bluuebunny/crossref_metadata_2025 huggingface dataset:
RISK ANALYSIS OF HEAVY METAL WEIGHT MERCURY IN SEA SEDIMENT IN THE COASTAL AREAS OF MAKASSAR CITY
Authors: Ishak Nuning Irnawulan
Published: July 2018

Monitoring of marine sediments as an indicator of heavy metal mercury pollution in waters has been conducted. This study used an observational design with an Environmental Risk Analysis approach with the objective of knowing the concentration of mercury (Hg) heavy metals and the risk of metal contamination in marine sediments. Sediment sampling was conducted at 10 points in 5 (five) urban villages of Makassar City. The results showed that the highest mercury concentration was in Cambayya Village at 1.871 mg / kg and the lowest mercury concentration was in Lae-Lae Island Kelurahan at 1,550 mg / kg. In general, the content of heavy metals mercury in marine sediments in coastal areas of Makassar City has exceeded the threshold of 0.13 mg / kg with the enormous environmental risk occurring in coastal areas of Makassar City due to exposure to mercury metals, ranging from 11-22 under the risk category high HQ> 10.Keywords : Risk Analysis, Sea Sediments, Mercury
Legal Aspects Occupational Safety and Health of the Work Force in the Bussiness Of Dinamis Abadi City Of Palu
Authors: Chairin Noor Andi Reza Alief , Andri Mohamad , Yani Ahmad , Sudirman Sudirman
Published: July 2018

Protection of Occupational Safety and Health given to workers is a preventive effort to prevent work accidents and occupational diseases. Occupational Safety and Health must be contained in the employment agreement, because Occupational Safety and Health is the normative right of the worker to be provided by the company. Research type using descriptive qualitative method. The results in this study are Occupational Safety and Health is important because it is closely related to the performance of employees and in turn affect the performance of the company. in fact there are companies that have not provided proper safety and health protection. In this study found the following problems: First, how the agreement is regulated in the legislation in Indonesia. Second, how the legal protection of Occupational Safety and Health according to the laws and regulations in Indonesia. Third, How to protect the law in the implementation of Occupational Safety and Health in UD. Dynamic Eternal.Keywords : Occupational Health and Safety, Health Law
Relationship Of Family Support With Quality of Life (QOL) Stroke Occurrence
Authors: Hamalding Hermawati , Muharwati Muharwati
Published: July 2018

World Health Organization (WHO) states that the clinical signs that develop rapidly due to focal or global brain function disorders due to a blockage or rupture of blood vessels in the brain that lasted for 24 hours or more.This study aims to determine the Family Support Relationship With Quality of Life on Stroke Occurrence at Poly Nerve General Hospital of Makassar Hajj Area 2017. The research design was observational with cross sectional approach. Sample amounted to 54 by using simple random sampling technique. The result of the research was obtained by informational support with x2 count (4,352)> x2 table (3,841), emotional support p value (0,751)> 0,05, instrumental support with p value (0,346)> 0,05, award support with value x2 count (5,178)> x2 table (3,841). Based on the results of the study, the conclusion of this study found that there is a relationship of informational support and awards support, While emotional support and instrumental support is not associated with Quality of Life stroke incidence. This study suggests to families to provide more support to patients so as to improve the quality of life.Keywords           : Family Support and Quality of Life (QOL)
THE FACTORS RELATED TO THE APPLICATION OF CONTRACEPTION METHOD OF WOMEN OPERATION (MOW)
Authors: Rahman Zulfajri , Kunoli Firdaus J , Amalinda Finta
Published: July 2018

Based on the data of Family Planning Field Officer in South Palu sub district in 2014, 10,138 women of childbearing age (WUS) were women aged ≥ 35 years old using women's method of contraception (MOW) as many as 439 women of childbearing age. The purpose of this study is to determine the factors associated with the use of contraceptive methods of women's surgery (MOW) in Kecamatan Palu Selatan. The design of this study is an analytical survey of cross sectional study approach. The population in this study were fertile couples aged ≥ 35 years amounted to 99 respondents. The analysis used in this research is univariate and bivariate analysis with chi-square test. The results of this study indicate that there is no correlation between knowledge with use of contraception method of operation of woman (MOW) with value p = 0,981 (p = 0,05), there is no correlation between education with use of contraception method operation woman (MOW) with value p = 0.604 (p = 0.05), there was a relationship between husband support and contraceptive use of female operation method (MOW) with p = 0,009 (p = 0,05). This research suggests that people can know and understand the usefulness in the use of contraceptive methods of women's surgery (MOW).Keywords              : Contraception, application of contraception Mow, method of women operation
HUBUNGAN PERILAKU HIDUP BERSIH DAN SEHAT (PHBS) DENGAN KEJADIAN DIARE PADA BALITA
Authors: Irianty Hilda , Hayati Ridha , Riza Yeni
Published: July 2018

Diare merupakan masalah kesehatan masyarakat dengan angka kesakitan dan kematian yang tinggi, terutama pada kalangan balita. Penelitian ini bertujuan untuk mengetahui hubungan perilaku hidup bersih dan sehat dengan kejadian diare pada balita. Penelitian ini adalah penelitian survey analitik dengan rancangan cross sectional serta analisis chi square. Penelitian dilakukan di wilayah kerja Puskesmas Martapura Barat dengan jumlah sampel 76 responden ibu yang memiliki balita. Hasil penelitian ada hubungan antara pemberian ASI eksklusif dengan kejadian diare (P value 0.000 < α= 0.05). tidak ada hubungan antara penimbangan balita dengan kejadian diare (P value 0.293 > α= 0.05). Ada hubungan antara penggunaan air bersih dengan kejadian diare (P value 0.026 < α= 0.05). Ada hubungan antara penggunaan jamban sehat dengan kejadian diare (P value 0.049 < α= 0.05). Ada hubungan antara perilaku cuci tangan pakai sabun dengan kejadian diare (P value 0.001 < α= 0.05). Perilaku hidup bersih dan sehat belum sepenuhnya diterapkan dengan baik di wilayah kerja Puskesmas Martapura Barat, hal ini dapat menyebabkan kejadian diare pada balita. Perlu adanya peningkatan program promosi kesehatan dari Puskesmas Martapura Barat, terutama tentang penerapan PHBS yang baik dan benar.
FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN PENGGUNAAN ALAT PELINDUNG DIRI PADA PETANI PENGGUNA PESTISIDA
Authors: Hayati Ridha , Kasman Kasman , Jannah Raudatul
Published: July 2018

