shifting to more efficient digital solutions, pharmacies have to adapt to current developments fast. Therefore, this paper can serve as a guideline for pharmacies in the rapid changes toward more digital markets.
ENTHESITIS IN ANKYLOSING SPONDYLITIS (AS) AND PSORIATIC ARTHRITIS (PSA) PATIENTS STARTING GOLIMUMAB IN DAILY PRACTICE
Authors: J Vanhoof , P Geusens
Published: August 2022

The key to successful management of spondyloarthritis (SpA) is early objective quantication of inammation and ongoing precise, tailored therapy to ensure long term suppression of inammatory disease activity (Brown).
TRAFFIC CONGESTION IN BILASPUR MUNICIPAL AREA
Authors: Karkashe Nupur , Yadav Shubham
Published: August 2022

Major metropolitan passages in Indian urban communities are conveying fundamentally high trafc prompting close to
immersed conditions for broadened top hours. As blended landuse and signicant excursion drawing in/creating
foundations are by and large situated along such passages for better availability, huge side grating is likewise seen along these hallways. Indian
urban areas have been seeing a fast expansion in vehicular populace, particularly close to home vehicle, in the new past. Given the requirements
in expanding street widths, this increment in vehicles has brought about a radical drop in degrees of administration on metropolitan streets.
Though gridlock disturbs business exercises and diminishes usefulness level, research has shown that it might likewise be an image of
development in an economy. As the economy develops and genuine pay of family builds, vehicle populace oods up, adding to gridlock,
especially inside urban areas. Gridlock is a never-ending issue for the supportability of transportation advancement. Gridlock creates setbacks,
burden, and monetary misfortunes to each part of advancement of a metropolitan space, just as air contamination, commotion contamination and
so forth Recognizable proof and evaluation of gridlock are critical for leaders to start moderation techniques to further develop the general
transportation framework's maintainability. The trafc congestion is presently concentrated near the market places, schools, colleges and
government ofces at peak hours. To ease trafc congestion, identifying the state of road trafc should be considered rst. The sequence steps
targeted trafc facilities or the trafc management measures. Even though the road development authorities are trying to keep pace with the
developmental activities of the city, the threshold has been reached and new solutions to control the trafc congestion has to be taken. No sooner
will the state of roads in Bilaspur be like the highly congested roads of Raipur the neighbouring city. If appropriate measures are not taken at the
right time, it will be a never ending problem, as roads cannot be widened at a later stage.