bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Metformin on Biochemical Marker of Recurrence Among Post Mastectomy Female Diabetic Patients
Authors: Siddique Tasnim Binta , Alam Syed Mahbubul , Rahman Mizanur , Hossain Mohammad Zaid , Rahman Kazi Afzalur , Jahan Ishrat , Sharif Sayeed Bin 
Published: March 2020

Background: The different modalities of the treatment of diabetes such as life style modification, metformin, insulin and combination of metformin & insulin have role on breast cancer outcome. Insulin and metformin have some influence on the outcome indirectly by affecting some biochemical markers such as S. adiponectin, HOMA IR & IGF-I. Therefore this study investigates the effect of metformin and insulin in postsurgical breast cancer patients which is evaluated by S. adiponectin levels and their association with obesity.
Objectives: To evaluate effects of metformin on biochemical marker of recurrence among post mastectomy female diabetic patients.
Materials and methods: It was a retrospective cohort study done in Sir Salimullah Medical College and Mitford Hospital Dhaka, from January 2015 to December 2015. In this study purposive consecutive samples were collected at base line from 3 months to 36 months post mastertomy. After fulfill all exclusion and inclusion criteria, 82 cases were selected as sample.
Results: Mean age was found 47.2 years with ranging from 26 to 75 years. Only 9(11.0%) respondents had family history. The mean BMI was 28.4 kg/m2 and mean waist circumference was 95.2 cm. Almost half (48.8%) respondents took oral contraceptive pill and post menopausal status was found in 48(58.5%) respondents. The mean S. adiponectin level was statistically significant when compared with different type of DM treatment and different BMI group.
Conclusion: This study finally focused that the effects of metformin; the antidiabetic medication has play an important role to change the S. adiponectin level which modify the outcome among post mastectomy diabetic patients. The recurrence can’t be evaluated clinically due to short period of time and need a further study for follow up.
J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 41-46
Evaluation of Extra Axial Cerebellopontine Angle Tumours through MRI
Authors: Biswas Prodip Kumar , Sardar Md Hafiz , Saha Gopal Chandra , Hossain Mohammad Zaid , Hossain Mohammed Shahadat , Paul Tushit , Azad Khan Abul Kalam 
Published: March 2020

Aim: This study aimed to evaluate the incidence of extra-axial cerebellopontine angle tumours and to characterize extra-axial cerebellopontine angle tumours.
Methods: The study was carried out in Dhaka Medical College for the duration of 2 years from July 2016 to July 2018. All patients with clinical suspicion of CP angle tumours subjected 1.5 T MR imaging system. Total 30 patients were evaluated during this period.
Results: Extra-axial CPA tumours accounts for 7-10% of brain tumours. Most common extraaxial CPA tumour is schwannoma (60%), followed by meningioma (27%), epidermoid (7%), arachnoid cysts (7%). 51-60 years is the most common age group involved. Schwannomas are common extra-axial CPA tumours which are enhancing round masses most commonly arise from the vestibular nerve and associated with enlargement of the internal auditory canal. Meningiomas are the second most common extra-axial CP angle tumours which oval or hemispheric lesions with a broad attachment to tentorium or petrous dura matter.
Conclusion: MRI is the most sensitive noninvasive modality to characterize extra-axial CPA tumours. MRI identifies the location and extension of the lesions based on their characteristic signal and enhancement pattern on contrast.
J Dhaka Medical College, Vol. 27, No.2, October, 2018, Page 104-107
Effectiveness of ultrasound-guided hydrostatic reduction of intussusception in children
Authors: Datta Sumi , Md Jamal - , Rahman Yesmina , Hussain Mahbuba , Yeshmina Fahmida , Rabbi Akanda Fazle , Sarker Pratul Kumar 
Published: March 2020

