bluuebunny/crossref_metadata_2025 huggingface dataset:
Öğretmenlik Mesleki Yeterliliklerine Yönelik Sosyal Bilgiler Öğretmen Adaylarının Görüşleri
Authors: KAYRAN Arda , TUNÇ ŞAHİN Canan
Published: August 2021

Araştırmanın amacı öğretmenlik mesleki yeterliliklerine yönelik sosyal bilgiler öğretmen adaylarının görüşlerini belirlemektir. Araştırma nitel araştırma yöntemlerinden durum çalışması olarak desenlemiştir. Araştırmanın katılımcılarını Batı Karadeniz’de bir üniversitede yer alan 15 sosyal bilgiler öğretmen adayı oluşturur. Veriler görüşme tekniğiyle yarı yapılandırılmış görüşme formu kullanılarak toplanmıştır. Araştırmada elde edilen veriler betimsel analiz yöntemiyle analiz edilmiştir. Araştırmanın sonucunda öğretmen adaylarının öğretmenden beklediği mesleki yeterlilikler yeterli alan bilgisine sahip olması, mesleki becerilere yönelik donanımlı olması, mesleğin gerektirdiği tutum ve değerlere sahip olmasını beklemektedir. Öğretmenin öğretim sürecini ve uygulamalarını; bireysel farklılıkları gözeterek farklı yöntem ve tekniklerle, etkili materyaller kullanarak, süreç odaklı ölçme değerlendirme yaklaşımıyla planlaması ve uygulaması önemlidir. Bu niteliklere sahip öğretmenlerin yetişebilmesi için kapsamlı bir eğitim planlanması gerekmektedir. Bu nedenle öğretmen yetiştiren eğitim fakülteleri ve Milli Eğitim Bakanlığı (MEB)’nın işbirliği içinde çalışması gerekmektedir. MEB’in belirlemiş olduğu öğretmen yeterlilikleri dikkate alınarak nitelikli öğretmen yetiştirmeye yönelik programlar hazırlanmalıdır. Öğretmen yeterlilikleri edinme süreci lisans programıyla sınırlandırılmayacak kadar geniş ve gelişime açık bir alandır. Bu nedenle hizmet içi eğitimler ve lisansüstü programlarla öğretmen eğitimleri desteklenmelidir.
Türkiye’de yapılan dijital ebeveynlik araştırmalarına yönelik bir içerik analizi çalışması
Authors: KAYA İdris , MUTLU BAYRAKTAR Duygu
Published: August 2021

Bu çalışmada, Türkiye’de yapılan dijital ebeveynlik çalışmalarının içerik analizi yapılarak, bu alandaki eğilimleri ortaya koymak amaçlanmaktadır. Bu amaçla, yapılmış çalışmalarla ilgili birçok unsur incelenmiş ve ileride yapılacak araştırmalara yol göstermesi açısından rapor edilmiştir. Dijital ebeveynlik üzerine yapılmış araştırmaları incelemek üzere içerik analizi yöntemi kullanılmıştır. İlgili konuda 30 Ocak 2021’e kadar YÖK ulusal tez merkezi ve TR-Dizin’de yayınlanan araştırmalar çalışmaya dahil edilmiştir. Belirlenen dahil etme ve hariç tutma kriterlerine göre 48 araştırma çalışma kapsamında analiz edilmiştir. Dijital ebeveynlik üzerine yapılmış araştırmaların yıllara göre dağılımına bakıldığında özellikle 2014 yılından itibaren yükseliş trendi göze çarpmaktadır. Bu araştırmalarda, en çok Ebeveyn Tutumu, Dijital Ebeveynlik, Aile, Dijital Oyun, Ekran Süresi, Teknoloji Kullanımı anahtar kelimeleri kullanılmıştır. Dijital ebeveynlik çalışmaları kapsamında en çok okul öncesi ve ergenlik döneminde çocuğu olan anne babalardan veri toplandığı görülmüştür. Araştırmaların bir kısmı çalışma grubu belirleme yönteminden bahsetmezken, seçkisiz yöntem ile birlikte amaçsal örnekleme en sık kullanılan çalışma grubu belirleme yöntemleri olmuştur. İçerik analizi kapsamında incelenen çalışmalarda, en çok BİT kullanımı, ebeveyn tutumları, dijital ebeveynlik ve dijital oyun değişkenleri üzerine çalışılmıştır. Çalışmaların odağının yıllara göre dağılımı incelendiğinde, ebeveyn tutumlarının ve BİT kullanımının tüm yıllarda en çok çalışılan konu olduğu görülmüştür. İncelenen araştırmalarda en çok nicel yöntemler kullanılmış olup karma ve nitel yöntemlere de eğilim görülmektedir. Bu araştırmalarda büyük oranda standart ölçek, görüşme ve anket tekniklerinden biri kullanılmıştır.
Yöneticilerinin Gözünden Halk Eğitimi Merkezlerinde Karşılaşılan Sorunlar ve Çözüm Önerileri
Authors: NAZLI Kemal , ÖZER Niyazi
Published: August 2021

