Indian Journal of Forensic Medicine & Toxicology <p>Indian Journal of Forensic Medicine &amp; Toxicology is a double-blind peer reviewed international journal. The frequency is quarterly. It deals with Forensic Medicine, Forensic Science, Toxicology, DNA fingerprinting, sexual medicine, environmental medicine, Forensic Pathology, legal medicine and public health laws. It has been assigned International standard serial No. p-0973-9122 and e-0973-9130. The Journal has been assigned RNI No. DELENG/2008/21789.The journal is also abstracted in Chemical Abstracts (CAS) database. The journal is also indexed /abstracted with many databases. </p> <p>This is an open access journal which means that all content is freely available without charge to the user or his/her institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.</p> Institute of Medico-legal Publications Pvt Ltd en-US Indian Journal of Forensic Medicine & Toxicology 0973-9122 <p><strong>Re use and mixing of content policy</strong>- We follow Creative Commons Licence Policy. We follow CC BY. Please refer below for all details</p> <p><a href=""></a></p> <p><strong>CC BY</strong></p> <p>This license lets others distribute, remix, adapt, and build upon our work, even commercially, as long as they credit us for the original creation.</p> <ol> <li>The journal allows readers to <em>read, download, copy, distribute, print, search, or link to the full texts of its articles</em> and allow readers to <em>use them for any other lawful purpose</em>.</li> </ol> <ol> <li>The journal allows the author(s) to hold the copyright without restrictions.</li> </ol> <ol> <li>The journal allows the author(s) to retain publishing rights without restrictions</li> </ol> Production, Purification and Characterization of Bacteriocin Produced by Novel L. Pentosus MW857478 for Enhancement of Food Safety and Shelf-Life of Paneer <p>This research paper is based upon the production, purification and characterization of bacteriocin by<br>L.pentosusMW857478 followed by its enhancement of food safety and shelf life of paneer. In recent<br>year LAB (Lactic acid bacteria) produced bacteriocin attract a great attention of researcher due to<br>their many potential applications. This paper focused on isolation, identification, evaluation of broad<br>spectrum inhibitory activity, production and purification, characterization and evaluation of food safety<br>and shelf life of paneer. Bcateriocin produced by L. pentosus showed antagonistic activity against food<br>spoiling pathogens in broad range of Bacteriocin production parameter was optimized with pH 5.5<br>incubated at 35°C for L. pentosus. Bacteriocin was purified by ammonium sulphate precipitation and<br>purified bacteriocin with single band on SDS-PAGE for molecular weight. The purified bacteriocin<br>stable at 2-10 pH and 30-75°C temperatures, suggesting L. pentosus a potent candidates for safety and<br>extending shelf life of paneer for 15 days.</p> Verinder virk Garima Verma Chand Ram Copyright (c) 2021 2021-11-02 2021-11-02 16 1 1 10 10.37506/ijfmt.v16i1.17396 Antibacterial Activity of (+) Usnic Acid against Multi Drug Resistant Acinetobacter baumannii from Clinical Isolates <p>Acinetobacter baumannii (Ab) is developing resistance to a variety of common antibiotics. and become<br />multidrug resistant, extreme drug resistant, and pan drug resistant pathogens, requiring the identification<br />of new antibiotics as well as the identification of new plant compounds capable of acting against Ab.<br />Recent research has revealed MDR Ab co-infections with COVID-19,, raising alarm bells. Since<br />its isolation, Usnic acid has been investigated for a variety of pharmacological activities, including<br />antioxidant, antitumor, antibacterial, antifungal, antiviral, antiprotozoal, and insecticidal. Many<br />Plant-derived drugs show promising activity as new antimicrobial agents against multidrug resistant<br />(MDR) strains. There is insufficient data to support the antibacterial activity of (+)-UA against MDR<br />Acinetobacter baumannii..</p> B. Nagaraju K. Fathimunnisa R. Vijayaraghavan B. Sreekanth Copyright (c) 2021 2021-11-02 2021-11-02 16 1 11 17 10.37506/ijfmt.v16i1.17407 A Comparative study to Evaluate the Efficacy of Supervised Exercise Program and Cyriax Physiotherapy on Pain and Function in Lateral Epicondylitis <p>Background: Lateral epicondylitis is a musculotendinous degenerative disease of the extensors origin<br>that occurs at the humerus lateral epicondyle. Various methodologies of treatment are utilized in the<br>board of lateral epicondylitis.<br>Objectives: The study will investigate the efficacy of the supervised exercise programme and cyriax<br>physiotherapy on the refinement of pain and the functional within Lateral epicondylitis patients.<br>Methods: Participants (n=30) with Lateral Epicondylitis (tennis elbow) shall be recruited to participate<br>in a comparative experimental study. Subjects will be randomized 1:1 to either (1) Supervised Exercise<br>Programme group, or (2) Cyriax Physiotherapy group. Over a 4-week time period, a 3 times in week<br>for the total of 12 sessions, subjects in supervised exercise programme group will receive the Extensor<br>Carpi Radialis Brevis muscle’s static stretching along with the wrist extensor’s eccentric strengthening<br>and Ultrasound. While those in group of cyriax physiotherapy will receive transverse deep friction<br>massage for the time of 10 min instantly amid by Mill’s manipulation/manoeuvre and Ultrasound. The<br>study will be conclude at the 4 weeks.<br>Discussion: Effectiveness of the interventions on the pain and the functional improvement will be<br>assessed by VAS (visual analogue scale) and the Tennis Elbow Function Scale (TEFS) respectively. The<br>findings of the study will greatly contribute for the evidence on the utilization of the supervised exercise<br>programme and therefore the cyriax physiotherapy in tennis elbow condition.<br>Conclusion: After the statistical analysis of the results, final statements regarding the conclusion of<br>which treatment approaches is effective will be made.</p> Gouri Kalaskar Pratik Phansopkar Copyright (c) 2021 2021-11-02 2021-11-02 16 1 18 24 10.37506/ijfmt.v16i1.17408 Profile of Paraquat Poisoning in Bellary District- A Retrospective Study <p>Study was conducted in VIMS bellary on cases brought for autopsy. The data was collected from the<br>postmortem report of the body brought for autopsy. The study done on 235 deaths due to paraquat<br>poisoning in retrospective manner. In this study it was found out that male mortality was higher in<br>comparison to females. The vulnerable or susceptible age group among the studied sample was involved<br>in the agricultural profession.</p> Gururaj Biradar Pavanchand Shetty H2 B Suresh Kumar Shetty Haneil Larson Dsouza Charan Kishor Shetty V Yogiraj Copyright (c) 2021 2021-11-02 2021-11-02 16 1 25 28 10.37506/ijfmt.v16i1.17409 A Study to Assess Respiratory Health Status among Bricks Workers <p>Introduction: Respiratory health problem is one of the major health problem among bricks industry<br>workers those who are working in dusty area. These problem can be reduce when proper intervention<br>taken like use of mask, hanky and other devices during working time.<br>Objectives:<br>1. To assess respiratory health status of bricks workers working in brisk industry.<br>2. To find the association among respiratory health status and selected demographic variables.<br>Methodology: Quantitative research approach utilized with cross sectional research study among Bricks<br>workers .91 Samples were collected by non probability convenient sampling technique. Demographic<br>and respiratory health assessment done through questionnaire.<br>Results: Result showed that Average age of participants was 33.20 ± 5.123(mean ± SD),Average<br>monthly income of participants were 12659.34,Average year of experience was 7.35 ± 4.510 (mean ±<br>SD), Gender majority of participants were males 82(91.1%), Disease or any issue other then respiratory<br>health,89 (97.8 %) had no any diseases, 67(73.6%) were not using any devices during working time,<br>47(51.6%) were smoker. In respiratory assessment symmetrical chest movement had seen in 91(100%)<br>participants. 21(23.1%) had Acute Cough. 8(8.8%) had white colour phlegm and 4(4.4%) had black<br>colour phlegm. 23(25.3) had Grade I of shortness of breath,1(1.1%) had history of self reported asthma.<br>there was significant Association found between cough and Age in year, Experience in year, Other<br>Health problem and Issue , Habits of smoking.<br>There was significant Association found between phlegm and Age in years , Other Health Issue , Habits<br>of smoking, drug and other supplements.<br>There was significant Association found between shortness of breath and Age , Qualification, Experience<br>in year , Habits of smoking.</p> Jyot B. Darji Siddaram Sarate Copyright (c) 2021 2021-11-02 2021-11-02 16 1 29 32 10.37506/ijfmt.v16i1.17410 Study of Ossification Centres Around the Elbow and Wrist of Adolescent Age Group 15-18 Years <p>Intoduction: Determination of age in both living and dead plays a pivotal role in medicolegal cases.<br>There are various parameters to assess the age by physical characteristics, odontological development<br>but the most valuable method seems to be the osteological changes observed by radiological examination<br>ie., the appearance and fusion of secondary ossification centres around respective joints The present<br>study was conducted on 131 subjects out of which 110 were males and 21 were females. The main aim<br>of the study was to find the age of fusion of secondary ossification centres around elbow and wrist joint,<br>to compare the distribution of fusion of ossification centres between males and females<br>Methods: Firstly informed consent was taken. Preliminary details of each individual was noted that<br>included general examination, physical examination, dental examination followed by taking X-ray AP<br>view of elbow and wrist joint for radiological examination. The results were noted based on the degree<br>of fusion as No Union (O), Beginning union(B), Recent union(R), Complete union(C).<br>Results: The present study showed among males, the fusion for each ossification centre around elbow<br>joint started by 15-16 years and was completed by 18-19 years whereas in females it started fusion by<br>15-16 years but complete fusion occurred around 16-17 years itself . In wrist joint the fusion starts at<br>16-17 years in males but only fusion of lower end of ulna is completed by 18-19 years, however both<br>lower end of radius and ulna are fused by 18-19 years in females.<br>Conclusion: Based on the analysis of fusion of ossification centres it shows that both thecentres around<br>elbow and wrist joint fuses earlier in females by 1-2 years than males.