Aim: To review the effectiveness of ultrasound- guided hydrostatic reduction of intussusception in children.
Methods: This prospective interventional study was done during one year period from January 2014 to December 2014 in the department of Radiology and Imaging of Dhaka Medical College and Hospital, Dhaka and included 30 children clinically and radiologically diagnosed as intussusception with symptoms d” 48 hours. They underwent ultrasound-guided hydrostatic reduction using normal saline and the effectiveness of this technique was reviewed.
Results: Majority of the study population were in the age group of 7-24 months with mean age of 9.04± 2.48 months. 100% patients who presented within 24 hours of their symptoms achieved successful reduction whereas success rate of reduction were 95% and 0% respectively in patients presented within 24-36 hours and after 36 hours of their symptoms. 60% cases required 5-10 minutes for successful reduction, 20% cases required 3-5 minutes and 10% patients needed > 10 minutes. Within 3 attempts, reduction happened in 90% cases whereas 10% cases failed to reduce. No case was tried for reduction after 3 attempts in consideration of the bowel pathology and complications. Only 10% patients developed negligible complications. No case showed recurrence.
Conclusion: Ultrasound guided hydrostatic reduction of intussusception is an effective nonoperative treatment of intussusception in children because of its high success rate, less complications and recurrence rate.
J Dhaka Medical College, Vol. 27, No.2, October, 2018, Page 134-140
Assessment of Nutritional Status through Body Mass Index (BMI) among First Year Students of MBBS & BSc Nursing Course of Government Medical Education Institutes in Dhaka
Authors: Kamal AHM Mostafa , Khatun Khadeza , Shams Shakil , Kazi Begum Dilruba , Rahman Kazi Afzalur , Shahnaz Tasmin , Hossain Muhammad Mahbub , Siddika Munira Afroz 
Published: March 2020

Context: Adequate knowledge about nutritional status of a community is necessary to have a comprehensive idea about its development process, as under-nutrition is one of the major health problems in developing countries. As an individual’s height and weight can be readily and inexpensively measured, body mass index (BMI) has become a popular heuristic approximation for body fatness in epidemiology and clinical practice. The BMI is the most common surrogate measure of obesity as well as nutritional assessment for individual. For this reasons an attempt has been taken to assess the nutritional status through the body mass index (BMI) among first year students of MBBS and B sc nursing course of government medical education institutes in Dhaka.
Material and Methods: This descriptive type of analytic study was conducted in the Anatomy Department of Dhaka Medical College, Dhaka. The study sample was 177 individuals of first year students of MBBS and B.Sc nursing course admitted in the session of 2017-2018 in the Dhaka Medical College & Dhaka Nursing College, Dhaka. Body Mass Index (BMI) was calculated as student’s weight in kilograms divided by the square of the student’s height in meters (kg/m2). The warning sign of poor nutritional health was calculated according to the checklist adapted by the Nutrition Screening Initiative, American Academy of Family Physicians July 2001. With the help of statistical software SPSS-20 comparisons between the two groups were done.
Result: The mean (±SD) height (meter), weight (kg) and BMI of groups MBBS and B Sc nursing were 1.63±0.09, 61.65±11.22, 23.11±3.53 and 1.56±0.07, 49.05±9.42, 20.15±3.47 respectively. Good nutritional health status was found 61.80% in MBBS and 53.30% in B Sc nursing groups.
Conclusion: The present study showed that the BMI of first year students of MBBS course is higher than first year students of B Sc nursing course.
J Dhaka Medical College, Vol. 28, No.1, April, 2019, Page 11-16
Distribution of Pruritus and Its Association With Serum Parathormone Level in Chronic Kidney Disease (Stage-5) Patients On Maintenance Hemodialysis
Authors: Hasan Rafiqul , Chowdhury Md Nizamuddin , Islam Md Nazrul , Ahmed Parvez Iftekher , Anwar ASM Tanim , Hossain Mohammad Bellal , Ali Mohammad Shawkat , Rahman Md Saidur 
Published: March 2020

