bluuebunny/crossref_metadata_2025 huggingface dataset:
Penghitungan Volumetrik Perdarahan dengan Metode Volume Automatik (Software Volume Evaluation) dan Metode Manual (Broderick) pada MSCT Kepala (Study Eksperimen pada Pasien Perdarahan Intraserebral di RS. Haji Surabaya)
Authors: Kiswoyo Agus Setyo , Wibowo Gatot Murti , Ferriastuti Widiana
Published: October 2018

Background : Intracerebral hemorrhage (ICH) is the brain parenchyma bleeding. The volume of intracerebral hemorrhage can affect mild to severe clinical symptoms due to increased intracranial pressure and it has a high risk of death. In addition, CT scan CTScan is a gold standard  on PIS examination. Methods : This was a quantitative research with experimental approach. There are two methods of volumetric hemorrhage calculation, namely automatic and manual method. Automatic Volume Method (SVE) is a volume calculation by computer software available on CT Scan tool with voxel calculation in HU value range. The manual method (Broderick) used is AXBXC/2 which is the multiplication of length (A), width (B) and height/thickness of bleeding slice (C) divided by 2. From the result, the volume differencewas tabulated and measured, then the normality and different test were done.Results : The sample consisted of 10 new bleeding patient data which then classified into small hemorrhage group, calculated volumes automatic(SVE) and manual(Broderick). volume calculations obtained different values of volume ranging from 0.37 cm³ to 10.01 cm³, the percentage ranged from 3% to 41%. The result showed a very significant difference value due to the different test Paired Samples T Test with significance value of 0.001 (p-Value 0.05). From the data, 8 patients with different percentage above 20%,with average 25% were PIS with irregular shape. And 2 patients with volume difference below 10% with average 6 % were Intracerebral Hemorrhage regular shape. Conclussions : There is a difference in the calculation of volumetric Intracerebral hemorrhage between the automatic volume method (SVE) and the manual method (Broderick). With a percentage average difference of average volume of 6% for regular shapes and 25% for irregular hemorrhage.
Analisis Informasi Citra Anatomi Vaskular dengan Multi Planar Reformating (MPR) dan Maximum Intensity Projection (MIP) pada Fase Early Arteri Pemeriksaan MSCT Abdomen
Authors: Istiningrum Ratna , Fatimah Fatimah , Wulanhandarini Tri
Published: October 2018

Background: The development in the field of image reconstruction is growing rapidly along with the development of  CT Scan. In  the early stages of  MSCT abdominal artery is usually found  various kinds of vascular abnormalities such as stenosis, aneurism and others. Post processing image techniques commonly used include MPR and MIP. The purpose of this study is to determine whether there is a difference between MPR and MIP techniques and to know which one is better between the two.Methods: This  research was  quantitative study with experimental approach. The study was conducted at Bhakti Dharma Husada Surabaya Hospital  with 15 samples by performing reconstruction on vascular anatomical image of coronal examination of  abdominal MSCT. Assessment of anatomical information data is done by 2 respondents. Data analysis was done by kappa test followed by Wilcoxon sign rank test.Result : The results showed the difference between the post-processing of MIP and MPR on the coronal stages of the early arterial phase of the abdominal MSCT examination, based on the results of  non-parametric statistical test analysis (Wilcoxon) showed  a significant value of p value = 0.001. The result of MIP mean rank value (8,46) is higher than the mean rank value of MPR (1,50), it can be known that post proceeding MIP technique on coronal phase cuts early arterial examination of abdominal MSCT produces better anatomical image information.Conclusion: On examination of abdominal MSCT in the early arterial phase should be at the time of processing the image is also done by using post-processing MIP because more clearly than the MPR.
REGULATING EXHIBITIONS AT CINEMA-HOUSES IN IMPERIAL ISTANBUL
Authors: ÇELİKTEMEL-THOMEN Özde
Published: October 2018

From its start, the new technology of cinema posed its own tangible and material challenges to entrepreneurs and governments all over the world. These included the use of power sources, the methods of film projection, the physical arrangement of cinema-houses, and other infrastructural measures. The expansion of permanent/seasonal cinema-houses eventually led to the need for standard regulations at exhibition venues. In the Ottoman Empire, after the growth of permanent cinema-houses in the mid-1910s, regulations of exhibitions at cinema-houses introduced obligations, restrictions and a set of rules. The 1916 Draft Regulation and the 1924 Ordinance, both examined in this article, show the Ministry of Interior’s (Dahiliye Nezâreti) regulations of the physical surroundings at cinema-houses. These regulations are direct products of the facilitative and the prohibitive mentality of political authorities. The article relies on governmental decrees, consular and trade reports, press reviews and memoirs gathered in archival research, and it explores the regulations and legal measures governing cinema-houses in Istanbul during the early cinema period.
Laparoscopic colorectal surgery in Baghdad teaching hospital A review of 12 patients
Authors: Ahmed Ahmed S.
Published: October 2018

