bluuebunny/crossref_metadata_2025 huggingface dataset:
Pengembangan Lembar Kerja Siswa Matematika Berbasis Penemuan Terbimbing Untuk Siswa Kelas VII Sekolah Menengah Pertama Pada Materi Segiempat
Authors: Fitriani Veta , Eka Afri Lusi
Published: January 2021

This study aims to produce valid guided discovery-based math worksheets on rectangular material. This type of research is development research. This research consists of three stages of development, definition, design, and development. This study's subjects were class VII students of SMP Negeri 3 Rambah Hilir in the second semester of the 2019/ 2020 school year. The instrument used in this study was a validation questionnaire sheet. Discovery-based worksheets guide the results of this study. Based on the validity test of the guided discovery-based student worksheet carried out on three validators with several revisions and improvements, the average score of the guided discovery-based student worksheet validation was 3.73 with a very valid category. So it can be concluded that guided discovery-based worksheets are very valid.
enerapan Model Problem Based Learning (PBL) Untuk Meningkatkan Hasil Belajar Matematika Peserta Didik Kelas VII-A SMP Negeri 40 Pekanbaru
Authors: Dwi Junita Resti , Solfitri Titi , Nur Siregar Syarifah
Published: January 2021

Penelitian ini bertujuan untuk memperbaiki proses pembelajaran dan meningkatkan hasil belajar matematika peserta didik melalui penerapan model problem based learning (PBL). Penelitian ini merupakan penelitian tindakan kelas yang terdiri dari dua siklus, setiap siklus terdiri dari 3 pertemuan dan 1 kali ulangan harian. Instrumen penelitian yang digunakan adalah perangkat pembelajaran yang terdiri dari Silabus, Rencana Pelaksanaan Pembelajaran (RPP) dan Lembar Kerja Peserta Didik (LKPD) serta instrumen pengumpul data yaitu lembar pengamatan dan tes hasil belajar matematika. Teknik pengumpulan data adalah teknik pengamatan dan teknik tes. Lembar pengamatan dianalisis secara deskriptif naratif, sedangkan tes hasil belajar dianalisis secara statistik deskriptif. Subjek penelitian adalah peserta didik kelas VII-A SMP Negeri 40 Pekanbaru tahun pelajaran 2019/2020 yang terdiri dari 39 peserta didik. Berdasarkan analisis data kualitatif disimpulkan bahwa terjadi perbaikan proses pembelajaran setelah menerapkan model PBL, yaitu peserta didik terlihat berpartisipasi aktif dan semakin mandiri dalam proses pembelajaran, mempresentasikan hasil penyelesaian masalah dan memberikan kesimpulan pembelajaran. Pada analisis data kuantitatif, persentase jumlah peserta didik yang mencapai KKM kompetensi pengetahuan pada skor dasar yaitu 12,82% meningkat menjadi 46,15% pada siklus pertama dan meningkat menjadi 66,67% pada siklus kedua. Pada kompetensi keterampilan, persentase jumlah peserta didik yang mencapai KKM pada siklus pertama yaitu 33,33% meningkat menjadi 56,41% pada siklus kedua. Berdasarkan hasil penelitian dapat disimpulkan bahwa penerapan model Problem Based Learning dapat memperbaiki proses pembelajaran dan dapat meningkatkan hasil belajar matematika peserta didik kelas VII-A SMP Negeri 40 Pekanbaru.
Meningkatkan Aktivitas dan Prestasi Belajar Matematika Materi Bangun Ruang Sisi Lengkung melalui Penerapan Model Pembelajaran Kooperatif Tipe STAD pada Siswa Kelas IX SMP LPMD Suka Maju Rambah
Authors: Nurbaiti Nurbaiti
Published: January 2021

The purpose of this study was to describe the change in learning attitudes of students IX SMP LPMD Suka Maju Rambah in the 2017/2018 academic year regarding the increase in mathematics learning activities on curved side space building materials after learning through the application of the STAD cooperative learning model. The type of research used is a classroom action research, with a design used in two cycles. The population in this study were students of class IX SMP LPMD Suka Maju Rambah. Each cycle includes planning, action, observation, and reflection. The first cycle's learning outcomes showed that 26 students who completed learning whose score reached ≥ 75 were 26 students, or the percentage reached 78.78%. In the results of reflection in cycle I, it was found that the active involvement of students was 12 students, or the percentage was only 36.36%. Learning outcomes in cycle II, there was an increase in the number of students who completed, namely as many as 31 students or 93.93%, with 15.15%. Meanwhile, students' activeness in the second cycle also increased to 23 students, or 69.69%, with an increase of 33.33%. So it can be concluded that the application of the STAD learning model can improve activities and mathematics learning outcomes of students in grade IX at SMP LPMD Suka Maju, Rambah.
Optimalisasi Limbah Kulit Rambutan menjadi Produk Minuman Kemasan dalam Meningkatkan Perekonomian Masyarakat Desa Sukaratu Kabupaten Serang
Authors: Sunaryo Deny
Published: January 2021

