bluuebunny/crossref_metadata_2025 huggingface dataset:
In Vitro učinkovitost topikalnih antimikrobnih lijekova
Authors: Zurak Kristina , Tonkić Marija
Published: December 2022

Cilj istraživanja: Cilj ovoga rada je utvrditi osjetljivost bakterija koje najčešće izazivaju lokalizirane infekcije u KBC Split tijekom 2020. godine na pojedine topikalne antimikrobne lijekove kako bi se ustanovilo koji od testiranih antibiotika je najbolji izbor za empirijsko liječenje ovih infekcija. Materijali i metode: Retrospektivnim istraživanjem analizirani su podatci o osjetljivosti na topikalne antimikrobne lijekove (aminoglikozide, fluorokinolone, kloramfenikol, kolistin te mupirocin) pojedinih vrsta bakterija koje su najčešći uzročnici lokaliziranih infekcija: Escherichia coli i ESBL E. coli, Klebsiella pneumoniae (uključujući i ESBL sojeve), Pseudomonas aeruginosa, Acinetobacter baumannii te Staphylococcus aureus (uključujući MRSA). Osjetljivost je ispitivana metodom disk difuzije, a za kolistin metodom dilucije u bujonu. Rezultati: Rezultati pokazuju visoku rezistenciju bakterije Escherichia coli na antibiotike ciprofloksacin i levofloksacin, a nisku na kloramfenikol i kolistin. U usporedbi s Escherichia coli, ESBL producirajući soj Escherichia coli pokazuje znatno visoku rezistenciju na sve ispitivane antibiotike osim na kolistin i kloramfenikol. Sojevi Klebsiella penumoniae su bili visoko rezistentni na antibiotik tobramicin, a nisko rezistentni na kloramfenikol i kolistin. ESBL producirajući sojevi ove bakterije su imali znatno visoku rezistenciju na sve ispitivane antibiotike osim na kloramfenikol i kolistin. Pseudomonas aeruginosa je bio visoko rezistentan na ciprofloksacin i levofloksacin, a nisko na kolistin. Sojevi Acinetobacter baumanni su bili visoko rezistentni na levofloksacin, a nisko na kolistin. Izolati Staphylococcus aureus su bili visoko rezistentni na levofloksacin, a dobro osjetljivi na kloramfenikol i norflok-sacin. MRSA sojevi su bili visoko rezistentni na levofloksacin, u značajno većim postotcima od MSSA sojeva, a dobru osjetljivost pokazali su na mupirocin. Zaključak: Podatci ove studije pokazuju visoke stope rezistencije ispitivanih bakterija na pojedine topikalne antimikrobne lijekove, što je u skladu s trendovima porasta rezistencije bakterija u svijetu, te možemo pretpostaviti da će se ta rezistencija u budućnosti još povećati.
Informirani pristanak kao proces ostvarenja bioetičkih principa u odnosu pacijent – liječnik
Authors: Carti Dajana , Balaž Gilja Andreja
Published: December 2022

Informirani pristanak je medicinsko-etičko područje koje povezuje temeljnu etičku spoznaju s kliničkom praksom i odnosom prema pacijentu, a s obzirom na kompleksnost primjene u praksi, sve je češća tema rasprave u profesionalnim krugovima. Stoga je cilj ovog rada prikazati na stvarnom, kliničkom slučaju proces informiranog pristanka, kao proces trajnog dijaloga i suodlučivanja između liječnika i pacijenta usmjeren objektivnoj dobrobiti. Klinički primjer prati bioetičke principe autonomije, dobročinstva, neškodljivosti i pravednosti u procesu informiranog pristanka i ukazuje na valjanosti/manjkavosti informiranog pristanka u kontekstu modela švicarskog sira. Zaključno, razmatra se jaz između zakona i medicinske etike koji uvelike doprinosi neadekvatnoj praksi.
PIK3CA mutacije u luminalnim, HER2 negativnim metastatskim karcinomima dojke
Authors: Tomić Snježana , Krželj Domagoj
Published: December 2022

Ciljevi: U bolesnica s luminalnim, HER2 negativnim, metastatskim karcinomima dojke rezistentnim na endokrinu terapiju, liječenim u KBC Split u 2020. i 2021. godini, u uzorcima tkiva tumora odrediti udio i tip PIK3CA mutacija, te dobivene podatke usporediti s rezultatima iz registracijske studije SOLAR1 koja procjenjuje učinkovitost i sigurnost alpelisiba u kombinaciji s fulvestrantom kod bolesnika s uznapredovalim rakom dojke koji je napredovao tijekom ili nakon liječenja inhibitorima aromataze.Metode (ispitanici i postupci): Prikupljeni su podaci o 99 bolesnika s dijagnosticiranim luminalnim, HER2 negativnim, metastatskim karcinomima dojke u vremenskom periodu od 2020. do 2021. godine. To je retrospektivna analiza. Za potrebe izrade empirijskog dijela ovog diplomskog rada pristupljeno je medicinskoj dokumentaciji i elektroničkoj bazi podataka Kliničkog zavoda za patologiju, sudsku medicinu i citologiju Kliničkog bolničkog centra Split. U bazu podataka uvršteni su dob, spol, prisutnost PIK3CA mutacije i distribucija specifičnih mutacija. Uzorci tumorskog tkiva analizirani su primjenom lančane reakcije polimeraze u realnome vremenu (RT-PCR) metode.Rezultati: Utvrđena je značajna razlika u zastupljenosti pacijenata prema spolu u uzorku od 99 pacijenata. Najveći broj paci-jenata nalazi se u dobnoj skupini od 60 do 70 godina, dok srednja životna dob iznosi 67 godina. U 99 uzoraka tkiva pacijenata s metastatskim hormon receptor pozitivnim, HER2 negativnim karcinomom dojke, koji su rezistentni na endokrinu terapiju liječenih u KBC-u Split, u njih 50 je nađena PIK3CA mutacija (51,51%). U 17 uzoraka tkiva pozitivnih na PIK3CA mutaciju (N=50) utvrđena je mutacija H1047X na egzonu 20, te 14 mutacija na egzonu 9 (E542,545X i545K). Ove mutacije predstavljaju 62% svih PIK3CA mutacija, što odgovara rezultatima SOLAR-1 studije, u kojoj su mutacije također nađene najčešće na egzonima 9 i 20.Zaključak: Na temelju rezultata ove studije, usporedivih s rezultatima registracijske studije SOLAR-1, RT-PCR metodologija korištena za detekciju PIK3CA mutacija je efikasna, specifična i senzitivna metoda za odabir bolesnica za liječenje PI3K inhibitorom, koja se može implementirati u većem broju laboratorija uz redovite vanjske i unutarnje provjere kvalitete i točnosti testiranja.
Kvaliteta života starijih osoba s kroničnom leukemijom
Authors: Kristić Bruna , Buljubašić Ante , Orlandini Rahela , Podrug Mario , Vladislavić Silvija
Published: December 2022