Alat pelindung diri merupakan salah satu cara yang dapat digunakan tenaga kerja untuk melindungi sebagian atau seluruh tubuhnya dari adanya potensi bahaya atau kecelakaan kerja. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan penggunaan alat pelindung diri pada petani pengguna pestisida di desa Candi Laras. Metode penelitian yang digunakan adalah penelitian observasional analitik, dengan pendekatan cross sectional. Populasi dalam penelitian ini adalah seluruh petani yang ada di Desa Candi Laras yang berjumlah 378 orang dengan jumlah sampel sebanyak 80 orang. Data dianalisis dengan uji chi square. Teknik pengambilan sampel accidental sampling. Instrumen yang digunakan dalam penelitian adalah kuesioner. Hasil penelitian menunjukkan 85% pengetahuan petani baik, 96,25% sikap petani positif, 58,75% status ekonomi petani rendah, 77,5% masa kerja lama > 3 tahun dan 37,5% petani menggunakan alat pelindung diri. Hasil analisis bivariat menunjukkan bahwa tidak ada hubungan antara pengetahuan dengan penggunaan alat pelindung diri (p=0,194), tidak ada hubungan antara sikap dengan penggunaan alat pelindung diri (p=0,288), ada hubungan antara status ekonomi dengan penggunaan alat pelindung diri (p=0,002), dan tidak ada hubungan antara masa kerja dengan penggunaan alat pelindung diri (p=0,678). Petani hendaknya selalu menggunakan alat pelindung diri secara lengkap, perlu adanya penyuluhan/pelatihan kepada petani tentang manfaat dari penggunaan alat pelindung diri dan bahaya yang dapat ditimbulkan akibat tidak menggunakan alat pelindung diri.
ANALISIS MANAJEMEN PENCEGAHAN DAN PENANGGULANGAN KEBAKARAN DI PUSKESMAS KECAMATAN CIPAYUNG JAKARTA TIMUR
Authors: Saputra Nazarwin , Saputri Winda Cinkarila
Published: July 2018

Kebakaran merupakan suatu peristiwa atau kejadian yang sangat merugikan semua pihak.  Dalam menjamin dan menjaga keselamatan hidup pasien, pegawai dan pengunjung. Upaya pencegahan dan penanggulangan tersebut bertujuan untuk mengantisipasi secara dini terhadap bahaya kebakaran sehingga tercipta lingkungan kerja yang selamat, bersih, nyaman, dan bebas dari sumber sumber bahaya kebakaran. Data diperoleh secara langsung dengan cara observasi langsung dan wawancara dengan pihak terkait serta  studi pustaka. Hasil penelitian ini adalah upaya-upaya yang telah dilakukan untuk pencegahan dan penanggulangan terhadap bahaya kebakaran di Puskesmas Kecamatan Cipayung diketahui bahwa Puskesmas Kecamatan Cipayung telah menyediakan sarana untuk pemadam kebakaran seperti APAR, tim pemadam dan usaha- usaha lain seperti pemasangan fire alarm system, tanda peringatan dan tersedianya assembly point. Penelitian ini menyimpulkan bahwa Puskesmas Kecamatan Cipayung telah melaksanakan upaya pencegahan dan penanggulangan kebakaran antara lain dengan penyediaan sarana pemadam kebakaran seperti APAR, tim pemadam dan usaha-usaha lain seperti pemasangan fire alarm system, tanda peringatan dan tersedianya assembly point.  Saran yang dapat diberikan adalah untuk penambahan pemasangan dan penempatan poster atau papan peringatan, penambahan sarana pemadam kebakaran seperti water sprinkle dan hydrant, peningkatan wawasan dan ketegasan terhadap peraturan-peraturan yang ada dan peningkatan pelatihan mengenai pencegahan dan penanggulangan kebakaran kepada karyawan.
FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEHAMILAN TIDAK DIINGINKAN DI INDONESIA
Authors: Anggraini Kirana , Wratsangka Raditya , Bantas Krisnawati , Fikawati Sandra
Published: July 2018