Background: colonic resections by laparoscopy are being performed with increasing frequency worldwide.Objective: The aim of this study is to evaluate our experience in the laparoscopic management of colorectal disease and to compare our results with other institutes.Patients and Methods: This is a prospective study conducted during the period from 1st of January 2017 till the 15th of November 2017, 12 patients underwent laparoscopic colectomy in in Baghdad Teaching Hospital and followed up for 30 days postoperatively.Results: 12 patients were included in this study, 83.3% of them were male, majority of patients (41.7%) were between 60 – 69 years, most of the patients (33.3%) have a body mass index of 23 -25, 83.3% of operations took 240 – 360 minutes and malignant diseases was the most common indication for surgery with (58.3%), while Abdominoperineal Resection was the most common indication for laparoscopic intervention (25%). Half of the patients discharged from hospital in 96-120 hours postoperatively, furthermore in majority of cases (66.7%) bowel sounds return to normal in 48-72 hours postoperatively. Conversion to open procedure occurred in 16.7% of patients, while complications occurred in 16.7% of patients.Conclusion: Although laparoscopic colorectal surgery is a not popular in our institute, our results are promising.Keywords: Laparoscopic, colorectal, conversion to open
جراحة القولون والمستقيم المنظارية دراسة حول 12 مريض في مستشفى بغداد التعليمي.
 د. أحمد صالح أحمد
 الخلاصة:
الخلفية:ان عمليات استئصال القولون والمستقيم باستخدام الجراحة المنظارية شهدت زيادة ملحوظة في العالم. ان الهدف من هذه الدراسة هو لتقييم خبرتنا في مجال جراحة امراض القولون والمستقيم المنظارية مع مقارنة نتائجنا بنتائج دول العالم الباقية.
المرضى وطرق العمل : هذه الدراسة أجريت في مستشفى بغداد التعليمي/ دائرة مدينة الطب للفترة من الأول من كانون الثاني 2017 الى الخامس عشر من شهر تشرين الثاني لنفس السنة وشملت 12 مريضا أجريت لهم عملية رفع للقولون والمستقيم باستخدام الناظور وتم متابعة المرضى لمدة ثلاثون يوما بعد العملية.
النتائج: تم اخذ 12 مريضا لهذه الدراسة، 83.3% منهم كانوا رجالا فيما كانت الأغلبية (41.7%) تتراوح أعمارهم بين 60 – 69 سنة. معدل كتلة الجسم لمعظم المرضى (33.3%) يتراوح بين 23 الى 25 واستغرقت العملية بين 240 الى 360 دقيقة لغالبية المرضى (83.3%). مثلت الأورام الخبيثة الجزء السبب الأهم لهذه العمليات وبنسبة (58.3%) فيما مثلت عملية رفع المستقيم الكامل عن طريق الناظور العملية الأكثر شيوعا (25%). نصف المرضى تم اخراجهم من المستشفى في فترة تراوحت بين 96 الى 120 ساعة، كما ان اغلبية المرضى (66.7%) عادت امعائهم الى العمل بصورة طبيعية في فترة تراوحت بين 48 الى 72 ساعة بعد العملية. تم تحويل العملية من ناظور الى فتح في 16.7% من العمليات فيما حدثت مضاعفات مرتبطة بالعملية بنسبة 16.7% من المرضى.
الاستنتاج: بالرغم من كون عمليات جراحة القولون والمستقيم غير مشهورة لدينا ومازالت في بداياتها الا ان نتائجنا كانت مشجعة في هذا المجال
كلمات الدلالة: ناظور، القولون والمستقيم، تحويل الى فتح
Comparison of Three DNA Extraction Methods for Detection Echinococcus granulosus Isolated from Sheep and Cows
Authors: Ahmed Dunya N. , Muhsin Salwa S. , Chyiad Abudulla L.
Published: October 2018

Background: Hydatosis caused by Echinococcus granulosus dog tap worm is zoonotic infection and economic importance and to public health constitutes a major threat in certain regions of the Middle East. There is an establishment of preventive and control strategy for characterization of E.granulosus in all endemic area which is essential in all molecular studies, to check the DNA of the parasite.Objective: Our study aimed to obtain the best from three extractions DNA methods from hydatid cyst protoscolecses isolated from sheep in Al-shawlla abattoir in Baghdad.Subjects and Methods: Three methods were used to extract DNA samples (boiling, crushing and commercial) DNA samples were performed with electrophoreses on 1.3% agarose. Regarding DNA for methods were compared by time and facility and cost-effectiveness.Results: The most method was boiling and crushing DNA extraction because of their easy, quickness besides the commercial kit method which had good bands on gel electrophoresis but had most cost effectiveness and time.Conclusion: The most method were boiling and crushing using for DNA extraction
 
مقارنة لثلاث طرق لأستخلاص الدنا الخاص بدودة المشوكات الحبيبية المعزولة من الأغنام والأبقار
 
 د. دنيا نجم الدين أحمد
د. سلوى صبر محسن  
د. عبدالله لفتة جياد
 
الخلاصه:
المقدمه: مرض الأكياس المائية يتسبب عن الأصابة بدودة الكلب( المشوكة الحبيبية)وله أهمية من الناحية كونها تسبب عدوى حيوانية مشتركة مما تؤثر على الناحية الأقتصادية والصحة العامة يشكل رئيسي وهذا ما يهدد مناطق محددة من الشرق الآوسط وهذه المناطق الموبؤة بدودة المشوكات الحبيبية "ولابد من  وضع استراتيجية للوقاية والتحكم .مما يتطلب وصف المشوكة الحبيبية في جميع الدراسات الجزيئية للتحري عن الدنا الموجود في هذا الطفيلي .
الأهداف : تهدف الدراسة الى تحديد الأفضل من طرق أستخلاص الثلاثة( قيد الدراسة)  لدنا الأكياس المائية  لطفيلي المشوكات الحبيبية التي تم جمعها من الأغنام والأبقار من مجزرة الشعلة في مدينة بغداد .  
طريقة العمل  : تم أستخدام ثلاث طرق لأستخلاص عينات من الحمض النووي الدنا وهي طريقة الغليان والسحق والعدة التجارية ورحلت النتائج على 1.3% من جل الأكاروز , وفيما يتعلق بطرق الأستخلاص للحامض النووي قورنت من ناحية الوقت والتكلفة ومدى الدقة ووضوح الدنا المستخلص .
النتائج : الطرق التي كانت الأحسن في أستخلاص الدنا هي طريقة الغليان وطريقة السحق لأنها سهلة وسريعة بالأضافة الى الطريقة التي تستخدم العدة التجارية التي تعطي حزم جيدة للحمض النووي الدنا أثناء الترحيل الكهربائي لكنها ذات تكلفة عالية وتأخذ وقت .
الأستنتاجات : الطرق الأحسن أستخداما لأستخلاص الحمض النووي الدنا هي طريقتي الغليان والسحق
 
مفتاح الكلمات: طرق استخلاص الدنا، الاكياس المائية، المشوكات الحبيبية
Enteral feeding in duct-dependent congenital heart disease
Authors: Day T.G. , Dionisio D. , Zannino D. , Brizard C. , Cheung M.M.H.
Published: October 2018

BACKGROUND:

Infants with duct-dependent congenital heart lesions are treated with a prostaglandin E1 infusion. We aimed to describe the feeding strategies used at our institution in such infants, and to describe the incidence of necrotising enterocolitis (NEC) in this patient group, investigating whether enteral feeding is associated with a higher risk.