</p> Kishore Kumar.G R.Jenifer Jacquiline Copyright (c) 2021 2021-11-02 2021-11-02 16 1 33 40 10.37506/ijfmt.v16i1.17411 Cheiloscopy - A Tool For Identification in Twins <p>Introduction : Lip prints are an adjuvant tool for identification in forensic medicine. The grooves on<br>the lips have discrete characteristics to make it different from one other. This study was conducted<br>on 24 pairs of twins out of which 22 pairs were Monozygotic twins and 2 pairs were Dizygotic<br>twins. Dizygotic twins are unique in all aspects while Monozygotic twins are similar phenotypically<br>and genotypically. The objective of this study is to find the most common pattern in the twins , the<br>commonest pattern among the male and female twins and to know the variations in the pattern of lip<br>prints among Monozygotic and Dizygotic twins.<br>Materials and Methods: A lipstick, drawing chart and magnifying lens were the materials used to<br>record the imprints of the lips. A four compartment method with a clockwise direction approach was<br>used and the analysis was done based on Suzuki and Tsuchihashi classification.<br>Results: The present study shows Type 1’ was the most common lip prints observed among the 24<br>pairs of twins. This pattern was predominantly present in the right lower lip quadrant. Out of the study<br>subjects of 24 pairs of twins, 38 were males and 10 were females in which Type I ‘ is common in males<br>and type I is common in females. Among the monozygotic twins those which had &lt; 50 % resemblance<br>were 14 pairs, 50% resemblance were 6 pairs, &gt;50% resemblance were 2 pairs in which Type is the<br>commonest. Among the dizygotic twins, both the pairs were totally different from each other yet Type<br>was the common pattern.<br>Conclusion: Based on the analysis of the lip print patterns among monozygotic twins, though similarities<br>were prevailing between them , they are not identical .Whereas among dizygotic twins both the pairs of<br>twins are unique. Hence Lip print can be utilized as a differentiating tool for identification.</p> M.Sugatha R.Jenifer Jacquiline M.Taqiuddin Khan Copyright (c) 2021 2021-11-02 2021-11-02 16 1 41 46 10.37506/ijfmt.v16i1.17412 Synthesis, Characterization, Molecular Docking of Sulphamethoxazole Schiff Base Metal Complexes and Its Antibacterial, Anti-Inflammatory and Anti Depressant Activity <p>In our study we have a tendency to synthesized schiff’ base of bactericide drug sulphamethoxazole on <br>treating with aromatic aldehydes like p-diethyl amino benzyldehyde and p-dimethyl amino benzyldehyde. <br>The synthesized schiff’s bases were regenerate to its ion Schiff bases by treating with methyl group <br>halide. The ion Schiff bases were regenerate to metal complexes by treating with metals like CuCl2, <br>ZnCl2 and CdCl2. All the synthesized compounds were characterised by Elemental analysis, IR and<br>H proton magnetic resonance. Docking study was performed to know the interaction of binding sites <br>with protein receptor using MAO-B enzymes (PDB ID: 2BK5) and COX-2 enzyme (PDB ID: 5IKR) <br>by Virtual Screening software for Computational Drug Discovery. Synthesized metal complexes were <br>evaluated for antibacterial, anti inflammatory and antidepressant activity. Copper metal complexes <br>showed potent antibacterial and anti-inflammatory activity. Significant anti-depressant activity was <br>shown for 2A2 and 2B2 zinc metal complexes</p> R.Gandhimathi Magdivari Sangeetha Copyright (c) 2021 2021-11-02 2021-11-02 16 1 47 57 10.37506/ijfmt.v16i1.17413 Aortic Atherosclerosis and Risk Factors: A Clinico- Demographic Autopsy-Based Study <p>Backdrop: Aortic atherosclerosis continues to be a complex process, with the genetic factors, personal<br>lifestyles, alterations in local hemodynamics, vascular injury, age related changes, endothelial<br>inflammation and autoimmune diseases, all contributing to its pathogenesis. The scenario of<br>atherosclerosis in India is appalling with highest loss in potentially productive years of life. As study<br>of atherosclerosis in living population is difficult, invasive and expensive especially in the developing<br>countries, autopsy studies have been proved to be a good method for assessing atherosclerosis. So, the<br>present study was planned to evaluate the prevalence of atherosclerosis, with the clinic-demographic<br>profiles of the victims of aortic atherosclerosis and analysing the risk factors associated with it.<br>Material and Methods: This is a cross-sectional descriptive study which was conducted to detect<br>aortic atherosclerosis among all the deceased who got referred to R.G. Kar Medical College Police<br>Mortuary for autopsy between 1st April to 30th September, 2014.<br>Resusts: Majority of the victims belonged to 4th to 8th decades, with male preponderance in all the age<br>groups. Though the residence has got no significant implication on atherosclerosis, age turned out to<br>be the single most culprit in the pathogenesis of atherosclerosis, with hypertwnsion, hyperlipidemia,<br>hyperglycemia and smoking playing their significant parts.<br>Conclusion: The authors feel, in most cases, atherosclerosis can be prevented as most risk factors<br>associated with this illness are directly connected with the lifestyle of an individual. In this regard,<br>educational campaign that focuses on informing the members of the society about the dangers of<br>atherosclerosis, its causes, and the ways of its prevention is likely to reduce the occurrence of this<br>disease and thus improve the overall health level of the nation.</p> Mainak Tarafder Suparna Datta Ranjan Biswas Prabir Chakraborty Saptarshi Chatterjee Copyright (c) 2021 2021-11-02 2021-11-02 16 1 58 65 10.37506/ijfmt.v16i1.17431 Estimation of Stature & Gender from Thumb Indices in Indian Population <p>Background: Human characteristics like stature and gender identification on basis of human remains <br>is a crucial element of any medicolegal investigation and is especially important in the field of forensic <br>anthropometry. Thus, this study was undertaken with the aim of determining stature and gender by <br>using thumb indices in the Indian population.<br>Material &amp; Methods: 568 adults (294 males and 274 females) belonging age between 18-25 years <br>participated in the present study. Thumb length, breadth, thickness and circumference were measured by <br>time to time calibrated measuring tape and digital vernier caliper. Unpaired ‘t’ test, Person Correlation <br>Coefficient, Linear and Logistic regression methods used to analyze the data.<br>Results: This study showed significant correlation of thumb indices with stature &amp; gender.<br>Conclusion: The stature and gender identification models are helpful to forensic experts and crime <br>scene authorities to determine the stature and gender of an isolated thumb.</p> Mohite Hemlata S Kakade Satish V Mohite Sandeep S Roy Priya P Doshi Megha A Copyright (c) 2021 2021-11-02 2021-11-02 16 1 66 75 10.37506/ijfmt.v16i1.17419 Sudden Death with Dual Organ Pathologies–An Autopsy -based Case Report <p>Sudden death due to cardiac cause is considered as a major health problem worldwide accounting for <br>15–20% of all deaths and cardiomyopathies account for 10–15% of the cases.According to the 2016 <br>WHO classification, angiomatous meningioma is a rare subtype of meningioma classified as Grade I. It <br>is an aggressive variety with a fair prognosis, with typical symptoms including headache and seizures.<br>We present a case of a 60-year-old man brought to the morgue for autopsy with a history of progressive <br>left-sided weakness and headache for several months with no prior diagnosis or treatment for the same <br>because of current pandemic of COVID-19.On conducting medicolegal autopsy significant pathologies <br>in heart and brain were found which could have contributed to the cause of death</p> Mukul Sharma Kimi Soumya Padhi Govinda Balmuchu Prachi Nemani ManasRanjan Sahu Copyright (c) 2021 2021-11-02 2021-11-02 16 1 76 82 10.37506/ijfmt.v16i1.17420 Demographic Study of Unnatural Deaths in Paediatric Age Group in General Hospital, Khammam <p>Introduction: The data regarding pediatric deaths are very limited particularly in developing countries <br>due to lacunae in death registration system. The present study is a retrospective study regarding the <br>causes which resulted in the deaths of children in pediatric age group from 0-12 yrs with an aim to know <br>the overall incidence, the causes of death and manner of death. Unnatural childhood deaths are not only <br>associated with intense trauma and distress, but also indicates a sense of self neglect to protect children <br>from harm. The unnatural deaths may be due to unintentional or intentional acts.<br>Materials and Methods: This study is a retrospective demographic study of unnatural deaths among <br>pediatric age group children between 0-12 years. All the unnatural deaths that were autopsied at the <br>mortuary, General Hospital, Khammam of Telangana state for a period of 2 years from August 2012 <br>to July 2014 were studied based on inquest, post mortem examination findings to know the profile of <br>paediatric deaths.<br>Results and Conclusion: A total of 1283 cases were autopsied during the study period and out of that <br>2.4% of cases are unnatural deaths in pediatric age group of 0-12 years. The most commonly involved <br>are male children in the age groups of the cases observed were between 3- 6 years and 9-12 years, <br>the least involved age group was between 0- 3 years. Most common manner of death is accidental <br>amounting to about 93.3%.Most common cause of death was due to road traffic accidents. These deaths <br>are common in the rural population belonging to the low socio economic status.</p> N. Devchand A. Krishnanjaneyulu Raja Sekhar Uppu Uday Pal Singh Copyright (c) 2021 2021-11-02 2021-11-02 16 1 83 88 10.37506/ijfmt.v16i1.17421 Emergence of Synthetic Cannabinoids as Drugs of Abuse Nupur Joshi Mahipal Singh Sankhla Copyright (c) 2021 2021-11-02 2021-11-02 16 1 89 97 10.37506/ijfmt.v16i1.17422 A Study of Metacognition in Adults with Type II Diabetes Mellitus – A Cross Sectional Study S.Dhivyashri A.Sangeetha Kumaresan M A.V.Anuja Karthika M Copyright (c) 2021 2021-11-02 2021-11-02 16 1 98 103 10.37506/ijfmt.v16i1.17425 Tertiary Care Teaching Institute of North India <p>Background: Smoking as a practice has been in existence since 5000 B.C. Smoking in public places <br>was banned in India from 2nd October 2008. According to reports by WHO Tobacco kills more than 7 <br>million people each year. Studies show that few people understand the specific health risks of tobacco <br>use. The present study was done to analyze the impact of the Anti-smoking Campaign in the Institutes’ <br>Campus and also to make people aware of the harmful effects of smoking and motivate them to quit <br>this habit.