bluuebunny/crossref_metadata_2025 huggingface dataset:
Counselling needs of secondary school students during the post-COVID-19 period
Authors: Jailani Mohd Azli , Yusooff Fatimah , Siew Wong Huey , Abas Wan Mohammad Ubaidillah Wan , Omar Mazuin
Published: October 2024

This study investigates the counselling needs of secondary school students as they face challenges in the post-pandemic era. It examines six domains of counselling needs: personal development, academic, family, emotional, peer relationships, and career development. A sample of 400 students from four secondary schools was selected using a cluster sampling technique. The study, which employed the quantitative research method, utilised the Secondary School Students' Counselling Needs Assessment Instrument to gather data from the respondents. The analysis revealed a significant gap between students' desired and current needs across all six counselling domains, with personal development emerging as the most required by the students, followed by academic, emotional, career development, peer relationships, and family needs. The study also investigated gender differences in counselling needs, showing that while both male and female students share similar patterns of counselling needs, female students have shown larger gap scores, which indicate gender-specific counselling needs that school counsellors must recognise and address in their intervention strategies. The research findings emphasise the need for school counsellors to develop tailored intervention programmes that specifically address the highlighted needs, providing students with necessary support as they navigate the evolving educational landscape of the post-pandemic era. The study highlights the vital role of responsive counselling services in promoting students' well-being and academic success, ensuring they are equipped to adapt to the new educational and social challenges they face.
Using the Buana Online Course web-based mobile application to improve English for specific purpose engineering courses
Authors: Suhardiman Sani , Margana  , Putro Nur Hidayanto Pancoro Setyo , Hakiki Muhammad , Fadli Radinal
Published: October 2024

This study investigates the effectiveness of the Buana Online Course (BOC) web-based mobile application in enhancing English for specific purposes (ESP) skills among engineering students and explores their perceptions of the course's effectiveness in improving their language proficiency and comprehension of technical texts. The BOC is a learning management system developed by Universitas Buana Perjuangan Karawang Indonesia, and the study involved 49 industrial engineering students from the university. A quantitative research design was employed, with data collected via questionnaires and analyzed descriptively to assess the responses. The findings indicate that the BOC is effective in teaching ESP, with a 49% improvement in reading skills, a 38.80% improvement in writing skills, a 38.80% improvement in communication skills, a 40.80% improvement in applying language skills in an engineering context, and a 38.80% improvement in communication skills. A total of 40.80% of the students showed that the BOC learning management system could be one of the learning media that increases understanding of the cross-cultural aspects among engineering students. The implications of this study suggest that online courses and web-based applications can play a significant role in facilitating ESP learning in engineering contexts and provides valuable insights for educators and institutions aiming to enhance language education through technological integration.
Construct an instructional approach based on collaborative learning and reflective learning for enhance students’ analytical thinking and critical thinking skills
Authors: Guo Rui , Jantharajit Nirat , Thongpanit Phichittra
Published: October 2024

In the context of rapid globalization and digitalization, the development of students' critical and analytical thinking skills is increasingly prioritized in education. This study aims to address the gap in instructional models by designing an eight-step instructional model that integrates collaborative and reflective learning strategies to enhance these essential skills. Drawing on social constructivist theories and Dewey's reflective thinking framework, the research develops a comprehensive model that includes phases such as goal setting, team formation, exploration, collaborative practice, reflection, integration, and feedback. The findings suggest that this model significantly improves students' analytical and critical thinking abilities by promoting structured collaboration and intentional reflection. Through diverse group interactions and continuous self-assessment, students achieve a deeper understanding and critical analysis. The model's iterative feedback mechanisms also contribute to sustained improvements in student learning outcomes. This study introduces an original instructional model that theoretically supports the enhancement of analytical and critical thinking skills through a systematic integration of collaborative and reflective learning, offering practical implications for educators seeking to foster these higher-order thinking skills in students.
GALL BLADDER ASCARIASIS: A RARE ENTITY
Authors: Akbar Ismail , Zanib Javed  , Zaib Zainab
Published: October 2024

Gall bladder ascariasis is a rare entity accounting for only 2.1% of biliary ascariasis features due to anatomical features of the cystic duct. It usually presents with vague abdominal features. Ultrasonography is the most sensitive and useful investigation for its diagnosis. We present a case of gall bladder ascariasis in an antenatal young female patient showing features of cholecystitis. She was diagnosed by ultrasonography and managed by laparoscopic cholecystectomy followed by oral anti-helminthic drugs. She made an uneventful recovery and is doing great in follow up visits.
PRIMARY ANTIBIOTIC RESISTANCE AND EFFECTIVENESS OF CLARITHROMYCIN VS METRONIDAZOLE BASED THERAPY FOR HELICOBACTER PYLORI INFECTION IN CHILDREN
Authors: Salman Nadia , Nighat Haider  , Muqaddar Shah  , Rehmana Waris  , Maryum Naseer  , Ayesha Razzaq  , Jai Krishin
Published: October 2024