Bu araştırma ile halk eğitimi merkezi yöneticilerinin karşılaştıkları sorunların ve bu sorunlara ilişkin çözüm önerilerinin ortaya çıkarılması amaçlanmıştır. Nitel araştırma yöntemlerinden olgubilim deseninde gerçekleştirilmiştir. Araştırmada yarı yapılandırılmış görüşme formu kullanılmıştır. Verilerin analizinde içerik analizi tekniği kullanılmıştır. Araştırma sonucunda halk eğitimi merkezi yöneticilerinin halk eğitimi faaliyetlerini yürütürken planlama, hizmet binası ve kurs yerlerinin fiziki koşulları, öğreticiler, kursiyerler ve kursların denetimiyle ilgili sorunlar yaşadıkları tespit edilmiştir. Üst yöneticilerin ve diğer kurum amirlerinin planlama toplantılarına yeterince katılım gösterme göstermedikleri belirlenmiştir. Katılımcıların nerdeyse tamamına göre, halk eğitimi merkezlerinin fiziki koşullarının iyi olmadığı, bağımsız hizmet binalarının olmadığı, hizmet binası olanların ise yetersiz olduğu ve donanım bakımından eksikliklerinin olduğu belirtilmiştir. Öğreticilerin eğitim düzeylerinin ve niteliklerinin düşük olduğu, öğretici görevlendirme ölçütlerine ilişkin mevzuatın muğlak olduğu belirtilmiştir. Kursiyerlerin çoğunluğunu ev hanımı olan kadınlar olmasından ötürü ciddi devamsızlık sorunlarının yaşandığı tespit edilmiştir. Denetim açısından yaşanan en önemli sorunların ise ulaşım, kursların fazlalığı ve denetimde zaman sorunu olduğu ortaya çıkmıştır. Yaşanan bu sorunların çözümüne ilişkin katılımcı önerilerinin başında, planlama toplantılarının mülki amirler ve diğer paydaş kurumlarca önemsenmesi, halk eğitimi merkezleri için bağımsız hizmet binalarının yapılması, kursların fiziki olanaklarının geliştirilmesi, usta öğretici görevlendirmelerinde eğitim düzeyi ve yeterliklerin öncelikli olması için mevzuat değişikliğinin yapılması gelmektedir. Bununla birlikte kursiyerlere malzeme ve mali destek sağlanması, kursların denetimi için kurum yöneticilerine ulaşım desteğinin sağlanması ve denetimlerde maarif müfettişlerinden destek alınması önerilmektedir.
Body mass index as predictor of carpal tunnel syndrome among garment workers
Authors: Merijanti Lie T.
Published: August 2021

Of the nerve entrapment syndromes the most well-known is the carpal tunnel syndrome (CTS) involving the median nerve. In the field of occupational medicine this condition is categorized as an occupational disease, for which industrial workers may claim compensation if the CTS occurs as a consequence of their job. However, although several occupational risk factors have been suggested as causing the development of CTS, a definitive role of work activities as the central cause of CTS is unclear. The aim of the present study was to evaluate both non-occupational and occupational factors associated with CTS in garment home-industry workers. A cross-sectional study was performed from April to June 2008 in the garment home industry in North Jakarta. A total of 99 workers, consisting of 45 males and 54 females were included in this study. Historical data were obtained from a self-administered detailed questionnaire, while anthropometric and provocative median nerve test variables were measured directly. The results showed that body mass index (BMI) was a significant predictor of CTS in male workers (p=0.031), while the risk of CTS was three-fold higher in female workers using hormonal contraceptives (Prevalence Ratio/PR = 3.3 ; 95% Confidence of Interval/CI = 1.0 – 10.5). In conclusion it appears that BMI and hormonal contraceptive use were CTS predictors.
Anemia decreases quality of life of the elderly in Jakarta
Authors: Meiyanti Meiyanti , Kalumpiu Joice Viladelvia , Mulia Julius I
Published: August 2021

Anemia is a very common disorder both in clinical practice and in the community. The recent rise in the population of the elderly has become the focus of attention in developing countries, because of the increasing longevity of the elderly, whilst the prevalence of anemia increases with age. The objective of this study was to determine the prevalence of anemia and its association with the quality of life in the elderly. A cross-sectional study was conducted from April to June 2008, located in the Mampang Prapatan district, South Jakarta. A total of 298 elderly persons participated in this study, comprising 109 (36.6%) males and 189 (63.4%) females. Anemia was measured by the parameters of hemoglobin and quality of life was assessed by the WHOQOL-BREF instrument, a short version of the WHOQOL-100 instrument. The results of the study showed the prevalence of anemia to be 26.2%, with a higher prevalence rate in females compared with males. The quality of life in the physical, psychological, social and environmental domains differed significantly with decreasing hemoglobin levels, whereas the physical and mental quality of life declined significantly with age. Anemia is thus indicative of a reduction in the quality of life of the elderly.
Cataract surgical coverage rate among adults aged 40 years and older
Authors: Tana Lusianawaty
Published: August 2021

Cataract is a leading cause of curable blindness. Hence, in its global declaration of ‘Vision 2020 Right to Sight’, the World Health Organization (WHO) encouraged its member countries to address the problem of incident cataract. Many factors are related to the cataract surgical coverage rate, such as gender and diabetes mellitus. The objective of this study was to determine the cataract surgical coverage rate and investigate the determinants factors of cataract surgical coverage rate among adults 40 years old and above with cataract. A cross sectional study was conducted using National Basic Health Research (Riskesdas) 2007 data. Cataract surgery was defined as surgery conducted within the last 12 months before the survey was performed. There were 6939 subjects (3105 male, 3834 female) who fulfilled the study criteria. The cataract surgical coverage rate was 19.3%. The cataract surgical coverage rate was lower in subjects with low education, in the group of farmers/fishermen/laborers, in the 40-49 years age group, in rural areas, and in subjects of low socioeconomic status (p<0.05). The cataract surgical coverage rate was not different between gender and diabetes mellitus (p>0.05). Determinants that were related to cataract surgical coverage rate were age, type of area of residence, socioeconomic status, and region of residence (p<0.001). The implementation of educational programs and reforms to local ophthalmic health services may improve the cataract surgical coverage rate.
Pterygium: degeneration, exuberant wound healing or benign neoplasm?
Authors: Tradjutrisno Nurbuanto
Published: August 2021