METHODS:

Patients diagnosed with hypoplastic left heart syndrome, coarctation of the aorta, pulmonary atresia, or transposition of the great arteries born over a defined period were identified. Premature infants, those with pre-existing gastrointestinal disease, and those who never received prostaglandin were excluded. Data were compared using univariable and multivariable logistic regression models.

RESULTS:

A total of 177 patients were identified, of them 18 received a diagnosis of suspected or confirmed NEC. There was no association between the diagnosis of NEC and enteral feeding ( P = 0.9).

CONCLUSIONS:

Based on these data, there does not appear to be an association between enteral feeding and NEC in infants receiving prostaglandin.
AMPEROMETRIC DETERMINATION OF PERRHENATE ANION USING A MICROSCOPIC INTERFACES BETWEEN TWO IMMISCIBLE ELECTROLYTE SOLUTIONS
Authors: Martynov L. Yu. , Lopatukhin E. V. , Astafyev A. A. , Shakhov A. M. , Nadtochenko V. A. , Zaitsev N. K.
Published: October 2018

Voltammetric responses associated with the simple reaction of perrhenate anions transfer across polarized micro-interfaces between two immiscible electrolyte solutions (micro-ITIES) was investigated, and their sensing applications were demonstrated. The micro-ITIES array was formed at polyethylene terephthalate membranes containing a 196 microhole array of radius 10.0±0.1 μm using a femtosecond laser. The characteristics of perrhenate ions transfer at the water/2-nitrophenyloctyl ether interface were first investigated using cyclic voltammetry (CV). CV was used in the estimation of some of the perrhenate anions thermodynamic parameters, such as the formal transfer potential and the Gibbs transfer energy. The technique of alternating current stripping voltammetry (ACSV) was also utilized to improve the sensitivity of the perrhenate anion detection. Under optimized preconcentration and detection conditions, a limit of detection of 0.3 μM with a wide linear dynamic range extending from 1.0 to 100 μM was achieved. The effect of various potential interfering anions on the perrhenate sensor was also investigated and an excellent selectivity over SCN-, I-, NO3-, NO2-, CO32-, SO42-, MoO42-, WO42- and CH3COO- ions was also achieved. This enabled quantitative measurements of rhenium in some mineral raw samples and the data was also validated by comparing with inductively coupled plasma atomic emission spectroscopy.
INFORMATION SYSTEM OF TESTING LABORATORY FOR RADIATION CONTROL
Authors: Kolybanov K. Yu. , Kuzin R. E. , Pisanenko S. S. , Tairov T. N.
Published: October 2018

Development of information-analytical system of radiation control is based on existing methods and hardware-software measuring instruments for the purpose of systematizing, storing and processing the results of analysis of samples of various composition and origin. Studying a large flow of environmental and technological samples includes the most difficult task to ensure the required accuracy of calculation of activities and errors, especially at low activities levels at the threshold of detectable area. The information system hardware includes a set of devices designed to measure the activity of the samples, and a local computer network. The server part of the software package includes a client-server database management system and a web application for database administration. In addition to the standard programs included in the delivery of radiometric equipment the client part of the software package includes the program "ODRA", developed using object-oriented language C# in Microsoft Visual Studio. The program "ODRA" includes modules for calculating the specific (volumetric) activity of radionuclides in low-active samples of materials and environmental objects, as well as for calculating the relative and absolute error of activity determination. The program has a convenient graphical user interface for database communication. The information system of the radiation testing laboratory of the enterprise that conducts work with radioactive materials has undergone a four-year approbation in the experimental production mode at VNIIHT in 2014-2017 and can significantly reduce the processing time of the results of determining the radioactivity of technological and environmental samples and reduce the operator error factor.
ANALISIS PERBANDINGAN HASIL PEMERIKSAAN KREATININ DARAH DENGAN DEPROTEINISASI DAN NONDEPROTEINISASI METODE JAFFE REACTION
Authors: Hadijah Sitti
Published: October 2018

Di berbagai RS pemeriksaan cepat sangat diperlukan untuk efesiensi waktu. Cara nondeproteinisasi merupakan cara yang paling sering digunakan. Selain faktor ekonomis, cara nondeproteinisasi lebih mudah digunakan. Namun, kekurangan dari metode ini adalah beberapa protein tidak diendapkan sehingga dapat menyebabkan tinggi palsu pada kreatinin. Untuk itu perlu adanya penambahan zat yang dapat mengendapkan protein tersebut. Salah satu cara yang dapat digunakan yaitu cara deproteinisasi. Tujuan dari penelitian ini untuk menentukan perbedaan hasil pemeriksaan kreatinin darah dengan deproteinisasi dan nondeproteinisasi metode jaffe reaction. Jenis penelitian yang digunakan adalah Observasi analitik study komparatif. Sampel penelitian yang digunakan sebanyak 15 penderita gagal ginjal di Rumah Sakit Islam Faisal Makassar pada tanggal 3 April sampai 9 April 2017. Hasil pemeriksaan kreatinin darah metode jaffe reaction didapatkan nilai tertinggi cara deproteinisasi 20 mg/dl dan nilai terendah 4,8 mg/dl, nilai rata-ratanya 9.793 mg/dl dan standar deviasi sebesar 3.7003 mg/dl sedangkan cara nondeproteinisasi didapatkan nilai tertinggi 20.3 mg/dl dan nilai terendah 5.7 mg/dl, nilai rata-ratanya 10.453 mg/dl dan standar deviasi sebesar 3.5689 mg/dl. Setelah dilakukan uji T dua sampel berpasangan didapatkan hasil yang menunjukkan bahwa T hitung<T tabel (0.497<1.753) hal tersebut menunjukkan bahwa tidak ada perbedaan yang signifikan antara kedua cara tersebut.Kata Kunci: Kreatinin Darah, Deproteinisasi, Nondeproteinisasi, Metode Jaffe Reaction
PEMERIKSAAN ANGKA LEMPENG TOTAL BAKTERI PADA MINUMAN SARI KEDELAI YANG DIPERJUALBELIKAN DI KECAMATAN MANGGALA KOTA MAKASSAR
Authors: Ahmad Mursalim
Published: October 2018