Background: Pruritus is a common manifestation in patients on hemodialysis. The aim of this study is to determine the distribution of pruritus and evaluate the association between pruritus and serum parathormone levels in chronic kidney disease patients on maintenance haemodialysis.
Methods:This analytic, descriptive, cross-sectional study was performed over 191 patients of maintenance haemodialysis in 2014. Information related to the patients including age, gender, residence, pruritus was extracted from questionnaires. Serum levels of intact parathormone were measured & data were analyzed.
Results: 68% of the patients had pruritus. The Mean ± SD of serum parathormone was 53.25±7.96 pg/ml in patients with pruritus and 81.91±9.34 pg/ml in patients without pruritus. Our study showed that most patients with pruritus had normal serum parathormone levels and no significant association was found between pruritus and serum parathormone levels.
Conclusion: serum parathormone level may not play a role in uraemic pruritus in these patients.
J Dhaka Medical College, Vol. 28, No.1, April, 2019, Page 54-59
Effect of BMI(Body Mass Index) on BMD (Bone Mineral Density) in Postmenopausal Women
Authors: Ghani Tabassum , Paul Subinoy Krishna , Begum Afrina , Noorjahan - , Sarkar Mandira , Hussain Taufiqua , Anar Mosammat Gul A , Rana Md Sohel , Hossain Md Sazzad 
Published: March 2020

Menopause is commonly associated with rapid bone loss and this bone loss manifests as a significant decrease in bone mineral density (BMD). Body weight or body mass index is the most important factor which influences BMD. Aim of this study was to evaluate the association between BMI and BMD in post menopausal women. Also to measure the correlation between age, duration of menopause, weight with BMD. This cross-sectional study was undertaken in the Department of Obstetrics and Gynaecology in Dhaka Medical College Hospital, Dhaka from January, 2012 to December, 2012. The study included women of 50 to 70 years who had menopause with three or more parity. Total 100 women were evaluated by history taking, physical examination and laboratory investigation (BMD).The results showed that there was significant positive correlation between BMI and BMD value of L1-4 and total femur (Pearson‘s coefficient was +0.285, P<0.01 and +.350, P<.001). There was also significant positive correlation between weight and T- score of L1-4 (r =+ .482, P<.01) and Total femur (r = +.513, P< .01). In addition, significant negative correlation was found between BMD with age and duration of menopause. It can be concluded that in postmenopausal women as the BMI decreases bone mineral density also decreases. So, adequate weight and BMI necessary for the prevention of osteoporosis.
J Dhaka Medical College, Vol. 28, No.1, April, 2019, Page 60-66
Induction of Labour by Intravaginal Misoprostol In Intra Uterine Death of Fetus at Ssmc and Mitford Hospital, Dhaka
Authors: Afroz Mahenaz , Anwar Begum Rokeya , Khanom Afroza , Biswas Prodip Kumar , Islam Sadia , Rouf Rozana 
Published: March 2020

Intra uterine fetal death occur in 1% of pregnancy. The patient goes into labour in most of the cases, spontaneously. Retained dead fetus may cause disseminated intravascular coagulation sometimes resulting death of a mother. Objective: The aim was to find out the reults after using intravaginal Misoprostol in Intrauterine fetal death in last trimester of pregnancy.
Study design: This was a cross sectional observational study prospective in nature on 160 cases of intra uterine fetal death patients in indoor of department of Gynae and Obstertrics of Sir Salimullah medical college Hospital, Dhaka from 02/01/13 to 01/07/13, for a period of 6 months.
Result: 60% of the patients were primi gravida. Mean age of the patients was 22.12±4.3 years 44% were in 33 to 36 weeks of pregnancy when induction was done. 41 (82%) patients having Bishops score d” 6 reqired 21±8.25 hours where as 09 (18%) patients having Bishops score e” 6 needed 10±1,1 hours to complete the delivery. There were no reports of maternal mortality. All the patients delivered per vaginally except one (2%) who needed ceasearean section due to development of chorioamnionitis.
Conclusion: Intravaginal misoprostol can aid in vaginal delivery safely.
J Dhaka Medical College, Vol. 28, No.1, April, 2019, Page 90-93
Ocular Fundus Changes in Pregnancy Induced Hypertension
Authors: Khanom Rashida , Faridi Jamsed , Nur Jinnatun , Akter Sumaiya , Basu Kamalesh Chandra 
Published: March 2020