Pengabdian Masyarakat ini berasal dari keinginan untuk memberikan keterampilan yang dapat meningkatkan ekonomi di Desa Sukaratu Kabupaten Serang Provinsi Banten dengan memanfaatkan produk alami yang ada sehingga mereka lebih bernilai secara ekonomi. Manfaat sumber daya alam rambutan bukan hanya buahnya tetapi kulit yang hanya menjadi limbah. Berdasarkan fenomena ini, limbah kulit rambutan diekstraksi menjadi minuman yang layak dikonsumsi. Metode dan pendekatan yang digunakan adalah pemecahan masalah dengan pembelajaran singkat dengan melakukan metode yang dilakukan melalui ceramah, diskusi dan praktik. Sedangkan hasil yang diperoleh dari kegiatan ini adalah 1) adanya pengetahuan dan keterampilan untuk mengolah limbah kulit rambutan menjadi minuman teh rambutan, 2) Produk ini dihasilkan dalam bentuk teh rambutan dari ekstraksi kulit rambutan. 3) Meningkatnya kesadaran lingkungan dan penciptaan lapangan kerja. Dua hasil di atas diharapkan mampu meningkatkan ekonomi masyarakat Desa Sukaratu, yang mayoritas adalah petani
Pemberdayaan Kader Posyandu melalui Peningkatan Pengetahuan Deteksi Dini Ibu Hamil Resiko Tinggi dan Keterampilan Pengukuran Tekanan Darah dan Lingkar Lengan Atas di Keurahan Tejosari Kecamatan Metro Timur
Authors: Riyanto  , Islamiyati  , Herlina
Published: January 2021

Risiko tinggi ibu hamil merupakan keadaan kehamilan yang dapat mengakibatkan bahaya kemungkinan terjadi komplikasi pada ibu hamil, bahkan kematian ibu saat melahirkan dan janin. Hasil studi pendahuluan pada kader Posyandu di kelurahan Tejosari kota Metro dari 16 kader yang aktif masih kurangnya kemampuan kader mengenali risiko tinggi kehamilan. Upaya yang dilakukan dengan pemberdayaan melalui pelatihan kader dengan tujuan PKM adalah meningkatkan pengetahuan kader Posyandu tentang deteksi dini ibu hamil risiko tinggi dengan pendekatan kartu skor poedji rockjati (KSPR) dan meningkatkan ketrampilan pengukuran tekanan darah dan LILA. Kegiatan pemberdayaan kader dilakukan dengan metode ceramah, diskusi, small group discussion dan praktik ketrampilan dengan simulasi. Hasil kegiatan PKM menunjukkan terdapat peningkatan pengetahuan dari rata-rata pengukuran pre test 69,67 menjadi 82,40 pada pengukuran post test dan ketrampilan dasar kader setelah pelatihan pengukuran tekanan darah dari hasil observasi rata-rata semua cukup baik dan untuk ketrampilan pengukuran LILA diperoleh hasil semua baik. Kesimpulan bahwa pemberdayaan kader Posyandu terjadi peningkatan pengetahuan dan ketrampilan tentang deteksi dini ibu hamil risiko tinggi. Perlu dilakukan pemantauan kemampuan kader langsung ke ibu hamil dalam melakukan fungsi edukasi.
Pengaruh Pemberian Tepung Maggot (Hermetia illucens) pada Pakan Terhadap Kualitas Eksterior Telur Burung Puyuh (Cortunix cortunix japonica)
Authors: Setia Muhammad Andi , Badriyah Nuril , Wahyuni Wahyuni
Published: January 2021

Penelitian ini dilaksanakan bulan Februari hingga April 2019. Lokasi bertempat di UPT. Agri Science Technopark Universitas Islam Lamongan. Tujuan penelitian ini ialah untuk melihat adakah pengaruh pemberian tepung maggot (Hermetia illucens) pada pakan terhadap kualitas eksterior telur burung puyuh (Cortunix-cortunix japonica). Kegunaan dari penelitian ini diharapkan dapat bermanfaat bagi para peternak burung puyuh sehingga dapat mengetahui kualitas eksterior telur burung puyuh. Materi menggunakan ternak burung puyuh petelur (Coturnix coturnix japonica) sebanyak 108 ekor umur 6 minggu. Metode yang dipergunakan ialah Rancangan Acak Lengkap, yang terdiri dari 4 perlakuan dan 3 pengulangan. 4 perlakuan tersebut meliputi P0: pakan komersial 100% tanpa penambahan tepung maggot, P1: Pakan komersial 98% + 2% tepung maggot, P2: Pakan komersial 97% + 3% tepung maggot, P3: Pakan komersial 96% + 4% tepung maggot. Setiap taraf perlakuan mendapat 3 ulangan dengan setiap ulangan terdiri dari 9 ekor burung puyuh. Variabel yang diamati ialah berat telur, indeks telur, tebal kerabang pada telur burung puyuh. Analisis data menggunakan metode statistik Rancangan Acak Lengkap. Penimbangan telur puyuh dilakukan 1 hari sekali setiap sore. Berdasarkan hasil analisis ragam dapat diketahui bahwa pemberian tepung maggot dalam pakan tidak berpengaruh nyata (P>0.05) pada berat telur, indeks telur, dan tebal kerabang.  Pemberian tepung maggot dalam pakan tidak memberikan hasil yang lebih baik dibandingkan pakan kontrol. Dikarenakan komposisi nutrisi pakan perlakuan tidak jauh berbeda dengan pakan kontrol, sehingga tidak berpengaruh nyata (P>0.05) terhadap berat telur, indeks telur dan tebal kerabang.
PRODUCT ATTRIBUTES DETERMINE THE PREFERENCE OF HERBAL MEDICINE CONSUMERS
Authors: Himmatul Miftah  , Novita Ita , Tsuwaibah H , Sunaryo M. A.
Published: January 2021

Abstract: The emergence of a wide variety of herbal medicinal products requires marketers to better understand consumer behavior. The various brands offered make consumers tend to have certain preferences before making a purchase decision. This study aims to determine the attributes of herbal medicinal products that determine the level of consumer preference in the purchasing process and the closeness of the attributes to consumer preferences. The method used is interviews with consumers which are then processed with conjoint analysis to determine the attributes that are most important to consumers in making a purchase. The research concludes that the most important attributes in purchasing herbal medicine in order from the most important are the properties, price, expiration time and packaging. There is a close relationship between the combination of attributes studied and consumer preferences for herbal medicine. This study is limited to four attributes and does not use ranking ratings on the stimulus or combination of attributes, consumer behavior. The uniqueness of this study is to analyze the attributes simultaneously.