Kehamilan tidak diinginkan merupakan masalah global, dan menyumbang 700.000 kematian ibu setiap tahunnya.  Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan kehamilan tidak diinginkan di  Indonesia. Desain studi adalah potong lintang, dengan responden sebanyak 13.955 perempuan berusia 15-49 tahun, yang melahirkan anak terakhir dalam 5 tahun sebelum survei. Penelitian ini menggunakan data sekunder, dari Survei Demografi Kesehatan Indonesia (SDKI) tahun 2012.  Uji analisis yang digunakan adalah uji kai kuadrat (bivariat) dan regresi logistik ganda (multivariat).  Hasil studi menunjukkan prevalensi ibu yang mengalami kehamilan tidak diinginkan di Indonesia sebanyak 8%, dengan prevalensi tertinggi terdapat di provinsi Sulawesi Tengah (11,9%) dan terendah di  Papua (2.9%).  Pada analisis bivariat didapatkan hubungan yang bermakna antara tingkat ekonomi, tingkat pendidikan, wilayah tempat tinggal, status pernikahan, paritas, jarak kelahiran, usia dengan kehamilan tidak diinginkan dengan nilai p< 0,25.  Pada analisis multivariat, variabel status pernikahan berhubungan signifikan dengan kehamilan tidak diinginkan setelah dikontrol dengan variabel tingkat ekonomi, tingkat pendidikan, wilayah tempat tinggal, paritas, jarak kelahiran dan usia.  Disimpulkan faktor status pernikahan merupakan faktor paling dominan yang berhubungan dengan kehamilan tidak diinginkan. Penemuan ini diharapkan dapat menjadi masukan bagi pemerintah untuk meningkatkan pengetahuan dan partisipasi masyarakat tentang program Keluarga Berencana.
KANGAROO MOTHER CARE PADA BAYI BERAT LAHIR RENDAH : SISTEMATIK REVIEW
Authors: Solehati Tetti , Kosasih Cecep Eli , Rais Yulia , Fithriyah Noor , Darmayanti Darmayanti , Puspitasari Neneng Ratnanengsih
Published: July 2018

Masa bayi merupakan masa pertama dalam fase kehidupan seseorang, dimana pada masa ini memerlukan adaptasi terhadap lingkungan. Bayi Berat Lahir Rendah adalah bayi baru lahir yang memiliki berat saat lahir kurang dari 2500 gram. Prevalensi BBLR diperkirakan 15% dari seluruh kelahiran di dunia dan lebih sering terjadi di negara berkembang atau dengan sosio ekonomi rendah. Angka kematian BBLR 35x lebih tinggi di banding pada bayi dengan berat lahir lebih dari 2500 gram. untuk mensistensis penelitian-penelitian secara empiris sehingga dapat mengidentifikasi perawatan dengan metode kangaroo mother care pada BBLR. Sistematik review ini dilakukan melaui tahapan : membuat pertanyaan penelitian, mencari sumber data dan ektraksi serta seleksi artikel. Pencarian artikel menggunakan database elektronik yaitu google scholar, Pub Med, SINTA, Kandaga, Nejm, Science Direct dengan kata kunci yang digunakan dalam bahasa Indonesia dan bahasa inggris adalah “BBLR” atau “Low birth weight”, “Kangaroo Mother Care (KMC)”. Kriteria inklusi artikel yang diambil yaitu yang diplubikasikan full text, dalam rentang waktu 2014-2018, jenis penelitian kuantitatif, kriteria peneliti minimal S1 Keperawatan, artikel yang memiliki konten utama intervensi Kangaroo Mother Care untuk perawatan BBLR. Hasil pencarian ditemukan 1.625 artikel pada Google Scholar 201 artikel, NEJM 12 artikel, Pub Med 633 Artikel, dan Science Direct 779 artikel. Setelah disesuaikan dengan kriteria inklusi maka artikel yang tersisa sebanyak 8 artikel. KMC dalam perawatan BBLR berpengaruh signifikan terhadap peningkatan respon fisiologis BBLR. Disarankan KMC sebagai terapi untuk perawatan BBLR  yang dapat dilakukan oleh ibu secara langsung, tanpa biaya dengan pemberian pendidikan kesehatan oleh tenaga kesehatan terlebih dahulu.
Murmurations
Authors: Cheville R. Alan
Published: July 2018

Point of view: I am a cisgender white male in my mid-fifties. I have spent most of my life in higher education in engineering departments. My experiences have included undergraduate and graduate education at a private, research-intensive institution, postdoc and faculty at a land-grant institution, serving for several years as a program officer at the National Science Foundation (NSF), and most recently as chair of the Electrical and Computer Engineering department at a private, liberal arts, predominantly undergraduate institution. This article draws on all these experiences, but particularly from my time serving at NSF and in the years since. I am also one of the founders of Murmurations: Equity, Emergence, and Education and represent my own perspective on what I hope this experimental journal can contribute to the larger education ecosystem.

Value: This article outlines my rationale in partnering with others to start a dialogue journal. I believe education is one of the best ways to address systemic inequities, but education systems in the US seem to be increasingly subject to criticism that they are unable to change and promote equity. This article hypothesizes that resistance to change is structurally built into the system through the mental models held by the system’s participants. These models can be broadly classified as oriented towards identifying problems rather than proposing solutions. While such approaches work in simple systems, they often backfire in complex systems that have multiple and often competing impacts. For meaningful change to occur we ourselves must seek to expand our perspectives and change our mental model of education to one of a complex ecosystem. Changing mental models is hypothesized to occur by engaging in meaningful dialogues with others who have experiences different than our own. By providing a forum for these conversations my hope is that Murmurations will serve as a vehicle to share perspectives from different niches within the larger ecosystem, which in turn can shift mental models. Since Murmurations is an experiment, an additional intent is to encourage voices from across the education ecosystem to make contributions.
What is engineering?
Authors: Chua Mel
Published: July 2018

Point of view:  I'm a contagiously enthusiastic hacker, scholar, and teacher with an industry background in Free and Open Source Software (FOSS) communities. As a teenager at the Illinois Math and Science Academy, I loved storytelling and cinematography and wanted to major in the arts. That wasn't an option for my family of immigrants, so I took up electrical and computer engineering at Olin College (BS), where I arrived thinking that a breadboard was for baking (it's for electronics). I am Deaf and have always been a strong visual thinker; this piece was written and drawn during my first semester as a PhD student in engineering education at Purdue University. I’m intrigued by how multiple interacting curricular cultures in higher education can deconstruct our notions of engineering, education, and just about everything else.