Purpose: Preeclampsia and eclampsia is one of the leading causes of maternal and fetal morbidity and mortality worldwide. Visual disturbances in (pre)eclampsia seem to be frequent phenomena. Therefore, the obstetrician/gynecologist may encounter women with serious, and sometimes debilitating, pathology of the visual pathways.
Methods: This is a cross sectional observational study was conducted over a period of 12 months (January 2016-December 2016) at Dhaka Medical College Hospital, Dhaka, Bangladesh. Patients with severe preeclampsia and eclampsia were included in the study. The association was measured with Chi-squared test and p value of 0.05 was treated as significant.
Results: During this 12-month period, 100 patients with severe preeclampsia and eclampsia were studied the mean age was 26.4 ± 5.5 years. The association between retinal changes and different variables was statistically significant positive association between the presence of retinal changes and blood pressure (P= 0.0118), proteinuria (P= 0.0025). However, age (P= 0.7123), and gravida (P= 0.7998) were not associated with occurrence of retinopathy in our study. The most common retinal change was noted and narrowing of arterioles, (83%) that retinal changes were significantly more in patients with severe hypertension, exudate (12%) and haemorrhages (10%) observed in present study. The presence of macular edema (5%) and retinal detachment (2%) are the warning signs for termination of pregnancy to save the vision of the mother.
Conclusion: It is called that eye is the gateway of medicine, so in pregnancy induced hypertension presence of changes in the retinal arterioles and retinal haemorrhages may indicate similar changes in the placenta. Since the well-being of the foetus depends on the placental circulation, ophthalmoscopic examination of mother’s fundus may give a clue to similar micro-circulation changes in the placenta and indirectly to the foetal wellbeing.
J Dhaka Medical College, Vol. 28, No.1, April, 2019, Page 94-99
ANALISIS VISUAL GIM CUPHEAD
Authors: Persada Satria Indra Praja 
Published: March 2020

Video gim merupakan salah satu karya desain komunikasi visual yang diminati saat ini, gim yang bersifat interaktif memiliki kelebihan dari karya desain lain karena dapat dimainkan oleh penggunanya dan berinteraksi langsung dengan objek yang ada dalam video gim tersebut, Saat ini sudah banyak sekali video gim dengan berbagai jenis mulai dari gim RPG (Role Playing Game), Petualangan (Adventure), Pertarungan (Fighting) hingga Lomba adu kecepatan (Racing) dengan berbagai macam gameplay dan konsep visual, salah satunya adalah Cuphead, Cuphead sendiri merupakan gim petualangan yang menawarkan konsep visual unik sehingga dapat menarik para pemain gim dalam membeli gim tersebut saat ini cuphead sendiri telah terjual sampai 5 juta kopi hal ini tidak lepas dari keunikan konsep visual yang diusung oleh Cuphead. Adapun penelitian mengenai gim Cuphead ini dilatar belakangi oleh konsep visual yang diusung oleh gim Cuphead dimana konsep visual yang di usung oleh gim Cuphead ini memakai konsep visual retro cartoon, adapun tujuan dari dilakukan penelitian ini adalah untuk mengetahui elemen-elemen visual yang terkandung dalam gim tersebut dan metode yang digunakan dalam penelitian adalah analisis deskriptif dimana objek penelitian ini akan dikelompokan sesuai dengan elemen-elemen yang terkandung didalamnya lalu dilakukan studi pustaka kepada tiap elemen tersebut dan dilakukan analisis sehingga dapat diketahui asal dari elemen tersebut, lalu hasil dari penelitian ini adalah gambaran dan keterengan mengenai elemen tersebut sehingga berdampak pada desainer ataupun pengembang gim agar dapat mempertimbangkan konsep visual beserta elemen visual yang diusung agar gim tersebut memiliki ciri khas sehingga dapat bersaing dengan pengembang gim lain.
Metrology of the Real Nanoclusters: Structure and Optical Characteristics
Authors: Kovalchuk V. V. , Smorzh M. V. 
Published: March 2020