 

Keywords: Herbal medicine product attributes, consumer preferences, conjoin analysis, level of importance
Russian and Soviet historiography of the life and work of Anatoly Fedorovich Koni in the 20th century
Authors: Kodintsev Alexander , Rybin Danil
Published: January 2021

The study analyzes historical researches on the life and work of the outstanding Russian lawyer A. F. Koni. It is noted that several directions in the study of the personality of this figure can be distinguished. It is concluded that systematic study of the legacy of Koni in the context of the era, taking into account the accumulated knowledge, coupled with archival materials will recreate the real face of the remarkable humanist figure of Russia in the past era.
BAALC is a differentially expressed gene in human metastatic breast cancer, in the brain and in the lymph nodes.
Authors: Mamoor Shahan
Published: January 2021

Metastasis to the brain is a clinical problem in patients with breast cancer (1-3). We mined published microarray data (4, 5) to compare primary and metastatic tumor transcriptomes for the discovery of genes associated with brain metastasis in humans with metastatic breast cancer. We found that brain and acute leukemia cytoplasmic protein, encoded by BAALC, was among the genes whose expression was most different in the brain and lymph node metastases of patients with metastatic breast cancer. BAALC mRNA was present at increased quantities in brain metastatic tissues as compared to primary tumors of the breast. Importantly, expression of BAALC in primary tumors was significantly correlated with patient recurrence-free survival in patients with breast cancer. Modulation of BAALC expression may be relevant to the biology by which tumor cells metastasize from the breast to the brain while evading immune clearance in the lymph nodes in humans with metastatic breast cancer.
Preprints in time of crisis
Authors: Le Tri Tam
Published: January 2021

Preprint as a form of publication is valuable in time of the COVID-19 pandemic.
MAGIX is a differentially expressed gene in brain metastatic human breast cancer.
Authors: Mamoor Shahan
Published: January 2021

Metastasis to the brain is a clinical problem in patients with breast cancer (1-3). We mined published microarray data (4, 5) to compare primary and metastatic tumor transcriptomes for the discovery of genes associated with brain metastasis in humans with metastatic breast cancer. We found that the MAGI family member, X-linked, encoded by MAGIX, was among the genes whose expression was most different in the brain metastases of patients with metastatic breast cancer as compared to primary tumors of the breast. MAGIX mRNA was present at increased quantities in brain metastatic tissues as compared to primary tumors of the breast. Expression of MAGIX in primary tumors was significantly correlated with patient recurrence-free survival. Modulation of MAGIX expression may be relevant to the biology by which tumor cells metastasize from the breast to the brain in humans with metastatic breast cancer.
Predatory monetisation? A categorisation of unfair, misleading, and aggressive monetisation techniques in digital games from the perspective of players
Authors: Petrovskaya Elena , Zendle David
Published: January 2021

Video game monetisation has changed rapidly in recent decades: not long ago, upfront payment was the only time a transaction was needed to guarantee a full gameplay experience. However, in recent years, technological shifts have facilitated rapid remote payments, enabling many games to evolve into platforms for repeated expenditure, rather than products in and of themselves. Monetising a game as a service is challenging, and there is concern that some monetisation strategies may constitute unfair or exploitative marketplace practices. However, thus far, no piece of academic research has asked for a stakeholder perspective on what these practices might be by surveying gamers. In the current work, we asked 1104 gamers to describe a time when they had been exposed to transactions which were perceived to be misleading, aggressive or unfair, using the lens of the UK Consumer Protection from Unfair Trading Regulations 2008. We found 35 separate techniques that players perceived to be misleading, aggressive, or unfair over 8 broad domains: intentional design to drive spending, product not meeting expectations, monetisation of basic quality of life, advertising, in-game currency, pay to win, general presence of microtransactions and other. Notably, several of these transactions seem to be in discord with existing UK consumer protection regulations. We discuss these potential contraventions, and offer recommendations for future steps towards consumer protection within the games industry.
The Self-Regulation of Healthy Aging: Goal-Related Processes in Three Domains
Authors: Hennecke Marie , Brandstaetter-Morawietz Veronika , Oettingen Gabriele
Published: January 2021

As people age, they experience typical age-graded challenges and opportunities, for example, their own retirement, changes in their social networks, or a decline in health condition. The extent to which people successfully process, respond to, and act on these challenges and opportunities is highly important for their health, at the core of which the WHO sees the possibility of “doing what one has reason to value.” In this article, we posit that individuals can play an active role in determining whether they can, in response to these age-graded influences, continue doing what they have reason to value, and that they can do so by deploying the self-regulatory processes of goal setting (including re-engagement in new goals after disengaging from a previous goal), goal pursuit, and goal disengagement. We discuss the role of these self-regulatory processes in three important goal domains: work/retirement, interpersonal relationships, and health. Across these domains, we consider typical challenges and opportunities including the increased availability of daily time in old age, the long past that lies behind older adults, and their limited future time perspective. Finally, we derive open research questions that may be studied to better understand how the very old may self-regulate their response to age-graded influences.
PEMBELAJARAN PPKN UNTUK PERGURUAN TINGGI
Authors: Khoiri M
Published: January 2021

