bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of humoral immune deficiency in Indian patients with bilateral bronchiectasis with no apparent aetiology
Authors: Rohit K.O. , Thangakunam Balamugesh , Mehta Vinay , Christopher Devasahayam J. , James Prince
Published: December 2022

Background:

Infections continue to be the leading aetiology of bronchiectasis in developing countries like India. Among non-infectious cases, the majority will have no identifiable cause despite extensive evaluation. Recently, immunodeficiency has been recognized as an important aetiology, but data on its prevalence remain rather sparse.

Objectives:

The objective of this study is to evaluate the prevalence of humoral immunodeficiency in a cohort of adults with bilateral bronchiectasis with no apparent aetiology.

Methods:

This is the single-site study from Christian Medical College (Vellore, India) of adults with HRCT-proven non-infectious bronchiectasis. Humoral immunity was assessed through quantitative analysis of immunoglobulins and IgG subclass levels.

Results:

Among 158 cases, immunoglobulin deficiency was found in 15%. Low IgM was the most predominate finding (7%), followed by common variable immunodeficiency (3%) and low IgA (2.5%). In addition, IgG subclass deficiency was found in 5%. In 53% of cases, no specific aetiology could be identified.

Conclusion:

Humoral immune deficiency is present in a significant proportion of patients with non-infectious bronchiectasis. Routine measurement of serum immunoglobulins should therefore be considered as part of the evaluation.
Clinical characteristics of pulmonary hypertension patients who underwent right heart catheterization in Thailand
Authors: Chiansirikraivuti Nichanun , Sapankaew Tunlanut , Pirompanich Pattarin
Published: December 2022

Aim:

Pulmonary arterial hypertension (PAH) is an uncommon and difficult-to-recognize condition. There is still limited evidence on Asian populations. This study aimed to clarify the clinical characteristics of pulmonary hypertension (PH) patients who underwent right heart catheterization (RHC).

Setting and Design:

A single-centre retrospective observational analysis.

Methods and Material:

An observational analysis of adult patients diagnosed with PH by RHC from 2015 to 2019; clinical characteristics and investigations were recorded and compared between PAH and non-PAH. The correlations between maximal tricuspid regurgitation velocity (TRVmax) and mean pulmonary arterial pressure (mPAP) were also estimated.

Results:

From a total of 243 RHC patients, 79 PH patients were enrolled. The mean (SD) age was 56 (19) years. Dyspnea on exertion (DOE) was the most common clinical manifestation; 70 (89%). Most of them were in functional class II; 58 (73%). PAH was the most prevalent PH group; 46 (58%), followed by PH due to left heart disease; 26 (33%). In the PAH group, congenital heart disease-associated PAH was the most common aetiology; 25 (54%). Compared with the non-PAH group, PAH patients were younger and had fewer comorbidities, particularly atrial fibrillation. There were strong correlations between TRVmax and mPAP (r = 0.62, P < 0.01).

Conclusion:

PAH was the most prevalent among PH who underwent RHC. The most common presentation of PH patients was DOE. There were strong correlations between parameters from echocardiography and RHC (TRVmax and mPAP).
Coronavirus disease-19 triggered systemic lupus erythematous
Authors: Garg Yadvir , Kakria Neha , Singh Sarvinder , Jindal Ashok Kumar
Published: December 2022

Coronavirus disease 19 (COVID-19) has been associated with varied immunological diseases due to dysregulated immune responses. We hereby report a rare case of COVID-19 triggered Systemic lupus erythematous arising in a young healthy male, necessitating the use of immunomodulatory drugs for the remission of the disease process.
The Necessity of Implementing Steroid Stewardship
Authors: Thorakkattil Shabeer Ali , Krishnan Gopika , Arain Savera Ikram , Karattuthodi Mohammed Salim , Ageeli Mamdouh Mohammed Ahmed , Chandran Sarath , Abdulsalim Suhaj
Published: December 2022

Stewardship programs aiming at optimizing medication use are a core element of healthcare organizations. It allows for strategic interventions to improve both financial and therapeutic outcomes. The antibiotic and opioid stewardship programs have already been successfully established in several healthcare organizations. In addition to the financial aspect, they have also improved clinical outcomes and minimized harm by reducing antibiotic resistance, opioid use disorders, morbidity, and mortality. Steroids, also known as corticosteroids, are anti-inflammatory medications used to treat a range of conditions. If used inappropriately, they can result in serious and undesirable adverse effects. Steroid stewardship is a rather novel concept that aims to reduce inappropriate prescribing and improve clinical outcomes by creating a careful balance between therapeutic doses vs. doses that may cause adverse effects. The article’s objective is to highlight the need for a comprehensive approach to implement steroid stewardship programs as a multicomponent program involving multidisciplinary teams to identify potential treatment gaps and establish cognitive and practical approaches to overcome them.
Prescription Patterns and Antibiotic Resistance Rates of Respiratory Tract Infections in a Saudi Tertiary Medical Centre
Authors: Al Munjem Manea Fares , Thabit Abrar K. , Rasool Sahibzada Tasleem , Emeka Promise Madu , Al Munajjim Fahad Fares , Al Habeeb Mohd
Published: December 2022

Objectives:

Respiratory tract infections (RTIs) are a significant cause of hospitalization due to morbidity and mortality. The unwise use of antimicrobial agents in RTI management may contribute to the emergence of bacterial resistance. Therefore, we aimed to assess prescription patterns and antibiotic resistance among hospitalized patients with RTIs.

Materials and Methods:

This retrospective study included patients with any RTI who were hospitalized between 2016 and 2017. Antibiotics prescribed and changes in antibiotic resistance over time were evaluated.