Value: This work is a playful contribution to engineering education ontologies (as a subset of philosophy), which explores questions of reality and being - what "is." It challenges the high consensus culture of engineering, especially the tendency to seek clearly defined and fixed meanings for terms. In this case, the notion of "engineering" itself is called into question. It also explores what graphical/non-textual scholarship in and about higher education might look like.

Summary:  This graphic essay was made when I was a first-semester engineering education graduate student. This past self was naive regarding "scholarly" and "academic" writing conventions, and frustrated both by the limitations of text as a standalone medium and the engineering disciplinary tendency to seek clearly defined and fixed meanings for terms rather than exploring their possibilities. I am now a slightly more seasoned scholar seven years down the line with a desire to engage in discussion and revision of the piece.

Note to readers:  This document consists of a comic submission which is meant to be experienced visually: What is Engineering?. Each page of the comic is presented separately here, followed by text descriptions for that page. Text descriptions are provided for acces.
Systematic Review: An Update on the Spectrum of Urological Malignancies in Lynch Syndrome
Authors: Huang Dora , Matin Surena F. , Lawrentschuk Nathan , Roupret Morgan
Published: July 2018

Background:

Lynch syndrome is an autosomal dominant disorder that predisposes individuals affected to certain malignancies. Colon and endometrial cancers are the malignancies most highly associated with Lynch syndrome. However, growing body of evidence links Lynch syndrome to urological cancers.

Objective:

This review aims to clarify the type of urological malignancies that fall under the Lynch-associated cancer spectrum.

Methods:

Using PRISMA guidelines, a systematic search between January 1990 to February 2018, was conducted using the MEDLINE database with the application of the following MESH terms: colorectal neoplasms, hereditary nonpolyposis; DNA mismatch repair; urologic neoplasms; kidney pelvis; ureteral neoplasms; urinary bladder; carcinoma, transitional cell; prostatic neoplasms; testicular neoplasms.

Results:

Upper tract urothelial cancers are well established under the Lynch spectrum. Increasing evidence supports its association with prostate cancer. However, there is, inconclusive and limited evidence for an association with bladder and testicular cancer.

Conclusions:

The evidence underpinning certain urological malignancies associated with Lynch syndrome has expanded in recent years. Our review may assist in providing a summary of the current standing in literature. However, we recommend further investigations to better clarify associations, particularly with prostate, bladder and testicular cancer.
Clinico-laboratory Profile of Enteric Fever and Antibiotic Sensitivity Pattern in Hospitalized Children
Authors: Rahat Farhana , Ghosh NK , Iman Kazi , Khanam Morsheda , Sultana Azmeri , Haque Md Fazlul
Published: July 2018

Background: Enteric fever is endemic in Bangladesh. This is an important cause of morbidity and mortality in developing countries. The aim of the study was to evaluate the clinical and laboratory profiles, culture positivity rate and sensitivity pattern of Salmonella enterica.Methodology: This was an observational study carried out in a tertiary care hospital in Dhaka, Bangladesh during the period from January to December, 2017. Total 120 children who had enteric fever diagnosed either by positive blood culture or widal test with significant titre for Salmonella Typhi or Paratyphi were enrolled in the study.Results: Fever and abdominal pain were the main presenting symptoms. Leucocyte and platelet count were normal whereas ALT and CRP found to be elevated. Culture positivity rate in our study was 43.33%. Of the culture positive isolates, 88.46% were Salmonella Typhi and 11.53% were Salmonella Paratyphi. All the isolates were sensitive to third and fourth generation cephalosporins while 79.54% showed intermediate sensitivity to ciprofloxacin.Conclusion: A good sensitivity to third and fourth generation cephalosporins against Salmonella was noted whereas ciprofloxacin found to be less sensitive. Ceftriaxone showed remarkable efficacy when used as monotherapy.Bangladesh J Child Health 2018; VOL 42(2) :54-57
Effectiveness of Light Emitting Diodes (LED) versus Conventional Phototherapy for Neonatal Jaundice
Authors: Rouf MA , Khairuzzaman Md , Ferdous Nur E Nazni , Mowla Md Golam
Published: July 2018

Background: Phototherapy is crucially an important aspect for the management of most neonatal jaundice. Neonates are prone to develop bilirubin encephalopathy (kernicterus). LED phototherapy is a new option of managing neonatal jaundice. The objective of this study is to compare the efficacy and safety of LEDs with fluorescent phototherapy in the treatment of indirect hyperbilirubinemia.Method: The study was Experimental research design, prospective study. The Study was conducted at Neonatal unit of Shaheed Suhrawardy Medical College Hospital, Dhaka. Total sample size of the study was one hundred neonates. Fifty for conventional phototherapy and fifty for LED phototherapy. Purposive sampling method was used for the study. The data collection tool of the study was pretested structured questionnaire. The modes of presentation, the clinical examination and investigation findings at admission and during daily follow up were recorded for individual patient.Result: The rate of fall of S. bilirubin was more in those neonates who have had LED phototherapy. As a result, duration of phototherapy as well as hospital stay was less in LED group. Furthermore, higher number of neonates developed rashes in LED group than in conventional group with statistically significant difference. Of course, variables regarding other adverse events did not show any statistically significant difference between two groups.Conclusion: Management of neonatal jaundice may be more effective in LED phototherapy than conventional phototherapy. LED device require shorter duration of phototherapy, thus, shorter hospital stay.Bangladesh J Child Health 2018; VOL 42 (2) :62-66
Randomized Controlled Trial between Levetiracetam and Phenobarbital in the Treatment of Neonatal Seizure due to Perinatal Asphyxia
Authors: Md Pervez Abu Faisal , Badal Md Fakhrul Amin , Nabi SM Nurun , Shabuj Mohammad Kamrul Hassan , Dey Sanjoy Kumer , Mannan MA , Shahidullah Mohammod
Published: July 2018