Selain disusun dengan mendasarkan pada dimensi-dimensi keilmuan yang dimiliki oleh penulis, buku ini juga didukung dengan pengalaman konkrit penulis sebagai pengampu mata kuliah PPKn dibeberapa Universitas, serta beberapa temuan penulis saat mengampu mata kuliah di program studi lain selain program studi PPKn, dimana mahasiswa program studi lain secara umum sedikit mengalami kesulitan dalam merangkum dan memahami esensi perkuliahan antara materi Pendidikan Pancasila dan materi Pendidikan Kewarganegaraan di Perguruan Tinggi, sehingga penyusunan materi dalam buku ini disesuaikan dengan pemahaman awal secara mendasar hingga ketahap yang lebih spesifik dan meluas, guna mengembangkan wawasan mahasiswa secara periodik. Buku ini disusun dalam 13 bab, yang masing-masing diperincikan menjadi beberapa sub-sub bab yang lebih khusus. Diawal setiap bab disajikan tujuan instruksional baik secara umum maupun secara khusus. Para mahasiswa diharapkan mampu membaca dan menganalisis buku ini secara urut agar lebih mudah memahami esensi materi yang disampaikan pada setiap bab nya.
Prevalence of lower urinary tract symptoms (LUTS) among young age medical population
Authors: N Zalina , N Aruku , N Azura , N Shahida , N Akhmarina , F Dian
Published: January 2021

Introduction: Frequency of lower urinary tract symptoms (LUTS) in young age women is not well studied. It is said to be common among female elderly and multiparous population. The aim of this study is to obtain the prevalence of LUTS among nulliparous students in relation to their personal hygiene. Materials and methods: This is a prospective cross-sectional study conducted among  200 nulliparous medical and nursing students aged between 18-28 years using standardized questionnaires. Urine samples were also collected from students to detect urinary tract infections. Results: The complete data sets of 146 students were analyzed. All of them were nulliparous, single and not sexually active. The prevalence of LUTS was 52.7% consist of over-active bladder, urinary incontinence (UI) and voiding difficulty respectively (51.3%, 34.9% and 45.2%). The most common type of UI was stress urinary incontinence which was 21.9% followed by 11.6% of urgency incontinence. Conclusion: The prevalence of LUTS among young age population is high at 52.7%. Public awareness regarding LUTS and availability of treatment is needed.
Wire-Induced Stent Crumpling Remedied By BailOut Crush Stenting; A Case Report
Authors: SMS Azarisman , MA Rosli
Published: January 2021

We report a-56-year old army pensioner who presented initially to a peripheral hospital with acute ST-elevation inferior myocardial infarction thrombolysed with streptokinase. He was subsequently referred to the National Heart Institute (Institut Jantung Negara, Malaysia) for coronary revascularization. Coronary angiogram revealed an ectatic right coronary artery with discrete lesions at the proximal and distal segments stented with bare metal stents (BMS). Post dilatation shots revealed a wire-induced, distal dissection at the posterior left ventricular artery remedied by balloon angioplasty but resulting in balloon-induced crumpling of the distal BMS. We discuss the importance of sequential, distal-to-proximal coronary intervention, stent crumpling and remedial strategies.
Antiphospholipid Syndrome Presenting as Mesenteric Vein Thrombosis and Gangrenous Small Bowel
Authors: WASR Wan Ali , MS Mohd Shahrir , H Hussein
Published: January 2021

A 35-year-old Jordanian gentleman presented with worsening right iliac fossa pain of three-day durations with vomiting, loose stool and intermittent fever. He later underwent laparoscopic surgery, which was subsequently converted to open laparotomy. Intraoperatively, there was thickened bowel with multiple mesenteric lymph nodes, and also thrombosis of the small bowel vein supplying the affected bowel lesion, the diagnosis which was later confirmed with the histopathological report. Resection with end-to-end anastomosis was done during the surgery. Within one-week post laparotomy, he developed another progressive abdominal pain and distension, vomiting and no bowel opening. He was sent for another exploratory laparotomy. Intraoperatively, there was a gangrenous small bowel segment measuring 130 cm, with an intact large bowel and previous anastomotic site. Resection of 150 cm of the small bowel was subsequently done.
Primary Ewing’s Sarcoma of the Lumbosacral Spine: A Case Report
Authors: Z Zamzuri , SY Mohd Adham , MA Saufi , AA Azian , M Fadhli
Published: January 2021

Ewing's sarcoma is a rare tumor first discovered by James Ewing in 1921. It is more common in bone or skeletal component compared to soft tissue or extraosseous Ewing's sarcoma. Among soft tissue Ewing’s, spinal cord involvement is rarer with only nine cases reported. We report a case of nine-year-old Malay girl who presented with low back pain for two months following a fall with progressive neurological deficits of bilateral lower limb. Magnetic resonance imaging was suggestive of a well-defined margin of intradural extramedullary tumor. With nerve sheath tumor in mind, surgical excision with laminectomy L2-S1 was performed. Intraoperative finding was an extradural mass from L3-L5 with extension to bilateral neuroforamen. Histopathology report defined a round cell tumour of Ewing’s sarcoma from the mass.
The Effects of Vasectomy on Testicular Tissue of Mice: Histological Changes and DNA Fragmentation Study
Authors: MO Salman , EA Al-Wasiti , KA Thamir , IM Al-Ani , AR Al-Salihi
Published: January 2021