Pterygium is a condition characterized by the encroachment of a fleshy triangle of conjunctival tissue into the cornea. Despite various studies, the pathogenesis of pterygium remains unclear. Chronic exposure to sun is the only factor of which the role has been clearly documented by epidemiologic and in vitro studies. Recent studies have provided data such as loss of heterozygosity and microsatellite instability, decreased apoptosis, increased growth factors, increased p53 expression, telomerase activity, and presence of oncogenic viruses, which support the concept that pterygia can be considered a neoplastic condition. Some of results are contradictory and some features were only found in a proportion of pterygia; this may be due to differences in methodology and study population, but may also be indicative of multiple causative factors. This implies that the pterygium should be viewed as a final common outcome of various etiological factors, such as geography and ethnicity, with ultraviolet radiation-induced damage as the main factor. Thus the pterygium remains an enigma, having the features of an exuberant growth but also those of a benign neoplasm. In this connection there is a need for a unifying theory capable of explaining all of the characteristics of the pterygium.
Pharmacokinetic interactions between rifampicin and efavirenz in HIV-TB coinfections
Authors: Yenny Yenny
Published: August 2021

The increased percentage of patients with HIV-TB coinfection leads to inevitable interactions between rifampicin and efavirenz. Efavirenz is a potent non-nucleoside reverse transcriptase inhibitor (NNRTI) for the treatment of HIV infection. The use of this drug combination with rifampicin causes problems in determination of the optimal dosage of efavirenz when administered concomitantly with rifampicin. Efavirenz is metabolized by the enzyme cytochrome P-450 (CYP), i.e. the CYP2B6 and CYP3A4 isozymes, of which rifampicin is an inducer. The induction of cytochrome P-450 by rifampicin is mediated by pregnane X (PXR) and constitutive androstane receptors (CAR) in the cell nucleus, resulting in a wide variation in the plasma efavirenz concentrations, such that a therapeutic failure or the occurrence of toxic effects are to be expected. The optimal dosage of efavirenz is commonly determined through pharmacokinetic studies, but this  is problematic in the combined use of the drug with rifampicin, due to the wide variation in study design, method, and sample size of each study. Ethnic factors and genetic polymorphism of the enzymes that metabolize efavirenz contribute to the problem of determining the optimal dose of this drug. Pharmacokinetic studies with good measurement parameters and methods are still necessary as the basis for determining the optimal dose of efavirenz in the Indonesian population.
The role of triptans in the management of migraine
Authors: Meiyanti Meiyanti
Published: August 2021

Migraine is one of the most prevalent disorders seen in clinical practice today and also a major cause of disability in the workplace. The prevalence of migraine is highest during the years of peak productivity, ie, between the ages of 25 and 55 years. The triptans are a group of selective 5-hydroxtriptamine (HT)1 serotonin receptor agonists that activate the 5-HT1B/1D receptor and possibly also the 5-HT1A dan 5-HT1F receptors. To date 7 subclasses of serotonin receptors have been identified, namely subclasses 5-HT1 to 5-HT7. Triptan causes cranial vasoconstriction, inhibits peripheral trigeminal activity and the trigeminal afferents. With its triple action, triptans can control acute attacks of migraine. Triptan is contraindicated in patients with previous ischemic or coronary artery disease, cerebral or peripheral vascular disease and other cardiovascular disorders. Triptans should be given immediately after an acute attack of migraine. The triptans are useful in the management of an acute migraine, but are not indicated for preventive therapy of migraine. Several new advances in migraine management have been made in regard to the recognition of the disease, the pathogenesis of migraine, and the phenomenon of central sensitization. More treatment options become available to patients and prescribers, the impact of such therapy on worker productivity will become more important in determining the value of such interventions.
Vaccines for prostate cancer : a new era?
Authors: Mulia Julius I
Published: August 2021

Prostate adenocarcinoma is the most prevalent type of noncutaneous cancer in the Western world, with an estimated 218,890 new cases and 27,050 deaths in the United States in 2007. Currently prostate cancer is detected by measurement of prostate-specific antigen (PSA), a serine protease synthesized by the prostatic epithelium. PSA is an organ-specific and tumor-associated antigen (TAA) but it is not tumor-specific.(1) Partly because of increased cancer screening with PSA, prostatic cancer may now be diagnosed when it is still localized. Localized tumors of the prostate are generally treated with radical prostatectomy, external-beam radiation therapy (EBRT), brachytherapy, or watchful waiting. Unfortunately, up to 30%-40% of patients fail local therapy. The standard treatment of recurrent or metastatic disease is androgen-deprivation therapy (ADT), but this is only a temporary measure as in the majority of cases the cancer ultimately becomes hormone refractory, the condition being termed androgen-independent prostate cancer (AIPC) or hormone refractory prostate cancer (HRPC), which then progresses rapidly. The only available nonpalliative therapy for androgen-independent prostate cancer is docetaxel in combination with prednisone. However, ADT given prior to the onset of clinical symptoms results in rising PSA levels with castrate levels of testosterone, often with a relatively low tumor burden. This systemic treatment earlier in the disease course combined with effective palliative chemotherapy is implicated in the improvement in median survival time of patients with AIPC from an average of about 12 months to about 17-18 months.
Etika Kepemimpinan Politik dalam Penyelenggaraan Pemerintahan Indonesia
Authors: Setiawan Anang , Fauzi Erinda Alfiani
Published: August 2021

Dengan etika dan moralitas yang kuat maka diharapkan praktek korupsi di Indonesia akan menurun. Selain dengan etika dan moralitas yang kuat maka reformasi birokrasi juga menjadi salah satu cara untuk mengurangi korupsi dan membangun pelayanan dan penyelenggaraan pemerintah yang baik. Etika dalam politik atau penyelenggaraan pemerintah memang memiliki sebuah fungsi yang sangat penting dalam pelaksanaan reformasi birokrasi ini. Pembahasan ini tentang bagaimana etika, moral dan contoh korupsi di Indonesia saling berhubungan. Pentingnya etika dan moral sebagai pemimpin. Penelitian ini menggunakan metode studi literature dimana membandingkan beberapa studi sebelumnya sebagai teori nilai budaya yang sama seperti diskusi sosial yang dilakukan di penelitian sebelumnya. Dalam penelitian ditemukan beberapa kasus korupsi yang terjadi di Indonesia yang berkaitan dengan etika kepemimpinan politik. Perilaku korupsi memang dipengaruhi oleh banyak hal , namun pada penelitian ini fokus membahas tentang dimana etika dan moralitas yang mempengaruhi perilaku korupsi yang dilakukan oleh pemimpin di Indonesia.
Collaborative Governance dalam Pengembanan Agroindustri Gula Semut (Studi Kasus pada Badan Usaha Milik Desa Hargorejo, Kecamatan Kokap, Kabupaten Kulon Progo pada tahun 2018)
Authors: Kurniawan Mohammad Ilham , Zuhriyati Erni
Published: August 2021