<br>Methodology: The campaign constituted of various interventions as screening &amp; collection, <br>monitoring through CCTV Surveillance, imposing penalty as per the Act, Destruction of collected <br>material, Behavioral change communication through Anti-smoking March, Public Lectures, Display <br>of Pamphlets/Signages at various places in the institute &amp; No smoking Pledge and involvement of top <br>management.<br>Results: Total about 2613 Kgs of Tobacco and Tobacco products has been collected and destroyed from <br>March 2014 till April 2020. On an average 40 Kilograms of Tobacco material is collected and destroyed <br>per month. Till April 2020, 108 offenders who were caught smoking in the institute were penalized. ‘No <br>smoking Pledge’ was taken by all the participants. <br>Conclusion: The success achieved by the anti-smoking campaign in the Institute suggests that there is <br>a dire need and challenge before us to launch such type of campaigns in all the institutes worldwide to <br>curb this menace from our society.</p> Shweta Talati Pankaj Arora Anil Kumar Gupta Prem Chand Sharma Copyright (c) 2021 2021-11-02 2021-11-02 16 1 104 109 10.37506/ijfmt.v16i1.17426 The Economic Impact of Government Sponsored Health Insurance Schemes on a Tertiary Care Multispeciality Hospital in South India <p>The number of people registered with health insurance schemes has increased from 161.2 <br>million(2011-12) to 335 million(2016-17), which is two-fold in just 5 years.1 As per the forecasts <br>regarding the increase in healthcare insurance market in India, it is evident that the hospitals have to <br>face the management of patient costs through the insurance schemes in large numbers as the number <br>of claims will increase eventually. With the present condition of schemes reimbursing the claims with <br>a huge time lag of about 3-4 months, the hospital have to carry the burden of opportunity costs lost <br>on these claims.2 This indicates the responsibility hospital administration should have to face the ever <br>increasing claims and manage them without incurring loss. This study was intended to do a cost analysis <br>between surgical procedures performed under two categories, Aarogyasri Health Insurance Scheme, A <br>Government Sponsored Health Insurance Scheme in the state of Andhra Pradesh and Cash category, <br>where patients do not hold any insurance policy and pay by cash all the hospital expenses. On the basis <br>of revenue generated the top 15 procedures under Insurance scheme are determined and costing is done <br>using Activity Based Micro Costing method. Costing is done for the determined 15 procedures under <br>both the categories of payment modes. The results are compared to evaluate the economic impact of the <br>health insurance scheme on hospital.</p> Sri Theja Karra Rajesh Kamath Charan Tej Koyi Renu Mirchandani Kamath Madhusudana Biju Soman Copyright (c) 2021 2021-11-02 2021-11-02 16 1 110 119 10.37506/ijfmt.v16i1.17427 Hate Speech Against Disabled Persons: A Forensic Analysis of Legal Framework in India and Beyond <p>Hate Speech is a social menace. Disability hate speech is nothing but hatred perpetuated against any <br>disabled person. It is prevalent offline as well as on the virtual platform. Despite the legal provisions <br>against hate speech, instances of hate speech are increasing rapidly. <br>There are many developed countries such as the US, UK or Australia that have specialized laws and <br>machinery at place to regulate speech towards the persons with disabilities. However, India lags behind <br>in framing policies or enacting laws, be it protecting the interest of disabled persons against hate speech <br>or hate crime perpetuated against them. <br>Amidst pandemic, discrimination and untold miseries faced by disabled individuals mount day by day, <br>in real world as well as virtual world. In these challenging times, there is a need to check as to what <br>are the laws in India that protect people with disabilities against hate speech. There is a need to analyze <br>in a forensic perspective the remedies available for the victimized individuals with disability. This <br>research paper further put forth various suggestions and means to improve protection of such persons <br>with disabilities.</p> Suvidutt M.S Aditya Tomer Copyright (c) 2021 2021-11-02 2021-11-02 16 1 120 125 10.37506/ijfmt.v16i1.17428 Assessment and Evaluation of Implantology Courses for Post Graduate Students <p>Introduction- In dentistry, dental implants have become an indispensable established therapy to replace<br>missing teeth in different clinical situations. Henceforth, implant education has become an integral part<br>of postgraduate prosthodontic curriculum.<br>Materials and Methods- This study was conducted in the Department of Prosthodontics, Crown and<br>Bridge at S. Nijalingappa Institute of Dental Science &amp; Research, Gulbarga, Karnataka. A questionnaire<br>of 22 questions was mailed to the postgraduate students of prosthodontics. A total of 83 students<br>participated in the study. The forms were analyzed by using suitable descriptive statistics.<br>Results- A variety of responses were received from the participants. A total of 82 (98.8%) participants<br>were included in the study. Most of the participants (around 56 of them) start to place implants from<br>the second year and remaining. 69 of the participants responded in affirmation with the use of CBCT<br>for routine implant cases. 54 participants reported that overall, in a month, more than 10 implants were<br>placed in their department. In culmination, out of the 83 participants 69 of them want to learn more as<br>implantology is evolving as a separate branch in dentistry.<br>Conclusion- Implantology treatment is constantly evolving as the prime line of treatment in different<br>edentulous situations. Within the limitation of this study, it is concluded that dental colleges of India<br>having active postgraduate program are moderately equipped with Implantology syllabus and courses.<br>Although, there are variations in responses, but it has made necessary to review and standardize dental<br>implant curricula among institutions.</p> Swati M Devani Arvind I Moldi Shrikar Desai Amol Sangewar Gaurav Khemaria Vijay Namdevrao Yannawar Shubhangi Lokhande Copyright (c) 2021 2021-11-02 2021-11-02 16 1 126 132 10.37506/ijfmt.v16i1.17433 Effectiveness of Learning Software for Teaching Curricula and their Influence on Developing Thinking Skills and Achievement among Senior Students <p>The developments taking place in the world in terms of informational modernity, called the knowledgetechnology<br>revolution. Such developments have relied on the use of computers, which have become<br>the main sphere of an individual’s life in various educational, sports, and other disciplines, in the<br>service of the learners. Hence, the importance of research in keeping pace with the educational process<br>of what has happened in the world in terms of inventions and developments, which accommodate<br>technology education and becomes an integral part of its curriculum and teaching methods in line with<br>the characteristics of society.<br>The research problem lies in that many of the teachers adopt the traditional method in teaching the<br>curricula without updating the teaching method by incorporating the educational software for this course<br>lesson, and the extent of its influence on developing thinking skills and achievement for fourth-stage<br>students in the Department of Physical Education and Sports Sciences - College of Basic Education at<br>Mustansiriya University that teaches this course in the curriculum of this stage.<br>The researchers concluded that these students are equal in their acquiring of thinking skills and obtaining<br>information, concepts, and subjects of the curricula, and there is an association in the achievement test<br>for the study group.</p> Israa Yaseen Abdul-Kareem Ban Abdul-Rahman Ibraheem Iman Hamad Shihab Copyright (c) 2021 2021-11-02 2021-11-02 16 1 133 139 10.37506/ijfmt.v16i1.17435 Health Satisfaction in Health Care between Patients of 3rd Tertiary Allergy Center in Kirkuk with Salam Primary Health Care Center Patients in Kirkuk <p>Background: Healthcare capacity in Iraq has deteriorated due to the effects of wars and political instability. The Iraqi<br>Ministry of Health expanded the provision of health services, by directing the public sector towards primary health care.<br>This study aimed to assess patients satisfaction with the primary health care services provided in 3rd tertiary allergy center<br>and Salam primary health care center patients in Kirkuk, and to determine the relationship between patient satisfaction and<br>their demographic data.<br>Method: A descriptive study was carried out at the 3rd tertiary allergy center and Salam primary health care center in Kirkuk<br>city, Iraq. Data were collected through the use of the constructed questionnaire from 100 patients who visit those centers<br>for routine care, through the period of the 1st December 2020 to 31st January 2021. Data were analyzed through (Measures<br>of central tendency and inferential statistics) using SPSS (V.22). Chi-square test for independence of two variables has<br>been utilized to test the hypothesis, through the use of cross-classification table to examine the nature of the relationship<br>between the variables. Ethical approval and permission to access the samples was obtained from Kirkuk Health Directorate<br>in Iraq.<br>Results: Overall, out of 100 clients responded to our questionnaire, age showed neutral score (Mean = 2.93, SD= 1.47).<br>and the age group (21 -30 years) were the highest represented (n=27; 27%). Mean of score was used for reference about<br>the client satisfaction, if the mean of score up to more than 3 that means positive satisfaction with the available services<br>otherwise it means dissatisfaction. Chi-square test for independence of two variables was applied, and the probaility<br>of high level of satisfaction were reported as there were a significat relationship (P &lt;0.005) in items related to (nursing<br>care services, availability of medical services, quality of prescribed medication, cooperation of pharmacist, availability<br>of laboratory services and. laboratory staff cooperation about diagnosis than other items.Also, there were a statistical<br>significant difference (P &lt;0.005) between respondents age more than other demographic characteristics.<br>Conclusion: The study highlighted the sources of patient satisfaction related to primary health care services. The medical<br>and nursing staff have a crucial role in providing health services, so their job satisfaction can improve the quality of care for<br>patients, and reduce health care costs. Additionally, these results can provide priorities for developing healthcare services that can improve patient satisfaction. The utilization of telemedicine services, patient-centered medical visits and eHealth applications can be adopted to increase patient satisfaction with primary health care services. The use of remote patient monitoring programs are also effective ways to treat the signs and symptoms of COVID-19 at home and protect health workers.