Penelitian ini dilatarbelakangi oleh tingginya angka bakteri total pada minuman sari kedelai yang ternyata melebihi batas maksimum cemaran SNI 01-3830-1995 baik dari pengolahan rakyat skala industry rumah tangga maupun dari pedagang kaki lima. Penelitian ini bertujuan untukuntuk menentukan jumlah bakteri pada minuman sari kedelai yang di perjualbelikan di Kecamatan Manggala Kota Makassar dan untuk mengetahui minuman sari kedelai tersebut memenuhi syarat kesehatan SNI. Jenis penelitian ini merupakan bersifat deskriptif dengan teknik pengambilan sampel secara accidental sampling sebanyak 8 sampel. Penelitian ini dilaksanakan pada tanggal 1 – 3 Agustus 2016 di Laboratorium Bakteriologi Jurusan Analis Kesehatan Poltekkes Kemenkes Makassar. Kesimpulan dari penelitian ini adalahpada 8 sampel minuman sari kedelai tidak melampaui batas cemaran yang ditetapkan oleh  Standar Nasional Indonesia (SNI). Saran dari peneliti adalah  bagi penjual minuman sari kedelai untuk memperhatikan aspek kebersihan dalam proses pengolahan dan penjualan sari kedelai serta bagi pembeli sari kedelai hendaknya lebih selektif dalam memilih tempat penjualan sari kedelai..Kata kunci : ALT, Sari Kedelai
UJI EFEK ANTI DIARE DAN UJI EFEK SISTEM SARAF OTONOM (SSO) INFUS DAUN TAPAK DARA ( Catharanthus roseus L.) TERHADAP HEWAN UJI MENCIT
Authors: Usman Samsidar , Ibrahim Ismail
Published: October 2018

Penelitian ini dimaksudkan untuk mengetahui efek pemberian Oleum Ricini yang merangsang timbulnya diare dan untuk mengetahui efek pemberian infuse Daun Tapak dara yang diujikan pada hewan uji mencit yang diinduksi diare dengan berbagai variasi konsentrasi infus dan sebagai pembanding digunakan Pilokarpin dan Atropin sulfat, di mana setiap konsentrasi infus dan kelompok pembanding tersebut, diteliti efeknya terhadap system saraf otonom, seperti miosis, midriasis, vasodilatasi, vasokontriksi, eksoftalmus, kejang, salviasi, dan diare pada interval waktu 30, 60, 90 dan 120 menit, begitupun dengan kelompok kontrol ( Air suling ). Hasil penelitian yang diperoleh menunjukkan bahwa infuse Daun Tapak dara dapat menghambat timbulnya diare dan menimbulkan efek pada system saraf otonom yaitu pada system saraf simpatis dengan konsentrasi 10% sebesar 48,7% dan pada system saraf parasimpatis sebesar 38%. Sedangkan untuk system saraf simpatis dengan konsentrasi 15% sebesar 64% dan pada sistem saraf parasimpatis sebesar 51,7%. Kata kunci : Daun Tapak dara ( Catharanthus roseus L.),  Sistem Saraf Otonom, Hewan Uji Mencit
PENGARUH EKSTRAK JAMUR SHIITAKE (Lentinula edodes) TERHADAP AKTIVITAS ANTIMUTAGENIK PADA MENCIT (Mus musculus) DENGAN MENGGUNAKAN METODE MIKRONUKLEUS ASSAY
Authors: Fardin Fardin , Zulkifli Zulkifli , Adpian Candra , Sinala Santi
Published: October 2018

Penelitian ini bertujuan mengetahui pengaruh ekstrak jamur shiitake (Lentinula edodes) terhadap aktivitas antimutagenik pada mencit (Mus musculus) dan menentukan tingkat konsentrasi ekstrak jamur shiitake dapat memberikan aktivitas antimutagenik paling baik. Uji antimutagenik dilakukan dengan metode ujimikronukleus (MN) dengan melihat penurunan jumlah mikronukleus pada 200 seleritrositpolikromatik (PCE) sumsum tulang paha mencit yang telah diinduksi larutan siklofosfamid 50 mg/kgBB. Hasil penelitian menunjukkan bahwa pemberian ekstrak etanol jamur shiitake (Lentinula edodes) dengan dosis 1000 mg/kgBB, 2000 mg/kgBB, dan 3000 mg/kgBB yang diberikan selama 7 hari secara oral mampu menurunkan jumlah persentase seleritrositpolikromatik (PCE) yang bermikronukleus yang diamati melalui preparat apusan sumsum tulang paha mencit. Konsentrasi yang paling efektif, yaitu pada dosis 3000 mg/kgBB dengan persentase penurunan MNPCE sebesar  93,83%, dan rerata peresentasi penurunan mikronukleus sebesar  85%. Kata kunci : Ekstrak Jamur Shiitake (Lentinula edodes)), Aktivitas Antimutagenik, Mikronukleus (MN)
PENGARUH EKSTRAK DAUN KELADI TIKUS (Typhonium flagelliforme) TERHADAP AKTIVITAS ANTIMUTAGENIK PADA MENCIT (Mus musculus) DENGAN MENGGUNAKAN METODE MIKRONUKLEUS ASSAY
Authors: Syafruddin Syafruddin , Suriani Suriani , Nahdawati Nahdawati , Pakadang Sesilia Rante
Published: October 2018