Cilj: Ispitati i utvrditi prisutnost poteškoća i kvalitetu života bolesnika s kroničnom leukemijom s obzirom na spol, bračni status i starosnu dob bolesnika.Metode: Za potrebe istraživanja proveden je anketni upitnik među 44 bolesnika koji imaju dijagnosticiranu kroničnu leukemiju duže od godine dana. Istraživanje je provedeno u razdoblju od 15.6.2021. do 14.8.2021. godine. Ispitanici su anketirani preko anketnog upitnika koji je proveden pismeno, zaokruživanjem jednog od ponuđenih odgovora.Rezultati: U provedenom istraživanju sudjelovalo je 44 ispitanika, od kojih su 58,82% muškarci i 41,18% žene. Za većinu ispitanika postoji statistički značajna povezanost u prisutnosti poteškoća i kvaliteti života s obzirom na starosnu dob.Zaključci: Poteškoće uzrokovane leukemijom koje utječu na kvalitetu života s obzirom na spol bolesnika izraženije su kod žena. Poteškoće uzrokovane leukemijom koje utječu na kvalitetu života s obzirom na bračni status ispitanika nisu značajno izražene kod nijedne grupe ispitanika. Postoji povezanost između učestalosti općih poteškoća i starosne dobi, odnosno osobe starije životne dobi bilježe učestalije opće poteškoće.
Vidni evocirani potencijali u dijagnostici migrena dječje dobi
Authors: Karlica Utrobičić Dobrila
Published: December 2022

Glavobolja je jedan od najčešćih simptoma u neurologiji i vrlo čest uzrok recidivirajućih bolova u djece. Glava, lice i meki oglavak bogato su opskrbljeni receptorima za bol u odnosu na ostale dijelove tijela, što može objasniti zašto su bolovi tako često lokalizirani u glavi. Glavobolje su vrlo česte u djece i adolescenata. One imaju negativan utjecaj na učenje djeteta, pamćenje, osobnost, međuljudske odnose ili odnose s vršnjacima, kao i na izvršavanje školskih i izvanškolskih obveza. To, naravno, ovisi o etiologiji, učestalosti i intenzitetu glavobolje. Metode liječenja za različite tipove glavobolje su različite. Važno je prepoznati vrstu glavobolje, tako da se može tretirati na pravilan način. Svako dijete s glavoboljom treba individualan pristup. Pravodobno i pra-vilno liječenje čini bolest podnošljivijom i osigurava bolju kvalitetu života. Elektrofiziološke pretrage procjenjuju funkciju vidnog puta na određenom nivou. Vidni evocirani potencijali (VEP) predstavljaju kortikalni odgovor na vidni stimulus. Parametri VEP-a koji se analiziraju i opisuju su latencija, vremenski interval između stimulacije i pojave odgovora, te amplituda P 100 vala. U ovom istraživanju ispitivali smo VEP testiranjem promjene u vrijednostima amplitude i latencija P100 vala za vrijeme migrena i mirne faze u djece.
Kirurško liječenje karcinoma želuca u KBC-u Split - trogodišnja retrospektivna studija
Authors: Mamić Josipa , Krnić Dragan
Published: December 2022

Cilj: Cilj ovog istraživanja bio je analizirati patohistološke osobitosti adenokarcinoma želuca i kratkoročne kliničke ishode u bolesnika operiranih u razdoblju od 1. siječnja 2018. do 1. kolovoza 2020. godine.Materijali i metode: U istraživanje su uključeni bolesnici operirani zbog adenokarcinoma želuca u razdoblju od 1. siječnja 2018. do 1. kolovoza 2020. Iz arhive povijesti bolesti i patohistoloških nalaza su prikupljeni sljedeći podatci: dob, spol, lokalizacija tumora, TNM stadij, gradus, histološki tip, status limfnih čvorova, dužina hospitalizacije, tip operacije. Rezultati: Od ukupnog broja bolesnika muških je bilo 36 (65%), a ženskih 19 (35%). Stariji od 63 godine čine 75% ukupnog broja bolesnika. Najzastupljeniji patološki stadij je IIIA (20%), a srednja vrijednost udaljenosti tumora od ruba je 5,00 cm. Medijan odstranjenih limfnih čvorova je 6,50. Srednja vrijednost pozitivnih limfnih čvorova je 3,00. Srednja vrijednost pozitivnih limfnih čvorova kod tumora visokog gradusa je 9,86, a kod tumora niskog gradusa 2,32. Međutim, ne postoji statistički značajna poveza-nost, P=0,276. Najčešći tip operacije je bila subtotalna gastrektomija. Komplikacije su utvrđene u 29,09%, a potreba za revizijom je utvrđena u 9,09% bolesnika. Neposredno nakon operacije nije umro niti jedan promatrani bolesnik. Srednja vrijednost duljine hospitalizacije u bolesnika s komplikacijama je bila za 9 dana duža u odnosu na bolesnike u kojih komplikacija nije bilo. Zaključci: Demografske i patohistološke odrednice adenokarcinoma želuca ne odstupaju od ostalih istraživanja. Duljina re-sekcijskih rubova je u skladu sa smjernicama. Prosječan broj odstranjenih limfnih čvorova je manji od preporučenog. Histološki gradus je povezan s većim brojem pozitivnih limfnih čvorova, ali povezanost nije statistički značajna.
Medicinsko-laboratorijska dijagnostika
Authors: Glavaš Obrovac Ljubica , Puljčan Katja , Sutlović Davorka
Published: December 2022