Background: NASPGHAN guidelines recommend regional antibiotic susceptibility profiling for H. pylori eradication treatment. Profiling local antibiotic resistance patterns is mandatory for successful H. pylori eradication in children. The aim of our study was to determine primary resistance to Clarithromycin and Metronidazole, most commonly used in the eradication regimens in children presenting with symptomatic H. pylori infection. This study was conducted at Children Hospital PIMS Islamabad from June 2020 to August 2021. Methods: The children of either gender age 2-14 years having symptomatic H. pylori infection (hematemesis, chronic abdominal pain) underwent stool for H. pylori Antigen. Children requiring urgent diagnostic endoscopy underwent rapid urease tests.  Biopsies were taken from children having positive stool H.pylori Ag and rapid urease test for histological examination. The biopsy specimens were cultured and subsequently tested for antibiotic sensitivity. Results:  Out of 54 children having H. pylori infection 40/54 (74.074%) children had strains susceptible to antimicrobials and 14/54 (25.92%) were having resistance to antimicrobials. According to the pattern of antimicrobial sensitivity, they were further grouped into three (a) Clarithromycin and Metronidazole sensitive group (18/40, 45%) (b) Clarithromycin sensitive and Metronidazole resistant group (12/40, 30%) (c) Metronidazole sensitive group (10/40 25%). Conclusion: Clarithromycin and Metronidazole cannot be used as1stline treatment for H. pylori eradication in children and can only be used with known antimicrobial susceptibility.
A DIFFICULT DIAGNOSIS AND CHALLENGING MANAGEMENT OF AN AGGRESSIVE CASE OF AQUAPORIN 4 NEGATIVE NMOSD
Authors: Khan Amna , Zahoor Warda , Zehra Taskeen , Ullah Zafar , Nabeel Muzaffar Syed
Published: October 2024

Neuromyelitis optica spectrum disorders can be challenging to diagnose and manage. There is considerable potential long term morbidity but this can be avoided by appropriate treatment. Here we present one such case that is interesting as well as instructive.
CELIAC AND AUTOIMMUNE THYROID DISEASE IN PATIENTS WITH ANTI-GAD POSITIVE TYPE-1 DIABETES MELLITUS
Authors: Versha Rani Rai  , Zubair Khoso  , Maira Riaz  , Roshia Parveen  , Shazia Mahar  , Mohsina Noor
Published: October 2024

Background: Type-1 diabetes mellitus (T1DM) and autoimmune thyroid disease can occur concomitantly and patients with TIDM have a high risk of other autoimmune conditions like thyroid disease and celiac disease. This study aimed to analyze the association of anti-GAD positive T1DM with anti-thyroid antibodies and celiac disease. Methods: This cross-sectional study was conducted at the Department of Paediatric Endocrinology & Diabetes, National Institute of Child Health, Karachi Pakistan from July 2022 to December 2022. A total of 115 children of both genders aged between 1-18 years having known T1DM were analyzed. Children with chronic kidney disease or chronic liver disease were excluded. Those children were also not included whose parents/caregivers did not wish their children to be part of this research. The blood sample of each child was taken in a sterilized container and sent to an institutional laboratory for biochemical investigations. Results: In a total of 115 patients, 67 (58.3%) were female and 48 (41.7%) males. The mean age was 8.87±3.43 (ranging between 1.5-17 years). The mean HbA1c was 11.86±7.31%. It was found that anti-GAD IgG was having signification association with celiac disease (p<0.001). Significant correlation of anti-GAD positive antibodies with Ttg-IgG antibodies (correlation coefficient=0.303, p=0.001), thyroid peroxidase antibodies (correlation coefficient=0.228, p=0.001). Conclusion: High proportions of children with anti-GAD positive T1DM patients were found to have thyroid disorders and celiac disease. A significant correlation was found between anti-GAD positive antibodies, celiac disease and anti-thyroglobulin antibodies.
WHEN THE SILENCE PREVAILS IMAGES TALK: THE CHARACTERISTIC CT FEATURES OF VOCAL CORD PARALYSIS, CAUSES OF MISSED PALSY BY RADIOLOGISTS AND MIMICS OF VOCAL CORD PALSY UNVEILED
Authors: Mariam Malik  , Salma Gul  , Belqees Yawar Faiz
Published: October 2024

Background: Causes of vocal cord palsy (VCP) can be identified even before its clinical presentation if a radiologist has knowledge about signs of vocal cord palsy, its various mimics and the anatomy of recurrent laryngeal nerve. Objectives are to know the signs and underlying causes leading to VCP and various mimics which may lead to the false positive diagnosis of VCP. Methods: A retrospective cross-sectional pilot study comprising 54 patients with vocal cord palsy proven by IDL was conducted. 3 groups were identified. The first group comprised missed VCP on cross-sectional imaging. The second group was, of missed cause of VCP in patients with clinical diagnoses. The third group was patients with mimics of the palsy. Results:Thirteen (76.5%) patients had missed diagnosis due to lack of knowledge of signs and 23.5% due to lack of time, overwork and tiredness. A vigilant search for the cause was not done in 31.6% of patients and in 68.4% of patients, the cause was identified but not correlated. A total of 8 patients had false positive diagnoses due to failure to differentiate from mimics. Conclusion: There is an increasing trend of missed diagnosis of vocal cord palsy on cross-sectional imaging in patients with established clinical diagnosis due to a lack of knowledge of VCP signs and missed causes along the course of recurrent laryngeal nerve.
FREQUENCY OF VAGINAL BIRTH AFTER CAESAREAN SECTION AND ITS FETOMATERNAL OUTCOME
Authors: Islam Bano  , Naz Sofia , Sidra Rashid  , Yasmin Fatima  , Pareesae Humayun  , Tabassum Muzaffar
Published: October 2024