Dalam rangka mengetaskan kemiskinan Gerakan Bela Beli Kulonprogo merupakan sebuah kebijakan yang sesuai dengan visi misi  RPJMD Kulon Progo 2011-2016 serta sesuai dengan pasal 5 UU No 25 Tahun 2004. Program Bela-beli kulonprogo merupakan suatu program yang berbasis collaborative governance yang dalam pelaksanaannya melibatkan tiga actor yaitu pemerintah, masyarakat, dan swasta. Untuk mencapai hal tersebut Industri pertanian yang di kembangkan dengan program OVOP (One Village One Product) merupakan solusi yang tepat  untuk dikembangkan untuk mengangkat ekonomi kerakyatan. Dalam hal ini Desa hargorejo sebagai salah satu desa yang produktif dalam memproduksi gula semut .Produksi gula merah di desa Hargorejo bisa dikatakan banyak dan produktif. Dan dapat membuka lapangan pekerjaan bagi masyarakat sekitar serta Meberdayakan Sumber Daya Alam yang ada. Namun dalam pelaksanaanya peran BUMDes, Swasta, Dinas terkait, dan Masyarakat sekitar desa Hargorejo sebagai komponen stakeholder masih banyak menemui kendala dilapangan walaupun kegiatan Agroindustri tetap berjalan.
Polemik Produk Legislasi Dewan Perwakilan Rakyat (DPR) di Indonesia dari Tahun 2015-2017
Authors: Pratama Prawira Yudha , Sarmiasih Mia
Published: August 2021

Salah satu implikasi dari adanya perubahan politik pasca Reformasi 1998 telah mendorong lembaga DPR menjadi lebih demokratis dan akuntabel. Hal tersebut setidaknya memberikan performance baru bagi DPR yang sebelumnya dinilai kurang berperan dalam menjalankan fungsinya pada masa Orde Baru, maka pasca reformasi peran dan fungsi DPR RI dikembalikan ke koridornya sebagai lembaga legislatif yang menjalankan fungsi legislasi. Namun, didalam pelaksanaannya terjadi beberapa permasalahan. Pasca pemilu tahun 2014, tepatnya ditahun 2015 sampai 2017 ada beberapa RUU (Rancangan Undang-undang) yang tidak bisa diselesesaikan dengan baik oleh badan legislatife ini.  Tercatat pada tahun 2015 dari 39 RUU prioritas hanya 3 yang akan disahkan. Setelah itu tahun 2016 dari 50 RUU prioritas hanya 10 Yang akan disahkan dan ditahun 2017 daru 52 RUU perioritas hanya 6 yang akan disahkan, ini jelas bahwa produk legislasi yang diahasilakn sanglah minim. Ini disebabkan oleh ketidakadanya komitmen badan legislatife didalam penyelesaian RUU. Tarik ulur kepentingan diinternal serta kepentingan individu maupun kelompok juga salah satu penyelesaian dan pengesahan RUU menjadi tertunda sehingga tidakadanya keharmonisasian didalam Badan Legislatif.
EVALUASI KEBIJAKAN PENGELOLAAN SAMPAH DI TPA KALIKONDANG KABUPATEN DEMAK
Authors: Hardiyanti Kiki
Published: August 2021

Tujuan penelitian ini adalah untuk mengentahui bagaimana capaian kebijakan pengelolaan sampah yang dilakukan di Kabupaten Demak khususnya pada TPA Kalikondang. Metode yang digunakan dalam penelitian ini adalah penelitian kualitatif deskriptif dengan teknik pengumpulan data primer melalui wawancara secara langsung, dokumentasi, dan observasi, serta data sekunder melalui jurnal dan studi kepustakaan. Hasil penelitian diperoleh berdasarkan lima kriteria yaitu efektivitas, efesiensi, kecukupan, perataan, responsivitas, dan ketepatan. Efektifitas pengelolaan sampah yang dilakukan di TPA Kalikondang Masih belum optimal dikarenakan sistem pengelolaan sampah masih menggunakan sistem open dumping; Efesiensi Masih belum optimalnya karena penimbunan sampah dengan tanah, pencacahan sampah, pembuatan pupuk kompos, kolam tinja dan kolam air lindi dikarenakan kurangnya sarana dan prasarana yang tersedia. Selain itu, biaya pengelolaan sampah terfokus hanya pada pembelian tanah dan BBM truk pengangkut sampah;  Kecukupan masih belum optimal karena pengelolaan sampah yang dilakukan tidak berjalan sesuai dengan jadwal seharusnya; Perataan masih belum optimal karena pembiayaan masih berfokus pada pembelian BBM untuk truk pengangkutan sampah dan pebelian tanah; Responsivitas masih belum optimal karena  masih terdapat pengaduan dari masyarakat seperti bau dan air lindi, serta solusi yang diberikan dari Dinas Lingkungan Hidup Kabupaten Demak tidak menyelesaikan persoalan yang terjadi; Ketepatan masih belum optimal karena penggunaan gas metan hanya sebatas keperluan pekerja di TPA Kalikondang.
SINERGITAS PEMERINTAH, SWASTA DAN CIVIL SOCIETY DALAM MEWUJUDKAN KOTA LAYAK ANAK DI KOTA YOGYAKARTA
Authors: Siskasari Agista
Published: August 2021