Medicinsko-laboratorijska dijagnostika sastavni je dio moderne medicine. Danas se više od 70% odluka u kliničkom liječenju oslanja na rezultate pretraga učinjenih od strane medicinsko-dijagnostičkih laboratorija. S obzirom na brz razvoj molekularne medicine, personalizirane medicine, kao i metoda i tehnologija koje se koriste u laboratorijskoj medicini, od ključne je važnosti kontinuirano stručno i znanstveno usavršavanje stručnjaka iz područja medicinsko-laboratorijske djelatnosti. To se postiže obrazovanjem na diplomskoj i poslijediplomskoj razini. Zapošljavanjem visokoobrazovanih stručnjaka, obrazovanih za rad u sustavu zdravstva i zdravstvene zaštite iz područja medicinsko-laboratorijske dijagnostike, unaprjeđuje se sustav analize bioloških uzoraka te značajno doprinosi procesu prevencije, otkrivanja i liječenja bolesti.
Upotreba umjetnih podloga u sportu
Authors: Burger Ante , Janković Stipan , Bjelanović Luka
Published: December 2022

Umjetne podloge na sportskim igralištima i terenima imaju sve veću primjenu posljednjih 20 godina. Razvoj modernih tehno-logija izrađivanja takvih podloga je u konstantnom porastu te se na tržištu mogu pronaći različiti proizvođači koji plasiraju svoje proizvode u sportskoj industriji. Nogomet kao najrašireniji sport u svijetu je među prvima implementirao terene s umjetnom travom u sustav treninga i odigravanja utakmica. Danas je u upotrebi umjetna trava 4. generacije koja se postavlja na nogometne travnjake diljem svijeta te bi trebala zadovoljavati najveće europske standarde. Pregledom istraživanja na travnatim površinama uočeno je da je umjetna trava prve i druge generacije imala zabilježenu veću incidenciju ozljeda u odnosu na prirodne travnjake. Osobito treba pripaziti na toksičnost granulata koji je bio postavljan na umjetnu travu te su zabilježena kožna i respiratorna oboljenja na travnjacima starijih generacija. Tenis pripada sportovima gdje su se među prvima koristile umjetne podloge različitih karakteri-stika. Učestale promjene igranja na različitim teniskim podlogama dovele se do ozljeđivanja igrača koji nisu bili adekvatno fizički pripremljeni. Dvoranski sportovi poput rukometa, odbojke, futsala koriste višenamjenske umjetne podloge za svoja natjecanja. Istraživanja na ozljedama u dvoranskim sportovima pokazala su da postoje povećani rizici od ozljede kada se igra na umjetnim podlogama. Cilj ovoga stručnoga rada je potaknuti znanstvenu i sportsku zajednicu na važnost prevencije i dobre fizičke pripreme sportaša za igranje na različitim umjetnim podlogama. Konačan je zaključak da treba konstantno provoditi kontrolu proizvodnje umjetnih podloga te redovito pratiti incidenciju ozljeđivanja za vrijeme treninga i natjecanja, kako se ne bi povećala opasnost ozljeđivanja sportaša.
Estadística aplicada al ámbito sanitario
Authors:   Université de Lille, Vitale Raffaele , Hermenegildo Caudevilla Marta ,   Hospital Universitario Dr. Peset de Valencia (Servicio de Farmacia), Ferrer Riquelme Alberto José ,   Universitat Politècnica de València
Published: December 2022

Esta monografía proporciona un resumen de las herramientas básicas de estadística descriptiva e inferencia estadística,con un apartado dedicado al análisis de supervivencia. Se presentan 3 ejemplos de aplicación de las técnicas con datos reales del ámbito clínico usando el programa estadístico SPSS. Está pensada para usuarios que quieran recordar de forma sencilla y rápida los conceptos básicos de estadística descriptiva y contrastes de hipótesis, así como tener una guía de qué técnica aplicar en función del problema a resolver. El capítulo dedicado al análisis de supervivencia está especialmente destinado a las personas interesadas en disponer de una guía práctica de cómo realizar este análisis con SPSS. Los ejemplos ilustrados son del ámbito de las Ciencias de la Salud, lo que puede ser especialmente útil, aunque no exclusivo, para todos los interesados de este ámbito.
Empatia, imersão e prototipação no desenvolvimento de projetos de tecnologia assistiva: um estudo de caso
Authors: Paulo Irandir Izaquiel , Muniz Erika Danielly Florêncio Pereira , Barbosa Josefa Laricia Ferreira , Fialho Francisco Antonio Pereira , Merino Giselle Schmidt Alves Díaz , Merino Eugenio Andrés Díaz
Published: December 2022

Esse artigo tem como objetivo identificar a aplicação e contribuição dos aspectos do Design Thinking, especificamente a empatia, imersão e prototipação, a partir de um estudo de caso. Trata-se de uma pesquisa de natureza aplicada, objetivo exploratório-descritivo e abordagem qualitativa. Quanto aos procedimentos técnicos foi dividida em duas fases, sendo: Fase 1 – TEÓRICA por meio de pesquisa bibliográfica e revisão narrativa  e a Fase 2 – APLICADA por meio de um Estudo de Caso que teve como finalidade desenvolver um dispositivo de Tecnologia Assistiva (TA) para facilitar a transferência de uma usuária de cadeira de rodas durante sua rotina diária, para tal utilizou-se como metodologia de projeto o Guia de Orientação para o Desenvolvimento de Projetos (GODP). Assim, foi verificado que a aplicação do Design Thinking, empatia, imersão e prototipação, é essencial para o desenvolvimento de projetos de Tecnologias Assistivas, contribuindo desde o momento inspiração até o momento de implementação. Permitindo a identificação de problemas e necessidades da PcD, organização e análise das ideias (mapas, matriz de decisão, blocos de referência) e desenvolvimento de possíveis soluções com o auxílio de protótipos. Com isso, espera-se reduzir o número de abandono dos dispositivos de Tecnologias Assistivas.
Effects of climate change on financial statements of entities listed in the Netherlands
Authors: van der Tas Leo , Aggarwal Yukti , Maksimovic Danijela
Published: December 2022

A survey of 88 companies listed on the Amsterdam Stock Exchange shows that the number of financial statements referencing climate change has increased significantly (from 9% in 2020 to 39% in 2021) and that the reported financial impact of climate change was not material. However, significant improvements in the disclosures can be achieved by disclosing assumptions used, sensitivity analyses made and comparisons against benchmarks such as Paris-aligned climate change scenarios. We also found a very significant increase in the references to climate change in the auditor reports (from 2% in 2020 to 70% in 2021). We conclude that the increase in references to climate change has most likely been caused by increased pressure from institutional investors, environmental lobby organisations and regulators upon preparers and auditors for more transparency.
Long Term Follow up of CT Angiography in Low to Intermediate Risk Patients of Suspected Acute Coronary Syndrome (ACS)
Authors: Rahman Fahd Ur , Saif Mohsin , Siddiqiue Bilal , Safi Shoaib Iqbal , Abbas Mutahir , Khan Sikandar Azam , Aziz Zohair , Azad Naseem , Sarfraz Sana , Anwar Maida
Published: December 2022

Objective: To assess long term outcomes of CT Angiography in low to intermediate risk patients of suspected ACS and to assess if CT-angiography is a safe modality to discharge patients with clinically non-significant coronary artery disease.