Background: Vaginal birth after caesarean section (VBAC) is associated with reduced blood loss and transfusions, fewer infections, and fewer thromboembolic events as compared to caesarean delivery. The current rate of repeat caesarean after one previous caesarean is above the WHO standard of 15%. We aimed to determine the occurrence of VBAC and to determine the occurrence of feto-maternal outcomes in successful VBAC cases so that trials of VBAC can be given to carefully selected patients in order to reduce the rate of repeat caesarean section. Methods: The Combined Military Hospital (CMH) Rawalpindi's Obstetrics and Gynaecology department conducted this cross-sectional study from March 20 to September 19, 2021. After obtaining ethical committee approval, data was collected using a non-probability, consecutive sampling technique from 150 patients on a self-developed structured proforma. Patients between the age range of 20-35 years with a history of previous lower segment caesarean section, having gestational age between 37-41 weeks and who presented in spontaneous labour were included in this study. After taking informed consent, all women were given a trial of labour and the outcome of the trial was noted. Women were followed for the feto-maternal outcomes. The gathered information was analysed using SPSS version 25.0. Post-stratification, a p-value of 0.05 or lower on the chi-square test was deemed statistically significant. Results: Following a C-section, 28.67% of patients experienced successful vaginal births. PPH was found in 2.32%, scar dehiscence in 0.0%, low birth weight babies in 16.28%, APGAR score <7 at 1 minute was 23.26% and NICU admission as 9.30% in women undergoing vaginal birth after caesarean section. Conclusion: Appropriate selection of patients for the trial of VBAC can help reduce the higher rate of repeat caesarean section after a previous caesarean section and increase the chances of successful vaginal birth.
THE ROLE OF LYMPH NODE METASTASIS IN EARLY GASTRITIS INDIVIDUALS FOLLOWING NONCURATIVE ENDOSCOPIC RESECTION: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Rostami Masoumeh , Mazin Hadi Kzar  , Zahraa Hamzaa Abd alzahraa  , Ali Abdul Kadhim Ruhaima  , Sarah A. Hamood  , Alzahraa S. Abdulwahid  , Sarmad Dheyaa Noori  , Ahmed Hussien Alawadi  , Ali Alsaalamy  , Ban Saifuddin Mahmoud
Published: October 2024

Background: Recent studies suggest that individuals who underwent noncurative endoscopic resection for gastric cancer may require additional surgery. We conducted a comprehensive systematic review and meta-analysis to investigate the risk of lymph node metastasis in these cases. Methods: We comprehensively examined relevant literature by extensively reviewing electronic databases such as PubMed, Cochrane Library, and Google Scholar. Subsequently, we analyzed clinicopathological outcomes and calculated pooled odds ratios and 95 percent confidence intervals using diverse effects models. Results: This analysis included 12 papers with 4808 individuals who underwent additional surgery after noncurative endoscopic resection for early gastric cancer. The results indicated significant associations between lymph node metastasis and submucosal invasion (Odd ratio 2.04, 95% (CI): 1.58-2.63, I 2 = 88.7%; p<0.001), vertical margin (Odd ratio 6.11, 95% (CI): 1.94-19.23, I 2 = 0%; p<0.001), lymphatic invasion (Odd ratio 10.02, 95% (CI): 7.57-13.27, I 2 = 92%; p<0.000), and vascular invasion (Odd ratio 7.11, 95% (CI): 5.49-9.22, I 2=92%; p<0.000). Conclusion: When choosing factors for surgical treatment, it is essential to thoroughly consider the invasion of lymph nodes, vascular system, submucosa, and positive vertical margin.
COMPARISON OF OXIDATIVE STRESS LEVELS DURING THE THIRD TRIMESTER IN NORMAL PREGNANCY AND PREECLAMPSIA
Authors: Taseer Muneeza , Naima Shakeel  , Munira Taseer  , Fawad  , Faiza Rehman  , Durrira
Published: October 2024

Background: The placenta is a complex transiently formed organ which plays a crucial role in the development of the foetus. As the placenta is responsible for maintaining pregnancy placental defects are mainly responsible for pregnancy-related issues. Preeclampsia is a pregnancy-related disorder due to uteroplacental insufficiency resulting from deficient remodelling of spiral arteries causing ischemic reperfusion injury which is finally responsible for the generation of reactive oxygen species and oxidative stress by the placenta. So, this study was planned to determine and compare serum levels of oxidative stress markers (ischemia-modified albumin and malondialdehyde) in preeclampsia and normal pregnancy in the third trimester. Methods: Study design: Cross-sectional comparative study Settings Gynae/Obs Department and Pathology Laboratory, Lahore General Hospital, Lahore. Study population: 42 Pregnant females at 34-36 weeks of gestation were selected. Group 1 compromised 21 normal healthy pregnant females and group 2 included 21 preeclamptic patients. Sampling technique: non-probability purposive sampling. Blood samples were taken at 34-36 weeks of gestation. Serum was stored for ischemia-modified albumin and malondialdehyde. Data was analyzed using SPSS version 20.  An Independent t-test was used to compare values between the groups during the third trimester. A p-value of ‰¤0.05 was considered significant. Results: Comparison of ischemia-modified albumin and malondialdehyde values between group I and group 2 showed a highly significant difference of p-value of <0.001. Conclusion: Oxidative stress markers were higher in preeclamptic patients as compared to normal pregnant females during the third trimester suggesting the role of the placenta in oxidative stress.
DIAGNOSTIC SIGNIFICANCE OF BONE MARROW EXAMINATION AMONGST THE PATIENTS WITH ABNORMAL HAEMATOLOGICAL PARAMETERS
Authors: Bashir Saima , Fahim Akhtar  , Misbah Salim  , Maham Arshad  , Zahra Tasleem Khan  , Farhan Akhtar
Published: October 2024