Background: Seizure occurs more frequently in neonatal period and incidence of seizure is 50%-68% in perinatal asphyxia. At present phenobarbital is the drug of choice for treating neonatal seizure, which has some adverse effects on neurodevelopment status. Levetiracetam is a novel antiepileptic agent well-tolerated and effective in focal, generalized and neonatal seizure as well and lacks the adverse effects like phenobarbital. The present study was undertaken to compare the safety and efficacy of levetiracetam to phenobarbital in the treatment of neonatal seizure due to perinatal asphyxia.Methodology: This interventional study (Randomized Controlled Trial) was conducted in Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka and Dhaka Medical College Hospital, Dhaka, Bangladesh from 1st January’ 2014 to 30th June’ 2015. Intravenous levetiracetam injection, 50 mg/kg loading followed by 10 mg/kg 8 hourly maintenance was used and phenobarbital intravenous 20-40 mg/kg loading and 2.5 mg/kg/dose 12 hourly maintenance was given as per institutional protocol.Results: Sixty-nine term asphyxiated neonates (intention to treat population) provided analyzable data. Seizure control was found significantly higher (p = 0.011) higher in levetiracetam group in comparison to phenobarbital group (71% vs 40%). Need for more than one drug was significantly lower in levetiracetan group (p=0.011). Adverse effects were found significantly (p=0.001) lower in levetiracetam group (9% vs 43%). No serious adverse effect was observed in any group and most common adverse effect was somnolence in both group followed by irritability. Restlessness, sedation and shallow breathing were found only in phenobarbital group.Conclusion: Levetiracetam is more effective and safe in comparison to phenobarbital in the treatment of neonatal seizure due to perinatal asphyxia.Bangladesh J Child Health 2018; VOL 42 (2) :67-72
Successful Separation of Conjoined Twins: Experience of a Tertiary Care Hospital
Authors: Islam Shahnoor , Masud Sadruddin Al , Chawdhary Nazmul Haider , Hossain M Mozaffar , Alam SM Shafiqul , Kalam M Abul , Sarkar Asit Chandra , Huq M Raziul , Shamsuzzaman M , Morshed AKM Amirul , Rupa Sharmin Akhtar
Published: July 2018

Background: The separation of conjoined twins presents a unique challenge to many pediatric surgical specialties. Meticulous preoperative investigations, planning and multidisciplinary team approach led by pediatric surgeon contribute to the success of surgical separation. The aim of this study is to share our experiences of one hospital to enhance skill for treating conjoined twins regarding anatomic variations, investigations, surgical aspects, outcomes and rehabilitation.Methodology: All cases of symmetrical conjoined twins who were treated from July 2009 to February 2018 at the Pediatric Surgery Department of Dhaka Medical College Hospital, Dhaka, Bangladesh were included in this prospective type of study. All types of parasitic twins were excluded. Prenatal ultrasound diagnosis, gender, birth weight, anatomy of the twins, the age and weight at the time of the separation surgery, the length of surgery, the duration of anesthesia during the separation surgery, a detailed description of the separation surgery, the type of skin closure, postoperative complications and death were studied.Results: There were three sets of thoraco-omphalo-ischiopagus twins, one set of thoraco-omphalopagus twins, one set of pygopagus twins. Three sets had no prenatal visit or ultrasound evaluation. Two sets of conjoined twins were failed to separate due to the complexity of the organs that were shared by both twins and instability leading to death. Only one set of pygopagus twins was successfully separated. Emergency colostomies were done on pygopagus twins due to the presence of anorectal anomalies. The surgical survival rate was 100%. One set of twins who did not undergo separation due to refusal of treatment was currently alive. One set of twins was under evaluation and currently alive.Conclusion: The overall success of conjoined twin separation depends on the experience and preparedness of treating team led by pediatric surgeon and resources available at the hospital. No single discipline can expect to have all the necessary talents.Bangladesh J Child Health 2018; VOL 42 (2) :73-78
Pulmonary Manifestations of Primary Immunodeficiencies in Children - A Review
Authors: Kabir ARM Luthful , Roy Sudipta
Published: July 2018

Primary immunodeficiency diseases (PIDs) are inherited defects of the innate or adaptive arms of the immune system that differs from secondary immunodeficiencies. Respiratory disorders are significant causes of morbidity and the leading causes of death (30% -65%) in both children and adults with PIDs. The spectrum of respiratory manifestations is extremely wide due to PIDs. PIDs are broadly classified according to the components of the immune system that is primarily disrupted. Predominant antibody deficiency disorders are the most frequent and comprise approximately 70-75% of all PIDs. The most common clinical manifestations are infections involving the respiratory tract e.g. rhinosinusitis, otitis media, bronchitis, bronchiectasis and recurrent pneumonia (30% -65%). Recurrent respiratory infections are often the first warning sign. Timely diagnosis and appropriate therapy can improve or at least decelerate the progression of these complications. Infectious and non-infectious respiratory complications determinate the patient’s prognosis. These complications are associated with significant morbidity and mortality in PID patients. Appropriate awareness of these manifestations is essential, especially for the pulmonologist to reduce morbidity and mortality in PID patients.Bangladesh J Child Health 2018; VOL 42 (2) :86-93
Healthcare and Medical Education
Authors: Haque M Manzurul , Mahmood Iftekhar
Published: July 2018

Abstract not availableTAJ 2009; 22(1): i-ii
Role of VIA and PAP Smear in the Diagnosis of Cervical Precancers: A Study of 115 C ases
Authors: Jahan RA , Rahman F , Badruddoza SM , Nasir TA , Ahmed ANNU , Kamal M
Published: July 2018