Study Design: Descriptive cross-sectional study Place and Duration of Study: Tertiary Cardiac Center in Rawalpindi, from Dec 2021 to Apr, 2022.

Methodology: A total of (n=600) patients who presented with ischemic sounding chest pain and suspicion of acute coronary syndrome (ACS) were selected via consecutive sampling technique and were followed up to 5-months. Patients' demographics, CT-Angiography findings and their outcomes were noted on data collection sheet. Data was analyzed by SPSS version-23. Descriptive statistics were run to present categorical data in frequencies and percentages. Chi-square and Fisher Exact Test was applied to find the association between study variables at 95% CI and 5% margin of error (α=5%).

Results: Out of (n=600) suspected cases of acute coronary syndrome (ACS), n=352 (58.7%) were males and n=248 (42.3%) were females. As a result of follow-up of the ptaients, cases that represented in emergency department, readmission cases and revascularized cases were (n=10,4, 1;1.7%, 0.7%, & 0.2%) respectively. Frequency of ACS and STEMI patient was 0.0%. Mortality rate was 0.0%. There was significant association of comorbids with CT-angiography findings and the findings with outcome variables (p<0.05) except revascularization (p>0.05).

Conclusion: In low to intermediate risk patients of suspected ACS, discharge decision from emergency department based on CT-angiography findings is safe and shows excellent long-term outcomes with no major adverse cardiac event (MACE) on long-term follow-up.
Prevalence of Brain and Neck Neoplasms among Interventional Cardiologists; A Multicenter Study
Authors: Tariq Muhammad Naeem , Samore Naseer Ahmed , Rashid Muhammad Humayoun , Tuyyab Farhan , Ali Jahanzab , Ahmed Iftikhar , Khan Muhammad Nadir , Noeman Ahmad , Chaudhery Ghoza , Farhan Shaheer
Published: December 2022

Objective: To determine the prevalence of brain and neck neoplasms among Interventional Cardiologists.

Study Design: Analytical Cross-sectional study.

Place and Duration of Study: Department of Cardiology/Interventional Cardiology of two Tertiary Cardiac Care Centers of Rawalpindi and Lahore Pakistan from Mar 2021 to Apr2022.

Methodology: By using the non-probability, consecutive sampling technique, fifty Interventional Cardiologists’ (n=50) of both genders between 35-75 years of age, working in the cardiac catheterization labs for more than 10-years are enrolled after their informed consents. The data was collected from the interviews of Interventional cardiologists, from the shared medical records and also from the family members and colleagues. The Interventional cardiologists were enquired about any neurological signs and symptoms particularly in relation to the head and neck malignancy and also asked about undergoing any CT/MRI or PET scan of head and neck region in the past or recent time. Descriptive statistics for data was computed byusing the SPSS version-25.

Results: The mean age of the Interventional Cardiologists of tertiary cardiac care center of Rawalpindi was 50.40±7.77years while of Lahore was 49.16±8.89 years. There were 47(94.0%) males and 03(6.0%) females, from both the Institutes. The mean duration of working in cardiac catheterization labs was 17.92±4.57 years. The head and neck neoplasm’s among Interventional Cardiologists was observed in 01(2%) case.

Conclusion: The research study concluded that the prevalence of head and neck neoplasms among Interventional Cardiologists is very low (2%). But still it is the need of hour to be more careful about radiation exposure among the Interventional Cardiologists working for long hours in the cardiac catheterization labs, to lessen down the chances of head and neck malignancy.
Frequency of Cardiac Arrhythmias in Hypertensive Patients
Authors: Tariq Muhammad Naeem , Samore Naseer Ahmed , Rashid Muhammad Humayoun , Aziz Sohail , Chaudhery Ghoza , Ali Jahanzab , Azad Naseem , Noeman Ahmad , Yamin Bukhari Syeda Neelam , Chaudhry Azhar Ali
Published: December 2022

Objective: To determine the frequency of cardiac arrhythmias in hypertensive patients.

Study Design: Analytical Cross -sectional study.

Place & Duration of Study: Tertiary Cardiac Center, Lahore Pakistan from Jan 2021 to Dec2021.

Methodology: Two hundred patients (males and females), age between 20-80 years, suffering from hypertensive disease (Blood Pressure ≥ 140/90mmHg), one year before were assessed in the study. After that ECG was done according to International standards. Then patients undergone 24 hour Holter monitoring test. Presence of cardiac arrhythmia was confirmed by the interpretation of 12 lead ECG and 24 hour Holter report. All the data was noted. Patients with cardiac arrhythmias were treated in consultation from the Electrophysiology (EP) department of the hospital. By using the SPSS version 26, the statistical data was tabulated, analyzed and interpreted.

Results: The mean age was calculated to be 58.64±7.74 years. In this study the males were 148(74%) while 52(26%) were females. The mean duration of hypertension was found to be 5.09±1.56 years. Cardiac arrhythmias were noted in 22(11%) cases. Out of 22 cases of cardiac arrhythmias, 02(1%) patients had premature atrial contractions, 02(1%) had atrial flutter, 04(2%) had premature ventricular contractions and 14(7%) had atrial fibrillation. Cardiac arrhythmias were significantly higher in patients above 40 years of age (p<0.05). There was no difference in both genders as well as duration of hypertension has unremarkable effect on cardiac arrhythmias (p>0.05).