Introduction: We aim to investigate the effect of vasectomy on the histology of the testis as well as to evaluate DNA fragmentation in testicular tissue of male mice. Methods: Bilateral vasectomy was performed on 20 mature male mice; 10 control mice underwent sham-operation. After 6 weeks, the testes were evaluated for histological changes and DNA fragmentation by single cell gel electrophoresis (comet assay). Results: Marked alterations were observed in the testes of vasectomized mice, including degeneration of spermatids, thickened basement membrane, dilatation of the seminiferous tubules, exfoliation of germ cells, reduction in the seminiferous cell population, vacuolated appearance of the epithelium in the tubules and marked interstitial fibrosis. Single cell gel electrophoresis showed a highly significant (P<0.0001) increase in DNA damage among vasectomized mice (46.02%) compared with control group (%27.17) after six weeks of operation. Conclusion: Vasectomy induced deterioration in the seminiferous tubules associated with increased testicular cell’s DNA fragmentation.
Pilot Study: A Review of Personnel Involved in School Vision Screening and the Training Module in Betong, Malaysia
Authors: AB Nurul Farhana , AH Chen , MN Abdul Rahim , PP Goh
Published: January 2021

Introduction: School vision screening program is a scheduled program under the Ministry of Health, Malaysia for 7, 12 and 15 years-old children in the government schools. The aim of this study was to review the school vision screening program from the perspective of the personnel involved as the screener. Methods: The evaluation of the performance of the screener was based upon the accurate referrals' outcome from the school health database of Betong Division in Sarawak, Malaysia in the year of 2008. Results: The total accuracy of the referrals was 50.7%. Lower accuracy of the referrals was found significantly associated with Grade 1 [χ2 (2.N=304) = 28.810, p<0.001, OR 4.472, CI.95= 0.843=2.335] and among Native Iban [χ2 (2.N=304) = 7.901, p<0.05, OR 1.502, CI.95= 0.935=2.414].  Conclusions: Further review on the training modules demanded improvement and enhancement to suggest that training module might be one of the contributing factors on the performance of the screener.
Continuity Theory of Ageing and Leisure Participation among Elderly Attending Selected Health Clinics in Selangor
Authors: HS Minhat , MA Rahmah , S Khadijah
Published: January 2021

Introduction: Leisure participation in old age is often a continuation of their participation at younger age. This study aims to explore the association between current and former leisure participation of the elderly. Methods: A cross-sectional survey was conducted among 268 persons aged 60 years and above, purposively selected from eight health clinics in Selangor. Current leisure participation was measured using a validated Leisure Participation Questionnaire (LPQ), specific for Malaysian elderly. The LPQ consists of 25 activities, categorized into recreational (physical), cognitive, social and productive activity. Frequency of participation in each activity was measured on a 6-point scale. Leisure participation at younger age only involved their general participation in leisure. The most common daily leisure activities were having conversations while relaxing (78.7%) and watching television (74.6%), while the least were from playing golf (0.01±0.12) and performing musical instruments (0.04±0.36). More than half (64.9%) reported being actively involved in any leisure activity at younger age. Results: The study found there was a significant association between former and current leisure participation, especially for cognitive (t=-2.45, p=0.015), social (t=-2.68, p=0.008) and productive (t=-2.89, p=0.004) activities. However, only productive activity involvement was predicted by their leisure participation while younger (B=1.304, p=0.027). Conclusion: The findings suggest the importance of considering active intervention programmes at younger age to ensure better leisure participation of the elderly, especially in recreational physical activity.
End of Life Decision: We are not Playing God?
Authors: WMN Wan Khairina , HA Ngow
Published: January 2021

Advances in neonatal care now enable more infants to be kept alive despite clear clinical evidence of inevitable or imminent death on a life-support system. It is therefore no longer acceptable to the society that a patient is left to die in the hospital, without any form of treatment or intervention. We report a case of severe birth asphyxia, hypoxic-ischemic encephalopathy, neonatal seizures and left cephalohematoma. In spite of initial successful resuscitation, the infant could not survive until all possible methods of treatment were exhausted. This case illustrates one of many examples of the process involved in dealing with ending of life decision in a condition considered as futile.
The Role of Training for Dental Students in Scoring Caries
Authors: Abllah Zurainie
Published: January 2021

Introduction: Training of dental students is an essential part of the teaching- learning activities in order to obtain reliable results in scoring of dental caries. The objectives of this study are to examine consistency in scoring of caries over a 3-month period following baseline training, calibration and retraining. Methods: Three examiners (dental students) received baseline training/calibration by a "gold standard" examiner (lecturer). This was followed by a re-calibration and retraining 3 months later. A set of 20 extracted teeth was used for the baseline training and for the re-calibration purposes. The International Caries Detection and Assessment System (ICDAS) was used to classify the visual caries lesion severity (0-6 scale) of surface of permanent teeth. The examination utilized a clinical light, dental mirror, dental probe and air syringe. Kappa (unweighted: Kappa) statistics were used to determine inter-examiner reliability at baseline and re-calibration. Results: For caries score criteria, the baseline calibration on 20 specimens indicated an inter-rater kappa ranging from 0.37-0.69. Re-calibration on the same 20 specimens 3 months later indicated an inter-rater kappa of 0.79-0.89. Activity kappa was in the poor to good range. All examiners improved with time. Conclusions: Training contributes to the consistency and reliability of dental caries scoring among dental students.
Anti-fertility potential of Trigonella foenum-graecum in comparison to oral contraceptive pills
Authors: Naji Allow Ahmed Kaid , Rebhi Hilles Ayah , Yousef Zainab , Mohamed Bakrim Norbaiyah , Ahmed Belqees , Saxena Anil Kumar
Published: January 2021