</p> Abdulameer Anwar Samad Fakher Abobaker Ahmed Gli Chinar Baqir Kanbar Diyar Mohammed Majeed Copyright (c) 2021 2021-11-02 2021-11-02 16 1 140 148 10.37506/ijfmt.v16i1.17436 Strengthening Human Resources as Lecturers Through the E-Learning Learning Method <p>Introduction: The concept of e-learning is an alternative for students who are unable to attend faceto-<br>face lectures. The use of e-learning as an alternative learning is increasing in line with technological<br>developments. Aim: This study applies e-learning learning methods to strengthen educational human<br>resources as lecturers using Computer-based Multimedia Communication (CMC). Method: This<br>research is a pre-experimental study. The research was conducted in STIKes Yarsi Mataram, Indonesia<br>in 2020. The measuring instrument used a questionnaire. The study population was all students, with<br>a total sample of 81 students. The independent variables include a method of learning. The dependent<br>variable in this study was knowledge. The analysis used was univariate and bivariate using paired t-test.<br>Result and Discussion: frequency of e-learning based on CMC in the experimental group, namely 63%<br>in the evaluation and 80% in the implementation process. While in the control group using conventional<br>methods, 50% of the intervention and 23% of the implementation. Conclusion: Improving student<br>learning outcomes in the community nursing process by using the CMC learning method is more<br>effective than using conventional methods.</p> Agus Supinganto Suharmanto Irwan Budiana Kusniyati Utami Copyright (c) 2021 2021-11-02 2021-11-02 16 1 149 154 10.37506/ijfmt.v16i1.17441 Study of Lipid Profile, Lipid Peroxidation and DNA Damage in Patients with Coronary Artery Disease <p>Background and Objective: This study was conducted to investigate some clinical aspects of coronary<br>artery patients, as it included some tests for lipid oxidation and DNA damage and the extent of their<br>association with the risk of coronary artery disease in the Iraqi population. Results: The lipid showed<br>significant differences between the preferred messages in measuring lipids, TG (P = 0.005), highdensity<br>lipoprotein P = 0.018 (HDL) and low-density lipoprotein (vLDL) P = 0.004. It was named in<br>lipid profile, and it was named In seizure patients (nonSTEMI). The glutathione analysis showed a<br>significant decrease in patients compared to healthy subjects, and the unstable, non-Stemi and Stemiseries<br>results were significant, and the significant differences were at (P = 0.00036). As for the research<br>results, the significant differences were when they were high (P = 0.00072). The results of the comet<br>assay showed differences between the four groups, for the group of patients with unstable angina and<br>who suffer from a heart attack (Non-Stemi), the results showed close to average levels in the genetic<br>material (P = 0.00014). The highest damage in the genetic material of patients with coronary artery<br>disease was in patients suffering from a heart attack (Stemi) where the level of significant damage was<br>very large compared to the rest of the groups (P = 0.00025). The results obtained on the biochemical<br>levels of GHs, VLDL, HDL, TG and MDA showed significant differences between the healthy and the<br>groups of patients with coronary artery disease below the probability level (P&gt; 0.05). Also, the incidence<br>of DNA damage in patients with coronary artery disease is much greater than healthy patients, and this<br>indicates a significant effect of DNA damage on blood vessels, and on the other hand, STEMI patients<br>are the most vulnerable to infection.</p> Ahmed Jabbar AL Jabbiry Kadhum J. Gattia Hazim I. Abd Albari Copyright (c) 2021 2021-11-02 2021-11-02 16 1 155 161 10.37506/ijfmt.v16i1.17442 The Effect of Aquatic Exercises on Special Endurance (Strength and Speed) and Achievement Run (800m) for Youth <p>The research aims to use Aquatic exercises to develop special endurance and run (800m) for youth to<br>identify the level of (speed endurance and force endurance) of the participants of the sample members<br>of the experimental group. The researchers used the experimental method for its suitability to the nature<br>of the study, and the sample was from Wasit Governorate clubs racers. The participants were (12) racers.<br>We were divided into two control and experimental groups. The duration of the experiment was (8)<br>weeks from (28/10/2020 to 10/3/2021). The place of the experiment is in the Al-Gharraf River (a branch<br>of the Tigris River) and the Kut Olympic Stadium. The researchers used tests to speed endurance of a<br>distance (600m), a test to endurance the strength of running by jumping for one minute (Bousing), and<br>an achievement test (800m). The researchers concluded that training in the aquatic medium exercises<br>affected the development of special endurance (speed endurance and force endurance) and it had a<br>positive effect in completing the 800m race for youth.</p> Ahmed Elewy Arhem MazinEnhier Lami Copyright (c) 2021 2021-11-02 2021-11-02 16 1 162 167 10.37506/ijfmt.v16i1.17443 Association of Adipoq +45 T>G Gene Polymorphism with Insulin Resistance and Icam-1 Value in Obese Adolescents Alexander Leonard Caesar Josediputra Nur Aisiyah Widjaja Roedi Irawan Copyright (c) 2021 2021-11-02 2021-11-02 16 1 168 175 10.37506/ijfmt.v16i1.17444 Hemorrhagic Varicella in a 41-Year-Old Woman with Evans Syndrome : Case Report <p>Background: Varicella is an infection caused by the varicella-zoster virus (VZV) with symptoms<br>of an exanthematous vesicular rash and systemic symptoms. Hemorrhagic varicella commonly<br>seen in immunocompromised patients. Evans syndrome (ES) is an autoimmune with two or more<br>cytopenias,including autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP).<br>Case: 41-year-old woman complains of swelling filled with reddish fluid almost all over her<br>body,sometimes painful and accompanied by fever. Patient also experienced vaginal bleeding resulting<br>in anemia (Hb 8.8 g/DL) and thrombocytopenia (platelets 34,000/uL). Dermatological status of the<br>generalized,multiple hemorrhagic vesicles with an erythematous base,partially ruptured. Tzank test<br>revealed multinucleated giant cells. Patient suffered AIHA and received therapy with methylprednisolone<br>4 mg/day and mycophenolic acid 2x500 mg/day.<br>Conclusion: We report a case of hemorrhagic varicella in a 41-year-old woman with Evan’s syndrome<br>with concurrent features of AIHA and ITP. Dermatological status of the generalized, multiple<br>hemorrhagic vesicles with an erythematous base,some of ruptured with erosions. Tzank test revealed<br>multinucleated giant cells. Patient was treated with acyclovir 5x800 mg for 7 days,2% salicylic acid and<br>0.5% menthol applied every 12 hours and mupirocin 2% ointment applied twice a day on the erosion<br>area and clinical improvement was found after 17 days of therapy.</p> Alfina Rahma Eka Devinta Novi Diana Frieda Wibisono Nugraha Muhammad Eko Irawanto Moerbono Mochtar Copyright (c) 2021 2021-11-02 2021-11-02 16 1 176 183 10.37506/ijfmt.v16i1.17445 Estimation of Interleukin‐10 and Interleukin‐22 Levels in the Advances of Breast Cancer <p>Background: Breast cancer is the secant-kind of carcinoma in women with higher incidence in Iraq.<br>There are many prognostic and predicitive factors used for management of the breast cancer. Serum<br>levels of the cytokines may be utilized as a marker of immunity status and prognosis in CA breast.<br>Aims of the Study: Measuring the IL-10 and IL-22 in breast cancer patients and association IL-10<br>and IL-22 with stage and grade for breast cancer. Materials and Methods: The case-control study<br>was conducted on 60 women with CA. Breast and 60 controls group, patients with CA. Breast were<br>referred to Middle Euphrates cancer center in Najaf during the period November 2019-October 2020.<br>Measurement of Interleukin-10 and Interleukin-22 by using ELISA. Results: The showed a levels of<br>IL-10 and IL-22 in breast cancer group higher than levels of IL-10 and IL-22 in control, and showed<br>a high levels of IL-22 in advances stage and grade III. The showed non-significant in IL-10 levels<br>between four stages and three grade. Conclusions: A significant elevation levels of IL-10 and IL-22 in<br>breast cancer groups comparison with control, elevation significant IL-22 levels in stages and grades<br>of breast cancer.</p> Ali Jabbar Abd Zaid Al-Kilabi Ghada Basil Ali Alomashi Copyright (c) 2021 2021-11-02 2021-11-02 16 1 184 190 Occupational Health Hazards among Workers at Government Garment Factory in-Al Najaf City <p>Descriptive design cross-sectional study was conducted in assess the occupational health hazards among<br>workers in Al-Najaf in garment factory and its association with socio-demographic characteristics of<br>workers in the province of Najaf during period from December 23th 2020 to February 9 the 2021. 180<br>male and female workers were selected through non-probability sampling (purposive sampling) and<br>the data collected using the questionnaire that was designed earlier from three main parts, first part<br>included socio-demographic data characteristic and the second part was included health care facilities<br>that include health services to workers and the three part (health hazards) and that consist of (physical<br>hazards, chemical hazards, biological hazards, psychological hazards The study found that the overall<br>risk score was moderate, the higher risk was for psychological risks, and the lowest risk was for safety<br>measures and protective equipment, The overall hazard score was found to have a statistically significant<br>relationship with each job title and work location (P 0.05). Further research, as well as an education<br>program and regulations for the use of safety measures, were strongly recommended.</p> Ali Sadoon Almusawy Murtadha K. Adea Aljebory Copyright (c) 2021 2021-11-02 2021-11-02 16 1 191 195 10.37506/ijfmt.v16i1.17447 Relationship between Parenting Stress and Risk of Attention Deficit Hyperactivity Disorder (ADHD) in Elementary School Children <p>Background: Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder<br>during child development with three symptoms which are comprised of inattention, hyperactivity, and<br>impulsiveness that may persist into adulthood. This condition can be a stressor for parents in performing<br>parenting and may lead into a state of parenting stress. Objective: To analyze the relationship between<br>parenting stress and the risk of developing Attention Deficit Hyperactivity Disorder (ADHD) in<br>elementary school children. Methods: This research was conducted in Surabaya from November 2020<br>to January 2021 with respondents consisting of parents of elementary school children who have ADHD<br>risk and agreed to participate in this study with a total of 55 samples selected using a purposive sampling<br>technique. The research design was cross-sectional using demographic questionnaire, Abbreviated<br>Conners Rating Scale (ACRS), and Parenting Stress Index-Short Form (PSI-SF) which were filled<br>out by respondents through an online form. The data were processed and analyzed using One-Sample<br>Chi-Square analysis test program with a p-value &lt;0.05, considered statistically significant. Results:<br>The majority of parents experienced moderate parenting stress levels (58.2%). There was a significant<br>relationship between each level of parenting stress and the risk of ADHD in children (p &lt; 0.001).