Results:

The 405 included patients ranged in age from a few months old to over 65 years old. The most common clinical manifestations were fever (98% of patients) and sore throat (57.5%), followed by cough (46.7%) and dyspnea (27.2%). C-reactive protein was elevated in 43%. The most common diagnoses among all the patients were tonsillitis (43.2%), pharyngitis (36%), and pneumonia (23%). The most commonly isolated organisms were Haemophilus influenza (93.2%), Streptococcus pneumoniae (90.9%), Pseudomonas aeruginosa (84.1%), and Klebsiella pneumoniae (84.1%). Amoxicillin/clavulanate was mostly prescribed for upper RTIs, whereas levofloxacin was mostly prescribed for lower RTIs. Amoxicillin/clavulanate was the major antibiotic prescribed for pediatric patients, whereas geriatric patients (≥65 years) were mostly prescribed levofloxacin. No major changes in resistance rates were observed for amoxicillin/clavulanate, levofloxacin, or ciprofloxacin before (in 2015), during the study period (2016–2017), and after the study (2018).

Conclusion:

Amoxicillin/clavulanate and levofloxacin were the most commonly prescribed antibiotics, but resistance to these antibiotics did not increase over time. However, clinicians should make every attempt to collect cultures from patients with severe RTIs to rule out bacterial involvement.
Prevalence and Patterns of Self-Medication during COVID-19 Pandemic Amongst Pharmacy Students in Jeddah, Saudi Arabia. Cross-Sectional Study
Authors: Badr Aisha F. , Alghamdi Lama , Baraidah Hanar , Alsulami Ruba
Published: December 2022

Objective:

Self-medication prevalence and characteristics during the ongoing pandemic have been assessed and documented in some countries for COVID-19 treatment; little is known of this practice among pharmacy students who are estimated to have higher knowledge of medications and their use. This study aims to assess self-medication prevalence and pattern during COVID-19 pandemic in this population.

Materials and Methods:

following IRB approval, a descriptive, cross-sectional study was implemented, and a survey link was distributed among pharmacy students enrolled at King Abdulaziz University, from 1/1/2021 to 17/2/2021. Questionnaire items included (1) students’ demographic, (2) self-medication prevalence during the pandemic, (3) medications, vitamins and supplements used (pre and post infection), (4) source of information, and (5) how long they used the medication for.

Results:

A total of 270 students completed the survey (39.9% response rate). Majority were between 21–23 years of age (63.7%), female (70%), and single (97%). A total of 149 (55.2%) students practiced self-medication during COVID-19 pandemic. Most used supplements were vitamin C (38.9%), followed by multivitamins (22.2%) and vitamin D (18.1%). Most used OTC medication was paracetamol (26.3%) whereas, most prescription medication used was anxiolytics (4.8%), and antibiotics (3.3%). Most relied on personal knowledge for their practice (77.18%) and continued taking the supplement for less than a month (56%). Moreover, 9.3% (n = 25) were tested positive for COVID-19 and self-medicated with: vitamin C 44% (n = 11), zinc 24% (n = 6), and aspirin 12% (n = 3).

Conclusion:

Although most used supplements and OTC medications during the pandemic; there was a minority who did use prescription medications, such as anxiolytics, antibiotics and antidepressants which raise concerns over their unattended use and mandate awareness of risks associated with these medications.
Avaliação de nucleários como técnica de restauração florestal em Mariana, MG, Brasil
Authors: Martins Sebastião Venâncio , Braz Josmaíle de Paula , Villa Pedro Manuel , Alves William Victor Lisboa , Valente Mirian Lago , Kruschewsky Gabriel Corrêa , Dias Andréia Aparecida , Nabeta Fabio Haruki
Published: December 2022

Este estudo teve como objetivo testar a eficiência do uso de um novo equipamento denominado nucleário, na sobrevivência e crescimento de mudas de espécies arbóreas visando à restauração florestal em áreas atingidas pelo rejeito da barragem de Fundão, em Mariana, MG. Foram avaliadas, por 12 meses, duas espécies arbóreas nativas (Piptadenia gonoacantha (Mart.) J.F. Macbr. e Inga edulis Mart.), sob um desenho de blocos aleatorizados e três tratamentos: hidrogel (T1), nucleário (T2) e controle (T3). Analisou-se o efeito dos tratamentos e do tempo após o plantio sobre a sobrevivência e crescimento das mudas, por comparação múltipla de médias e modelos lineares mistos. Foram observadas diferenças significativas de crescimento em altura e em diâmetro ao nível do solo (DNS) entre os tratamentos. As taxas de crescimento relativo para altura e DNS das duas espécies se mantiveram relativamente constantes, sem diferenças entre os tratamentos. Constatou-se que I. edulis apresentou sobrevivência maior na presença do nucleário, em comparação com os demais tratamentos. Os resultados indicam que apenas o uso de nucleários não foi suficiente para garantir o bom desenvolvimento e sobrevivência das mudas em campo, sendo recomendada sua avaliação para outras espécies arbóreas nativas.
Mineralogical and geological characteristics of the Nui Phao tungsten deposit and its resource in the Dai Tu area, northeastern Vietnam
Authors: Luong Khang Quang , Khuong Hung The , Vo Dung Tien , Nguyen Tuyen Danh ,   Hanoi University of Mining and Geology, Hanoi, Vietnam
  Masan High-Tech Materials, Thai Nguyen, Vietnam
  Vinacomin - Vietbac Geology Joint Stock Company, Hanoi, Vietnam
Published: December 2022