Penelitian ini bertujuan mengetahui pengaruh ekstrak daun keladi tikus (Typhoniumflagelliforme) terhadap aktivitas antimutagenik  pada  mencit (Musmusculus) dan menentukan pada konsentrasi berapa ekstrak daun keladi tikus memberikan aktivitas antimutagenik paling baik. Uji antimutagenik dilakukan dengan metode uji mikronukleus (MN) dengan melihat penurunan jumlah mikronukleus pada 200 seleritrositpolikromatik (PCE) sumsum tulang paha mencit yang telah diinduksi larutan siklofosfamid 50 mg/kgBB. Hasil penelitian menunjukkan bahwa pemberian ekstrak etanol daun keladi tikus (Typhoniumflagelliforme) dengan dosis 0,5 mg/kgBB, 1 mg/kgBB, dan 1,5 mg/kgBB yang diberikan selama 7 hari secara oral mampu menurunkan jumlah persentase seleritrositpolikromatik (PCE) yang bermikronukleus yang diamati melalui preparat apusan sumsum tulang paha mencit. konsentrasi yang paling efektif yaitu pada dosis 1,5 mg/kgBB dengan persentase penurunan MNPCE sebesar  92%, ,dan rerata peresentasi penurunan mikronukleus sebesar  80%.
UJI MUTU FISIK SEDIAAN KRIM EKSTRAK ETANOL BUAH BELIMBING WULUH (Averrhoa bilimbi L.) DENGAN VARIASI KONSENTRASI NA. LAURIL SULFAT
Authors: Arisanty Arisanty , Anita Anita
Published: October 2018

Buah Belimbing wuluh (Averrhoa bilimbi L.)  biasanya digunakan oleh masyarakat sebagai obat jerawat secara tradisional sehingga pengobatannya kurang efektif dan efisien. Tujuan penelitian ini adalah untuk memformulasikan sediaan krim dari ekstrak etanol Buah Belimbing wuluh (Averrhoa bilimbi  L.) dan untuk mengetahui  mutu fisik dari sediaan krim yang dibuat dari ekstrak etanol buah belimbing wuluh (Averrhoa bilimbi L.). Desain penelitian ialah pre and post test design pada krim yang dibuat dengan 3 variasi pada emulgator Na. lauril sulfat 0,5%, 1% dan 2% yang diuji sebelum dan sesudah penyimpanan selama 12 hari. Hasil penelitian menunjukkan bahwa ekstrak etanol Buah Belimbing wuluh (Averrhoa bilimbi L.) dapat di formulasikan sebagai sediaan krim dan pada pengujian organoleptik, daya sebar, dan homogenitas terdapat 2 formula yang memenuhi syarat yaitu Na. lauril sulfat 0,5% dan 1%, dan pada pengujian pH tidak terdapat formula yang memenuhi syarat Kata kunci : Ekstrak Buah Belimbing wuluh, Mutu Fisik dan Na. lauril sulfat.
CLINICAL OUTCOME OF MEASLES AND RUBELLA WITH MACULOPAPULAR RASH AT CHILDREN'S HOSPITAL, PIMS, ISLAMABAD
Authors: Kirshin Jai , Afghan Sameena , Ayub Aqeela , Shah Kishor , Hussain Maqbool
Published: October 2018

BACKGROUND: Measles is highly endemic disease in Pakistan that can be prevented by vaccinating the child.Patients with rash and fever are the major syptoms of this infection. The aim of this study was to find the associationof clinical and serological outcome of measles and rubella with demographic profiles in patients hospitalised withclinical suspicion of these conditions. METHODS: A descriptive cross sectional study was conducted in children hospital of PIMS Islamabad where allchildren presenting with maculopapular rash in outdoor patient, indoor patient and accident and emergencydepartment were enrolled. The study duration was one year or the completion of required sample size. A total of 73children who fulfilled the inclusion criteria were enrolled in this study. A purposive sampling technique was used toselect cases. Data was collected through a structured proforma especially designed for this study. Permission wastaken from the Hospital Ethical Committee before the commencement of the study. A written consent was also takenfrom the parents of children prior to conduct the study. RESULTS: All the children in this study was 46.5 (Â± 40.1) months of age, the mean (SD) age was 4 years and 10months (Â± 3 years and 4 months). The median age of all children was 24 months (2 years). The youngest child was 7months old while the eldest child was 12 years (144 months) of age. Out of 73 children enrolled in the current studywho presented with maculopapular rash and their serological outcome was assessed, 50 (68.5 percent) were boyswhereas 23 (31.5 percent) were girls. Koplik's spots were present among 56 (76.7 percent) children whereas 17(23.3 percent) did not have Koplik's spots at the time of enrolment. lymphadenopathy was assessed in 35 (47.9percent) children while 38 (52.1 percent) did not have lymphadenopathy at the time of enrolment. CONCLUSION: Study concluded that a higher proportion of children presenting with maculopapular rash werediagnosed to have measles on the basis of serology.
CHILDHOOD IMMUNIZATION AMONG INTERNALLY DISPLACED PERSONS (IDPS) OF UNDER FIVE-YEARS FROM NORTH WAZIRISTAN AGENCY, PAKISTAN: A CROSS SECTIONAL STUDY
Authors: Sultan Ali Shezina , Khan Ejaz Ahmad , Mushtaq Mudassar , Ur Rahman Mujib
Published: October 2018

BACKGROUND: Immunization is an important and cost effective public health tool for controlling Vaccine Preventable Diseases (VPDs) among children. Developing countries have low level of immunization coverages. This is further compromised during armed conflicts and disasters with displacement of vulnerable populations leading to VPDs outbreaks. Tribal areas of Pakistan have been subjected to armed conflict for a long time with massive population displacement. METHODS: We conducted a cross sectional survey to assess the vaccination status of child under five of the Internally Displaced Persons (IDPs) of North Waziristan Agency (NWA) of Pakistan. We used a structured questionnaire to collect information from the caregivers in the IDP camp of Bannu, Khyber Pakhtukhwa. RESULTS: Overall immunization coverage was very low. Out of 480 children under 5 years, less than one-third (30.6%) were vaccinated against BCG, about a quarter (27.7%) had received the Pentavalent and measles vaccines. However, OPV coverage was excellent mostly amid to polio mass campaigns. CONCLUSION: Routine immunization coverage among the IDPs of North Waziristan agency in Pakistan is extremely poor. There is a need to improve the coverage to optimum level to avert any potential VPD outbreaks.
ASSESSMENT OF SKILLED BIRTH ATTENDANTS REGARDING HELPING BABIES BREATH INTERVENTION TO IMPROVE NEWBORN CARE IN RURAL DISTRICT OF SINDH
Authors: Mureed Sheh , Gandro Muhammad Hassan , Hassan Walid
Published: October 2018