<br>Conclusions: There is a significant relationship between parenting stress and the risk of ADHD in<br>children.</p> Alma Rossabela Setyanisa Yunias Setiawati Irwanto Izzatul Fithriyah Satria Arief Prabowo Copyright (c) 2021 2021-11-02 2021-11-02 16 1 196 203 10.37506/ijfmt.v16i1.17448 Quantitative Risk Assesment of Benzene Exposure in Printing Industry X Surabaya City <p>Benzene is a compound chemically volatile and lasts a long time in the air and quickly<br>inhaled into the human body. The use of benzene is widely used in various industries, one of<br>which is the printing industry. Benzene produced right in the printing industry are ink, cleaning fluid,<br>and when the machine in operation. Workers exposed to benzene can risk cancer and non-cancer health<br>effects that are harmful to the human body. This study aimed to assess cancer and non-cancer risk of<br>workers in the printing industry X Surabaya City. This research is observational, cross-sectional with<br>the same sample with a total population of 11 workers in the printing industry X Surabaya City. The<br>risk assessment method uses four stages: hazard identification, exposure analysis, dose and response<br>analysis, and risk characterization. This research shows that the average concentration of benzene is<br>1.0729 mg/m3 or 0.34 ppm. RQ value &gt; 1 both real-time and lifetime. As many as 63.6% of workers<br>have real-time ECR &gt;10 -4, and 81.8% of workers have ECR lifetime &gt;10-4. This study concludes that<br>workers are in an unsafe condition and have non-carcinogenic and carcinogenic health risks.</p> Amanda Fithri Habibati Abdul Rohim Tualeka Juliana Jalaludin Syamsiar Russeng Ahsan Puji Rahmawati Copyright (c) 2021 16 1 204 212 Age Estimation with Cemental Incremental Lines in Normal And Periodontally Diseased Teeth Using Phase Contrast Microscope <p>Background: Forensic age estimation defines an expertise in forensic medicine, which aims<br>to define in the most accurate way to determine the unknown chronological age of the person<br>involved in judicial or legal proceedings. Dental cementum is a vital tissue which demonstrates<br>continuous apposition throughout the life of the tooth. Literature studies have revealed that tooth<br>cemental annulations(TCA) would serve as a reliable tool in establishing the age of an individual.<br>The use of specialized microscopic methods are been employed to enhance the assessment of<br>the cemental annulations. The study aims at assessment and evaluation of cemental annulations<br>in normal and periodontally diseased extracted teeth using phase contrast microscopic method.<br>Methodology: A total of 60 teeth were included in the study and out of which thirty teeth were normal<br>and 30 were periodontally involved teeth respectively. Longitudinal ground sections were prepared using<br>micromotor and diamond disc. Sections were mounted and observed under phase contrast microscope.<br>Measurements were made using an image analyzer software. The total width of cementum was divided<br>by the distance between two incremental lines. The eruption age of the tooth was then added to this to<br>obtain the chronologic age for each individual. The results of the study showed no significant deviation<br>of estimated age from the actual age in both periodontally sound and periodontally diseased teeth.<br>Conclusion: The study concludes that the use of phase-contrast microscopy in conjunction with image<br>enhancement procedures improves the accuracy of age estimation and may serve as a reliable aid in<br>forensic identification.</p> Ameena Sultana Heena Zainab Pramod Jahagirdar Deepa Hugar Shaimaa Copyright (c) 2021 16 1 213 223 Vascular Endothelial Growth Factor (VEGF) Expression on Placenta Accreta Spectrum (PAS) FIGO Grading <p>This study aims to analyze the role of placenta VEGF level using immunocytochemical techniques and<br>comparing the obtained results with PAS FIGO grading. This retrospective cross sectional study on<br>total sampling of formalin fixed paraffin-embedded tissue from placenta sampling of elective surgery<br>which were diagnosed as PAS. Sample were immunostained using VEGF and semi-quantitatively<br>Immuno Reactive Score (IRS) measured based on modified Remmele scale index. The result obtained<br>32 samples that meet inclusion criteria which are found into grade I (n=5), grade II (n=11) and grade<br>III (n=16). This study showed average VEGF at grade I (4.68±1.03), grade II (3.81±1.41), grade III<br>(4.46±1.82) and no significant difference of VEGF expression between grade I, grade II and grade III<br>(p = 0.264). Intraplacental VEGF do not describe the severity of PAS FIGO grading.</p> Ana Puji Rahayu Agus Sulistyono Ernawati Grace Ariani Rozi Aditya Aryananda Copyright (c) 2021 16 1 224 229 Sexual Dimorphism and Clinical Relevance of Thickness and Angulation of Lateral Lamella of Cribriform Plate-A Multidtector Computed Tomographic Study <p>Background: The aim of this study was to establish the morphometry and sexual dimorphism of lateral<br>lamella of cribriform plate in the North Karnataka region.<br>Method: Six hundred and forty four (644) Multidetector computed tomographic scans were collected<br>from North Karnataka region and analyzed by using RadiAnt DICOM Viewer. The thickness and<br>angulation of lateral lamella of cribriform plate of olfactory fossa were calculated on both the sides in<br>both genders. Statistical analysis was done by using Student unpaired‘t’ test.<br>Conclusion: There was statistically significant difference in the angle of lateral lamella of cribriform<br>plate when compared between right side (mean=106.25˚) and left side (mean=109.38˚) in males.<br>There was no such difference among females. Statistically significant difference was observed in the<br>angle of lateral lamella of cribriform plate in male patients (mean=106.25˚) when compared to female<br>patients (mean=109.61˚). The thickness of lateral lamella of cribriform plate was not significant when<br>compared between two sides in males and females. Hence, these variations in the morphometry of the<br>lateral lamella of cribriform plate of ethmoid bone will be of importance for the surgeons in Functional<br>endoscopic sinus surgeries and anterior skull base surgeries.</p> Anandagouda V Naikanur Balappa M Bannur Manjula Patil Sanjeev I Kolagi Copyright (c) 2021 16 1 230 236 Effectiveness of Pisang Raja Peel Extract (Musa Paradisiaca L) on Bacterial Growth of Porphyromonas Gingivalis as the Cause of Periodontitis <p>Background. Periodontal disease is a chronic inflammatory infection that causes damage to the<br>tissue supporting the teeth. The most common periodontal diseases are gingivitis and periodontitis.<br>Periodontitis is a complex, localized chronic inflammatory disease characterized by the destruction of<br>connective tissue, periodontal ligaments, and bone supporting teeth. This periodontal disease is caused<br>by plaque bacteria on the surface of the teeth, where the plaque is a thin layer of biofilm containing<br>a collection of pathogenic microorganisms such as Porphyromonas gingivalis, Actinobacillus<br>actinomycetemcomitans, Prevotella intermedia, Tannerella forsythia and Fusobacterium nucleatum<br>which are soft deposits. Porphyromonas gingivalis is a gram-negative, black pigmented, rod-shaped<br>anaerobic bacteria. Porphyromonas gingivalis is one of the dominant bacteria in chronic periodontitis<br>which is found in subgingival plaques. Indonesia is a country with a tropical climate which makes<br>it rich in biodiversity, which can be used as antibacterial agents. Plantain (Musa Paradisiaca L) is<br>a fruit that is easy to get, but the skin is rarely used. The Pisang Raja peel (Musa Paradisaca L)<br>contains chemical compounds saponins, tannins, flavonoids, and alkaloids which have antimicrobial<br>properties. Objective: To determine the effectiveness of Pisang Raja peel (Musa Paradisiaca L) extract<br>against the inhibition of Porphyromonas gingivalis bacteria as a cause of periodontitis. Methods: Using<br>laboratory experimental methods, the test was carried out in the laboratory with the form of research<br>in the form of Posttest Only Control Design and sampling by random sampling through 4 treatments<br>and 6 repetitions. Statistical test was One Way Anova. Results: Based on the oneway Anova test, the<br>concentration group of 16%, 32%, and 64% and the control group obtained a p-value of (p &lt;0.01)<br>which means that there is a significant difference. Conclusion: Based on the results of this study, it is<br>shown that the effectiveness of Pisang Raja peel extracts concentrations with concentration 16%, 32%,<br>and 64% in inhibiting Porphyromonas gingivalis bacteria and control group obtained p-value (p&lt;0,01)<br>means there was significant correlation. Conclusion: Based on this research that there is effective<br>correlation Pisang Raja peel extract with concentration 16%, 32%, dan 64% can inhibit the growth<br>Porphyromonas gingivalis.</p> Andy Fairuz Zuraida Eva Masriadi Nur Rahmah Hasanuddin Muhammad Ajis Copyright (c) 2021 16 1 237 243 Measurement of Maximal Oxygen Uptake (VO2Max) as a Cardiorespiratory Physiological Fitness Parameter Using Sensor Technology-Based Device Development <p>Background: This study aims to measure the maximal oxygen uptake (VO2Max) as a cardiorespiratory <br>physiological fitness parameter using the development of a sensor technology-based tool.<br>Methods: This study uses a research and development design (Research And Development). Validation <br>is carried out by competent experts. In this study, the researchers asked for validation from three <br>experts, namely IT (electronics) experts, test and measurement experts and Sports Physiology experts <br>(maximum oxygen volume). A total of 19 male and 11 female adults participated in this study. The <br>usage trial was carried out using the expert validity method with an assessment using a questionnaire, <br>test and retest. The data analysis technique used is r-correlation<br>Result: Based on expert validation tests, the reliability, practicality, and effectiveness of the development <br>of test instruments based on sensor technology can be used to measure VO2Max and provide accurate <br>and effective results.