Conclusion: The research study concluded that in hypertensive patients, the cardiac arrhythmias frequency is low but its value is not unremarkable.
Frequency of In-Stent Restenosis among Different 2nd/3rd Drug Eluting Stents in Patients Presenting with ACS/Angina at Trtiary Cradiac Care Centre
Authors: Ghaffar Shakir , Rehman Waheed-Ur- , Khan Alam , Abbasi Muhammad Amad , Ali Sajjad , Tariq Muhammad Naeem , Arif Zeeshan , Shahzad Syed Khurram , Kamran Javeria
Published: December 2022

Objective: Primary objective was to determine the frequency of in-stent restenosis (ISR) among second/third generation drug eluting stents (DES), diagnosed angiographically in cardiac catheterization laboratory either in emergency settings or elective stage procedure and to determine the risk factors precipitating ISR.

Study Design: Analytical Cross-sectional study.

Place and Duration of the study: Tertiary Cardiac Care Center of Rawalpindi Pakistan, from Nov 2021 to Apr 2022.

Methodology: After hospital ethical committee approval, medical data of consecutive patients were analyzed. Clinical and bio data were obtained followed by admission. Risk factors for atherosclerosis obtained along with baseline investigations and echocardiogram obtained to calculate ejection fraction. Classified interventional cardiologists analyzed angiographic images and confirmed the presence of ISR. Details of previous angioplasty and type of stent were documented.

Results: Out of total 137 patients, 98(72%) were males and 39(28%) females. 94(68%) patients were diabetic, 102(72%) were hypertensive, 72(52%) had dyslipidemia, 56(40%) were smokers, and 32(23.35%) strong family history of CHD. After coronary angiography we found that frequency of ISR was 32(23%) in patients who had Xlimus sirolimus stent, 34(24.8%) patients had Xience (everolimus eluting stent), 33(24%) had Ultimaster (sirolimus eluting stent), 38(27%) had Biomatrix stent with p-value=0.25.

Conclusion: The clinical presentation of ISR is usually with angina in all new generation DES. There was no statistically significant difference in terms of ISR among second/3rd generation DES. DES ISR not only depends upon the type of DES used but also depends upon multiple patient ...
Effect of Post Dilatation on TIMI Flow in Patients Undergoing Primary Percutaneous Coronary Intervention
Authors: Abbasi Muhammad Amad , Samore Naseer Ahmad , Ali Khurshid , Rehman Waheed-Ur- , Shafique Hafiz Muhammad , Jokhio Abdul Rehman , Tariq Muhammad Naeem , Sana Ayesha , Kamran Javeria , Qureshi Sanam
Published: December 2022

Objective: To evaluate the impact of post dilatation performed with Non- Compliant Balloon on Angiographical outcome (that is TIMI flow grade) in patients who underwent the primary percutaneous coronary intervention.

Study Design: Retrospective cross-sectional study.

Place and Duration of Study: At Tertiary Cardiac Care Center, Rawalpindi Pakistan from Nov 2020 to Apr 2021.

Methodology: The retrospective data of the all the patients with STEMI was assessed via non-probability consecutive sampling technique and analyzed statistically. The study participants were classified into two categories based on whether they underwent post-dilatation or not, i.e., Category-I: patients who underwent post-dilatation with NC balloon and Category-II: patients who did not undergo post-dilatation. The primary study end-point was post-dilatation TIMI flow grade. Continuous study variables were expressed as Mean±S.D and categorical variables as frequencies and percentages. Chi square test was applied to find the association between study variables by keeping 95% CI and 5 % margin of error. p-value <0.05 was considered statistically significant.

Results: The study included (n=410) eligible patients in total. Majority were males (n=303; 73.9%), 217 (52.9 %) patients underwent PD procedure. TIMI flow grade did not differ significantly between the two study categories (p-value > 0.05). Postprocedural success rate was 81.3% for patients with PD.

Conclusion: The current study illustrates that PD does not adversely affect the final angiographic outcomes when performed after primary angioplasty.
Comparison of Amiodarone with Combined Doses of Magnesium Sulphate and Lidocaine for Prevention of Ventricular Fibrillation Following Coronary Clamp Release During Coronary Artery Bypass Graft Surgery
Authors: Akram Muhammad Adnan , Naseer Mehwish , Fayaz Fakher-e- , Khurshid Hana , Ali Nasir , Chaudhry Imtiaz Ahmed
Published: December 2022

Objective: To compare the effects of amiodarone with effects of combined doses of magnesium sulphate and lidocaine for prevention of ventricular fibrillation following coronary clamp release during (coronary artery bypass grafting) CABG.

Study Design: Comparative cross sectional study.

Place and Duration of Study: Army Cardiac Centre, Lahore Pakistan, from Jun 2021 to Dec 2021.

Methodology: One hundred patients who reported at Army Cardiac Centre Lahore, Pakistan for coronary artery bypass grafting surgery, were involved in comparative study. Patients satisfying the inclusion criteria were allocated into the LM(Lidocaine Magnesium) and A (Amiodarone) groups. Following aortic cross clamp release, the incidence of ventricular fibrillation (VF) and other arrhythmias was calculated in first 30 minutes and up to 24 hours later. The ionotropic agent used was epinephrine at a rate of 0.05 to 0.1 micrograms/kg/minute. Within 15 minutes of anesthetic induction and 15 minutes after the CPB pump was removed, hemodynamic parameters were assessed and recorded.

Results: Arrhythmias within 30 minutes and up to 24 hours after aortic cross clamp ACC release in A and LM group were compared. The difference between two groups, having arrhythmias and no arrhythmias was statistically insignificant (p≥0.050) except VF up to 24 hours after ACC release. The highest voltage for defibrillation was used in Group-A n=20 (40.0%) and n=27 (54.0%) in L.M group, (p=0.004). The average electrical defibrillations in group-A was less than that of group L.M,(p=0.000). While, the use of ionotropic agent was almost equal in both the groups, (p=0.975).

Conclusion: Overall, the amiodarone group had a decreased incidence of VF when the ACC was released, while the difference was not statistically significant.
Adjunctive use of Ketorolac for Postoperative Pain Management in Elective Cardiac Surgery Patients: A Randomized Control Trial
Authors: Muzaffar Maaida , Khuwaja Amin M. , Ahmed Aftab , Iqtdar Rabia , Chohan Haris Tariq , Siddiqi Rashad
Published: December 2022

Objective: To compare between the efficacy of Ketorolac and Paracetamol in the management of post-operative pain following elective cardiac surgery.