Background: Globally, 3.1 million newborn deaths occur every year out of these estimated 400,000 neonatal deaths occur in Pakistan. All neonatal deaths 99% take place in poorest region and countries of the world, usually within hours of birth; mostly the cause of neonatal deaths is hypoxia. To access knowledge and practice of SBAs regarding HBB and to access the availability of equipments required for HBB. Methods: Descriptive Cross-Sectional Study on SBAs as trained in HBB. All 46 SBAs trained on HBB working in Labour room eight rural Health centers, four Taluka, One district Head Quarter Health Facilities and thirteen Mlbcs of the district, were included in the sample for study. All 41 SBAs were trained on HBB participated in the study. Results: Mean age of 30 years. Out of total 41 participants 25 were working in B-EmoNC (61%), 3in C-EmoNC (7.3%) and 13 in mid wife laid birth Centre (MLBC) or birth station (31.7%). About 92.7% of participants said that main purpose of HBB training is to decrease the NMR by improving newborn care. Drying of newborn is 82.7%, hand washing is 95.12% and 85.3% of the study participants said that they gave 30-40 breaths per minutes. Cord clamp and pair of ties was accessible to 85% of participants versus 14.3% who reported it's not accessible. Almost one quarter (34.1%) participants have low knowledge and practice. Knowledge and training had significant effect on the overall practices of the skilled birth attendants for skilled birth deliveries and reduce the neonatal deaths (P <0.001). Conclusion: Tools play a vital role for the implication of the knowledge into practices and tools were available almost to every participant. Although few barriers also identified for the less application of the helping hand babies trainings in the community.
7TH ANNUAL PUBLIC HEALTH CONFERENCE 2016 AT HEALTH SERVICES ACADEMY: EXPERIENCES IN THE FIELD OF PUBLIC HEALTH AND WAY FORWARD
Authors: Khan Neelam A , Hamid Saima , Ronis Katrina
Published: October 2018

Background: Health Services Academy held its 7th Annual Public Health Scientific Conference in December 2016 in Islamabad, Pakistan. The theme was Sustainable Development Goals (SDGs) in Health: Collaborating for Prosperity. Over seven hundred international and national public health specialists attended to share research initiatives, build partnerships and strengthen networks. Post-conference online survey was emailed to all participants to facilitate a more structured feedback and hence evaluation of the two day event. Methods: An online instrument was developed using the â€œSurvey Monkeyâ€ template. Total participants (n=757) were invited to complete the online survey which consisted of five sections: Likert scales were utilised to ascertain how â€œinformativeâ€ the conference was to the participants. Comment boxes were provided for each section to collect qualitative responses. The quantitative data was collated by Survey Monkey and presented in percentages. Manual thematic analysis was utilised for the qualitative data. Results: The final online surveys emailed was seven hundred and four and of these just over two thirds (67%) were opened and 33% (n=230) were unopened. The latter emails may have been in the â€œspamâ€ box or not opened. Of the opened surveys (n=474) nearly two hundred were completed and emailed back, a response rate of forty two percent (n=199). The quantitative data revealed that the majority of respondents (75%) found the plenary sessions to be 'very informative 'and approximately half of the respondents considered the scientific sessions to be 'extremely informative' or 'very informative'. With respect to how useful the conference was to the participant's field of public health, almost half (44%) responded 'very useful and over a third (34%) responded 'extremely useful'. The top three themes recommended for the 2017 Conference included Nutrition; Non-Communicable Diseases and Mental Health and Sustainable Development Goals. Conclusion: The majority of survey respondents agreed that the conference was a success and the theme was useful in their own field of public health. Several themes for the 2017 conference were provided with a focus on nutrition the most popular.
CHALLENGES AND EXPERIENCES OF LADY HEALTH WORKERS WORKING IN POLIO CAMPAIGNS IN DISTRICT NOWSHERA, KHYBER PAKHTUNKHWA, PAKISTAN
Authors: Bahar Shaista , Khalid Rozina , Khan Shehzad Ali , N Naseemullah , Batool Nazish
Published: October 2018

Background: Lady Health Workers (LHWs) are recruited from the local rural communities under the National Programme for Family Planning. In addition to their assigned duties, they conduct door to door polio vaccination campaigns. However, for the last five years, amid to the security situation in the country Khyber Pakhtunkhwa (KP), Quetta and Karachi, remained the main highest -risk areas for them for polio campaigns. Methods: We conducted this qualitative study in two union councils of District Nowshera by doing IDIs and FGDs with LHWs who performed their duties in polio campaigns. We used a field guide for interviewing. District coordinator of EPI and two Lady Health Supervisor (LHS) were also interviewed. Interviews were conducted and recorded, the audiotapes were transcribed and categorized on themes and sub themes. Content analysis was carried out. The data was presented in narrative form using summative and verbatim quotes. Results: There was shortage and insufficient supply of medicines. The second most important issue the LHWs faced was the security. Delay in salary release, no incentives and promotion, community disrespect, administrative constraints, misperceptions regarding polio vaccines and work load were important challenges. Conclusion: We conclude that the LHWs in both the union councils faced some challenges. Awareness through media is a good option but due to threats to the polio campaigns it is hard to work in these campaigns.
ESTIMATED PROPORTION AND FACTORS ASSOCIATED WITH ACUTE RESPIRATORY INFECTIONS IN CHILDREN UNDER FIVE IN ISLAMABAD PAKISTAN
Authors: Jabeen Nadia , Khan Shahzad Ali , Qureshi Zubia
Published: October 2018