Background: Bone Marrow examination is considered to be the most indispensable diagnostic tool for the evaluation of many neoplastic and non-neoplastic haematological disorders. After an initial assessment of suspicious cases on abnormal laboratory parameters along with the clinical presentation of the patient bone marrow examination is finally required for diagnosis as well as management of many haematological malignancies as it offers a clear cytological as well as histological picture of Bone Marrow aspirate and biopsy respectively. The Objective was to evaluate the significance of Bone Marrow examination in patients with abnormal haematological parameters. Methods: A retrospective study conducted at the Pathology Department of Pak Emirates Military Hospital from (Jan-June 2022) On data from 150 patients who were advised to undergo bone marrow examination due to abnormal lab parameters and peripheral smear findings after informed consent and approval from the ethics review committee, to find out the correlation of abnormal haematological parameters and aspirate findings which have led to a definitive diagnosis. Data comprising basic demographic variables (age, gender etc.), Abnormal Haematological Parameters (CBC), peripheral smear findings and Aspirate findings were analyzed using SPSS version 23.0. Results: Out of 150 studied participants with abnormal haematological parameters 24 (16%) were diagnosed on bone marrow examination as acute leukaemia / Hodgkin's and Non-Hodgkin's lymphoma respectively, 13 (9%) cases of aplastic anaemia and Autoimmune Haemolytic Anaemia, 33 (22%) cases of hypersplenism, CML and multiple myeloma. While 22 (15%) cases were diagnosed with BME as CKD and reactive changes. Moreover, 22(15%) cases were found to have Iron Deficiency anaemia respectively. Conclusion: The study revealed that patients with abnormal haematological parameters should undergo bone marrow examination to ascertain the diagnosis for malignant as well as non-malignant conditions that could cause abnormal lab parameters.
DIALECTICAL BEHAVIOUR THERAPY FOR CSA-RELATED PTSD AMONG YOUNG ADOLESCENTS: A SINGLE CASE STUDY
Authors: Nazir Sadaf , Syeda Farhana Kazmi
Published: October 2024

Childhood sexual abuse (CSA) is a pervasive and traumatic experience that can lead to long-lasting and profound psychological costs, especially post-traumatic stress disorder (PTSD) among young adolescents. This single case study explores the application of Dialectical Behaviour Therapy (DBT) as ground-breaking therapeutic approach for the treatment of child sexual abuse related PTSD in this vulnerable population. DBT found to be effective for treating CSA related PTSD, according to a growing body of research. This case study presents the course of treatment of 13 years old girl with CSA-related PTSD who received Dialectical Behaviour Therapy as treatment. In this instance, the client reacted to the therapy and displayed positive changes. Following the treatment, the client's PTSD criteria were no longer met, evidenced by substantial drops on the scale used for evaluation. The article discusses the treatment implications of DBT and how well it treats children with PTSD related to CSA.
APPENDICEAL TIE SYNDROME: A RARE CAUSE OF SMALL BOWEL OBSTRUCTION
Authors: Habib Rohan , Zainab Zaib  , Muhammad Waqas Afzal  , Rameesha Habib  , Maha Wasim  , Muhammad Nauman Shah Afridi
Published: October 2024

Acute appendicitis and intestinal obstruction are two common surgical emergencies. Acute appendicitis as a cause of closed-loop bowel obstruction is a rare surgical entity. The first case was reported in 1901 and since then only a few cases have been reported. We report an unusual case of a 25-year-old female who presented with the clinical picture of acute small bowel obstruction and was found to have an appendicular knot intraoperatively, through which a small bowel was herniating. The patient was managed via a midline laparotomy and appendectomy.
FREQUENCY OF CD44 EXPRESSION IN DIAGNOSED CASES OF ORAL EPITHELIAL DYSPLASIA AND SQUAMOUS CELL CARCINOMA
Authors: Momin Zumrud , Rahat Noshaba , Shahzad Humera , Umair Marvi , Raima Kaleemi  , Khursheed Asma
Published: October 2024

Background: Oral cavity cancer is one of the most widespread head and neck cancers in the world. 90 percent of oral cavity cancers are squamous cell carcinoma (SCC). Oral Potentially Malignant Disorder (OPMD), are well known to develop into squamous cell carcinoma. CD44 is a glycoprotein present on the cell surface and plays a vital role in cancer cell invasion, migration, metastasis of cancers and prognosis. The present study aims to detect the frequency of CD44 immunomarker expression in epithelial dysplasia and squamous cell carcinoma samples and correlates the expression with histologic grades of this lesion. Methods: cross sectional study at the Department of Pathology, BMSI, JPMC, Karachi between 01-01-2018 to 31-12-2021. 95 patients diagnosed on morphological characterization of the lesion as squamous cell carcinoma/dysplasia were selected by using non-probability purposive sampling technique, among them 41 were diagnosed as epithelial dysplasia and 54 as SCC and were subjected to immunohistochemistry. Results: A total of 95 cases were selected. The mean age was 49.32 years. The majority of cases were seen in 4th and 5th decades. 69 (72.6%) were males and 26 (27.4%) were females with male to female ratio 2.65:1. The closest site was buccal mucosa 75(78.9%). Among 41 cases of dysplasia, 36 showed membranous positivity for CD44 (87.8%), and 45 showed positive membranous CD44 immunoreactivity (83.3%) among 54 cases of squamous cell carcinoma. Conclusion:  Increased frequency of CD44 expression was found with increasing grades of dysplasia and squamous cell carcinoma, which may be a possible indicator of malignant transformation and can serve as a prognostic biomarker for oral SCC.
THE EFFECT OF PHYSICAL THERAPY INTERVENTION AFTER CEREBELLAR RESECTION
Authors: Shalabi Kholood M , Alabdulathim Danah A. , Al-Taleb Hanan M. , Almarzuqi Raghad K. , Alsaleh Dalal A. , Takroni Manar A. , Alsaleh Rahaf M. , Reem M.Basuodan
Published: October 2024