Typically, granitic intrusions that document the lengthy and intricate history of the magmatic-hydrothermal system are linked to tungsten deposits. Uncertainty persists about the genetic relationship between tungsten mineralization and magmatic-hydrothermal development. The primary tungsten deposit in the Dai Tu region, known as the Nui Phao deposit, has been the subject of a petrographical and microscopic examination. Tungsten mineralization in the Dai Tu area often occurs in association with the formation of skarn and greisen bodies, and it has drawn much attention from geoscientists. Based on microscopic observations, tungsten ores can be divided into three mineralization stages, namely skarnisation, greisenization, and hydrothermal stage. To examine the geochemical features of the tungsten ores, the SEM-EDS and Microscope analytical methods were performed in this study. Research results indicate that the Nui Phao tungsten deposit was formed due to different tectonic and magmatism episodes. Accordingly, the Nui Phao tungsten deposit is relatively complicated with the multi-sources of ore components. Most of the tungsten ore was accumulated in association with the metasomatism between the Ordovician-Silurian carbonate-terrigenous sedimentary rocks of the Phu Ngu formation and the Cretaceous two-mica granite of the Pia Oac complex. The research results indicate that tungsten resources obtained at levels 122 and 333 are about 227.6 thousand tons. Moreover, the hydrothermal alteration and metasomatism in the study area are influenced by at least three metasomatic episodes, including skarnisation, greisenisation, and the late hydrothermal alteration of medium to a low temperature that is genetically related to fluorite-polymetallic mineralization.
Technology solutions and challenges for marginal development of heavy oil fields in CuuLong basin, offshore Vietnam
Authors: Nguyen An Hai , Nguyen Vinh The , Pham Thang Manh ,   PetroVietnam Exploration Production Corporation (PVEP), Hanoi, Vietnam
 Faculty of Oil and Gas, Hanoi University of Mining and Geology,  Vietnam
 CuuLong Joint Operating Company (CLJOC), HoChiMinh City, Vietnam
Published: December 2022

The production of heavy oil at Dong Do field located in CuuLong basin is a success in the application of advanced technologies. Dong Do field is a marginal project in Vietnam, so its development requires to overcome several challenges, such as high water-cut from early stage, highly unconsolidated sandstone reservoir, flow assurance problems of sour and viscous crude oil, high power artificial lift system, and complex crude treatment at topsides, among others. Over the past decades, production technology application in heavy oil production has been widely deployed in the industry. Apart from the thermal method, the combination of gaslift and ESP technology makes the remarkable advances by enlarging the draw-down created over the conventional pumping lift in heavy oil projects. In fact, heavy oil production with a high flow rate has appeared water-coning in near wellbore region that made the water breakthrough early and water-cut increased rapidly. The pilot test of injecting diesel into heavy oil wells has been applied to producers with the positive results while significantly reduced water-cut comparing before wells shutin. This paper provides a thorough analysis of the new technologies that are applied to Dong Do field, highlighting its key difficulties and how they were resolved through a successful pilot and testing of the cutting-edge advanced solutions, improving the project reliability and thus motivating the consortium to move on to the new field. Also, the updated new heavy oil field schedule is described, highlighting the challenges to be faced during the next projects of marginal development.
Identification of PEKKA Characteristics for the Women Empowerment Strategy in Sumedang Regency
Authors: Ferdiansyah Hadi
Published: December 2022

Gender income disparity is one of the challenges in realizing community welfare in the SumedangRegency. PEKKA worker is one of the vulnerable objects that need to be improved by the government ofSumedang Regency. This study aims to identify the individual characteristics of PEKKA to determine goalsand priorities for women's empowerment strategies. This study’s method is quantitative research in theform of a description with numbers or numerals (statistics). Reference studies that corroborate theanalysis complement this study's method. The analysis describes the characteristics of female heads ofhousehold in Sumedang Regency. The results showed that PEKKA in Sumedang Regency dominates bymiddle-aged and older women. Their level of education and competence is low, so they commonly workin the informal sector as unassisted entrepreneurs and in the formal sector as laborers. Thesecharacteristics are factors that cause their common welfare. Therefore, the PEKKA EmpowermentProgram in Sumedang Regency needs to involve other regional government affairs, namely Education,Health, Social, Labor, Communication and Information, Cooperatives, Small and Medium Enterprises,Agriculture, and Fisheries. Through this strategy, the PEKKA Empowerment Program can be right on targetto encourage the realization of the welfare of the people of Sumedang Regency.
Modern innovative forms of teaching law at other schools in Ukraine
Authors: Tsilmak Olena , Iasechko Svitlana , Poplavska Myrolava , Motlyakh Oleksandr , Kabanets Oleksandr
Published: December 2022

The article is devoted to topical issues of modernization and improving the quality of higher legal education in Ukraine in the context of its European integration. Particular attention is paid to innovative technologies of legal education faculties. The article examines innovative teaching methods used in the modern educational system process Characteristic features of means, forms and methods of innovative education are determined, revealed the specifics of their use in the interactive educational environment of higher education institutions of Ukraine.
Moral and patriotic coordinates of volunteer activity as a means of building educational and socio-pedagogical work
Authors: Zozuliak-Sluchyk Rоksoliana , Yurchenko Liubov , Onypchenko Oksana , Bilozerova Marianna , Vorovka Marharyta
Published: December 2022

In the article, the built picture of the four-vector phenomenology of voluntary activity (heroic, victim, transformative, life-affirming) can serve as a kind of “ethical map” for measuring the motivation for participation in volunteering. In addition, it can serve as the basis for determining the goals and mission of building educational and socio-pedagogical work in various volunteer associations.

The problem of the formation of social activity of student youth in the conditions of reforming Ukrainian society is analyzed, the criteria of social activity, the importance of social activity for the further development of society and the professional development of students are considered. The concept of volunteering as a segment of civil society, the main directions of volunteering in modern Ukraine, the impact of hostilities in the East of the country on the development of volunteering have been studied. The thesis about the dialectical relationship between social activity and students' participation in volunteer activities is substantiated, where volunteer activity is considered as a manifestation of social activity and as a factor in its formation. An example of the activities of a higher educational institution regarding the involvement of students in volunteer practice as an important factor in the formation of students' social activity is given.
Rancangan Program Pengembangan Pendidikan Individual untuk Siswa Lambat Belajar (Slow Learner)
Authors: Anggraeni Anggi
Published: December 2022