<br>Conclusion:The development of a test instrument based on sensor technology can provide accurate and <br>effective results for measuring maximal oxygen uptake (VO2Max) as a cardiorespiratory physiological <br>fitness parameter. This tool provides advances for monitoring VO2Max routinely in daily life, especially <br>for carrying out training programs for athletes without the need for trained personnel and special <br>equipment and expensive costs.</p> Anton Komaini Wiyonna Gusvominesia Syahrial Bakhtiar Yendrizal Novadri Ayubi Copyright (c) 2021 16 1 244 250 Alpha-Mangostin and Gamma-Mangostin Isolated from Mangosteen (Garcinia mangostana L.) as Promising Candidates against SARS-CoV-2: A Bioinformatics Approach <p>The world is endangered by the COVID‐19 pandemic caused by SARS‐CoV‐2, people are dying in <br>thousands every day, and without an actual treatment, it seems that bringing this global health problem <br>to a quit is impossible. Natural products have been in constant use since ancient times and are proven <br>by time to be effective. Medicinal plants from Indonesia may lead to the discovery of the novel drugs. <br>Mangosteen or Garcinia mangostana L. is a native tropical fruit from Southeast Asia and is known to <br>contain bioactive compounds. Interestingly, the main xanthone derivatives are alpha-mangostin and <br>gamma-mangostin, these compounds have a variety of pharmacological activities such as antiviral <br>activity. In summary, this study showed potential pharmacological benefits of alpha-mangostin and <br>gamma-mangostin isolated from mangosteen against SARS-CoV-2. Thus, mangosteen exhibits as a <br>valuable plant and a candidate for future drug development to fight SARS-CoV-2. However, further <br>trials, such as in vitro and in vivo evaluation, are needed to prove the validity of these findings</p> Arif Nur Muhammad Ansori Copyright (c) 2021 16 1 251 258 Prevalence of Musculoskeletal Disorder in Wrist and Fingers amomg Amateur Piano Players in Vellore <p>Background: Now a days the number of students studying piano in tertiary institution is being <br>increasing. The piano player is similar to athletic activity to play the notes accurately. Posture plays <br>a vital role in piano playing. Musicians are prone to injuries due to the nature of musical practice, <br>inappropriate body postures and potentially harmful playing techniques. Majority of amateur players <br>are prone to injuries, the main objective of the study was to find out the prevalence of musculoskeletal <br>discomfort among piano players in three different wrist styles in piano playing. Methodology: A total <br>150 samples of age 8 to 15 years of both gender from Kingsway music academy. who use to play piano <br>minimum 30 mins with minimum 6 months of learning experience were recruited for the study, initially <br>their level of pain and discomfort in hand and wrist was measured using Cornell hand discomfort <br>questionnaire Conclusion: The statistical analysis shows that there is pain in fourth and fifth finger in <br>all wrist position and also weight playing method has significant pain among three wrist position .This <br>also study concludes that correct positioning during piano playing can minimize the playing related <br>musculoskeletal disorder.</p> Ashish Mathew A S.F.Mariyam Farzana Copyright (c) 2021 16 1 259 266 Estimateof Biological Activity of Parsleyextract on the Isolated Pathogenic Bacteria in Baghdad City <p>This research investigates the most common urinary tract infection bacteria and their susceptibility to <br>antibiotic disc and parsley (Aquas and methanol) extracts. The urinary tract microbial were isolated <br>from patients of urinary tract infection (UTI) pregnant women patients from Baghdad Hospital. The <br>pathogenic organisms were collected, cultured and identified. 50 microbial isolate wasset as, E. coli <br>56 (46.66%), Staphylococcus aureus19 (15.8%). Proteus mirabilis 6 (5%) and Klebsiella pneumonia<br>3 (2.5%). The pathogenic bacterial showed various zone of sensitivity to different antibiotics. Within <br>the parsley Antimicrobial activity ranged from 3 to 20 mm. Antibacterial activity of parsley extract (5-<br>22) mm on UTI isolated pregnant women and methanol extracts was between (3-15) mm. Therefore, <br>Parsley extract had a pharmacological to treat all of 50 isolates that were identify from patients. In <br>conclusion, the findings suggested that different extractsmay content as a broad-spectrum bactericidal <br>factor, to control the emergent pathogens any way of their drug resistance mechanismsto treat urinary <br>tract infections</p> Ashwak Jasim Kzar Shammari Copyright (c) 2021 16 1 267 273 Psychological Autopsy: A Lead to the Truth Untold <p>Psychological autopsy is an important technique of investigation of an alleged suicidal case. The <br>fundamental of psychological autopsy is based on the ultra-careful collection of records that help <br>reconstruct the psychosocial domain of individuals. This paper gives insight into understanding of <br>autopsy types and their uses. Relevance of psychological autopsy in forensic practice is highlighted <br>such as validity, admissibility, scope and application in court of law for administration of justice.</p> Mohd Asrarul Haque Copyright (c) 2021 16 1 274 277 Diplopia as the Initial Manifestation of Cerebral Vasculitis in a Patient with Systemic Lupus Erythematosus: Diagnostic Approach and Challenges <p>The term Neuropsychiatric systemic lupus erythematosus (NPSLE) encompasses all neurologic <br>and or psychologic symptoms arising in patients with SLE after other causes have been ruled out. <br>Cerebral vasculitis as a manifestation of NPSLE is a rare case with a very broad spectrum of clinical <br>presentation and severity. We report a case of a female with cerebral vasculitis presenting with diplopia <br>as its early manifestation. Diagnosing cerebral vasculitis remains challenging given that biopsy as the <br>gold standard is an invasive procedure and may not be available in many settings. A high suspicion of <br>diagnosis requires clinicians’ judgement in reviewing combination of detailed history taking, physical <br>examination, neuroimaging, and other available supporting modalities.</p> Audy Ariana Awalia Copyright (c) 2021 16 1 278 282 The Levels of Salivary IgA and Lactoferrin and Some Salivary Parameters in Waterpipe Smokers and Cigarette Smokers <p>Background: Waterpipe and cigarette are two types of tobacco consumption, their smoking is associated <br>with many adverse effects it has a detrimental effect on saliva and causes a reduction in salivary pH <br>and flow rate in addition to their controversial effect on salivary IgA and lactoferrin. Materials and <br>Methods: unstimulated saliva was collected from 84 subjects in the early morning between 8-10 am. <br>Subjects were divided equally into three group’swaterpipe smokers, cigarette smokers, and non-smokers <br>all of the participants are adult male aged between 25-60 years, Sandwich ELISA technique was used <br>for detection and estimation the level of salivary IgA and lactoferrin. Result: IgA and Lactoferrin results <br>showed significantly(p≤0.01), higher concentration in cigarette and waterpipe smokers group than nonsmokers Results also showed that Salivary flow rate(SFR) and pH was higher in the non-smoker’s group <br>followed by waterpipe and cigarette smokers groups with a highly significant difference (p≤0.01), The <br>correlation between Lactoferrin and salivary IgA also showed a significant (p≤0.01),moderate positive <br>correlation in the cigarette group only. Conclusions:Smokingincrease Salivary IgA and lactoferrin <br>concentrations while it reduces SFR and pH of saliva, a significant positive correlation was founded <br>between lactoferrin and salivary IgA only in cigarette smokers</p> Ausama Ahmed Fathallh Maha Adel Mahmood Copyright (c) 2021 16 1 283 290 Incidence of Abruption and Placenta Previa in Pregnant with Previous Caesarian Section <p>Caesarean section is a surgical procedure in which the incision made through a women’s abdomen<br>(laparotomy) and uterus (hysterectomy) to deliver one or more babies. In each previous c/s the risk of<br>placenta previa and abruption increase. The aim of this study is to find out the associated between the<br>previous caesarean section and placenta previa and abruption in this pregnancy. A retrospective study<br>was carried out during the period between 1st July 2018 and 20th august 2019 in Al-Zahraa Teaching<br>Hospital. During the period of study, 119 pregnant women with history of previous scar presented to the<br>hospital for vaginal delivery or c/s, 70 of these patients diagnosed that they have placenta previa and as<br>have placenta abruption by ultrasound and confirmed during delivery. Another 49 patients were without<br>complication. Pregnant women with APH due to other causes were excluded. Data were collected<br>through detailed history. Official agreements and verbal consent of all women were taken. Statistical<br>analysis performed by using the statistical package for social sciences and appropriate statistical test<br>were applied.</p> Baidaa Abdulkareem Alwan Areej Sabah abdulridha Copyright (c) 2021 16 1 291 297 Levels of Suicidal Ideations and Intents among the Inmates in the Correctional Institutions in Baghdad City - Iraq <p>Background: Suicidal ideations concern thinking about suicide or an uncommon and inappropriate<br>preoccupation with suicide. The range of suicidal ideation and intent differs significantly from brief<br>thoughts to wide thoughts, to comprehensive planning, and role-playing.<br>Objectives: To explore inmates’ levels of suicidal ideation and intent in the prisons of Baghdad City<br>and to find out the relationship between these levels and some demographic characteristics of those<br>inmates.<br>Methodology: A descriptive analytic design was used to guide this study which was conducted<br>from October 15th, 2015 to the June 10th, 2016. A non-probability sample of 100 inmates in Baghdad<br>correctional institutions was recruited. The study instrument is a questionnaire consisted of nine<br>demographic characteristics and 19 items represent Beck suicidal ideations and intents scale. Data<br>were analysed by using descriptive statistical measures of frequency, percent, and distribution; and<br>inferential analysis (Chi-squire).<br>Results: The study results displayed that more than half of the inmates are from twenties and thirties<br>decades (58.0%), 68.0% having elementary and secondary school, half of them are with six to 15<br>years imprisonment, and 69.0% are married. Three quarters have moderate and high levels of suicidal<br>ideations and intents. The study also finds that the more the period of imprisonment and the less of<br>income the inmates have the higher the levels of suicidal ideation they have.