In this paper, we have discussed in detail the electronic structure and optical characteristics of the silicon nanoclusters. One of the main conclusions is that the comparison between theoretical calculations and experimental results are correct. We shows the possibility of different radiative channels for the recombination in porous silicon. We now analyze the case of stronger disorder as obtained in amorphous silicon (a-Si). It raises extremely interesting problems related to the confinement-induced blue shift of the energy gap: (a) does it exist in nanoclusters of a-Si and is it comparable to what is obtained for c-Si; (b) what is the behavior of disorder-induced localized states in this regard. It has been often assumed that quantum confinement’s effects are small in a-Si nanostructures due to the short coherence length of free carriers in these materials. We will see that it is not true.
We calculate the electronic structure of a-Si and a-Si:H spherical clusters using the parametrized density functional theory (PDFT) model [1]. The starting structure for the a-Si or a-Si: H nanoclusters is obtained by selecting the atoms belonging to the respective atoms unit cell. Due to the new boundary conditions the structure is no more in equilibrium and we have thus relaxed the atomic positions using a Keating potential.
Marchas y contramarchas. El derecho a la educación y las dinámicas de exclusión incluyente en América Latina (a sesenta años de la Declaración Universal de los Derechos Humanos)
Authors: Gentili Pablo 
Published: March 2020

El presente artículo analiza los complejos procesos de consolidación de la educación como un derecho humano fundamental en América Latina y el Caribe, desde la proclamación de la Declaración Universal de los Derechos Humanos de 1948. Sostiene, a tal efecto, que los enormes avances alcanzados en la universalización de la escolaridad –aunque sin derecho a la educación–, asociados a una muy significativa expansión de los sistemas nacionales de educación, se han producido en el contexto de un incremento de la desigualdad social, la cual se articula a la cada vez mayor y más compleja desigualdad educativa que, sumada a la falta de equidad, se producen en el interior de los sistemas escolares. Se analiza el hecho de que, aunque en la Declaración no hay una argumentación que asigne valor a la educación por su aportación a la generación de riquezas, sea precisamente esa la concepción que se ha impuesto, dando lugar a un binomio de objetivos opuestos entre la concepción socializante y la privatizadora: una interpretación mercantilizada de los bienes educativos que reduce la función del Estado, garante del derecho a la educación, a la subsidiariedad y al asistencialismo. El texto aborda críticamente los procesos de «exclusión incluyente» –la lucha por el conocimiento es siempre la lucha por el poder– como dinámica que ha caracterizado el desarrollo educativo latinoamericano contemporáneo. Así, en el marco de las marchas y contramarchas que definen la expansión de la escolaridad y la persistente negación del derecho a la educación a grandes sectores de la población, se apuntan diversas líneas de análisis para pensar algunos de los desafíos que se delinean en el horizonte de las políticas educativas de la región.
EFEKTIVITAS PENGELOLAAN LIMBAH PADAT MEDIS INFEKSIUS DI RUMAH SAKIT XYZ KOTA BALIKPAPAN
Authors: Sari Iin Pratama 
Published: March 2020