Lambat belajar atau slow learner adalah kondisi dimana siswa mempunyai potensi intelektual sedikit dibawah rata-rata anak seusianya. Dengan kemampuan yang berada dibawah, membuat kemampuan belajar siswa slow learner lebih lambat bila dibandingkan dengan anak seusianya. Kondisi seperti ini membuat siswa lambat belajar (slow learner) memerlukan layanan pendidikan khusus sesuai dengan kebutuhan belajarnya agar potensi yang dimiliki dapat berkembang dengan optimal, sehingga mereka dapat mencapai hasil belajar sesuai dengan capaian kelompok usianya. Penelitian ini membahas mengenai rancangan program pendidikan individual untuk siswa lambat belajar (slow learner) yang dikembangkan dari teori Reddy, diantaranya pemberian motivasi, pemberian perhatian secara individual, mengembangkan kepercayaan diri pada siswa, mengembangkan kebiasaan menyelesaikan tugas dengan baik, serta pengulangan pelajaran. Bila lima hal ini dilakukan oleh guru dan orangtua secara konsisten, maka akan sangat efektif dalam menunjang keberhasilan belajar pada siswa lambat belajar (slow learner). Penelitian ini menggunakan pendekatan studi pustaka (literature review) menggunakan buku, jurnal, dan review artikel dari beberapa sumber database seperti Proquest, Google Scholar, dan Pubmed dari tahun 2006-2021.
Makna “TUHAN Menyesal”: Studi Komparasi dalam Kitab Yeremia 18:8; Yoel 2:13; Amos 7:3; dan Yunus 3:10
Authors: Josua Rezky Alfero , Sualang Farel Yosua , Sulistya Philipus Pada
Published: December 2022

Makna frase “TUHAN menyesal” adalah salah satu tema yang paling diabaikan dalam keilmuan alkitabiah. Artikel ini memperhatikan terdapat pola yang sama mengenai frase “TUHAN menyesal” dalam kitab Nabi-nabi yaitu Allah memilih kasih karunia daripada penghakiman kepada umat-Nya. Metode yang digunakan yaitu analisis tematik dengan prosedur analisa kata untuk mengetahui makna pada dasarnya. Artikel ini menemukan ada satu ide yang sama, yaitu TUHAN akan membatalkan setiap hukuman-Nya. Pembatalan yang TUHAN lakukan ada perbedaan dari setiap teksnya. Pertama, Yeremia 18:8 pembatalan dilakukan membutuhkan ketaatan determinatif Yehuda dan kedaulatan responsif-Nya akan terjadi. Kedua, Yoel 2:13 TUHAN bebas berubah pikiran untuk menarik kembali perkataan-Nya dengan kata penghubung waw yaitu menegaskan sifat-Nya; penyayang, pengasih, setia, berlimpah kasih dan panjang sabar. Ketiga, Amos 7:3 penggunaan bahasa anthropomorfisme yaitu TUHAN memiliki perasaan yang ditekankan kesedihan akibat dosa, sehingga pembatalan terjadi karena adanya permohonan dari sang nabi kepada TUHAN. Keempat, Yunus 3:10 menunjukkan adanya perubahan pikiran Allah dengan memilih kepada kasih karunia daripada penghakiman dan bukti bahwa Allah menerima pertobatan orang-orang Niniwe, walaupun tindakan yang mereka lakukan di hadapan Allah sangat jahat.Meaning of the phrase “LORD repent” is one of the most neglected themes in biblical scholarship. This article notices that there is a similar pattern regarding the phrase “LORD repent” in the prophets, namely that God chooses grace over judgment to His people. The method used is thematic analysis with word analysis procedures to find out the basic meaning. This article found there was one common idea, namely that GOD will cancel each of His punishments. God's cancellation is different from each text. First, Jeremiah 18:8 the annulment was carried out requiring Judah's determinative obedience and His responsive sovereignty would occur. Second, Joel 2:13 The LORD is free to change his mind to take back His words with the conjunction waw which is to emphasize His character; merciful, loving, faithful, abundant in love and long-suffering. Third, Amos 7:3 uses the language of anthropomorphism, namely that God has feelings that are emphasized by sadness due to sin, so that the cancellation occurs because of a request from the prophet to God. Fourth, Jonah 3:10 shows God's change of mind by choosing grace over judgment and evidence that God accepted the Ninevites' repentance, even though their actions before God were very evil.
Pelayanan Misi Mahasiswa STT Ebenhaezer kepada Masyarakat Suku Enim Menggunakan Paradigma Misi David J. Bosc
Authors: Harefa Febriaman Lalaziduhu , Paath Jeane , Baluseda David
Published: December 2022