A variety of diseases, including gait ataxia, lack of coordination, diminished dexterity, and unsteady posture, can be brought on by cerebellar dysfunction. This case study looks into how a physical therapy program affected a 40-year-old patient's dynamic balance after cerebellar tumour surgery. The patient complained of losing his balance and having uncoordinated motions on the left side of the body. The Timed Up and Go (TUG) test was used to gauge how the Frenkel coordination exercises and balance training affected dynamic balance following cerebellar tumour removal. The patient's muscle strength in the left-side hip extensors, abductors and adductors, knee flexors and extensors, as well as the left-side shoulder, elbow, and wrist flexion and extension, significantly improved.
CURRENT AND EMERGING TRENDS IN THE MANAGEMENT OF PYODERMA GANGRENOSUM: A LITERATURE REVIEW
Authors: Wali Muhammad Sobia , Nadia Hassan  , Samra Khan  , Atia Gohar
Published: October 2024

The first description of Pyoderma gangrenosum (PG) was made about a century ago. It is difficult to understand the aetiology, pathophysiology, and therapy of PG. This disease is believed to be caused by a systemic inflammatory response to neutrophil chemotaxis and faulty innate immune system control. Nearly fifty percent of the cases have underlying systemic symptoms. Significant improvements in PG management have been made over the years. The main goals of treatment are to reduce inflammation and speed up the healing of the PG wound. Even though the most recent medicines show promise, they are found on isolated case reports. The majority of patients are typically managed with topical treatment and local wound care, while resistant cases necessitate immunosuppressive medications. More progress can be made with improvements in technology in deciphering this complex disease and getting a greater understanding of the condition. The present standard therapies for refractory PG are not well supported by studies. In refractory PG, corticosteroids and cyclosporine have historically been administered. Tumour necrosis factor inhibitors are becoming a viable option; nonetheless, this requires careful research and upkeep. This review intended to describe the current trends in managing the PG. Several next-generation treatment options including the conventional therapies introduced to treat PG. We encompass the advantages and disadvantages of new treatments for PG.
HEPATIC HYDROTHORAX WITHOUT ASCITES: A DIAGNOSTIC AND MANAGEMENT CHALLENGE
Authors: Malick Maria , Shahid Wajeeha , Latif Anum , Zarafshan Zubair  , Zaidi Syeda Moazzama
Published: October 2024

Hepatic hydrothorax refers to the presence of a pleural effusion (usually >500 mL) in a patient with cirrhosis who does not have other reasons to have a pleural effusion (e.g., cardiac, pulmonary, or pleural disease). Hepatic hydrothorax occurs in approximately 5-6% of patients with cirrhosis. It results from the ascitic fluid draining into the pleural cavity through the diaphragmatic defects. The presentation of patients with hepatic hydrothorax includes chest pain, hypoxemia, cough, shortness of breath and fatigue. The atypical feature, in this case, is the presence of hepatic hydrothorax in a patient with chronic liver disease without ascites. The management of hepatic hydrothorax is difficult. The initial treatment should be a low-salt diet plus diuretics. The best diuretic regimen is probably the combination of furosemide and spironolactone. However, about 25% of patients are refractory to this regimen, and additional therapy is indicated. This patient underwent thoracentesis, however, considering the re-accumulation of fluid, a pigtail catheter was placed which drained up to 8 liters of fluid.
SIGNIFICANCE OF CA15-3 IN CARCINOMA OF THE BREAST WITH VISCERAL METASTASES
Authors: Bhunisha  , Haider Ghulam , Shaikh Zoya , Memon Paras , Shahid Aisha , Rahul Raja , Kumar Pavan , Beg Shumyla , Parkash Jai
Published: October 2024

Background: The most common malignancy and second most common cause of death is breast cancer among women. About 2.09 million fatalities from breast cancer happened in 2018. The objective was to evaluate the elevated CA15-3 in breast cancer patients with visceral metastases presenting at the tertiary care hospital of Karachi. Methods: It was a cross-sectional study conducted at the Department of Oncology of Jinnah Postgraduate Medical Center from 15th December 2018 to 15th November 2019. Female patients aged 26-80 years diagnosed with visceral metastatic (defined as metastasis to lung, liver, brain and adrenal glands) breast cancer were included in the study. The diagnosis of breast cancer was confirmed on histopathology whereas the metastatic sites were evaluated using physical examination and imaging. The serum CA15-3 concentration was assessed using assay kits. The serum CA15-3 level of 0-32 U/ml was taken as normal range for all the patients whereas CA15-3 level greater than 32 U/L was considered as elevated CA15-3. SPSS version 23 was used to enter and analyze data. Results: A total of 139 females were included in the study. The mean age & BMI of the patients were reported as 46.5 years & 26.69 kg/m2. In the majority of the patients' metastases were detected in the liver (n=54), 92 in the lungs+ parenchymal disease, 20 in adrenal glands, 12 in pleural effusion and 10 in the brain. Out of 139 patients with visceral metastases, 52(37.4%) had normal CA15-3 level whereas 87 (62.6%) had elevated serum CA15-3 levels (>32 U/L). Conclusion: The serum CA15-3 tumour marker is elevated significantly in visceral metastases and can be used as a prognostic marker in metastatic breast cancer patients.
The Ideal Impact of Transformational Leadership Behaviors and their Role in Enhancing the Innovation and Flexibility of Organizational Processes: An Exploratory Study
Authors: Alsowaidi Majid Fahem Jaafar
Published: October 2024