Carcinoma of cervix is the most frequent neoplasm of female genital tract. In Bangladesh cervical cancer is the commonest malignancy of women. This high incidence of cervical cancer is attributed to the lack of screening program, particularly in the women of low socio-economic status. Invasive cervical cancer is preceded by a tong premalignant phase known as cervical intraepithelial neoplasia (CIN). The goal of cervical cancer screening is the detection and treatment of precancer before cancer develops. The aim of this study was to evaluate the test parameters using visual inspection with acetic acid (VIA) and cervical cytology in screening and early diagnosis of the precancerous lesions of cervix. This study deals with 115 cases from Gynecology Outpatient Department of Rajshahi Medical College, Rajshahi from July 2006 to June 2008. After vaginal examination Pap smear was collected, followed by VIA and punch biopsy of cervix. All the data were evaluated by standard statistical methods. The sensitivity of VIA was 94.11% while Pap smear was 64.7%. The specificity of Pap smear was 93.94% while VIA was 57.57%. These two tests may be considered as a suitable early detection technique in the developing countries where other test like HPV-DNA detection is a costly oneTAJ 2009; 22(1): 183-189
Incidence of 1-lyponatraemia in Patients with lschemic Stroke: Our Experience at RMCH
Authors: Mahmood I , Rahman MK , Khan MMR , Haque MA , Chowdhury MMH , Lqbal A , Rashid MH , Ahad MA , Kamal SM
Published: July 2018

Hyponatraemia is a common electrolyte disorder in central nervous system (CNS) disease and is often attributed to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). By contrast, there are patients with intracranial disease who develop hyponatraemia with similar characteristics, but differ in that there is clinical evidence of a contracted extracellular fluid (ECF) volume. This form of hyponatraemia is caused by excessive renal Na excretion, resulting from a centrally mediated process, and is termed cerebral salt wasting (CSW). Hyponatraemia, if acute that is developed within hours or days may cause confusion, coma restlessness or seizures. 72 patients with ischemic stroke admitted at RMCH were selected for this prospective cohort study. Among the subjects 34 (47.22%) cases were found to have hyponatraemia. The number was quite large and screening patients with stroke for electrolytes may be extremely helpful to reduce mortality and morbidity.TAJ 2009; 22(1): 212-215
Drug-lnduced Esophagitis in a Tertiary Care Hospital
Authors: Haque MA , Alim MA , Mahmood I , Chowdhury MM Hoque
Published: July 2018

Drug induced esophagitis, also known as pill-induced esophagitis or drug-induced esophageal injury, is uncommonly encountered in clinical practice. This observational study was jointly carried out by the Department of Medicine and Department of Gastroenterology, Rajshahi Medical College, from January 2005 to December 2009. Total number of patients included was 32. Patients who presented with history of odynophagia and chest pain after ingesting some medications and having endoscopic evidence of esophagitis were included in this study. Out of 32 patients 17 were female and 15 were male (F: M=1.1:1). Mean age of the patients were 36.7±8.5 years. Doxycycline was the drug most commonly associated with esophagitis, 25 cases (78.1%) had doxycycline induced esophagitis. Other drugs were tetracycline in 3 cases (9.4%), alendronate in 1 case (3.1%), ciprofloxacin in 1 case (3.1%), paracetamol in 1 case (3.1%), and naproxen in 1 case (3.1%), Increased awareness among the physicians and patient education can prevent this distressing clinical condition.TAJ 2009; 22(1): 235-238
A Study on Hypcrcalcaemia in Patients with Bronchial Carcinoma: At a Tertiary Level Hospital
Authors: Mahmood I , Rahman MK , Haque MA , Khan MMR , Chowdhury MMH , Lqbal A , Ekram ARMS , Rashid MH , Alam MJ
Published: July 2018

Bronchial carcinomas often present with some paraneoplastic features which may present even before the offending tumor has been detected. Hypercalcaemia is one of the most common paraneoplastic sypmtoms. In this prospective cohort study attempts has been made to demonstrate the incidence and pattern of hypercalcaemia in bronchial cancers. The study was undertaken at the Medicine Department of Rajshahi Medical College Hospital, Rajshahi in between July, 2009 to December 2009. In this study hypercalcaemia was found i_n 30.76% cases with anorexia, dyspepsia, nausea, polyuria, polydipsia and constipation being most common features related to it.TAJ 2009; 22(1): 245-247
A Case of Renal Cell Carcinoma (RCC) Presenting with Polycythemia and Stroke
Authors: Mahmood I , Rahman MK , Khan MM Rahman , Chowdhury MMH , Shahabuddin AKM , Basak PM , Hasan MA , Ahamed F
Published: July 2018

We report a case of middle aged man who presented with stroke with right sided weakness. Later on, routine investigations reveal erythrocytosis on complete blood count and left renal mass on USG of abdomen. Further investigations correlate the above scenario with renal cell carcinoma.TAJ 2009; 22(1): 248-250
Haemorrhagic Corpus Luteum Mimic Appendicitis
Authors: Jesmin S , Akhter R , Afroz H , Hassan M
Published: July 2018

Haemoperitoneum secondary to ruptured corpus luteum is a rare complication for women of reproductive life. The differential diagnosis of hemoperitoneum includes various of acute abdomen that usually associated with acute lower abdominal pain and swelling lower abdomen. The differential diagnosis includes ruptured ectopic pregnancy, ruptured chocolate cyst, twisted ovarian tumor, pelvic inflammatory disease and pelvic peritonitis. Ruptured hemorrhagic corpus luteum is an uncommon cause of acute abdomen. Its occurrence is unknown but is likely quite frequent and without symptoms. Most cases are self-limiting; enquire only observation with abdominal pain relieved with analgesics. Some need laparoscopy or laparotomy to achieve homeostasis if the patient is haemodynamically unstable.TAJ 2009; 22(1): 276-278
Psoriasis- its Presentation and Modalities of Management
Authors: Hossain MM , Mahmood I , Newaz MS
Published: July 2018