Penelitian ini mengkaji doing mission mahasiswa STT Ebenhaezer kapada masyarakat adat suku Enim Sumatera Selatan. Dimana dalam dekade terakhir ini mengalami kemunduran yang disebabkan oleh beberapa faktor. Untuk memberikan solusi terhadap masalah di atas, maka diadakan penelitian lapangan dengan pendekatan kualitatif metode studi kasus dengan menggunakan kajian teori misi David J Bosc. Hasilnya adalah mahasiswa STT Ebenhaezer harus membangun motivasi misi berdasarkan Alkitab, dalam melayani dan menjangkau masyarakat adat suku Enim, mahasiswa STT Ebenhaezer berusaha menjalin kerja sama dengan lembaga-lembaga pendidikan, yayasan dan gereja-gereja untuk membuat program pelayanan misi holistik, konstruktif dan kontekstual, mahasiswa membangun komunikasi misi dengan pendekatan kontekstualisasi, inkulturisasi budaya suku Enim, mahasiswa menjadi solution maker terhadap isu-isu sosial yang sedang berkembang dan berdampak dalam kehidupan masyarakat adat suku Enim secara langsung dan STT Ebenhaezer sebagai lembaga pendidikan berusaha melakukan digitalisasi dalam pelayanan. Penelitian ini akan memberikan kontribusi langsung kepada pencapaian visi dan misi STT Ebenhaezer dan memaksimalkan pelayanan lintas budaya mahasiswa STT Ebenhaezer khususnya dalam menjangkau masyarakat suku Enim-Sumatera Selatan.This study examines the doing mission of STT Ebenhaezer students to the indigenous people of the Enim tribe, South Sumatra. Where in the last decade it has experienced setbacks caused by several factors. To provide solutions to the above problems, field research was carried out using a qualitative case study approach using David J Bosc's mission theory study. The result is that STT Ebenhaezer students must build mission motivation based on the Bible, in serving and reaching the indigenous people of the Enim tribe, STT Ebenhaezer students try to collaborate with educational institutions, foundations and churches to create holistik, constructive and contextual mission service programs, students build mission communication with a contextualization approach, inculturation of the culture of the Enim tribe, students become solution makers on social issues that are currently developing and have an impact on the lives of the indigenous people of the Enim tribe directly and STT Ebenhaezer as an educational institution trying to digitize services. This research will make a direct contribution to achieving the vision and mission of STT Ebenhaezer and maximizing cross-cultural services for STT Ebenhaezer students, especially in reaching out to the Enim-South Sumatra ethnic community.
AMBULANS PERSONELİ ACİL TIP TEKNİSYENLERİ(ATT) VE PARAMEDİKLERİN EKİP ÇALIŞMASI TUTUMLARI ÜZERİNE BİR ARAŞTIRMA
Authors: KEKLİK Belma , ÖZGÜNEŞ Ömür
Published: December 2022

Sağlık sektörü emek yoğun ve işbirliğine dayalı bir alan olduğu için ekip çalışmasının araştırılabileceği örnek bir yapıya sahiptir. 112 çalışanları ise takım olma ve zaman yönetimi konusunda en hassas gruplardan biridir. Özelikle ambulans içinde görev yapan ATT (Acil Tıp Teknisyenleri) ve paramedikler 112 Acil Çağrı Merkezlerinin can damarı niteliğindedirler. Ambulansla hastaya ulaşmak, ambulans içinde ilk müdahaleyi yapmak ve hastayı hızla hastaneye yetiştirmek için ATT ve paramediklerin ekip uyumunun yüksek olması hayati öneme sahiptir. Çalışmanın amacı, ambulans içinde görev yapan ATT ve paramediklerin ekip çalışmasına ilişkin tutumlarının incelenmesi ve demografik değişkenlere göre değerlendirilmesidir. Bu bağlamda Adana il merkezinde 112 Acil Çağrı merkezinde çalışan 191 ATT ve paramedik’e Ekip Çalışması Tutumları Ölçeği (EÇTÖ) uygulanmıştır. Beş boyut (durum izlemi, karşılıklı destek, iletişim, ekip yapısı, liderlik) ve 28 sorudan oluşan ölçekten yüksek puan almak ekip çalışmasına karşı olumlu tutum içinde olunduğunu göstermektedir. Katılımcıların verdikleri cevapların ortalamasının yüksek olduğu gözlenmiş, ekip çalışmasının öneminin farkında oldukları ve ekip çalışmasına uyumlu oldukları tespit edilmiştir. SPPS 22 ile yapılan analizlerde non-parametrik testler kullanılmış, ikili karşılaştırmalarda Mann Whitney U, çoklu karşılaştırmalarda Kruskal-Wallis uygulanmıştır. Analizlerde cinsiyet değişkeni için “durum izlemi” boyutunda istatistiksel olarak anlamlı fark bulunmuş; yaşve meslek değişkenleri için hiçbir boyutta anlamlı fark tespit edilmemiştir. Meslekte geçirilen çalışma yılına göre “karşılıklı destek” boyutunda gruplar arası istatistiksel olarak anlamlı fark tespit edilmiştir. Sonuç olarak katılımcı ATT ve paramediklerin ekip uyumunun yüksek olduğu, ekip içinde yardımlaşma ve işbirliğinin bulunduğu, ekip liderinin ekip performansındaki etkisinin farkında olunduğu, etkili iletişimin yürütüldüğü tespit edilmiştir.
Analisis Fundamental Gangguan Hubung Singkat Simetri 14 Bus IEEE Modifikasi Menggunakan MATLAB
Authors: Apriliyanto Idham , Yasir Muhammad Atha Rafid , Geodimetrico Yonif , Mandawari Yusril Ihza , Rifaldi Muhammad , Alham Nur Rani
Published: December 2022

Pada isuatu isistem itenaga ilistrik iterjadi igangguan ihubung isingkat, igangguan ihubung isingkat iadalah ihubungan iantara isuatu isistem idengan itegangan idan isistem ilain iyang iterhubung ilangsung idengan iimpedansi iyang isangat ikecil. iSambungan ilangsung imendistribusikan iarus ipada ititik igangguan ike iarus inominal. iKondisi iini imempengaruhi iketidakstabilan isistem iketika isistem iberoperasi idalam ikeadaan itidak iseimbang idan idapat imerusak iperalatan ijika igangguan itersebut idiamankan. iGangguan ihubung isingkat ibiasanya iterdiri idari igangguan isimetris idan iasimetris. iGangguan isimetris, isering idisebut isebagai igangguan itiga ifasa, idapat idigunakan isebagai ireferensi iuntuk imenentukan ikapasitas ipemutus idengan imemodelkan igrafik igaris idan imemasukkan idata ireaktansi isistem iuntuk imenentukan inilai iini. iAnalisis iini imenggunakan i14 ibus isebagai ireferensi idan imengamati imatriks iZBus iuntuk imenentukan inilai iimpedansi ihubung isingkat iuntuk isetiap ibus. iPerhitungan iini imenggunakan isoftware iMatlab iuntuk imenentukan ibesarnya iarus ibocor iuntuk isetiap ibus. iAnalisis imenggunakan imetode iFast iDecoupled idilakukan ipada idata idari i14 iBUS iIEEE iPowerSystems iModifikasi.
Rancang Bangun Prototype Follower Cargo Cart with Obstacle Avoider Berbasis Arduino Uno
Authors: Sudiro Aprilliyan Manuel , Putra Marson Ady , Yadie Erry
Published: December 2022