Kota Layak Anak merupakan kabupaten/kota yang mempunyai sistem pembangunan berbasis hak anak melalui pengintegrasian komitmen dan sumber daya pemerintah, masyarakat, dan dunia usaha, yang terencana secara menyeluruh dan berkelanjutan dalam kebijakan, program dan kegiatan untuk menjamin terpenuhinya hak dan perlindungan anak. untuk mewujdukan Kota Layak Anak diperlukan Collaborative Governance melalui keterlibatan pemerintah, swasta dan civil society untuk bersama-sama mengupayakan pemenuhan hak anak. Penelitian ini bertujuan untuk mengetahui proses Collaboratuve Governance dalam pelaksanaan program Kampung Ramah Anak (KRA) dengan menggunakan pendekatan kualitatif deskriptif. Kampung Ramah Anak RW 07 Pakuncen telah melibatkan pemerintah, swasta dan civil society dalam melaksanakan program Kampung Ranah Anak (KRA).
Kelayakan Upah Minimum Provinsi (UMP) Daerah Istimewa Yogyakarta Dalam Memenuhi Kebutuhan Hidup Layak Pekerja Tahun 2019
Authors: Prasetiyo Yoko , Permatasari Ane
Published: August 2021

Pelatihan dilakukan dengan tujuan untuk mengetahui Kelayakan Upah Minimum Provinsi (UMP) Daerah Istimewa Yogyakarta Dalam Memenuhi Kebutuhan Hidup Layak Pekerja Tahun 2019. Penelitian menggunakan data primer yang diperoleh berdasarkan wawancara terhadap pejabat yang berwenang pada Disnakertrans DIY serta data sekunder  sebagai data untuk memperkuat analisa penelitian. Data diolah dan dianalisis dengan menggunakan teknik analisis kualitatif. Hasil penelitian ini menunjukkan bahwa variabel kelayakan dalam menentukan besaran upah dan pendampingan bagi pekerja/buruh untuk memperjuangkan haknya dalam terpenuhinnya upah yang harus diterima, memperjuangkan hak pekerja /buruh dalam proses untuk mencapai kesejahteraan dalam pengupahan adalah bentuk keadilan untuk terus mencapai kesejahteraan bagi para pekerja/buruh di Daerah Istimewa Yogyakarta.
EFEKTIVITAS KINERJA APARATUR SIPIL NEGARA DALAM PELAYANAN PUBLIK DI MASA PANDEMIC COVID-19 (STUDI KASUS DINAS KEPENDUDUKAN DAN PENCATATAN SIPIL KABUPATEN SLEMAN)
Authors: Sarel Alifbata , Atmojo Muhammad Eko
Published: August 2021

This study aims to determine the effectiveness of the performance of the State Civil Servants of the Sleman Regency Population and Civil Registration Service in serving the community during the Covid-19 pandemic. This research is presented by the author using a qualitative approach. The analysis used by the author includes, data collection, data reduction, data presentation, and concluding. The results of this study indicate that in its implementation, the performance of ASN at the Department of Population and Civil Registration of Sleman Regency is based on indicators such as adaptability, work performance, and work ability. The existence of the Covid-19 pandemic has not had a major effect on performance, it affects the service mechanism that implements health protocols such as maintaining distance, wearing masks, limiting the number of people who take care of population administration. In addition, the Department of Population and Civil Registration of Sleman Regency also implements an online service system, but the existence of this online service, according to the expressions of some of the community, this service cannot be fully relied upon because to process documents still have to come and wait a long time.
Pattern and etiological factors of surgical site infection among patients undergone surgery at Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh
Authors: Islam Mohammad Jayedul , Md Rasell , Majumdar Krisna Rani , Islam K. M. Shaiful , Muhammad Iqbal Abu Khaled
Published: August 2021

Background: Surgical site infections (SSIs) has been reported to be one of the most common causes of nosocomial infections which accounting for 20% to 25% worldwide. Despite recent advances in aseptic techniques, SSIs continue to be a major source of morbidity and mortality in developing countries and continue to represent about a fifth of all healthcare-associated infections. The aim of the study was to assess the pattern and etiological factors of surgical site infection among the patients who had undergone in surgery.Methods: This study was a cross-sectional study conducted at the department of surgery in Sir Salimullah Medical College and Mitford Hospital (SSMC and MH), Dhaka, Bangladesh from August 2017 to July 2018. Total 160 admitted patients who had undergone surgical procedures during the study period were assessed and interviewed.Results: The mean±SD age of the participants was 51.79±11.30 SD years. About 59% were male and 41% were female. Most of them came from rural areas (61%).  Surgeries were done in different indications and 21% developed SSI. Of all SSIs, 73% were superficial and 27% were deep infections. The most common organism involved in SSI was S. aureas (42.4%), followed by E. coli (27.3%), P. aeruginosa (12.1%), bacteroids (12.1%), and Klebsiella spp. (6.1%). Meropenem was the most sensitive drug followed by Ceftriaxone. Gentamycin showed cent percent sensitivity on the gram-negative organisms.Conclusions: The incidence of SSIs was found in about one-fifth of the post-surgical cases, where Staphylococcus aureus was the most prevalent organism.
Correlation between C-reactive protein, intravenous hydrocortisone, systemic tranexamic acid and post mastectomy seroma
Authors: Albatanony Ayman A. , Assar Ahmed M. A. , El Balshy Mohammed A. E.
Published: August 2021