Psoriasis is common (with 2% prevalence) chronic inflammatory papulosquamous disorder  of the skin and nails with or- without the joint involvement .The exact cause is still illusive but the disorder has distinct genetic predisposition with some environmental factors triggering the clinical expression and the immunological aberration playing a pathogenic role. Psoriasis is not contagious but can be inherited. Psoriasis needs long-term treatment. The different modalities of management are self-care at home, medical treatment, phototherapy using UV-8 in the Goeckermanregimen and Ingram method and PUV-A therapy may be given according to the types of psoriasis and facilities available.TAJ 2009; 22(1): 298-301
Diagnosis and Management Update of Hemoptysis
Authors: Rahman MK , Rashid MH , Khan MMR , Tarik H , Chowdhury MMH , Alim MA , Mahmood I , Ekram ARMS
Published: July 2018

Hemoptysis is defined as the spitting of blood derived from the lungs or bronchial tubes as a result of pulmonary or ' bronchial hemorrhage1. Hemoptysis is classified as non-massive or massive based on the volume of blood loss; however, there are no uniform definitions for these categories. In this article, hemoptysis is considered non-massive if blood loss is less than 200 ml per day. The lungs receive blood from the pulmonary and bronchial arterial systems. The low-pressure pulmonary system tends to produce small-volume hemoptysis, whereas bleeding from the bronchial system, which is at systemic pressure, tends to be pro fuse.TAJ 2009; 22(1): 324-329
Hepatitis E Vaccine: Present and Future
Authors: Rashid MH , Alim MA , Rahman MK , Chowdhary MM Hoque , Khan MM Rahman , Mahmood I , Ekram ARMS
Published: July 2018

Viral hepatitis is a major public health problem in the world, and it can be caused by blood- and food-borne viruses. Blood-borne 'hepatitis agents are HBV, HCV and HDV, whereas HAV and HEV are food-borne hepatitis viruses. HEV infection is an important infectious agent in developing countries, but it is also an emerging disease in developed countries, which is likely due to travel or immigration from endemic areas. The main route of human HEV transmission is fecal-oral (fecally contaminated water), although other routes were also reported such as person-to-person transmission, blood products, mother-to-child transmission and zoonotic transmission (e.g., by pigs, particularly in developed countries, and seafood. Epidemiologically, only one serotype of HEV exists in the world, Genetically , the virus has been classified  into four genotypes  and several subgenotypes  designated  1 (1a-e), 2 (2a and b), 3 (3a­j) and 4 (4a-g). Each genotype shows a distinct geographical distrib ution. Genotype 1 of HEV is reported from developing countries in Asia and Africa; genotype 2 has been detected in some countries in Africa as well as in Mexico; genotype 3 is distributed globally and genotype 4 of HEV is only found in Asian countries. The genotypes may not only vary with respect to their geographical distribution, but also in their pathogenicity. Genotypes 1 and 2 are primarily human pathogens, causing acute hepatitis in young, nonimmunocompromised people; genotypes 3 and 4, however, have been found in swine and other animals and could therefore be responsible for zoonotic transmissions, preferentially in the elderly or in immunocompromised patients.TAJ 2009; 22(1): 330-336
Survival and Kidney Transplant Incidence on Home versus In-Center Hemodialysis, following Peritoneal Dialysis Technique Failure
Authors: Kansal Sheru K. , Morfin Jose A. , Weinhandl Eric D.
Published: July 2018

Background

Peritoneal dialysis (PD) technique failure is often accompanied by complications that increase risks of hospitalization and death. Planned transition to hemodialysis may improve outcomes. Transitioning patients from PD to home hemodialysis (HHD) may improve continuity of lifestyle and facilitate delivery of more frequent treatment.

Methods

We analyzed United States Renal Data System (USRDS) data to compare the incidence of death and kidney transplant in patients who transferred from PD to HHD and matched patients who transferred from PD to in-center HD (IHD). We used Fine-Gray regression to estimate hazard ratios (HRs) of death and transplant for HHD versus IHD.

Results

We identified 521 patients who transferred from PD to HHD. Survival in HHD patients was 89.1% at 1 year and 80.5% at 2 years. In intention-to-treat analysis, the HR of death for HHD versus matched IHD patients was 0.76 (95% confidence interval [CI] 0.65 – 0.90). In subsets of non-Medicare and Medicare patients, corresponding HRs were 0.57 (95% CI 0.43 – 0.75) and 0.92 (95% CI 0.75 – 1.13), respectively. Kidney transplant incidence in HHD patients was 10.6% at 1 year and 21.0% at 2 years. In modified intention-to-treat analysis, the HR of transplant for HHD versus matched IHD patients was 1.36 (1.14 – 1.61).

Conclusions

Transfer to HHD after PD technique failure was rare, but associated with lower risk of death and higher incidence of transplant than transfer to IHD. Heterogeneity in relative risks by Medicare coverage suggests uncertainty about the magnitude of benefit. Still, these data suggest that clinical outcomes after PD technique failure can be improved.
Peritoneal Infections in Children Undergoing Acute Peritoneal Dialysis at a Tertiary/Quaternary Central Hospital in Kwazulu-Natal, South Africa
Authors: Nepfumbada Mulalo , Naicker Elaene , Bhimma Rajendra
Published: July 2018

Background

In a resource-limited setting, acute peritoneal dialysis (APD) is the modality of choice as a form of renal replacement therapy in children with acute kidney injury (AKI). However, there is a high risk of peritonitis that causes significant morbidity and mortality. Data on PD and peritonitis in developing countries are scarce. The purpose of this retrospective study was to determine the prevalence of APD-related peritonitis at a central referral hospital in KwaZulu-Natal, South Africa.