Cargo Cart merupakan alat yang dapat digunakan untuk mengangkut barang dalam jumlah yang banyak seperti mobil kargo pada umumnya, namun dalam bentuk prototype yang lebih kecil. Alat ini dirancang agar dapat bekerja seperti follower, yang artinya Cargo Cart akan bergerak mengikuti objek yang ada di depannya apabila terdeteksi pada rentang jarak tiga buah sensor ultrasonik yang disematkan pada bagian depan Cargo Cart. Penelitian ini membedah bagaimana karakteristik ketiga sensor ultrasonik tersebut dan menganalisis setiap hasil pembacaan sensornya. Sensor ultrasonik diuji untuk mengetahui apakah jarak yang terbaca sesuai dengan pengukuran mistar dan kemudian membandingkan hasil ketiga pengukuran jarak sensor tersebut. Sensor ultrasonik diatur pada sudut kemiringan 20° agar mampu membaca objek yang lebih tinggi, dengan masing masing nilai eror pembacaan jarak dibawah 10% pada jarak 400 cm untuk sensor kiri, 250 cm untuk sensor tengah dan 350 cm untuk sensor kanan. Persentase eror tertinggi sensor kiri mencapai 16,67% pada jarak 450 cm, sensor tengah 83,53% pada jarak 500 cm dan sensor kanan 73,93% pada jarak 400 cm. Dari parameter tersebut, sensor dipasang pada Cargo Cart agar mendapatkan posisi yang terbaik untuk membaca objek yang ada di depannya. Terlihat dari hasil pengujian yang telah dilakukan, Cargo Cart dapat bekerja sesuai dengan tujuannya, yaitu mengikuti objek yang ada di depannya, bermanuver ke kiri dan kanan, serta berhenti bergerak dan membunyikan buzzer ketika obstacle avoider mendeteksi adanya suatu penghalang
CPEC – Geo-Politics to Geo-Economics
Authors: Rashid Muhammad Tahir , Abbas Nargis , Ashiq Uzma
Published: December 2022

The China-Pakistan Economic Corridor (CPEC) is a multi-billion-dollar collection of ongoing and planned Chinese projects in Pakistan ranging from infrastructure development to the establishment of special economic zones and the sharing of technical expertise by China. For China, it is an integral part of its ambitious Belt and Road Initiative (BRI) through which it aims to establish its economic hegemony in Eurasia and Africa. For Pakistan, it is an opportunity to bring its stumbling economy to some semblance of stability and even growth. Therefore, now the policy makers of the country must wake up and use the valuable human resource like youth for nation building. In this context, attainment of higher education should be ensured. However, there are controversies regarding the initiative as well, with critics decrying it as an attempt at the economic exploitation of Pakistan at the hands of China. In any case, CPEC is a project that has immense ramifications for the geo-politics of the entire region, particularly with regard to economic affairs. Hence, it is important to analyze its effects and the views of the general public regarding it in order to understand the situation in terms of geo-economics.
Microsurgical Reversal of Sterilisation – Is This Still Clinically Relevant Today?
Authors: Tan Heng Hao , Loh Seong Feei
Published: December 2022

Introduction: Women with previous tubal sterilisation seeking fertility are faced with treatment options of reconstructive tubal surgery or in vitro fertilisation (IVF) techniques. The aim was to assess the current viability of tubal anastomosis in a local clinical practice. Materials and Methods: A retrospective cohort review of all sterilisation reversal cases from January 1998 to January 2008. The main outcome measures included first pregnancy success and live birth after surgery. Subsequent live births, ectopic pregnancies, miscarriages, duration of surgery and hospitalisation within the study period were also reported. We included cases aged less than 40 years, without any known semen abnormalities, and performed by only one operator. Cases with only unilateral reversal were excluded. Results: Nineteen cases with previous Filshie clip ligation (9 laparoscopic/10 open) were reviewed. Cumulative pregnancy rates with surgery were 47.4% (<6 months), 57.9% (6 to 12 months), 68.4% (12 to 48 months) and 73.7% (>48 months). Pregnancy (77.8% vs 70.0%) and live birth rates (66.7% vs 60.0%) were similar between laparoscopy and open surgery. The mean interval to pregnancy was marginally lower via laparoscopy (11.3 vs 13.6 months). Hospitalisation stay was significantly halved (1.43 vs 3.00 days) but ectopic pregnancies were increased 3-fold (3 vs 1) with laparoscopy. Compared with IVF, the estimated average cost per delivery for laparoscopic reversal was reduced for laparoscopic reversal with no multiple pregnancies. Conclusion: Our results favour surgical reversal after sterilisation for patients younger than 40 years old. It avoids hyperstimulation risks and the economic burdens associated with multiple pregnancies. Where expertise is available, laparoscopic reversal should be performed.