Background: Breast cancer is the second leading cause of death among women worldwide. Formation of a seroma most frequently occurs after mastectomy and axillary surgery. The objective was to find the correlation between the formation of post modified radical mastectomy seroma and C-reactive protein (CRP) and the effect of preoperative intravenous (IV) hydrocortisone, systemic tranexamic acid.Methods: This prospective study was conducted at Menoufia university hospital on female patients with primary operable breast cancer who were divided to two groups; each included 30 patients: group I received general anesthesia with hydrocortisone therapy (Solu-Cortef 100 mg solution once), systemic tranexamic acid (kapron 5 ml once) and group II received general anesthesia without hydrocortisone nor tranexamic acid. CRP serum levels before surgery and 24 hour after the procedure. All patients were followed up postoperatively for registration of the total drainage volume until drain removal, timing of drain removal, incidence of seroma formation and management of seroma.Results: Our results revealed that a significant difference between both groups as regard CRP, the incidence of seroma, time of removing the drain and total collection of the drain in favor to those who received IV hydrocortisone and systemic tranexamic acid.Conclusions: Induction of IV hydrocortisone, systemic tranexamic acid with general anaesthesia during modified radical mastectomy (MRM) are significantly decreasing the level of CRP, the incidence of seroma, time of removing the drain and total collection of the drain.
Complications of appendicitis in a tertiary care centre
Authors: Gudi Nanditha , Francis John M. , . Shivananda , K. Thinagaran
Published: August 2021

Background: Acute appendicitis is the most common surgical emergency. An appendicectomy is considered the gold standard of treatment for acute appendicitis because of the potential risk of disease progression to perforation, gangrene and peritonitis. The aim of this study was to determine the incidence of complications in patients diagnosed with acute appendicitis.Methods: A total number of 70 patients were studied with various symptoms of acute appendicitis and their complications, all patients were presented to PESIMSR, Kuppam from December 2016 to June 2018. Clinical assessment , investigations like WBC counts, X-ray erect abdomen, USG abdomen and pelvis and management were recorded. The incidence of complications were studied. The cases of appendicular mass was treated conservatively, except for those who do not respond to antibiotics.Results: During this study period, among 70 patients aged between 5-45 years, male were 53 and female patients were 17 and 11 patients belong to pediatric age group and 59 patients aged more than 18 years. The commonest complication was postoperative surgical site infection (20%) found in perforated appendix patients in our study. Around 76% of the patients developed complications. Among the female patients diagnosed with acute appendicitis, appendicular perforation being the most common complication and it was the postoperative surgical site infections in males.Conclusions: Acute appendicitis is the most common surgical emergency. Open appendicectomy is the most commonly done procedure in our hospital. The commonest complication is postoperative surgical site infection (20%) found in perforated appendix patients in our study.
A study of non-traumatic gastrointestinal perforations in a tropical country
Authors: Hota Prasan Kumar , Bung Nikitha , Prashanth Yeramaneni Venkat
Published: August 2021

Background: Gastrointestinal perforations constitute one of the commonest surgical emergencies encountered by surgeons all over the world. However, non traumatic gastrointestinal perforations are more commonly seen in tropical countries. They cause considerable mortality and usually require emergency surgery. This study was designed to study the clinical spectrum of non traumatic gastrointestinal perforation in a tropical country and thereby assessing the surgical outcome.Methods: An observational study was conducted in the department of general surgery, Mamata medical college, Khammam to analyse the clinical spectrum and their management protocol with outcome of the patients presenting with non traumatic gastrointestinal perforation. A total number of 140 patients of various etiologies of non traumating gastrointestinal perforations were found to be treated over a period of six years. Detailed demographic profile, clinical presentations and etiological factors were studied along with various management protocols offered to them with the outcome.Results: Most common age of presentation was 41-60 years with 72%being males. Most common site of perforation was duodenum (28.57%) followed by stomach (25%). Peptic ulcer (53.57%) was the predominant etiology followed by appendicular perforation (15.71%), enteric perforation (12.85%), tubercular (4.28%), malignancy (1.42%) and diverticula (0.71%). Most common post-operative complication was wound infection (37.14%) followed by dyselectrolytaemia (31.42%). Mortality was 7.14%.Conclusions: Gastrointestinal perforations constitute one of the commonest surgical emergencies. Non traumatic gastrointestinal perforations are quite common in a tropical country like India. The high rates of mortality among those, who present late, prompt an early diagnosis and active management protocol in order to reduce mortality and morbidity in such patients.
Prospective study using Apache II scoring to predict the outcomes of patients undergoing emergency gastrointestinal procedure
Authors: Shelgaonkar Vaishali C. , Butey Swatika P. , Nandagawali Vishal R.
Published: August 2021

Background: Many scoring systems have been used to assess the morbidity and mortality of patients presenting with acute abdomen, of which Apache II (acute physiology and chronic health evaluation) score has been accepted widely. This study predicted the effectiveness of Apache II scoring system as a potential clinical and research tool which could be included as routine part of patient assessment to predict the morbidity and mortality in patients undergoing emergency gastrointestinal procedures.Methods: This study was conducted in the surgical intensive care unit of our tertiary care hospital. It was a prospective observational study done over a period of one year where we assessed the efficacy of Apache II score in eighty two patients.Results: The Apache II scores were divided into three categories, 0-15 low risk group, 16-30 moderate risk group and 31-45 high risk group. There were 25 patients in the low risk group with all being satisfactorily discharged. With 44 patients in the moderate risk group 13 expired (29.54% mortality) and out of 13 patients in the high risk group 11 patients died (84.61% mortality).Conclusions: In the present study the APACHE II scores have correlated well with the outcomes and ICU stay of the patient groups.
All in one meshplasty verses conventional open meshplasty in inguinal hernia in a tertiary care setup
Authors: A. Ajay Raja , R. Lakshmana , Dube Saumitra , Chintada Govinda Raju , K. Dhinesh
Published: August 2021