Background: Acute Respiratory Infection (ARI) is an important cause of mortality and morbidity in children, especially in under-fives, it is necessary to explore its risk factors for better health of children. Methods: This study was a cross sectional study, conducted in the Federal Government Polyclinic Dispensary of G- 7/3-4, Islamabad on 104 under five children, from April 2016 to June 2016. All the children from 0-59 years of age, irrespective of sex visiting dispensary were included in the study. Structured questionnaire used to collect the data. Frequencies and proportions were calculated as descriptive part of the analysis while Qui/Fisher Exact test was done as inferential analysis by using SPSS. Results: Out of 104 under five children ARI was found in 34 (32.7%). It was more in male children 23 (37.1) compared to female 11 (26.2%). A significant association was found between ARI and child's birthplace, their history of low birth weight, breast-feeding history, vaccination status, mothers education, mother's occupation, number of family members, smoking in fathers, ventilation condition of home, kitchen type, and knowledge of mothers regarding ARI signs and symptoms. Conclusion: The present study found that ARI is prevalent in under five children of the studied area. Results suggested that there is need to enhance the knowledge of mothers regarding ARI risk factors, its signs and symptoms, prevention and treatment.
FACTORS AFFECTING WILLINGNESS OF DOCTORS TO WORK IN RURAL AREAS OF PAKISTAN
Authors: Sultana Abida , Awais Sayema , Mughal Aashi , Anwar Bushra
Published: October 2018

Background: The objective of this study was to assess the willingness of medical doctors to work in rural areas. The study also aimed to elucidate the factors influencing the decision of doctors to work in rural versus urban location of clinical practice. Methods: It is a cross-sectional study that was conducted from 8th January 2016 to 18th January, 2016 including randomly selected House officers (Hos), Postgraduate Trainees (PGTs) and Medical Officers (MOs) working in various departments of Holy Family Hospital, Rawalpindi using a self-administered semi-structured questionnaire. The questions related to demographic details, future plans and willingness of doctors. Factors facilitating or preventing them from accepting a rural position were also enquired about. Results: Thirty (30%) of the respondents were found willing to work inrural areas while 45% were neutral and 25% had a negative attitude towards practice in rural areas. Factors significantly related to rural choice of practice included rural place of birth (p value=.001), previous experience of having lived in rural settings (p value= .001)payment of fees by parents rather than by family or loans (p value=.001) and with the doctors' expectations of whether they are likely to work in rural/urban/foreign locations (p value=.001). Conclusion: The study shows that most of the doctors who have a rural birthplace/ experience of living are more willing to work in rural areas. Therefore, if the government wants to fill the vacant posts in rural locales, scholarship schemes for students from rural areas should be increased.
COMPLEXITIES OF MEDICAL RESEARCH IN DEVELOPING COUNTRIES: STANDARD OF CARE: RESPONSIBILITIES OF ETHICS COMMITTEES
Authors: Memon Inayat Ullah
Published: October 2018

Increased awareness of human rights particularly those of vulnerable and emphasis on protection of less strong from stronger groups, have extended the limits of biomedical ethics where human participants are involved in the research. Inequalities amongst various global groups and subgroups in respect to financial resources and healthcare with increased collaborative biomedical research, particularly for-profit institutions have raised ethical issues one being the standard of care in research in developing countries. Emergence of newer and complex infectious diseases and resurgence of older ones in recent past has prompted Western world to undertake research in the Eastern hemisphere of the globe. But it has generated complex and various ethical dilemmas. Ethics demands that enrollees of research in developing countries not only be judiciously remunerated but outcomes of the studies be directly beneficial and affordable to them along with provision of parallel benefits. The core point of discussion amongst various partners is the selection from possible choices of standard of care to human participants in less developed countries. While some authors have argued for alternate standards whereas others suggest to compromise on this demand in particular conditions with permission from Ethics Committees. These suggestions, besides empowering the ERCs have put more burden on them to prepare guidelines and resolve the encountered issues where presently available guidelines are inadequate or insufficient. This work provides in-depth discussion and analyses possible alternatives to this complex dilemma.
HEALTH SEEKING BEHAVIOR OF PSYCHIATRIC PATIENTS AT AN OUTPATIENT DEPARTMENT OF A TERTIARY CARE HOSPITAL IN LAHORE, PAKISTAN
Authors: Chaudhry Muhammad Ashraf , Butt Aneeqa Shamshad , Khan Ejaz Ahmad , Latif Asma Abdul , Kamran Jalil , Khan Mumtaz Ali , Rana Muhammad Saleem
Published: October 2018

Background: Mental and psychological disorders are responsible for significant morbidity and disability worldwide. Results of World Mental Health Consortium demonstrate that common mental disorders are highly prevalent globally. Only a limited proportion of patients with psychiatric disorders attend the healthcare facilities, in severe condition. Treatment by unqualified medical practitioners and faith healers is a common practice, which significantly delay the proper treatment. Methods: We conducted this survey at the psychiatry OPD at Jinnah Hospital Lahore from March 2015 to May 2015. 1000 study subjects of 14 -70 years of age from both genders were enrolled for this study randomly, who sought psychiatric opinion for first time. Results: One hundred patients were examined, mean age of subjects was 31 years (SD + 15.02), with 53.0% females. More patients (60.0%) were first time recognized by their family members, remaining sought treatment by themselves. As per history 42.4% patients had consulted to Qualified Medical General Practioners, 19.9% to Piers, 12.0% to Religious Clerics and 10.5% to Hakim, Fakir, Malang etc. and only 2.6% consulted to psychotherapist. Conclusion: It is concluded that in our setting psychiatric illnesses are always recognized late and medical practitioners do not bother to obtain consultative opinion from psychotherapist.
EXPLORING GAIT, BALANCE PERFORMANCE AND FEAR OF FALLING AMONG ELDERLY PEOPLE LIVING IN RURAL AREAS OF THAILAND
Authors: S Pummarak , R Samrongtong , Kumar Ramesh
Published: October 2018