The research aimed in of these fit study of or analyze transformational leadership behaviors, as well as innovation of or flexibility of organizational dues of or in of these fit know the relationship of or impact between them in of these fit accomplish a number of objectives, the primary ones being in of these fit emphasize the significance of transformational leadership characteristics in encouraging creativity of or adaptability in organizational dues of or in of these fit raise awareness of current concepts in leadership of or try in of these fit harmonize them with the Iraqi environment as they are in remarkable progress of or discuss ways in of these fit keep pace with the rapid development of or highlight the transformational leadership features available in of these fit administrative leaders in the research sample of or their importance in Enhancing the innovation of or flexibility of organizational dues, the research was applied at the University of Al-Qadisiyah through the design of a questionnaire that is consistent kept the study's goals in mind, of or a variety of suitable statistical techniques were employed in of these fit examine the questionnaire. The study produced a number of these fit face risks in organizations, ideas of or solutions must be developed in of these fit bring about effective changes of or develop the course of the organization, of or it must be characterized by specific behavioral traits of or characteristics that contribute in of these fit achieving change of or motivating the team in of these fit achieve common goals. There are many characteristics that distinguish of findings, the most significant of which was that transformational leadership behaviors will to been tie a significant influence in encouraging creativity of or adaptability in organizational procedures.
Polycystic Ovary Syndrome and Infertility in Niger State, Nigeria: Challenges, Outcomes, and Early Intervention
Authors: Nwakobe Chinaza Felicia , Ilouno Innocent Onyebuchi
Published: October 2024

Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder and a leading cause of infertility among women of reproductive age. This study examines the diagnostic challenges, clinical features, and treatment outcomes for women with PCOS in Niger State, Nigeria. A prospective analysis of 47 women diagnosed using the Rotterdam criteria revealed a strong association between PCOS and infertility, alongside common symptoms such as irregular menstrual cycles and obesity. The combination of Clomiphene Citrate with Metformin showed the highest success in achieving pregnancy. The study highlights the importance of early intervention and tailored treatment strategies to improve reproductive outcomes for women with PCOS in this region.
IMPLEMENTATION OF HEALTH CARE POLICIES IN PUSKESMAS INPATIENT SERANG CITY
Authors: Nikki Prafitri
Published: October 2024

Public policy implementation is an important process towards achieving policy objectives. Health service policies during the pandemic are very crucial because of adaptation to social restriction policies. Health centers in this case have an important role as the frontline of health services and also need to implement health service policies optimally. The Serang City Public Health Center is considered to provide good health services based on the Serang City community satisfaction index. The purpose of this study was to determine the implementation of health services at the Serang City Public Health Center and to identify the success factors of implementation. The research method used in this research is descriptive qualitative research method. The research findings in this research are that the successful implementation of health services at the Serang City Publis Health Center is due to the integrity factor and the understanding of the officers in understanding the main tasks and functions, the commitment of the officers in providing honest, fair and friendly services, the availability of adequate and competent human resources. as well as good supervision from the leadership.
PUBLIC SERVICE CHALLENGES IN THE NATIONAL CAPITAL CITY (IKN) OF THE ARCHIPELAGO
Authors: Haryo Setyoko  , Suhud Alynudin  , Agus Widiarto
Published: October 2024

The relocation of the National Capital City (IKN) of the Archipelago from DKI Jakarta to Kalimantan became the government's current focus is on the national recovery period caused by the pandemic Covid-19. Limited funds, less strategic location from a security perspective, as well forest fire disasters that often occur since Kalimantan is one of them the lungs of the world, including the natural wealth contained therein, become something what is important to note. One of them is by using a service approach based on the Development Program of the United Nations (UN), namely Tata Manage Good governance. The research method used is through the study literature, such as documents from official government institutions and sources other relevant. Referring to the newly passed regulation, the government has already loaded it public services in accordance with good governance. Process the transfer of the capital city needs to be escorted so that the previous evaluation is like the people who not yet involved not repeated.
POLEMIC POLICY OF PERMENDIKBUD RISTEK NUMBER 30 OF 2021 ABOUT THE PREVENTION AND MANAGEMENT OF SEXUAL VIOLENCE IN HIGHER EDUCATION ENVIRONMENT IN PUBLIC POLICY PERSPECTIVE
Authors: Agus Widiarto  , Suesilowaty
Published: October 2024

On August 31, 2021 Regulation of the Minister of Education, Culture, Research and Technology (Permendikbudristek) Number 30 of 2021 concerning Prevention and Handling of Sexual Violence in Higher Education was stipulated by the Minister of Education,Culture, Research and Technology and promulgated on September 3, 2021. The stipulation of this rule is only one day after the Legislation Agency ( Baleg) DPR RI on August 30, 2021 finally agreed to start from the beginning the process of formulating the Preliminary Draft of the Bill on the Elimination of Sexual Violence (RUU PKS) with a slight change in the title, becoming the Bill on Criminal Acts of Sexual Violence (TPKS). Substantially, the initial draft of this bill has similarities with Permendikbudristek Number 30 of 2021, namely regarding the definition, scope, and content of sexual consent which causes controversy in thecommunity. The controversy, which initially focused on the Bill on the Elimination of Sexual Violence, turned to the Permendikbudristek. This article will review Permendikbudristek in substance and its controversy in the midst of society and the implications it causes. Analysis of public Policy, including in the Formulation and Implementation is used as an approach to unravel various aspects, including the position of this Permendikbudristek in the hierarchical aspect of Indonesian legislation.
THE INFLUENCE OF CUSTOMER SERVICE ON CUSTOMER SATISFACTION AT XL CENTER RANGKASBITUNG
Authors: Amalia Mawar
Published: October 2024