Key words: Laparoscopic tubal reversal, Microsurgery
Comparison of Oral Glucose Insulin Sensitivity with Other Insulin Sensitivity Surrogates from Oral Glucose Tolerance Tests in Chinese
Authors: Wu Chung-Ze , Pei Dee , Su Ching-Chieh , Hsiao Fone-Ching , Chu Yi-Min , Lee Li-Hsiu , Wang Kun , Hsieh An-Tsz , Lin Juinn-Diann , Hsia Te-Lin
Published: December 2022

Introduction: There is no single method of measuring insulin resistance that is both accurate and can be easily performed by general researchers. We validate the accuracy of oral glucose insulin sensitivity (OGIS) in the Chinese by comparing the OGIS120 and OGIS180, homeostasis model assessment of insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (OUICKI) with steady-state plasma glucose (SSPG) in different glucose tolerance subjects. Materials and Methods: We enrolled 515 subjects, aged between 20 and 75 years old, during routine health evaluations. All subjects were divided into normal, obese, impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and type 2 diabetes (T2D) groups. Participants had a 3-hour oral glucose tolerance test (OGTT) and SSPG with an insulin suppression test. The relationships between SSPG and OGIS120, OGIS180, HOMA-IR, and QUICKI were evaluated. Results: The normal group had the highest OGIS120, OGIS180 and lowest SSPG as compared with the other 4 groups. OGIS180, HOMA-IR and QUICKI in all 5 groups were significantly related to SSPG (r = 0.397-0.621, all P <0.05). OGIS120 in all 5 groups was not significantly related to SSPG (r = 0.003-0.226). Additionally, the r value of OGIS180 against SSPG was not higher than the other 2 insulin sensitivity surrogates from OGTT. Conclusions: Although OGIS180 was more accurate in estimating insulin sensitivity than OGIS120 in the Chinese, it was not superior to the traditional surrogates such as HOMA-IR or QUICKI.

Key words: Homeostasis model assessment, Insulin resistance, Quantitative insulin sensitivity check index
Changing Epidemiological Patterns of Hepatitis A Infection in Singapore
Authors: Lee Hsien Chieh , Ang Li Wei , Chiew Paul K T , James Lyn , Goh Kee Tai
Published: December 2022

Introduction: Singapore has experienced remarkable socioeconomic progress over the last few decades, with a corresponding rise in standards of sanitation and living conditions. We undertook a study to describe its epidemiological trends of hepatitis A over the last 2 decades. Materials and Methods: We analysed the epidemiological data on all laboratory-confirmed cases of hepatitis A from 1990 to 2009. We also described 3 outbreaks which occurred in 1991, 1992 and 2002. To determine the changing prevalence of hepatitis A virus (HAV) infection, we compared the findings from a seroepidemiological study conducted in 1993 with earlier surveys in 1975 and 1984/1985. Results: The incidence of indigenous hepatitis A cases per 100,000 population declined significantly from 1.8 in 1989 to 0.7 in 2009, and more than half were imported. While majority of the imported cases were Singapore residents, the proportion of imported cases among Singapore residents had decreased significantly. Most of the Singapore residents contracted the disease from Southeast Asia and the Indian subcontinent. The overall prevalence of HAV infection in the population declined from 31.8% in 1984/85 to 25.9% in 1993. Conclusion: The incidence and seroprevalence of hepatitis A in Singapore are comparable to other developed countries. As Singapore is situated in a region highly endemic for HAV, it is very vulnerable to the introduction of the disease because of the high volume of regional travel and import of food, especially shellfish. While we note that there have been no further shellfish-associated outbreaks since 2002, sustained vigilance, strict control of food import by the authorities and public health education on the risk of consuming shellfish, especially cockles, raw and half-cooked, should be maintained. Key words: Cockles, Imported cases, Outbreaks, Oysters, Shellfish, Seroprevalence
Thoracic Endovascular Aortic Repair: A Local Single Institution Experience
Authors: Neo Wee Thong , Pua Uei , Wong Daniel ES
Published: December 2022

Introduction: The purpose of this retrospective study was to evaluate the short- to mid-term results of the endovascular repair of thoracic aortic disease and to present an overview of our experience with thoracic endovascular aortic repair (TEVAR) in our institution. Materials and Methods: A retrospective review of all patients who were treated and underwent TEVAR in our institution between August 2004 and November 2009 was conducted. Results: Technical success was achieved in 100% of the patients and the 30-day mortality rate was 0%. Perioperative endoleak was visualised at the end of the procedure in 4 patients. Secondary endoleak was observed in 2 patients. Mean hospital length of stay post-TEVAR was 15.4 days. Postoperative major complications were observed in 4 patients. The 30-day mortality rate was 0%, with 2 mortalities (11.1%) during the follow-up period. Conclusion: This study adds to the growing body of literature that support TEVAR as an effective procedure in the management of thoracic aortic diseases and reflects its feasibility in our population. Further technical advancement in stent grafts, careful selection of patients and standardised peri-procedural care would contribute to further improvements in clinical outcomes.

Key words: Endovascular, Stent graft, TEVAR, Thoracic aneurysm, Thoracic dissection
Yaşlı Kadınlarda Homosistein Düzeyinin Kırılganlıkla İlişkisi
Authors: İDİL Eral , ÇAM MAHŞER Alev , ÖNTAN Mehmet Selman
Published: December 2022