</p> Maan Hameed Ibrahim Al-Ameri Copyright (c) 2021 16 1 298 305 Relationship between Vitamin D AND IL6 in Convalescent Healthcare Workers with Covid-19 in Baquba Hospitals in Diyala Province <p>The outbreak of coronavirus disease 2019 (COVID-19) and pandemic, caused by severe acute<br>respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a major concern globally. One hundred<br>Convalescent HCWs patients with COVID-19 works in Diyala, Hospitals center, from October 2020 to<br>March 2021 were included. We recruited 100 non-infected from healthy people and 100 PCR-confirmed<br>infected HCWs. In this review, we have summarized and discussed recent immunological studies<br>focusing on the response of the host immune system, cytokine storms such as IL6 have been discussed<br>as part of immunopathology mechanisms in SARS-CoV-2 infection. This may help us understand<br>patients’ immune status with COVID-19, particularly those with severe clinical presentation, and form<br>a basis for further immunotherapeutic investigations. This study calculate that there is the relation<br>between IL6 and Vitamin D3 in convalescent patients, accounting for a range of previously described<br>clinical predictors and, potentially directing future therapeutic strategies, including about Vitamin D.</p> Maysam Abbas Luma T. Ahmed Mohammed A. Alkarkhi Copyright (c) 2021 16 1 306 312 A Clinical Study of Parasitical Leishmaniasi in Al-Kut Province <p>leishmaniasis is a potentially intense and skin disease. individuals with leishmaniasispossess one or<br>different long lesions on the skin. We obtained the sample from the patients init at alzahra Teaching<br>Hospital, a total of 190 cases of leishmaniasis have been registered. In this study were 190 individuals.<br>72 (38 %) females and 118 (62 %) males. The most infection with cutaneous leishmaniasis was in the<br>male. The majority of patients were at the age of (1-15) years 63 (53.3%) in males while in females the<br>highest proportion 39 (54.1%). Infection with cutaneous leishmaniasis had the highest percentage in<br>February 44 (23%) when compared to other months ofinfection.Results observed for infection with<br>cutaneous leishmaniasisin patientsuneducated had the highest percentage 116 (16%) when compared<br>to educated of infection.Medical reference have to be knowing the truththat chronic diseaseactivities<br>produceexpansion of the disease and riserange rate in the status that outlet to medical treatment is not<br>easy mostly in poorly conditions of cutaneouschronic diseaselocations.</p> Bushra Qasim Dhumad Al Edhari Copyright (c) 2021 16 1 313 317 Determinant Factors affecting Quality of Life of Children with HIV/AIDS <p>HIV/AIDS causes physical problems, such as recurrent infections, growth disorders and malnutrition.<br>HIV/AIDS also causes psychosocial problems, such as being shunned by friends and getting<br>discriminatory behavior. All of the problems described earlier affect children’s mental growth and<br>development which will affect the quality of life of children with HIV/AIDS.<br>This research is a cross sectional study, conducted at the Intermediate Care Unit of Infection Disease of<br>Children Outpatient Clinic in Dr. Soetomo General Hospital Surabaya and Voluntary Counselling and<br>Testing Outpatient Clinic in Gresik General Hospital, Probolinggo General Hospital and Trenggalek<br>General Hospital in November 2019-May 2020. Data collected was descriptively, then statistically<br>analyzed by bivariate and multivariate analysis.<br>According to bivariate analysis, factors significantly related to quality of life of children with HIV/<br>AIDS were age, monthly caregiver income, distance between diagnosis and therapy, immunological<br>status, nutritional status and treatment adherence. Multivariate analysis showed that age (p=0,014,<br>Odds Ratio [OR] 18,780, confidence interval [CI] 1,810-194,844) and treatment adherence (p=0,010,<br>OR 7,823, CI 1,631-37,516) had a significant relationship with the quality of life of children with HIV/<br>AIDS (p &lt;0.05).<br>In conclusion, age, monthly caregiver income, distance between diagnosis and therapy, immunological<br>status, nutritional status and treatment adherence are significantly related to the quality of life of children<br>with HIV/AIDS. Age and treatment adherence have the most significant relation with the quality of life<br>of children with HIV/AIDS .</p> Candra Maulana Irwanto Dominicus Husada Copyright (c) 2021 16 1 318 326 Study of Psychosocial Risks in the Professional Environment of Health Care Workers in Morocco <p>Caregivers are a particular target for psychosocial risks, including stress and burnout. Burnout is a<br>consequence of exposure to permanent and prolonged stress. It concerns professions with high mental,<br>emotional and emotional demands and high responsibility such as nurses. The objective of this study<br>was to describe and identify psychosocial risks, occupational stress and its components in health<br>professionals. This epidemiological study involved 191 health professionals working in the provincial<br>hospital centers of Kenitra and Sidi Slimane, Morocco. The questionnaire included: socio-demographic<br>and occupational data; the Karasek scale (KJCQ) with its three components: psychological demand (DP),<br>decision-making latitude (LD) and social support (SS). These three dimensions allow the identification<br>of risk situations. Job strain is the combination of low decision latitude and high psychological demand.<br>The Maslach Burnout Inventory (MBI) scale consists of three dimensions (emotional exhaustion,<br>depersonalization and feeling of personal fulfillment at work). The positive diagnosis of burnout was<br>chosen if the score exceeded the values defined in one of the three components of MBI (high for the<br>first two and low for the third).</p> Chakhtoura Khalid Chaib Yassine Elanssari Anas Aboussaleh Youssef Ahmed O.T.Ahami Copyright (c) 2021 16 1 327 336 The Epistemological Aspects of Investigative Hypotheses <p>This paper is about the philosophical and epistemological aspects of investigative hypotheses.<br>Criminal investigation is a kind of cognition, so it is important to know the basic philosophic concept<br>of knowledge and truth. Different schools and traditions of philosophy have given different answers to<br>these.<br>One of the basic elements of investigative thinking is, in addition to being reconstructive and<br>retrospective, thinking in hypotheses. Logical, semantic, syntactic, epistemological, and ontological<br>principles must be taken into account when formulating hypotheses. Choosing between the hypotheses<br>should be based on preference and indifference criteria. These criteria of preference and indifference<br>will also be logical and epistemological.<br>Testing, validating, and rejecting hypotheses is an essential element of investigative work. The<br>plausibility, credibility, and accuracy of competing hypotheses are constantly changing depending<br>on the investigative data obtained. It is a basic principle that all hypotheses should be tested and, if<br>possible, the testing should be performed in parallel.</p> David Petretei Copyright (c) 2021 16 1 337 342 CT Scan Finding Characteristics of Confirmed Covid-19 Patients Based on Clinical Symptom Onset Patterns <p>Chest computed tomography (CT) scan is one of the main modalities to detect COVID-19 infection.<br>Several CT scan findings are the hallmark to rapidly detect suspected COVID-19 infection, therefore<br>timely treatment could be administered. This study aims to describe chest CT scan findings of confirmed<br>COVID-19 patients based on clinical symptom onset patterns.<br>This study is a descriptive study with a retrospective design in confirmed COVID-19 patients. Data<br>regarding characteristics of chest CT scan findings and the patient’s history including clinical symptoms<br>onset were collected.<br>There were 123 subjects in this study. The study data were categorized into modified clinical symptom<br>onset patterns which were early, progressive, peak, absorption, and advanced phases. Most of male<br>(57%) and female (43%) patients that were admitted to the hospital were in absorption phase of the<br>disease with fever, cough, and dyspnea as the most prevalent symptoms. Chest CT scan findings of<br>absorption phase included GGO (ground glass opacity) in 28 patients (76%), crazy paving pattern in<br>18 patients (49%), consolidation in 22 patients (59%), and fibrosis in 31 patients (84%). Chest CT scan<br>findings of confirmed COVID-19 patients vary depending on the phase of the disease. Risk factors and<br>secondary bacterial infection may contribute to long-term persistence of symptoms.</p> Dewi Roziqo Anita Widyoningroem Prijambodo Rosy Setiawati Copyright (c) 2021 16 1 343 351 Isolation and Diagnosis of the Bacteria Causing Corneal Ulceration Associated With Ocular Myiasis Infection <p>The current study was conducted to isolate and diagnose the bacteria that company cases ocular myiasis<br>as complications. The bacteria were collected using a cotton swab for 30 individuals who came to the<br>Diwaniyah Teaching Hospital due to their infection with ocularmyiasis. The swabs were cultivated<br>on many culture media, such as blood agar and MacConkey, and mannitol salt and EMB medium<br>for diagnosis of Ecoli. The results of the culture were positive for all samples under study. Various<br>types were isolated; including rod and coccobacilli gram-negative in addition to gram-positive cocci,<br>fermented and non-fermented mannitol species, and the identification of the species was confirmed<br>using the VITEK2 system, the antibiotic susceptibility test was also checked using the same test and<br>the results were as the following Ecoli in 5 cases, Pseudomonas spp in 4 cases, Kelbssilla pneumonia<br>in one case, S aureus in 4 cases, S.epidermides in 5 cases in addition to many other different species.</p> Dhuha Mahdi Jabir Esraa Fadhel Wathah Copyright (c) 2021 16 1 352 357 Study the Effect of Many Medications in Ophthalmomyiasis Treatment and the Possibility of Using these Medications Instead of Mechanical Removal <p>This study was aimed to find the most suitable method to treat ophthalmomyiasis cases in Iraq, especially<br>in diwanyia city. So that the study was conducted on 30 cases, where the drug xylocaine was dropped<br>to the eye eight of them, and turpentine oil was dropped to eight others, while both anesthetics were<br>applied to four of the patients, Then wait for 20 minutes and remove the larvae using forceps and by<br>a specialist ophthalmologist .ten of patients were given ivermectin orally without any ivermectin to<br>gather can immobilize the larvae thus facilitate their removal, it also found that using ivermectin is very<br>effective in the treatment and can be used for clearing eye from larvae even after mechanical removal<br>without any danger from side effect.