Background: Inguinal hernia surgery has continued to evolve historically from tissue repair to the present tension free repair by using mesh. Various tension free mesh repair have been demonstrated throughout the years after lichten stiens tension free meshplasty but inguinodynia continues to be a problem with all hernioplasties. All-in-one mesh hernioplasty showed zero incidence of inguinodynia in 50 patients who underwent this novel procedure.  The primary aim of the study was to compare between all in one meshplasty vs conventional open meshplasty in inguinal hernia in tertiary care setup.Methods: Our study was done in SRM Medical college and research center attached to SRM University in Kattankullathur, Chennai for one and half year. It was comparative study between all in one meshplasty verses conventional meshplasty. A sample size of 100 patients was the part of this study, out of which 50 underwent mesh fixation by all in one meshplasty and 50 patients underwent mesh fixation by conventional meshplasty.Results: All-in-one meshplasty can be considered superior to conventional meshplasty in view of incidence of post-op neuralgia, operative time, duration of stay in hospital.Conclusions: All-in-one meshplasty can be considered as a good replacement for conventional hernioplasty in inguinal hernia repair expecting lesser post-operative morbidity and a better quality of life post-operatively.
Microbiological profile of urinary tract infection in patients with burn injuries
Authors: Kundu Rajib , Das Swapan , Chattopadhyay Bani P.
Published: August 2021

Background: As per WHO around 1,95,000 people died every year due to burn injuries. After initial 72 hours, Infections are the most common cause of death in patients with burn injuries and urinary tract infection was second most commonly reported infectious complication. This study was tried to determine the pattern of microorganisms responsible for urinary tract infection.Methods: After matching inclusion and exclusion criteria, total 55 patients were taken for this institution based prospective observational study. Samples were collected on day 7 and cultured aerobically in MacConkey agar and 5% blood agar and antibiotic susceptibility testing was done on Muller Hinton agar using Kirby-Bauer disc diffusion method.Results: 29.1% samples were positive for microorganisms, of which Escherichia coli was most common isolated organism, it is found in 18.2 % of study population. nitrofurantoin was found to be most effective antibiotic against Escherichia coli.Conclusions: Gram-negative cocci were most prevalent organisms, causing urinary tract infection in patients with burn injuries. Escherichia coli was most common isolated organism and nitrofurantoin was most effective against it. Overall piperacillin/tazobactam has height sensitivity.
Diagnostic accuracy of acute appendicitis by comparing clinical judgment of surgeons and Alvarado scoring in suspected acute appendicitis
Authors: Bhusal Ishory , Agarwal Chandra Shekhar , Gupta Rakesh Kumar , Sah Suresh Prasad
Published: August 2021

Background: The Alvarado score is a clinical scoring system used in the diagnosis of acute appendicitis. The aim of the study was to compare the clinical judgment of surgeons and Alvarado score in diagnosing acute appendicitis within Nepalese people and to refine the score and suggest a new score to make a more accurate diagnosis of acute appendicitis.Methods: In this prospective, parallel-group, quasi-randomized study of patients presenting at a tertiary hospital in eastern Nepal with suspected appendicitis during 1 year were assigned in weekly alternation to either group A or group B. The group A patients were treated on the basis of their Alvarado score, and the group B patients based on the clinical judgment. The correctness of the methods was assessed by the final histology.Results: In this study, the mean age of patients in Alvarado group was 26.45 years and in clinical judgment was 28.68 years. The sensitivity, the specificity, the diagnostic accuracy, the positive predictive value and negative appendectomies in Alvarado group were 95.5%, 68.9%, 90.91%, 93.4% and 6.56% respectively whereas in clinical judgment group were 98.51%, 85.71%,496.4%, 97.04% and 3.59% respectively.Conclusions: This study showed clinical judgment to be more reliable in the diagnosis of acute appendicitis than the Alvarado score, but the score is a useful diagnostic aid, especially for young colleagues. The use of the new scoring system has become easier. It includes fewer criteria as well as an important and sensitive predictor: the ultrasound investigation.
A prospective study of outcome in patients with intra-abdominal hypertension
Authors: Rampal Kapil , Prajapati Devendra K. , Sharma Meghna , Singh Parampreet , Singh Jasmaan , Singh Harinder
Published: August 2021

Background: Intra-abdominal hypertension (IAH) and Abdominal compartment syndrome (ACS) is increasingly recognized in critically ill patients, and the deleterious effects of increased intra-abdominal pressure (IAP) are well documented. It is known to affect almost all the system in the body, but mainly the renal, cardiovascular and pulmonary systems. The purpose of this study is to prospectively observe the outcome of IHP in patients admitted in ICU, acute surgical and emergency wards over three years and give our recommendations based on the outcome in such patients.Methods: We measured intravesical pressure using simple manometry to measure IAP.Results: We observed cardiac dysfunction in 16.30%, renal dysfunction in 10.86%, respiratory dysfunction in 21.74% and mortality of 15.2%. Significant mortality was associated with IAH grade II (55.6%) and grade III (100%).Conclusions: Due to the contribution towards mortality and common occurrence we suggest that intra-abdominal pressure be measured in ICU conditions.
Asymmetrical erythematous rash secondary to subcutaneous emphysema
Authors: Lata Tahmina Jahan , Bull Nicholas , Dick Madeline , Anderson Benjamin
Published: August 2021

Subcutaneous emphysema is a frequent post-operative complication. Although many cardiorespiratory complications associated with subcutaneous emphysema has been described, skin rashes have not been described as a complication. We present a case of asymmetrical erythematous skin rash secondary to subcutaneous emphysema. To the best of our knowledge this association has not been reported before. It is important to recognise cutaneous changes such as skin rash as a potential complication of subcutaneous emphysema and avoid inappropriate management and prolonged hospital stay. complication.
Adhesive small bowel obstruction in a virgin abdomen in an elderly: a case report
Authors: Ismail Althaf Adnan , Sasy Ahmed Hegazy Mahdy , Saadullah Mohamed Abdelraouf Hassan
Published: August 2021