This research is based on the company's increasing competition, therefore, every company must have a good quality of service so as to provide satisfaction to customers to remain subscribed or use their products. This research aims to find out the influence of customer service on customer satisfaction at XL Center Rangkasbitung. The study uses quantitative research methods, analytical models used in simple linear regression tests, correlation coefficients, determination coefficients, and t tests using manual calculations. Data sources are obtained from the results of questionnaires that contain their opinions or assessments of customer service that affect customer satisfaction. Taken as many as 100 respondents determined by axidental technique. The results of this study showed that customer service positively affects customer satisfaction, this is based on the results of calculations that show a thitung value of 1,425 > a ttabel value of 1,282. While the large influence of customer service on customer satisfaction (adjusted r2) is50.8%. The simple linear regression equation obtained is Ȳ = 1.535 + 0.973X.
ANALYSIS OF THE EFFECT OF PRODUCT QUALITY AND PROMOTION ON PURCHASE DECISIONS OF EXCITED LIQUID IN VAPE STORE (Case Study at DjawayVape Store in Pandeglang)
Authors: Miftah Faiz Ali Ramdhani  , Tubagus Rizki Chandra Nugraha
Published: October 2024

Product quality and promotion are important things that can influence purchasing decisions, the better the quality of the products you have and supported by attractive promotions, it will be able to provide encouragement to consumers in making purchasing decisions on marketed products. This study aims to determine whether there is an effect of product quality on purchasing decisions, and whether there is an influence of promotion on purchasing decisions and whether there is an influence of product quality and promotion on purchasing decisions of excise liquid products. The population in this study were all consumers of the Djaway Vapestorestore. Sampling in this study used the slovin formula with the results of 100 respondents being the sample. The data analysis technique used validation test, reliability test, descriptive analysis, multiple linear regression, classical assumption test, t test, f test, and coefficient of determination. The results of this study indicate that the product quality variable has a significant effect on purchasing decisions, and the promotion variable has a significant effect on purchasing decisions. Based on the simultaneous test of product quality and promotion variables have a significant effect on purchasing decisions.
CAPACITY BUILDING OF VILLAGE APPARATUS IN IMPROVING PUBLIC SERVICES IN PASIR KARAG VILLAGE, KORONCONG SUB-DISTRICT
Authors: Topik Hidayat Topik  , Natta Sanjaya
Published: October 2024

Capacity Building is a process to improve individuals, groups, organizations, communities and society to achieve the goals that have been set This study uses qualitative methods, is a study to manage and describe data and information based on facts which are then analyzed further. The number of informants in this study amounted to 12 people using purposive sampling. From the results in the field, it shows that: 1) There is a covid-19 outbreak which has resulted in the performance of both government and private activities decreasing drastically, so that activities or activities both in the public space and outside the public space have to be limited. 2). The BPD of Pasir Karag Village has not yet fully played an active role in carrying out its duties and functions, there is still a lack of experience and knowledge of the members. 3). The budget issued by the central government in fulfilling the capacity development of the village apparatus, especially in Pandeglang district is still very minimal. 4). the influence of political factors is still high which causes injustice related to information regarding aid programs and others.
PENGARUH PERENCANAAN INOVASI SISTEM PELAYANAN ADMINISTRASI KEPENDUDUKAN BERSAMA KANTOR POS (SIMPELPOS) TERHADAP EFEKTIVITAS PELAYANAN ADMINISTRASI KEPENDUDUKAN PADA DINAS KEPENDUDUKAN DAN PENCATATAN SIPIL KABUPATEN PANDEGLANG
Authors: Marsalino marsel  , Firmansyah Hidayat Wahyu
Published: October 2024

Dalam situasi pandemi penyakit virus corona 19 (Covid-19) pelayanan administrasi harus dijalankan bagi masyarakat yang membutuhkan pelayanan, disisi lain protokol pencegahan Covid-19 juga harus dilaksanakan. Dengan adanya Kantor Pos (SIMPELPOS), layanan residensial di masa pandemi virus corona untuk mempermudah pengurusan dokumen administrasi kepada masyarakat, selain efisiensi penggunaan waktu, biaya dan kepastian penyelesaian dokumen administrasi sehingga dapat diterima oleh masyarakat, Disdukcapil kabupaten pandeglang bekerja sama dengan kantor pos pandeglang untuk mendistribusikan dokumen kependudukan kepada penerima manfaat. Dengan rumusan masalah sebagai berikut : 1. Seberapa Besar Pengaruh Perencanaan Inovasi Sistem Pelayanan Administrasi Kantor Pos (SIMPELPOS) Terhadap Efektivitas Pelayanan Administrasi Pada Dinas Kependudukan dan Catatan Sipil Kecamatan?
PENGARUH HARGA TERHADAP MINAT BELI TIKET OBJEK WISATA AQUALAND KOTA SERANG
Authors: Ali Mahmud , Arif  , Ali Ramdhani Miftah Faiz
Published: October 2024