Rumah Sakit XYZ Kota Balikpapan yang di bangun pada tahun 1949 oleh perusahaan minyak dari belanda yang didirikan diatas luas tanah 35.577,28 m2. Rumah Sakit XYZ mempunyai 19 ruangan rawat jalan, 17 ruangan rawat inap (150 tempat tidur) dan beberapa fasilitas lainnya. Penelitian ini menggunakan penelitian deskriptif kualitatif dengan jumlah responden 5 orang, pertimbangan yang digunakan untuk menentukan sampel dalam penelitian ini yaitu petugas cleaning service (pemisahan, pengemasan dan pengangkutan limbah infeksius), petugas pembakaran limbah medis (penyimpanan dan pembakaran limbah padat infeksius) dan kepala HSE rumah sakit XYZ kota Balikpapan, hal ini dilakukan karena ketiga bagian tersebut sangat berkaitan erat dengan limbah padat infeksius yang ada di rumah sakit. Dari hasil observasi dilapangan menunjukan adanya respon positif terhadap peneliti dalam melakukan observasi dilapangan yang berkaitan tentang efektifitas penanganan limbah padat infeksius yang ada di rumah sakit XYZ. Berdasarkan penelitian di rumah sakit terdapat kondisi pengelolaan limbah (pemisahan, pengemasan, penyimpanan dan standar bangunan TPS) 89% sesuai dengan aturan dan 11% tidak sesuai dengan aturan, karna terdapatnya penumpukan limbah B3 digudang TPS limbah infeksius, dan untuk penelitian kondisi incinerator rumah sakit XYZ terdapat 80% kondisi sesuai dan 20% kondisi yang tidak sesuai, yaitu dimana tidak tercapainya temperature pada kondisi maksimal yaitu 1000�C yang pembakaran hanya pada kondisi 300 - 400�C yang mengakibatkan kondisi limbah infeksius tidak menjadi abu.
Upper Control Limit (UCL) didapat nilai sebesar 672; dari hasil analisis daerah rawan kecelakaan dimana nilai EAN tertinggi sebesar 102 kecelakaan dengan jumlah korban 5 meninggal dunia, 5 luka berat serta 4 luka ringan dan nilai UCL tertinggi sebesar
53 terjadi di segmen/ruas jalan KM 13 Jl.Soekarno Hatta Balikpapan, sehingga ruas jalan KM 13 dinyatakan Daerah Rawan Kecelakaan (Black site). Dari hasil karakteristik kecelakaan terdapat adanya hubungan antara beberapa faktor usia,pekerjaan, jenis kelamin,kondisi lingkungan dan kecepatan dengan jumlah kecelakaan yang terjadi di Jl.Soekarno Hatta terutama pada ruas jalan KM 13 (blacksite).
Karakteristik kecelakaan di dominasi oleh laki-laki dengan usia rata-rata 15-20 tahun dan berstatus pelajar/mahasiswa;dengan kendaraan sepeda motor pada kecepatan rata-rata 68,8 km/jam di atas kecepatan yang seharusnya 60 km/jam (area sekitar pemukiman) faktor penyebab diatas adalah faktor manusia. Karakteristik kecelakaan berdasarkan waktu kejadian terjadi pada pada waktu gelap (18.00 � 05.59) merupakan faktor penyebab adalah kondisi lingkungan
SWEDISH MASSAGE SEBAGAI INTERVENSI KEPERAWATAN INOVASI DALAM MENURUNKAN TEKANAN DARAH PADA LANSIA HIPERTENSI
Authors: Ritanti Ritanti , Sari Darnis Arneta 
Published: March 2020

Latar belakang: Salah satu penyakit degeneratif yang paling banyak diderita lansia adalah hipertensi. Banyak masyarakat yang menganggap bahwa hipertensi hal yang wajar dan biasa terjadi pada lansia sehingga tidak perlu diatasi. Swedish massage merupakan bentuk intervensi keperawatan yang berfungsi menurunkan tekanan darah guna mencegah terjadinya komplikasi lebih lanjut. Implementasi dilakukan selama 20-30 menit pada satu kali pertemuan, selama 12 kali. sebelum dan sesudah implementasi dilakukan pengecekan tekanan darah terlebih dahulu. Tujuan: Karya ilmiah ini dibuat dengan tujuan untuk mengetahui efektifitas intervensi swedish massage terhadap penurunan tekana darah pada lansia. Metode: Penelitian ini menggunakan desain Quasi Eksperimen dengan One Group pretest-posttest dengan 8 responden. Analisa data menggunakan Paired Sample T-Test. Hasil: penelitian menunjukkan adanya pengaruh yang signifikan antara swedish massage dengan penurunan tekanan darah saat sebelum dan sesudah intervensi (p value = 0,000). Saran: Peneliti merekomendasikan agar intervensi keperawatan terapi Swedish Massage dapat digunakan sebagai salah satu cara penanganan hipertensi non farmakologis yang efektif dan efisien di rumah. Kata kunci : Hipertensi, Lansia, Swedish Massage