Introduction: This study examines the anti-fertility effects of Trigonella foenum-graecum (fenugreek) seeds extract in the reproductive system of female rats in comparison to combined oral contraceptive pills (COCPs). Methods: Thirty two female Sprague Dawley rats of 8 weeks old were divided into four groups (A, B, C and D). All female rats were allowed to mate with male rats. Group A is a positive control and not given any treatment. Group B is a negative control group. Group C and D were treated with 0.05 mg/kg body weight of COCPs and 750 mg/kg body weight of fenugreek seed aqueous (FSA) extract for 15 days respectively. Blood samples were subsequently taken on the proestrous phase to evaluate the serum levels of follicular stimulating hormone (FSH). The embryo implantation rate was studied in all groups. Results: Administration of 750 mg/kg FSA extract and COCPs both resulted in decreased FSH serum levels, to 25.62 ng/ml and 71.56 ng/ml respectively (p<0.01). The embryo implantation rate was zero in both FSA extract and COCPs treated groups. Conclusions: Anti-fertility effects of FSA extract and COCPs are potentially similar in terms of their ability to reduce FSH serum levels and inhibit implantation.
Hearing impairment among scuba divers in Kuantan and neighbouring regions
Authors: Alisaputri Marina L. , Yusoh Siti Hazwani
Published: January 2021

Introduction: Hearing impairment has been listed as one of the health risks associated with scuba diving. Evidence of hearing loss associated with inner ear barotrauma was found in previous studies. This cross-sectional study investigates the relationship between hearing status and years, depth and total hours of diving. Methods: Thirty male divers from Kuantan and neighbouring areas, with age ranging between 22 and 45 years old, were recruited as subjects. Details regarding diving activity were gathered using a set of questionnaires. Assessment of hearing status was done using otoscopic examination, tympanometry, pure tone audiometry (PTA) and distortion-product otoacoustic emission (DPOAE). Results: Fifteen subjects were found to have sensorineural hearing loss at high frequencies. Pearson's correlation showed no significant correlation between pure tone hearing thresholds and years, depth and total hours of diving. Significant negative correlation was found between DPOAE at 6 kHz on the left ear and years of diving (r= -0.378, p= 0.04) and depth of diving (r= -0.404, p= 0.027). Conclusions: These findings indicate that scuba diving activity may affect cochlear function, particularly in the basal region of the cochlea.
Differential methods of cell lysis for protein profiling of Alexandrium sp. using 2D gel electrophoresis
Authors: Hamdan Nurul Ashima , Mohammad-Nor Normawaty , Abd. Hamid Shafida , Md. Zin Nor Hasniza , Muhamad Bunnori Noraslinda
Published: January 2021

Introduction: Protein profiling of harmful algae is an ongoing study where the latest analysis was conducted on A. minutum. It is a fundamental study where the protein expression of targeted species can be used to understand the biochemical pathway of selected proteins. The Malaysia Alexandrium spp. has the potential to cause massive blooming that brings harm to the aquatic ecosystem. Methods: In this experiment three methods of cell lysis were tested against A. leei isolated from Malaysian waters. Results: The Axenic culture of the sample was established in enriched seawater media (ESDK) with 12 hours of light and 12 hours of dark conditions. The sample was extracted during exponential phase (day 18) where the same amount of cells was collected via centrifugation. The same buffer was used for each technique of cell lysis in order to get the best protein profiles in terms of a band or spot intensity and number. The cells of A. leei were lysed using sonication in the ice-cold water bath, sonication with probe and freeze-thawing followed by sonication in iced bath is the best method of protein extraction. Conclusions: Nevertheless, it can be concluded that the qualitative analysis using SDS-PAGE and 2D gel electrophoresis could be best method and the freeze thawing mode of cell lysis produced an excellent result among others as the protein spots produced were precise and less streaking were observed.
The effect of particle size, methods and time of extraction on the natural antioxidant content and radical scavenging activity of Phyllanthus niruri
Authors: Bunnori Noraslinda Muhamad , Darnis Deny Susanti , Yusof Muhammad Najib , Abd. Halim Khairul Bariyyah
Published: January 2021

Introduction: Phyllanthus niruri has a high antioxidant capacity due to high phenolic and flavonoid content. This study is to determine and evaluate the effect of particle size, methods and time of extraction on its antioxidant activities. Methods: P. niruri was dried overnight in drier at 40˚C and grounded to different particle sizes. The extraction methods by using a rotary evaporator were soxhlet and maceration.Three types of biochemical assays were conducted: total phenolic content (TPC), total flavonoids content (TFC) and 1,1-Diphenyl-2 picrylhydrazyl (DPPH) radical scavenging activity assay. Result: The best TPC and DPPH value are recorded for the sample of less than 0.7 mm, treated by a soxhlet extraction method at 8 hours extraction time with TPC valued at 4.95 ± 0.803 mg GAE/g of dried extract and IC50 value of 0.403 ± 0.03790 mg/mL respectively. The highest TFC amount is recorded for the sample treated at less than 0.7 mm particle size, by the maceration method of extraction and at 8 hours extraction time with the total flavonoid content of 56.43 ± 0.594 mg QE/g of dried extract. Conclusions: It can be concluded that there are a synergistic effect between TPC and TFC on the quality of the anti-radical property of the sample affecting DPPH activity within the sample.
Application of Three Dimensional Geometric Morphometric Analysis for Sexual Dimorphism of Human Skull: A Systematic Review
Authors: Ibrahim Abdelnasser , Alias Aspalilah , Shafie Mohamed Swarhib , Nor Faridah Mohd
Published: January 2021