Methods

A retrospective study from January 2010 until December 2014 was done at Inkosi Albert Luthuli Central Hospital (IALCH). All children under the age of 13 years with AKI requiring APD were included in the study.

Results

Forty children were included in the study. Age ranged from 0.2 years to 12.25 years; 25 (62.5%) were male and 15 (37.5%) female. Twenty-seven (67.5%) were admitted to the intensive care unit (ICU) and 13 (32.5%) to the pediatric high care ward. Septicemia with multi-organ dysfunction was the was the main cause of AKI requiring APD in 18 (45%) children followed by poststreptococcal glomerulonephritis in 8 (20%). Acute PD was complicated by culture-proven peritonitis in 19 (47.5%) children of whom 16 (84.2%) had a single organism cultured while in 3, (15.7%) there was a mixed culture. The total number of organisms cultured was 24: 8 (33.3%) were gram-positive organisms, 12 (50%) gram-negative organisms, and 4 (16.67%) fungal. The Paediatric Index of Mortality (PIM) 2 Score risk of mortality was 99.4% for patients admitted to ICU. Mortality rate was 65%, and 14 (53%) of the children who demised had peritonitis.

Conclusion

This study showed an inordinately high complication rate of peritonitis, mostly secondary to gram-negative organisms, of children undergoing APD in a central referral hospital. The use of surgically placed, tunneled catheters, meticulous attention to aseptic techniques and judicious use of antimicrobials is highly recommended in reducing the incidence of peritonitis in children undergoing APD.
BANYAN. XIII. A First Look at Nearby Young Associations with Gaia Data Release 2
Authors: Gagné Jonathan , Faherty Jacqueline K.
Published: July 2018

In this paper, we examine the nearest 100 pc entries in Data Release 2 of Gaia to identify previously unrecognized candidate members in young associations. We analyze 695 952 stars with the BANYAN Σ Bayesian classification software and discover 898 new high-likelihood candidate members that span a wide range of properties, from spectral types B9 to L2, including 104 comoving systems, 111 brown dwarfs, and 31 new bona fide members. Our sample is mostly composed of highly active M dwarfs and will be crucial in examining the low-mass end of the initial mass function of young associations. Our sample includes new candidate members near the Galactic plane where previous surveys suffered from a high rate of contamination. This paper represents the first step toward a full reassessment of young associations in the solar neighborhood with the second data release of the Gaia mission.
The Quest for the Inflationary Spectral Runnings in the Presence of Systematic Errors
Authors: Li Xiaolei , Weaverdyck Noah , Adhikari Saroj , Huterer Dragan , Muir Jessica , Wu Hao-Yi
Published: July 2018

Cosmological inflation predicts that the scalar spectral index “runs” with scale. Constraints on the values of the spectral runnings,

and

, therefore provide a fundamental test of the physics of inflation. Here, we study the feasibility of measuring the runnings when information from upcoming large-volume galaxy surveys is used to supplement the information provided by a cosmic microwave background (CMB)-S4 experiment, particularly focusing on the effect of including high-k, nonlinear scales. Since these measurements will be sensitive to modeling uncertainties for the nonlinear power spectrum, we examine how three different ways of parameterizing those systematics—introducing zero, two, or several hundred nuisance parameters—affect constraints and protect against parameter biases. Considering statistical errors alone, we find that including strongly nonlinear scales can substantially tighten constraints. However, these constraints weaken to levels not much better than those from a CMB-S4 experiment alone when we limit our analysis to scales where estimates are not strongly affected by systematic biases. Given these considerations, near-future large-scale structure (LSS) surveys are unlikely to add much information to the CMB-S4 measurement of the first running α

s
. There is more potential for improvement for the second running, β

s
, for which LSS information will allow constraints to be improved by a factor of 3–4 relative to using the CMB alone. Though these constraints are still above the value predicted by slow-roll inflation, they do probe regions of parameter space relevant to nonstandard inflationary models with large runnings, for example, those that can generate an appreciable abundance of primordial black holes.
Evidence of Environmental Quenching at Redshift z ≈ 2
Authors: Ji Zhiyuan , Giavalisco Mauro , Williams Christina C. , Faber Sandra M. , Ferguson Henry C. , Guo Yicheng , Liu Teng , Lee Bomee
Published: July 2018

We report evidence of environmental quenching among galaxies at redshifts of ≈2, namely the probability that a galaxy quenches its star formation activity is enhanced in the regions of space in proximity of other quenched, more massive galaxies. The effect is observed as strong clustering of quiescent galaxies around quiescent galaxies on angular scales of θ ≤ 20 arcsec, corresponding to a proper (comoving) scale of 168 (502) kpc at z = 2. The effect is observed only for quiescent galaxies around other quiescent galaxies; the probability to find star-forming galaxies around quiescent or around star-forming ones is consistent with the clustering strength of galaxies of the same mass and at the same redshift, as observed in dedicated studies of galaxy clustering. The effect is mass dependent in the sense that the quenching probability is stronger for galaxies of smaller masses (M
* < 1010
M
☉) than for more massive ones, i.e., it follows the opposite trend with mass relative to gravitational galaxy clustering. The spatial scale where the effect is observed suggests that these environments are massive halos, in which case the observed effect would likely be satellite quenching. The effect is also redshift dependent in that the clustering strength of quiescent galaxies around other quiescent galaxies at

z

¯

=
1.6

is ≈1.7× larger than that of the galaxies with the same stellar mass at

z

¯

=
2.6

. This redshift dependence allows for a crude estimate of the timescale of environmental quenching of low-mass galaxies, which is in the range of 1.5 ∼ 4 Gyr, in broad agreement with other estimates and with our ideas on satellite quenching.