Study Design: Randomized (single-blind) Control Trial (RCT NCT05361824.)

Place and Duration of Study: This study was conducted in the Surgical Intensive Care Unit (SICU) at the National Institute of Cardiovascular Diseases Hospital, Karachi Pakistan, From 1st Jan to 30th Jun 2021.

Methodology: Randomization of 60 patients undergoing elective cardiac surgery into either Paracetamol (30 control patients) or Ketorolac (30 treatment patients) was done.In addition, to a low dose, short duration background infusion of Nalbuphine, the control group was administered. Injection Paracetamol 1gm every six-hours. Whereas the treatment group was administered injection Ketorolac 30mg every eight-hours. Assessment of pain was done at 6, 12, 18 and 24 hours post-extubation, using a Visual analog scale (VAS). For the purpose of this study, a score of 4 or less was taken as a cut-off for adequate pain control.

Results: VAS score was significantly lower in Ketorolac group as compared to the Paracetamol group at all four-time points with an average rating of 3.2±1.9 vs. 5.3±1.7; p<0.001, 3.5±1.5 vs. 5±1.7; p<0.001, 3.3±1 vs. 5.0±1.4; p<0.001, and 3.0±1.4 vs. 4.3±1.6; p<0.001 at 6, 12, 18, and 24 hours respectively. The total dose of Nalbuphine administered (infusion + bolus doses) over 48 hours post-operatively was 15.3±5.2 vs 25.7±6.8 ml; p<0.001 in the Ketorolac and Paracetamol groups, respectively.

Conclusion: The use of Ketorolac in conjunction with Nalbuphine gives better control over post-operative pain in elective cardiac surgeries than Paracetamol and Nalbuphine.
Incidence and Predictors of Postoperative Atrial Fibrillation after Coronary Artery Bypass Grafting Surgery
Authors: Siddiqeh Musfireh , Khan Imran , Fayaz Fakhar-e- , Hasan Kirmani Syed Muzaffar , Hamshary Mustafa El , . Wahidullah , Khan Zahid M , Javaid Rehana
Published: December 2022

Objective: To study the incidence of postoperative atrial fibrillation (POAF) and its predictors after coronary artery bypass grafting (CABG) in an Asian cohort.

Study Design: Cross sectional study.

Place and Duration of Study: The study was conducted at the department of Cardiothoracic Surgery, Almana Hospital, Al Khobar, Saudi Arabia, which is a tertiary care hospital. The study duration was form Oct 2019 to Dec 2021.

Methodology: All the male and female consecutive patients with coronary artery disease undergoing coronary artery bypass grafting (CABG) were included in the study. All the surgeries were performed through median sternotomy using cardiopulmonary bypass. Patients with emergency CABG, off pump CABG and those undergoing multiple procedures were excluded from the study. A total of 220 consecutive patients were included in the study. Patients were followed in the perioperative period. Various variables were recorded on a preformed proforma. Patients were divided into two groups, those who had atrial fibrillation (AF) and those who did not have AF. Data was analyzed using SPPS version 23 (SPSS, Inc., Chicago,IL).

Results: The mean age of the patients was 51.50±11 years in the AF group and 49.38±9 years in the no AF group. The incidence of atrial fibrillation postoperatively in our cohort was (n=52, 25%). There was no statistically significant difference between the groups with respect to hypertension and diabetes (p=0.408 and p=0.054) respectively).

Conclusion: In spite of a younger population, the incidence of AF in our cohort undergoing CABG is comparable to the international literature. Lack of preoperative β-blockers, statins and low ejection fraction are predictors of new onset POAF.
Spectrum of Grown up Congenital Heart (GUCH) at Armed Forces Institute of Cardiology/ National Institute of Heart Diease: 10 years Experience
Authors: Akbar Hajira , Nawaid Mohammad Amir , Muzaffar Tabassum , Imtiaz Sana , Ansari Asma
Published: December 2022

Objective: To determine the spectrum of Grown up Congenital Heart (GUCH) at Armed Forces Institute of Cardiology/National Institute of Heart Dieases.

Study Design: Descriptive cross sectional study.

Place and Duration of Study: Paediatric Cardiac Surgery and Obstetric department of Armed Force Institute of Cardiology/National Institute of Heart Diease, Rawalpindi Pakistan, from 2011 to 2021.

Methodology: It was a descriptive cross sectional study conducted at Paediatric Cardiology, Paediatric Cardiac Surgery and Obstetric department of AFIC/NIHD. After taking informed consent, a total of 1344 patients fulfilling inclusion and exclusion criteria with non probability consecutive sampling were enrolled in study from 2011 to 2021. Diagnosis, transthoracic echocardiography findings, procedural details (cardiac catheterization/cardiac surgery/obstetrical intervention) and outcome of all patients were noted.

Results: Out of 1344 patients, 700 patients had cardiac catheterization. Among patients who underwent cardiac cath, 304(43%)were males and 396(56.6%) were females. 279(39%) diagnostic and 421(61%) cardiac interventional procedures were done.Most common procedure done was ASD device closure in 227(32%) patients. Complications were seen in 29(4%) patients and mortality in 3(0.4%) patients. There were a total of 188 patients who underwent congenital cardiac surgery. Out of patients who underwent congenital cardiac surgery procedures, 96(51%) were male and 92(49%) were female patients. Major complications were observed in 51(25%) patients and the mortality was 11(5%).There were total of 456 patients in obstetrics department. Out of 456 patients, 54(11%) were with congenital cardiac lesions .The most common defect was VSD 27(6%)patients and dilated cardiomyopathy (DCM) 27(6%) patients followed by ASD and TOF. The maternal and fetal mortality was12(2.7%) and 22(5.5%) respectively.