Small bowel obstruction (SBO) is a major cause of morbidity and financial burden in hospitals around the world. Although adhesions account for more than 70% of SBO, they were thought to be less likely etiologies in a virgin abdomen. However, emerging evidence appears to challenge such a dogmatic approach. Here, we report a case of a 68 years old Maldivian man with a virgin abdomen who presented as small bowel obstruction secondary to de novo adhesions at terminal ileum. He was treated successfully with uneventful postoperative outcome in a government regional referral hospital.
Coexistence of thymoma and necrotizing pneumonia: a case report with a fatal outcome
Authors: Nieves-Condoy Jefferson Fabian , Acuña-Pinzón Camilo Levi , Narváez-Fernández Salvador , Chavarría-Chavira José Luis , Crocco-Quirós Bruno , Rivera-Márquez Daniel Augustin
Published: August 2021

Thymoma is an entity with an estimated incidence of 1.2-3.2 per million people, with a prognosis and treatment determined by its clinical stage and histological classification, the most widely used classification systems being the Masaoka-Koga for clinical stage and that of the world health organization (WHO) for histology. Necrotizing pneumonia is another rare entity that was initially described in adults in the 1940s; however, it is currently being studied more extensively in the pediatric setting, and currently its treatment, especially in adults, is unclear and surgical treatment usually reserved in the presence of complications and poor response to medical management. The coexistence of two rare entities is a problem for which therapeutic options are limited; the general condition of the patient is a determining factor in the outcome in a critically ill patient. In the present case, the association of two infrequent entities is reported, which presented a pneumothorax as a complication that required placement of an endo-pleural tube for drainage, pre-surgical biopsy a B1 thymoma was reported. The post-surgery pathology report was an encapsulated thymoma, WHO type A, the broad-spectrum antibiotic management did not prevent the dissemination of the septic focus in the context of a patient with malnutrition and immunosuppression.
‘Away from home’ extra hepatic hepatocellular adenocarcinoma in gastric fundal submucosa
Authors: Mohd Samathani Mohd Helmi , Khairy Azuddin Bin Mohd
Published: August 2021

Patient presented with upper gastrointestinal bleeding which was scoped and diagnosed as bleeding gastrointestinal tumour intra procedure, subjected to laparotomy and wedge resection with unchanged postoperative diagnosis. Only later to find out the tissue was interpreted as metastases hepatoid adenocarcinoma without primary liver pathology. Thus likely point towards malignancy changes of undiagnosed ectopic liver tissue on gastric wall.
Spontaneous splenic rupture in a patient with chronic granulocytic leukemia
Authors: Miranda Hector Vergara , Martínez Zarazúa Raúl Omar , Hernandez Ramírez Mayra Alexandra , Rodríguez Briseño José Angel , Muñoz Maldonado Gerardo Enrique
Published: August 2021

Spontaneous splenic rupture is a rare phenomenon that is not associated with trauma. The most common causes of splenic rupture are hematological diseases (30.3%), inflammatory diseases (20%), infectious diseases (27.3%), drugs (9.2%), mechanical disorders (6.8%), and unknown causes (6.4%). Spontaneous splenic rupture secondary to hematological malignancy is rare; in this group of patients, chronic granulocytic leukemia is the main cause. The mechanism of spontaneous splenic rupture is uncertain. Three mechanisms have been suggested: the mechanical effect of leukemia and its infiltration in the spleen, especially if the capsule is invaded; splenic infarction with subsequent subcapsular hemorrhage and rupture of the splenic capsule, and coagulation abnormalities.
Peritoneal gliomatosis: a case report
Authors: Vaca Enrique , Ventura Claudia V. , Nieves Jefferson , Acuña Camilo , Rivera Daniel A.
Published: August 2021

Peritoneal gliomatosis is the mature neuroglial tissue in peritoneum, this is commonly associated with immature teratoma. Can be associated with ascites alone or ascites and pleural effusion in which case it is called pseudo Meigs syndrome, the lymph node invasion has been described. In the imaging studies such computed tomography they can be show as multiple peritoneal nodules, the positron emission tomography has shown utility in cases of doubt of recurrence of mature teratoma without evidence of primary tumor with elevated tumor marker. The initial treatment depends on the treatment of the teratoma, reserving the surgical treatment of the peritoneal gliomatosis in the presence of complications related to the implants. A 21-year-old woman without chronic degenerative disease story with clinical presentation of abdominal distension, a CT scan is performed that shows a right ovary tumor; a laparotomy was performed in which ascites and peritoneal nodules were evidenced suggesting the presence of carcinomatosis. Histopathological study demonstrated peritoneal gliomatosis.
Extensive gastric necrosis in an infant
Authors: Gandhi Suraj R. , Shenoy Neha S. , Joseph Vini , Makan Apoorva P. , Basu Syamantak , Tulsian Akriti R. , Shah Hemanshi S.
Published: August 2021

Gastric necrosis is a rare condition, more so in children and can be potentially fatal. The sloughing of the necrosed wall results in perforations or large defects in the gastric wall.  We report a rare case of extensive gastric necrosis in a 2 months old female infant, managed successfully. Child presented with non-bilious vomiting and excessive cry. There was history of recurrent upper abdominal distension. X-ray of abdomen showed massive pneumoperitoneum. Intra operatively, posterior gastric wall was sloughed off and lower end of feeding tube was lying in the peritoneal cavity. Necrotic wall was debrided and stomach tube was created from remaining anterior gastric wall. Gastrostomy and jejunostomy was done. Post-operative period was uneventful. Dye study at three months showed good gastric capacity. Stomach being a well vascularised organ, necrosis is rare. There is varied etiology of gastric necrosis, volvulus being one of them. Gastric volvulus might be associated with other congenital anomalies like eventration, asplenia, wandering spleen. The incidence of perforation in gastric volvulus with necrosis is 5-28% and a mortality of 50% is reported with such perforations. Vigilant clinical observation in pediatric patients with upper abdominal distension and pain can point the diagnosis and prevent fatal outcome.