Background: Previous evidence indicates that older people allocate more of their attentional resources toward their gait and that the attention-related changes that occur during aging increase the risk of falls. Methods: A cross sectional study was conducted in Banna District and Ongkarak District, Nakornnayok Province, Thailand. One hundred elderly people participated in this study. Gait was assessed by a Time Up and Go Test (TUGT) while the One legged stance test (OLST) assessed balance performance. The Falls Efficacy Scale (FES) measured fear of falling of the elderly people. A WHOQOL-BREF instrument assessed the quality of Life among elderly people. Results: The findings revealed that 58% of the participants were female, aged between 60-74 years (mean = 66.39, SD 3.65). Over a 12 month period, 57% of participants had experienced a fall once, 41% had experienced 2 falls while 2% had experienced 3 or more falls. One-third of the elderly people who participated in the study had a fear of falling. Almost all of the elderly participants (76%) had a moderate fall risk perception score. The mean score of total quality of life was moderate (80.43). Conclusion: Study concluded that the elderly people face a valid risk of falling based on prevalent risk factors that results in a fear of falling. An assessment of fall risk factors are important in establishing a fall prevention program for the elderly faced with fall risk factor from fear of falling and. Assessment fall risk factors are important to provide the suitable falls prevention program for the elderly.
RELUCTANCE TO SERVE IN RURAL AREAS: DOCTORS' PERSPECTIVE
Authors: Jaffry Tamkeen Nishat , Mirza Samiha , Farheen Shehla , Khalid Sadaf
Published: October 2018

Background: Pakistan's health care system has been adversely affected by the non-availability of doctors in its rural and remote areas. It is the high time to realize that the improvement in the standard of health care services can be achieved with willingness and dedication of doctors to work in these areas which is only possible by providing them with suitable working environment. Methods: This was a descriptive cross-sectional study conducted on 200 doctors working in public and private hospitals/clinics of Islamabad, Pakistan. Data was collected through a questionnaire and processed in SPSS software version 16. Results: 200 doctors comprising of 113 males and 87 females were recruited for the study. The mean age was 30 years (0.65 SD). Majority (86.5 %) of the doctors were of the view; that indeed it was the non-availability of doctors at rural health care centres for poor health services in such areas. 83.9 % agreed that basic facilities were lacking in rural areas. Regarding transportation, 74.5 % had the opinion that these facilities were inadequate in rural areas. Nevertheless, 84.5 % agreed that by improving the basic facilities of life, working conditions could be improved. However, 72.5 % supported the idea of extra hard area grant to improve doctors' motivation towards serving rural areas. Conclusion: Doctors were reluctant to serve in rural areas because of the difficulties affecting their social, professional and family life. By developing the infra-structure of health centres and by providing some special incentives to the serving doctors, this issue can be resolved to a considerable extent.
NUTRITIONAL STATUS AND ASSOCIATED FACTORS AMONG NOMAD CHILDREN UNDER FIVE YEARS OF AGE IN DISTRICT FAISALABAD
Authors: Babar Mawera , Khan Rukhsana , Ullah Aziz
Published: October 2018

Background: Globally, more than 150 million under five children are malnourished. In Pakistan 43.7% of under five children were stunted, 15.1% were wasted and 31.5% were underweight according to NNS, 2011. Nomads are the shifted or migrated people, they are the neglected ones therefore have a very poor health status and knowledge about nutrition. The aim of this study was to improve the nutritional status of the under five nomad children in district Faisalabad. The objectives were to assess the nutritional status of nomad children, knowledge of mothers regarding the nutritional status of their children, factors associated with the nutritional status of these children. Methods: A cross sectional study was conducted in nomad settlements of four Union councils of district Faisalabad. A structured questionnaire was used and anthropometric measurements like height, weight and MUAC of 296 children selected consecutively were calculated. Results were analyzed by using WHO Anthro to identify stunting, wasting and underweight cases whereas SPSS-20 was used for descriptive and inferential statistics. Results: Results showed that the proportion of malnutrition among under five children was 86% in which 10.8% were wasted, 53.4% were stunted and 58.8% were underweight. About 76% of the mothers have no knowledge about their child's nutritional needs. A significant association was found between malnutrition and sociodemographic, child health and maternal health characteristics including knowledge of mothers. Conclusion: The nutritional status of the nomad children less than five years was unsatisfactory. Therefore efforts should be made to enhance nomad mothers knowledge through CMW's and LHW's and also provide nutritional support to them.
ACCREDITATION AND HEALTH CARE QUALITY ASSURANCE IN PAKISTAN: A DESK REVIEW
Authors: Rabbani Fauziah , Abbasi Imran Naeem
Published: October 2018

Background: Pakistan has a well-established healthcare system with 70% healthcare needs catered by private health sector. The latter's unregulated and unchecked expansion has resulted in quackery and compromised quality of care. This situation analysis provides a snapshot of health system's quality assurance and accreditation processes. Methods: Two validated questionnaires from World health Organization gauged the current state of health care accreditation and quality of care initiatives in Pakistan. Information was obtained from peer reviewed articles, grey literature, policy documents on government websites and newspapers. Results: Pakistan has a number of regulatory bodies responsible for ensuring quality in healthcare through accreditation and defined standards. National Institute of Health issues updated clinical quality guidelines pertaining to disease epidemics. A national quality policy was also formulated in 2004. However, implementing and ensuring accreditation has been challenging. Though statutory bodies are in place for registering different cadres of healthcare professionals, policies and mechanisms regarding licensure of healthcare establishments are missing. Emergence of national health vision 2012-2020, provincial health sector strategies and healthcare commission acts have focused on regulation of private health sector and accreditation of healthcare establishments. Despite presence of regulatory bodies, there are implementation gaps. Conclusion: This paper highlights some important gaps regarding accreditation and quality in healthcare. Quality assurance should be incorporated into national health policies, programs and strategies. National health policy should include explicit laws concerning quality Indicators and standards for quality in health care. Need to regulate private health sector and ensuring quality in overall healthcare is more than ever.