Conclusion:With immense advancement in diagnosis and management of congenital cardiac diseases, a significant number of patients remain undiagnosed and untreated till the time they present as GUCH. Most common presentation is ASD which is mostly manageable by transcatheter intervention, however late presentation carries a risk of complications like pulmonary hypertension.
KONTRIBUSI ENJOYMENT (RASA SENANG) DAN PRIDE (RASA BANGGA) SELAMA BELAJAR DI KELAS TERHADAP SELF-ESTEEM PADA PESERTA DIDIK SEKOLAH MENENGAH PERTAMA
Authors: Vrismaya Anggun , Primana Linda
Published: December 2022

Tujuan dari penelitian ini adalah untuk mengetahui kontribusi enjoyment (rasa senang) dan pride (rasa bangga) selama belajar di kelas terhadap self-esteem peserta didik Sekolah Menengah Pertama. Partisipan penelitian ini adalah peserta didik di salah satu Sekolah Menengah Pertama Negeri, Kota Depok (n=334). Penelitian ini merupakan model penelitian kuantitatif dan noneksperimental. Instrumen yang digunakan pada penelitian ini adalah AEQ (Achievement Emotions Questionnaire) untuk mengukur enjoyment dan pride selama belajar di kelas serta RSES (Rosenberg Self-Esteem Scale) untuk mengukur self-esteem. Hasil pada penelitian ini menunjukkan bahwa enjoyment dan pride secara bersama-sama memiliki kontribusi yang signifikan terhadap self-esteem (p = 0,00). Lebih lanjut lagi enjoyment memiliki kontribusi sebesar 14% terhadap self-esteem dan pride memiliki kontribusi sebesar 2% terhadap self-esteem peserta didik Sekolah Menengah Pertama. Temuan penelitian ini memberikan dapat menjadi referensi bagi perancangan program intervensi untuk meningkatkan self-esteem melalui penanaman pride peserta didik.
STUDI PERBANDINGAN KUALITAS HIDUP ANTARA REMAJA TUNANETRA DAN REMAJA AWAS DI KOTA BANDUNG DAN KOTA CIMAHI
Authors: Samiasih Novi - , Moeliono Marisa Fransiska , Purba Fredrick Dermawan
Published: December 2022

Kualitas hidup merupakan penilaian seseorang tentang hidupnya serta menikmati segala peristiwa selama hidupnya. Remaja perlu memiliki kualitas hidup yang baik untuk menikmati kehidupan yang dirasakan dan merasakan peluang untuk perubahan atau peningkatan diri, begitupun dengan remaja tunanetra walaupun memiliki keterbatasan fisik. Tujuan utama dari penelitian ini adalah untuk melihat adakah perbedaan kualitaas hidup antara remaja tunanetra dengan remaja awas. Data dikumpulkan dari 155 remaja (n = 155), 50 remaja tunentra dan 105 remaja awas dengan teknik pengambilan purposive sampling. Kualitas hidup dinilai dengan kuesioner Pediatric Quality Of Life Inventory (PedsQL) Generic Score versi 4.0. yang mencakup empat domain kualitas hidup yaitu domain fisis yang terkait dengan kesehatan, domain psikologis yang trkait dengan emosional, domain sosial, dan domain fungsi lingkungan sekolah. Hasil dari uji t test menunjukkan terdapat perbedaan yang signifikan rerata skor total kualitas hidup remaja tunanetra dengan remaja awas (p = 0,022). Terdapat perbedaan pada domain fisik yang mana remaja awas memiliki skor lebih tinggi dibandingkan dengan remaja tunanetra hal ini dikarenakan adanya keterbatasan fisik yang dimiliki oleh remaja tunaneta menghambat untuk melakukan aktivitas dengan ruang gerak yang luas dibandingkan dengan remaja awas. Serta pada domain sosial juga terdapat perbedaan yang signifikan pada remaja tunanetra melaporkan lebih banyak mengalami kesulitan dalam berinteraksi di lingkungan sosial terutama saat berinteraksi dengan remaja awas.
PERBEDAAN KUALITAS HIDUP PASIEN GAGAL GINJAL YANG BEKERJA DAN TIDAK BEKERJA YANG MENJALANI HEMODIALISIS DI YAYASAN GINJAL DIATRANS INDONESIA
Authors: Priyanti Dwita
Published: December 2022

AbstrakPenyakit gagal ginjal kronis (GGK) adalah kerusakan fungsi ginjal yang progresif, yang akhirnya dapat berakibat fatal pada uremis (kelebihan urea dan sampah nitrogen di dalam darah). Salah satu metode pengobatan GGK adalah menjalani hemodialisa atau cuci darah. Penyakit GGK maupun pengobatannya menimbulkan perubahan dalam berbagai aspek kehidupan penderitanya, diantaranya adalah kehilangan pekerjaan. Dari 4123 orang yang menjalani hemodialisis di USA, Eropa dan Jepang, hanya terdapat 21% di Amerika, 30% di Eropa dan 55% di Jepang pasienyang masih bekerja dari total keseluruhan. Kualitas hidup adalah konsep multidimensional yang terkait dengan persepsi dan evaluasi subjek mengenai kehidupannya. Banyak hal yang mempengaruhi kualitas hidup seseorang salah satunya adalah pekerjaan. Tujuan dari penelitianini adalah untuk melihat perbedaan kualitas hidup pasien GGK yang bekerja dan tidak bekerja. Penelitian ini bersifat kuantitatif. Populasi adalah seluruh pasien GGK yang menjalani hemodialisa di Yayasan Ginjal Diatrans Indonesia. Sampel diperoleh dengan cara purposive sampling. Jumlah subyek dalam penelitian adalah 149 orang. Data kualitas hidup diperoleh dengan menggunakan kuesioner KDQOL-SF 36 dan data status pekerjaan diperoleh dari data demografis. Pada hasil penelitian ditemukan bahwa proposi pasien GGK yang bekerja sebanyak 39,4% dan yang tidakbekerja sebanyak 60,4%. Rata-rata skor KDQOL-SF 36 pasien adalah 58.07 (SD=19.52). Hasil uji independent sample t-test menunjukkan adanya perbedaan skor kualitas hidup antara pasien yang bekerja dengan pasien tidak bekerja (p<0.05). Dari hasil penelitian dapat disimpulkanbahwa terdapat perbedaan antara kualitas hidup pasien GGK yang bekerja dan tidak bekerja. Pasien GGK yang bekerja memiliki kualitas hidup yang lebih baik dibanding yang tidak bekerja. Terdapat pengaruh yang signifikan antara pekerjaan dengan persepsi umum pasien mengenaikesehatannya secara fisik dan mental. Pada pasien GGK yang bekerja cenderung tidak terbebani hidupnya seperti pasien yang tidak bekerja.Kata kunci : Gagal Ginjal Kronis, Kualitas Hidup
KAJIAN RESISTANCE TO CHANGE DAN PERCEIVED ORGANIZATIONAL SUPPORT (Studi Empiris Pada Karyawan Perusahaan Swasta di Bandung)
Authors: Nindyati Ayu Dwi
Published: December 2022