The present systematic review explores the most sexually dimorphic parameters by using geometric morphometric analysis of human skull. An extended search was conducted in Google Scholars and PubMed (published between 2005 and 2017). The main inclusion criteria were research articles published in English, and studies that used geometric morphometric analysis for classification of human skull. The literature search identified 54 potential relevant articles whereby, five had met the inclusion criteria. Most studies reported positive contribution of geometric morphometric as an alternative and accurate tool for classification of unknown human crania. Geometric morphometric method resulted in a high classification accuracy of sexual dimorphism among different populations. Further studies are required to approach the best method used for varied types of postcranial bones equipped with a more advanced meta-analysis of the results.
Knowledge, Attitudes and Behaviours Towards Exclusive Breastfeeding Amongst Mothers in Sarawak, Malaysia: A Qualitative Study
Authors: Buss Dr Imogen Margaret
Published: January 2021

Introduction: Exclusive breastfeeding is recommended as the optimal method of infant feeding for the first six months, but the rate remains low in many countries, including Malaysia. It is important to understand barriers preventing exclusive breastfeeding, to enable tackling these issues and thereby improving maternal and child health. This study aims to do this by exploring the knowledge, attitudes and behaviours of mothers towards breastfeeding in Sarawak, Malaysia. Material and Methods: Qualitative methods were employed, using semi-structured interviews with an interpreter, conducted in Sarawak General Hospital between 16th April and 11th May 2012. Convenience sampling was used to recruit participants from the maternity wards. Interviews were conducted using a topic guide, were audio-recorded and transcribed verbatim. Analysis was based on conventional content analysis, with codes and themes developing from the interviews. Results: Analysis of the 17 interviews identified five major themes; (1) positive attitudes towards breastfeeding, (2) lack of knowledge relating to exclusive breastfeeding, (3) fear of insufficient milk, (4) methods to improve awareness and knowledge of breastfeeding, (5) improvements in the workplace. There is a lack of knowledge amongst mothers in Malaysia regarding breastfeeding, causing anxiety and early discontinuation of breastfeeding. Methods to improve education of mothers and healthcare staff have been suggested, as well as improvements to encourage breastfeeding in the workplace. Conclusion: Focused education for new mothers and widespread community education may help improve breastfeeding continuation rates. The provision of workplace facilities and flexible working hours for new mothers may help overcome physical barriers preventing breastfeeding continuation once back at work.
Symptomatic Cerebral Ependymal Cyst : A Case Report
Authors: P Rauf , MN Aidil , KH Chan , A Saufi , M Fadli
Published: January 2021

Cerebral ependymal cyst is a rare benign neuroepithelial cyst. We report a case of cerebral ependymal cyst in a 62-year-old lady who presented with status epilepticus. She gave history of progressive right occipital headache over a year. Magnetic Resonance Imaging of the brain showed a large occipital cyst. She underwent a right craniotomy, deroofing of the cyst and insertion of Ommaya catheter. The clinicopathological aspects of the cyst are discussed.
Compliance of Hour-1 Sepsis Care Bundle in Patients with Surgical Infection Requiring Surgery in Hospital Tengku Ampuan Afzan
Authors: Ganisan Dhayalan , Din Jiffre
Published: January 2021

Introduction:  Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. According to Sepsis 3 definition, an increase of 2 or more in the qSOFA score should create a suspicion of sepsis and organ dysfunction. It is a dire condition as studies show; patients with a qSOFA score of ≥ 2 have a mortality rate of ≥ 0%. The Surviving Sepsis Campaign guidelines have depicted an Hour-1 Sepsis Bundle in managing patients with sepsis which has proven to reduce morbidity and mortality. The objective of this study was to analyze the demographic data of patients presenting with surgical sepsis requiring surgery and compliance to the Hour-1 Sepsis Bundle, concurrently the mortality rate of these patients. Materials and Method:  A retrospective epidemiological study was done from the 1st of October to the 31st of December 2018. Patients included in the study were all patients with evidence of surgical infection requiring emergency surgery and patients presenting with trauma were excluded. This number of patients was then scrutinized into patients with evidence of sepsis, subsequently the compliance to the Hour-1 Sepsis Bundle. Results: The analysis showed that 23 of the 156 patients with surgical infection requiring surgery were in sepsis. Of this, 5 patients succumbed during the same admission. Results also showed patients who developed sepsis in their 5th decade of life are more susceptible to death. In accordance with the Hour-1 Sepsis Bundle, compliance to measuring lactate level was 70%, obtaining blood culture was 47.8%, administration of antibiotics was 82.6% and rapid administration of crystalloid was 0%. All three patients requiring vasopressors were started on vasopressors within the hour. Conclusion: Compliance to the Hour-1 Sepsis Bundle in whole was unsatisfactory. This was noticeably apparent especially to fluid resuscitation where it was not delivered as recommended by the Sepsis Bundle.
Synchronous Esophageal and Renal Malignancies with Unexpected Site of Metastasis: A Case Report
Authors: Bahrudin Sharhanin
Published: January 2021