Amaç: Kırılganlık; düşme, sakatlık, uzun süreli bakım alma ve ölüm riski ile ilişkilendirilen bir geriatrik sendromdur. Bu nedenle kırılganlığın önceden saptanabilmesi ve önlenebilmesi için kırılganlık ile ilişkili olabilecek belirteçlerinin bulunması oldukça önemlidir. Vitamin B12 ve folik asit eksikliği hiperhomosisteinemiye (HHS) neden olmaktadır. HHS; ateroskleroz, tromboemboli, sarkopeni, kemik rezorbsiyonu gibi birçok olumsuz sonuç ile ilişkilendirilmektedir. Tüm bunlar HHS’yi kırılganlığın önemli bir risk faktörü olarak karşımıza çıkarmaktadır. Çalışmadaki amacımız yaşlı kadınlarda homosistein (HS) düzeyi ile kırılganlık ilişkisini ortaya koymaktır.Gereç Yöntemler: Retrospektif olarak tasarlanan çalışmamıza 50 yaş üstü, dosya kayıtlarında eksik olmayan 275 kadın hasta dahil edildi. Hastalar HS düzeylerine göre 2 gruba ayrıldı. Hastaların plazma homosistein (HS) değeri için 75. persentile denk gelen 17,2 mmol/L değeri kesme değer olarak alındı. Tüm hastaların kullandıkları ilaç sayısı, sosyodemografik özellikleri, komorbiditeleri, geriatrik sendrom varlığı, laboratuvar sonuçları, ayrıntılı geriatrik değerlendirme (AGD) parametreleri ve kırılganlık durumları kaydedilerek gruplar arası karşılaştırma yapıldı.Bulgular: Çalışmaya dahil edilen hastaların yaş ortalaması 75,35±7,41’di. HS seviyesi normal olan hastaların %19,0’ında, HHS olanların %37,3’ünde demans tanısı vardı(p<0,01). Serum HS düzeyi ile serum vitamin B12 ve folik asit düzeyleri arasında düşük düzeyde negatif korelasyon; serum kreatinin düzeyi arasında ise orta düzeyde pozitif korelasyon vardı (p<0.01). HHS’nin, tükenmişlik, düşük yürüme hızı, düşük fiziksel aktiviteyle ilişkili olduğu; dolayısıyla kırılganlık riskini arttırdığı saptandı. Yaş, serum vitamin B12, folik asit, kreatinin düzeyleri ve demans faktörü düzeltildiğinde ise HHS ile kırılganlık arasındaki ilişkinin ortadan kalktığı gözlendi.Sonuç: Plazma HS seviyesi kırılganlık ile ilişkili olabilir. Hastalarda HS’i yükselten faktörlerin düzeltilmesi, kırılganlığın önlenmesi için de önemli bir strateji olabilir.
VENTRICULAR TACHYCARDIA AS A FIRST PRESENTATION OF ARRHYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY (ARVC) IN A PREVIOUSLY ASYMPTOMATIC SEXAGENARIAN
Authors: Asad Muhammad , Bin Nazir Talha , Hussain Khan Qurban
Published: December 2022

Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is characterised by morphological and histological changes in the ventricles. Progressive myocyte loss and fibrofatty tissue replacement, producing islands of scar, can lead to reentrant ventricular tachycardia and sudden cardiac death. It usually presents as chest pain, palpitations, heart failure, or syncope. The majority of cases are seen before the age of 40. Ventricular arrhythmia as a first presentation in the elderly is seen infrequently. We present a case of a previously asymptomatic 62-year-old gentleman who had an episode of ventricular tachycardia as the first manifestation of ARVC without having any positive family history for this disease. He was managed with amiodarone and was later planned for an implantable cardiac defibrillator (ICD).
NONCOMPLIANCE TO TREATMENT AND COMMON PRECIPITATING FACTORS IN STAGE C HEART FAILURE
Authors: Shah Jehangir Ali , Solangi Bashir Ahmed , Kumar Rajesh , Ali Gulzar , Butt Muhammad Hassan , Shaikh Javed Khurshed , Nisar Ambreen , Baqai Muhammad Asad , Saghir Tahir , Qamar Nadeem
Published: December 2022

Objectives: The objective of this study was to determine the frequency of non-compliance to treatment and common precipitating factors in stage C heart failure (HF) patients at a tertiary care cardiac hospital of Karachi, Pakistan.
Methodology: This descriptive cross-sectional study was conducted at a tertiary care cardiac center of Karachi, Pakistan. Required number of consecutive patients of either gender between 18 to 75 years of age who were diagnosed with stage C HF were included in this study. Data for the study were collected on a pre-defined proforma consisted of demographic characteristics (gender, age), clinical factors, and precipitants of decompensation of HF (duration of disease, non-compliance to the treatment, infection, arrhythmias, uncontrolled hypertension, and anemia).
Results: A total of 114 patients with stage C HF were included. Mean age was 56.7 ± 9.9 years with 34.2% (39) patients above 60 years of age. Male patients were 51.8% (59) of the total sample and median duration of disease was 36 [20 to 60] months. Non-compliance to the HF treatment was observed in 48.2% (55), while among other precipitants, infection was observed in 21.9% (25), arrhythmias in 20.2% (23), uncontrolled hypertension in 13.2% (15), and anemia in 18.4% (21).
Conclusion: A significant proportion of stage C HF patients were found to be non-adherent to the prescribed treatment. The most commonly observed triggering factor was infection followed by arrhythmias. Routine practice must include an ongoing assessment of compliance to the treatment and lifestyle modifications among HF patients for the proper counseling of non-complying individuals.
CONDITION LEADING TO PEDIATRIC CARDIOLOGY CONSULTATION IN TERTIARY CARE HOSPITAL PESHAWAR
Authors: Gul Huma , Hussain Ijaz , Dil Haseen , Ullah Ikram , Rehman Yasir , Hissamuddin Effat , Khan Muhammad Sohail , Moeed Abdul , Gohar Faiza , Ali Farman
Published: December 2022

Objectives: This study was conducted to determine the basis for cardiology consultation and the rationale for different clinical conditions in the pediatric population.
Methodology: This descriptive study was conducted in Pediatric Cardiology department, Peshawar institute of Cardiology from June 2021 to December 2021. A data of 817 patients was collected from monthly log of patients maintained by the consultation services, files of admitted patients, echocardiographic and laboratory reports. Patients enlisted through consecutive sampling irrespective of patients age, gender. Data collected was analyzed on IBM SPSS version 20. For numerical variables, mean/standard deviations were determined. For categorical variables, frequency and percentages were determined, and a p-value of 0.05 was deemed a significant difference.
Results: Age at the time of consultation was 3.2 ± 11.7 years (range 1 day to 47 years). The most common basis for consultation were intercurrent illness in underlying congenital heart disease 288 (35.25%). A total of 551(67%) had Single consultation and 266(32.92%) had multiple consultation ranging from 2 to 4.
Conclusion: Systematic approach should be followed to assess these patients in tertiary care hospital and all consultants must follow the curricula to get the required knowledge and gain expertise in these diseases to diagnose properly. None the less these data confirm the impression of increasing demands of the pediatric cardiologist, and thus may be useful in planning consultant services within the specialty.