Abstrak: Topik penelitian ini adalah resitance to change yang telah diketahui sebagai salah satu konsekuensi adanya perubahan yang terjadi di organisasi dalam bentuk yang negatif. Tujuan dari penelitian ini adalah untuk memahami pengaruh perceived organizaational support terhadap resistance to change yang dialami karyawan. Kerangka berpikir peneliti adalah karyawan yang mendapatkan dukungan perusahaan dengan cukup maka memiliki resistance to change yang rendah. Penelitian ini dilakukan pada 70 karyawan perusahaan swasta. Hasil penelitian menunjukkan bahwa karyawan yang merasakan perceived organizaational support lebih akan memiliki resistance to change yang lebih rendah. Hal ini berarti perceived organizational support sebagai aspek eksternal juga berperan pada resistance to change yang dimiliki karyawan.Kata kunci: Resistance to change, Perceived organizational support, private company
A Caminho de Yauyos, uma campanha eleitoral em segundo plano
Authors: Radomsky Guilherme F. W.
Published: December 2022

Quem sai de Lima, Peru, pela estrada Panamericana sentido sul, vislumbra uma paisagem que margeia o frio oceano Pacífico de um lado, enquanto se avolumam os pálidos morros esbranquiçados de outro. Não raro se aparecem favelas e moradias populares à vista, subindo as íngremes encostas peladas e num relance de pensamento não sabemos como as casas permanecem em pé na areia em declive. A paisagem se torna dramática também porque as casinhas são vistas contrapostas às praias de veraneio dos limeños de classe média alta com suas chamativas mansões de temporada.Ao se chegar em San Vicente de Cañete para subir a serra próxima da capital peruana, o verde dos vales começa a se pronunciar e os rios que correm para o mar são ladeados por colinas. Neste ponto do trajeto que um estranho plano de fundo prendeu minha atenção e originou a narrativa aqui exposta.Parte desse recorrido no fim de dezembro de 2010 era guiado por imagens recorrentes: passando por cidades e vilas chegando até o espaço rural, que nos dá impressão de remoto, a campanha visual de Keiko Fujimori (filha do ex-mandatário do país vizinho) para presidência do Peru em 2011 quase não dá trégua.Durante o trajeto, nas situações menos esperadas, “Fuerza Keiko” estava lá, sempre em segundo plano. Asia, Lunahuana, Zuñiga, Catahuasi, Capillucas e outras pequenas localidades no caminho de Yauyos, nosso destino. Eventualmente só “K” nos relembra da política partidária nos lugares recônditos. Procissão, festa, desfile, trabalho de pastoreio, uma efervescência de acontecimentos, e a campanha eleitoral do partido de direita Força Popular acompanhava o percurso. Curiosamente, num golpe de captura Che Guevara se intromete, mostrando que as forças políticas se chocam até nos detalhes. Foi nesse “acidente”, um olhar que escaneia lentamente as imagens feita no passado, que me deparei mais propriamente com o que Benjamin (1985) denominou de inconsciente óptico, especialmente considerando o tempo que se interpõe neste caso entre o registro das fotografias em campo e a reflexão (Leal, 2013).Na época que as fotografias foram realizadas, havia a sensação de que tudo era movente e transitório, menos as pinturas de Keiko no fundo. No aparelho de captura técnica acionado aqui e ali (Flusser, 2011), o que esvanece e permanece (Soulages, 2010) parecem entrar em conflito nas imagens. Mas as próprias imagens já indicavam uma possível novidade que se tornaria velha logo. Nem Keiko venceu esse pleito, altamente conflitivo e litigioso no Peru como tem sido nas últimas décadas, nem desistiu da candidatura nas eleições seguintes, ficando estas pinturas logo apagadas, talvez substituídas por outras, e pouco propensas a chamar a atenção dos que vivem nessas terras, nem a despertar qualquer sentimento de mudança social por meio da política. A vida seguiu com festas, procissões, desfiles, pastoreios.
Metabolic Profile in Dairy Cattle with Displacement of the Abomasum
Authors: COŞKUN Alparslan , AYDOĞDU Uğur , GUZELBEKTES Hasan , ŞEN İsmail
Published: December 2022

The objective of this research was to evaluation metabolic, biochemical and hematological parameters in dairy cattle with displacement of the abomasum (DA). In this study, 80 dairy cattle with DA and 10 healthy dairy cattle in early lactation were used. Jugular venous blood samples for blood gases, hematological parameters and serum biochemical analysis of all cattle were taken. Glucose, lactate, triglycerides, BHB, NEFA, insulin, VLDL, GGT, CK concentrations and pH and hematocrit value of cattle with DA were significantly (P
Polymorphism of prolactin (PRL) gene exon 5 and its association with egg production in IPB-D1 chickens
Authors: Rohmah Lailatul , Darwati Sri , Ulupi Niken , Khaerunnisa Isyana , Sumantri Cece
Published: December 2022

Abstract. The prolactin (PRL) gene regulates the egg production and incubation in laying chickens. Local chickens' reproductive systems will disrupt as a result of the incubation period activity, and they will lay fewer eggs. This study aimed to determine the prolactin gene polymorphism in IPB-D1 hens and its relationship to egg production. The polymorphism of the exon 5 prolactin gene was examined on 112 samples of the IPB-D1 chicken DNA collection from the Division of Animal Genetics and Breeding, Faculty of Animal Sciences, IPB University. By performing the phenol–chloroform method, the genomic DNA was obtained. A polymerase chain reaction (PCR) product with a size of 557 bp was produced as a result of the DNA amplification. Three single-nucleotide sequences were discovered. Three single-nucleotide polymorphisms (SNPs), g.7835A > G, g.7886A > T, and g.8052T > C, were found in exon 5 of the PRL gene. Each mutation was polymorphic and in Hardy–Weinberg equilibrium. The point mutation g.8052T > C significantly impacted the egg production of IPB-D1 chickens, according to the SNP association analysis on egg production, and may serve as a marker to enhance the selection for the features of egg production in IPB-D1 chickens.