Introduction: Esophageal cancer is the fifth most common cancer in Asia. Synchronous malignancies with an esophageal malignancies is not uncommon however synchronous esophageal malignancy and renal cell carcinoma is rare. Case Report: A 70 years old non smoker man with comorbid of hypertension and diabetes mellitus presented with multiple episode of hemoptysis and pleuritic chest pain within one day duration. He also complaint of worsening dysphagia to solid food for 1 month duration with constitutional symptoms. Otherwise he does not have any other symptoms. Clinically he was pale and cachexic, otherwise all systemic examination was unremarkable. His blood investigation reveal low hemoglobin level of 9.9g/L with normal coagulation and renal profile. He underwent Oesophagoduodenoscopy which showed a tumor narrowing the lumen of the lower esophagus. Biopsy of the tumor revealed esophageal adenocarcinoma. CT thorax, abdomen and pelvis showed smooth circumferential wall thickening of the distal part of the esophagus near the gastroesophageal junction. Incidentally, there were heterogenous enhancing lobulated mass seen at the lower pole of left kidney with no obstructive uropathy features. Otherwise, others solid organ were normal. A left renal mass biopsy performed revealed renal cell carcinoma. An oncologist opinion was gathered for initiation of palliative chemotherapy however he developed symptomatic malignant pleural effusion which need a drainage. HRCT Thorax revealed multiple bilateral intrapulmonary nodule. He also complaint of a new right upper eyelid mass that increasing in size with contact bleeding however does not affect his visual. An assessment from an ophthalmologist and CT orbital performed consistent with features of a metastasis. Conclusion: Synchronous malignancies with an esophageal malignancies is not uncommon. Most common site reported is head and neck followed by lung malignancies. However synchronous esophageal malignancies and renal cell carcinoma is rare. Esophageal malignancies often have distant metastasis to the liver, lung and bone however rare to the eyelid.
The Alarming Community Concern on Household Insecticide Exposure and Usage
Authors: AH Abdul Alif , M Muhammad Lokman , MY Afzan , PL Siew , NH Nik Fakhuruddin , M Hussin
Published: January 2021

The utilization of insecticide in a household environment is a necessity especially for those living in the tropical country such as Malaysia. Tropical climate with high humidity and urbanization lead to pests breeding problem hence contributing to the spread of vector diseases such as dengue. Household insecticide such as aerosol sprays, coils and mats are made from a combination of chemicals from type 1 pyrethroid group which are recognized as safe and have minimal toxic effects on human. However, there have been cases of accidental and intentional insecticide poisoning which demonstrates the lack of studies on factors of knowledge, attitude and practice of insecticide usage, the exposure as well as clinical presentation since the symptoms are similar to other compounds which may lead to misdiagnosis. These insecticide chemicals do not only exert toxic effects to pest but to human too due to its highly toxic characteristic which causes diseases such as asthma, cancer, and other diseases following short or long-term exposure to the chemicals. As a result, there is a growing community health concern regarding the uncertainty and risk of insecticide exposure to human. Thus, the risk assessment of community’s knowledge, attitude and practice regarding the insecticide are essential in aiding towards the development of improving insecticide profile, safer insecticide handling and exploration of insecticide alternative. This will result in better insecticide awareness, as well as minimize the insecticide risk exposure and its adverse health effects to the community.
Mortality Due to Underestimation of Soft Tissue Injury and Misdiagnosis of Rhabdomyolysis
Authors: LJ Tan , RZ Tan , MS Shafie , F Mohd Nor , H Shamsuddin , MA Md Onzer
Published: January 2021

Rhabdomyolysis is characterized by the breakdown of muscle tissue, and release of intracellular muscle constituents into the blood circulation. The severity of the illness may range from asymptomatic elevation in serum muscle enzymes to a life-threatening disease. One disease may behave differently in different way in different individuals. The first patient was involved in a motor vehicle accident and developed acute kidney injury on the third day of admission. The second patient complained of lower limb weakness, and was discharged with vitamin D supplements. Both patients’ conditions were not properly diagnosed or treated, and succumbed to death. Autopsies were conducted in both cases, in which rhabdomyolysis were diagnosed. This case report emphasizes the importance of making a correct diagnosis of rhabdomyolysis Progression of the disease and its complications should be monitored closely. Timely management may save life in high risk patients.
Soil Transmitted Helminth Infection among Children Admitted to Hospital Tengku Ampuan Afzan, Kuantan, Pahang
Authors: Asady Asady , Ismail Soraya , Abdul Jalil Marsitah , Pakeer Oothuman
Published: January 2021

Soil-transmitted helminth (STH) infections by Ascaris lumbricoides, Trichuris trichiura and hookworms still persist in rural and urban areas of developing communities. Recent studies in Malaysia focused on Orang Asli communities and none in the hospital settings. This study aimed to investigate the prevalence and associated risk factors for STH among children admitted to Paediatric ward of the Hospital Tengku Ampuan Afzan (HTAA). This study was conducted among 135 (78 males, 57 females) patients in HTAA from December 2017 to May 2018. Faecal samples were examined using wet smear, Kato-Katz, Harada-Mori and sedimentation techniques. Demographic data and hygiene practice information were collected using a pre-tested questionnaire. The overall prevalence of STH was 5.9% (A.lumbricoides 5.2%, T.trichiura 0.7%, and hookworms 0.7%). Prevalence among males was 3.8% and females 8.8%. Majority (95.6%) were Malays. Chi square analysis showed that factors significantly associated with STH infections are household monthly income (p<0.05), education level of mother (p><0.05) and father (p><0.05), the source of drinking water (p><0.05), the method of garbage disposal (p><0.05). Logistic regression analysis confirmed garbage disposal via burning as a risk factor of STH infections (p= 0.021, OR=23.8, 95% CI=1.6- 350.06). Conclusion: This study shows that the prevalence of STH infections is low in children probably due to the effective implementation of control programs and good hygiene practice. Differences in individual lifestyles and the humid weather condition are probable reasons for sporadic infection to still exist.>