Penelitian ini bertujuan untuk mengetahui harga tiket objek wisata Aqualand Kota Serang, untuk mengetahui minat beli tiket pada objek wisata Aqualand Kota Serang, dan untuk mengetahui seberapa besar pengaruh Harga terhadap Minat Beli Tiket Objek Wisata Aqualand. Penelitian menggunakan metode penelitian kuantitatif deskriptif, menggunakan sampel 100 responden dengan teknik probability sampling. Hasil Analisis Korelasi diperoleh nilai r sebesar 0,747, berdasarkan interval koefisien korelasi (0,600 – 0,799) menyatakan adanya tingkat hubungan yang kuat. Sedangkan nilai koefisien determinasi sebesar 55,8% dapat diartikan bahwa variabel harga memberikan kontribusi sebesar 55,8%. Kemudian hasil uji signifikansi korelasi dengan menggunakan uji t hipotesis, diketahui t hitung lebih besar dari t tabel yaitu 11,119 > 1,661. Hal ini membuktikan bahwa H0 ditolak dan Ha diterima. Pada dasarnya terdapat pengaruh positif dan signifikan antara harga terhadap minat beli tiket objek wisata Aqualand Kota Serang.
PENGARUH KUALITAS PELAYANAN DESA GERENDONG TERHADAP KEPUASAN MASYARAKAT
Authors: Hayati Hayati  , Ahmadi
Published: October 2024

ABSTRAK
Desa merupakan salah satu lembaga pemerintahan yang memberikan pelayanan terdepan kepada masyarakat di wilayah desa yang bersangkutan. Oleh karena itu, keberadaan desa menjadi ujung tombak pembangunan kemajuan bangsa ini. Seiring pentingnya pelayanan yang maksimal pada sebuah desa, maka diharapkan aparatur pemerintahan desa memiliki kapasitas dan kapabilitas sesuai tugas pokok dan fungsi melayani masyarakat. Oleh karena itu, Desa mempunyai peranan penting dalam memperhatikan kualitas pelayanan. Penelitian ini bertujuan untuk menganalisis pengaruh kualitas pelayanan Desa Gerendong terhadap kepuasan masyarakat. Data diperoleh dari 95 responden yang ditentukan dengan metode purposive sampling dan dianalisis menggunakan analisis deskriptif dan SEM-PLS. Berdasarkan hasil penelitian kualitas pelayanan Desa Gerendong berpengaruh secara positif dan signifikan terhadap kepuasan masyarakat.
Kata Kunci: Kepuasan Masyarakat, Kualitas Pelayanan, Kepuasan
IMPLEMENTASI PERATURAN BUPATI LEBAK NOMOR 1 TAHUN 2022 TENTANG TATA CARA PEMUNGUTAN PAJAK BUMI DAN BANGUNAN PERDESAAN DAN PERKOTAAN DI KELURAHAN MUARA CIUJUNG TIMUR KECAMATAN RANGKASBITUNG KABUPATEN LEBAK
Authors: Saepudin Firman , Andayani Nopi
Published: October 2024

Pajak Bumi dan Bangunan Perdesaan dan Perkotaan merupakan pajak daerah yang bersifat kebendaan dalam arti besarnya pajak terutang ditentukan oleh keadaan objek yaitu bumi atau tanah dan/atau bangunan. Permasalahan dalam penelitian ini mengenai pemungutan Pajak Bumi dan Bangunan meliputi : (1) Belum tercapainya target Pajak Bumi dan Bangunan Perdesaan dan Perkotaan di Kelurahan Muara Ciujung Timur; (2) Kurangnya sosialisasi mengenai Pajak Bumi dan Bangunan Perdesaan dan Perkotaan di Kelurahan Muara Ciujung Timur; (3) Kinerja pemungut Pajak Bumi dan Bangunan Perdesaan dan Perkotaan (PBB-P2) di Kelurahan Muara Ciujung Timur kurang optimal; (4) Kurangnya kesadaran masyarakat dalam pembayaran Pajak Bumi dan Bangunan Perdesaan dan Perkotaan di Kelurahan Muara Ciujung Timur. Metode yang digunakan dalam penelitian ini adalah metode penelitian deskriptif kualitatif, teknik penentuan informan menggunakan teknik purposive sampling, dan teknik pengumpulan data yaitu wawancara serta observasi dan dokumentasi. Berdasarkan hasil penelitian diperoleh bahwa pemungutan Pajak Bumi dan Bangunan Perdesaan dan Perkotaan belum berjalan dengan optimal. Saran dari penelitian ini : mengadakan evaluasi, meningkatkan sosialisasi yang langsung bersentuhan dengan masyarakat, harus lebih memperhatikan dan mempertimbangkan untuk menjadi pemungut Pajak Bumi dan Bangunan di Kelurahan tersebut agar tidak terjadi lagi penyimpangan ataupun kekeliruan.
PENGELOLAAN SAMPAH UNTUK KESEJAHTERAAN MASYARAKAT LINGKUNGAN TPST BANTARGEBANG
Authors: Audia Febrianti Adis , Stiawati Titi
Published: October 2024

Penelitian ini berfokus pada implementasi pengelolaan sampah TPST Bantargebang dalam menjamin kesejahteraan masyarakat yang memiliki tempat tinggal di sekitar tempat tersebut. Adapun tempat yang dipilih oleh peneliti untuk melakukan penelitian adalah TPST Bantargebang dan sekitarnya, dikarenakan tumpukan sampah Bantargebang yang setiap hari semakin bertambah jumlahnya dan daerah sekitarnya banyak bangunan rumah warga, maka dari itu peneliti berminat untuk meneliti masalah ini lebih dalam dengan mengacu pada teori pengelolaan menurut George R. Terry serta menggunakan metode pengumpulan data berupa wawancara langsung antara peneliti dan informan. Hasil yang didapatkan dari penelitian ini adalah pemerintah masih kurang maksimal dalam pelaksanaan indikator manajemen terutama pada tahap pengawasan dan perencanaan keuangan. Oleh karena itu pemerintah diharapkan dapat lebih mengawasi implementasi kebijakan yang dijalankan oleh daerah masing-masing serta sering melakukan kontrol rutin.