</p> Dhuha Mahdi Jabir Ghada Basil Ali Alomashi Copyright (c) 2021 16 1 358 365 Physical and Psychological Stressor Exposure during Pregnancy Impacts the Expression of Synapsin and Neuronal Cells Number of MUS Musculus Offspring <p>Introduction: Stress during gestation can lead to inappropriate fetal brain development, especially<br>psychological stress. Psychological stress play pivotal role in offsprings’ brain development.<br>Objective: The aim of this study was to investigate the effects of maternal exposure to physical and<br>psychological stress during pregnancy on the cerebrum in mice offspring.<br>Method: This study was an analytical experiment study with the subject were 24 female mice Mus<br>musculus. The sample were divided into treatment and control group. Treatment groups divided into<br>three conditions, 1 group was given physical stress, 1 group with psychological stress, and 1 group<br>was given combination of physical and psychological stress intervention. The data were analyzed with<br>ANOVA test then followed by LSD to find the differences between all groups.<br>Results: The ANNOVA test results showed significant differences of the expression of synapsin with<br>p = 0.0000. The number of neuronal cells also represented significant differences with p = 0.000 on the<br>cerebrum.<br>Conclusion: Stress exposure during pregnancy can induce bad impacts in brain development, especially<br>the expression of synapsin and the number of neuronal cells on the cerebrum in mice offspring.</p> Diana Estu Rumahastuti Hermanto Tri Joewono Widjiati Copyright (c) 2021 16 1 366 372 Distribution of Virulence genes in Streptococcus pneumoniae Isolated from Different Baghdad Hospitals <p>Streptococcus pneumoniae causes serious infections (pneumonia, meningitis and bacteremia) with<br>significant morbidity and mortality rates. The goal of this study is to isolate and identify S. pneumoniae<br>from clinical samples in Baghdad City hospitals in order to explore the presence of three virulence<br>genes (lytA, ply and psaA) in clinical isolates. A total of 120 separate clinical samples were obtained<br>from inpatients and outpatients with upper and lower respiratory tract infections at different hospitals in<br>Baghdad. Twenty-five isolates of S. pneumoniae were identified by using cultural, morphological and<br>biochemical characteristics as well as the diagnosis by VITEK2 system. Clinical samples were including<br>sputum 19 isolates (76%) and urine 6 isolates (24%). The results of collected specimens showed that<br>male’s percentage is highest than female’s patients, which was out of 25 isolates are 15 (60%) males<br>and 10 (40%) females, The results also showed that it is much more common in elderly people than<br>in younger people. The genomic DNA of bacterial isolates was applied in a polymerase chain reaction<br>(PCR) to amplify certain genes. The PCR results were: Six isolates (24%) show positive results for<br>the presence of lytA gene. Five isolates (20%) showed positive results for the presence of ply gene.<br>Twenty-three isolates (92%) show positive results for the presence of psaA gene. As concluded from<br>the present study, that the results exhibited that the presence of the virulence genes can be considered<br>as a serious issue.</p> Dina Muthana Fahran Basima Qasim Hasan Al-Saadi Copyright (c) 2021 16 1 373 380 Prevalence of Biofilm Genotype Pattern( algD −/pslD −/pelF –) with Multidrug-Resistant in Clinical Local Pseudomonas Aeruginosa Isolates <p>The study was designed to explore the distribution and association of the biofilm genotype pattern(<br>algD −/pslD −/pelF –) with multidrug-resistant in clinical local Pseudomonas aeruginosa isolates. A<br>total of one hundred isolates of Pseudomonas aeruginosa were included in this study, which has been<br>collected from different specimens, from July to September 2020. The isolates included were 34 from<br>burns, 19 from wounds, 23 from ear infections, 22 from urinary tract infections (UTI), and 2 from cystic<br>fibrosis (CF). Identification of the isolates was carried out using microscopical, cultural characterization<br>on MacConkey agar, Cetrimide agar, then Pseudomonas agar. Biochemical tests were performed, and<br>further identification was carried out by the VITEK_2_compact system. Genotypic identification has<br>been completed by16SrRNA. To assess the frequency of multidrug-resistant of Pseudomonas aeruginosa<br>(MDR), the antibiotic susceptibility test was done. It was carried out by using different groups of<br>antibiotics (10 antibiotics) using the Kirby–Bauer disk diffusion method. The results showed that the<br>resistance were Ceftazidime(62%),Gentamicin(26%,(Piperacillin-tazobactam(25%), Ticarcillin(24%),<br>Meropenem(20%), Cefepime (18%),Amikacin(17%) Levofloxacin(16%), Colistin(15%) Imipenem(10%).<br>Biofilm production was assessed using a microplate examination method. The results showed that 93%<br>of isolates were positive for biofilm production, while (7%) were non-biofilm producers. There were<br>differences in the rates of biofilm-production distributed into 21 (21%) were strong biofilm producer<br>(OD was more than 2.156), 25 (25%) intermediate biofilm producer, and 47 (47%) were weak biofilm<br>producer (OD was less than 1.078), and the non -biofilm producer was 7(7%).<br>Three virulence factors genes ( algD, pslD, and pelf ) were chosen, which responsible for the phenotypic<br>pattern of biofilm formation and identified as genotypic algD −/pslD −/pelF – pattern. The differences<br>in genotypic pattern prevalence among the MDR-positive isolates of different origins were statistically<br>significant. Chi-square analysis showed a highly significant association between strong biofilm capacity<br>and genotype pattern (p&lt;0.0001), also the analysis showed a highly significant association between<br>moderate biofilm capacity and genotype pattern (p&lt;0.002). Chi-square analysis showed a highly<br>significant association between weak biofilm capacity and genotype pattern ( p&lt;0.001).<br>In the current study the percentage of resistance among P. aeruginosa local isolates for multiple antibiotics<br>(MDR) was relatively low, maybe due to the combination strategies based on appropriate anti-pseudoantibiotic<br>agents that may be used to improve treatment from the related infections, according to these<br>results, P. aeruginosa local isolates that produced biofilm were mostly (70%) indicated as non-MDR.</p> Duraid K. AlRawi Huda M. Mahmood Copyright (c) 2021 16 1 381 391 The Effect of Long Storage of Whole Blood Components on the Level of 2,3 Diphosphoglycerate and Lactic Acid in the Blood Bank, Dr. Soetomo General Hospital, Surabaya, Indonesia <p>The purpose of this study was to analyze changes in levels of 2,3 DPG and lactic acid on WB storage<br>time. This research is an observational analytical with time series design was conducted at the Clinical<br>Pathology Installation and Blood Bank Dr. Soetomo General Hospital Surabaya in the period July<br>- September 2020. Levels of 2,3 DPG and lactic acid were measured in 16 bags of Whole Blood<br>components on the day 1, day 5, day 10, day 20 and day 30. Statistical analysis was performed using<br>the Friedman test. The results were statistically significant if p &lt;0.05. The Friedman statistical test<br>showed that there were significant differences in levels of 2.3 DPG (p &lt;0.001) and levels of lactic<br>acid (p &lt;0.001) during storage. The results showed that the level of 2,3 DPG in WB which was stored<br>decreased according to the duration of storage. The yield of lactic acid on stored WB increased with<br>the duration of storage. Therefore, saving WB is recommended to be given within &lt;6 days to reduce<br>the risk of acidosis. Further research is needed for other parameters that can affect the storage process.</p> Dwi Ajeng Roosanti Betty Agustina Tambunan Arifoel Hajat Copyright (c) 2021 16 1 392 398 The Effect of Practical Exercises for the Technique of Ballistic Training to Develop Some Functional Capabilities of the Goalkeepers of the National Youth Football Team) <p>The importance of the research lies by recognizing the importance of using the Ballistic training method,<br>which is one of the important methods in explosive strength training and the characteristic force with<br>speed, and this method works by overcoming other traditional strength training such as weight lifting,<br>and overcoming the shortage in speed as a result of these exercises in a position, a set of special<br>exercises for this method to train goalkeepers for the youth national football team, and the researcher<br>decided to tackle the problem according to the following question:<br>The question? ... Do special exercises prepared by the researcher using the method of Ballistic training<br>contribute to raising the level of development of some functional abilities of the individuals of a research<br>specimen...?<br>The answer to this question is through the results that the researcher will obtain for all field procedures<br>that he will prepare and implement on the research specimen, and the research aims to develop a set<br>of applied exercises for the method of Ballistic training to develop some functional abilities of the<br>individuals of the research sample, as well as to identify the rate of development Also, as for the<br>imposition of the research, there were statistically significant differences between the results of the pre<br>and post tests for the values of some functional abilities and in favor of the results of the post tests of the<br>individuals of the research sample, and the researcher used the experimental method in a comparative<br>method for one group, and the research specimen consisted of four Goalkeepers for the Iraqi national<br>youth football team, and then the sample was tested with pre-tests of functional capabilities, after which<br>the special applied exercises according to the Ballistic method were applied to the members of the<br>research specimen, as the duration of their application lasted eight weeks with three training units per<br>week, after which Post-tests were conducted on them, and the statistical application Statistical Package<br>for the Social Science (SPSS) was used to obtain and discuss the results of tests of the goalkeepers.<br>The special applied exercises according to the Ballistic method have a positive effect on the functional<br>capabilities of the goalkeepers. The recommendations, the use of the Ballistic training method in the<br>goalkeeper’s position was emphasized because of its clear importance in the development and upgrading<br>of the career capabilities of the goalkeepers in football.</p> Ehab Mohammed Farhan Abdulwahhab Ghazi Hammoodi Copyright (c) 2021 16 1 399 407 Analysis of Physico-Chemical and Bacteriological Parameters of Liquid Effluents from the Provincial Hospital Center in Sidi Kacem Morocco <p>Background: The effluents generated by the hospital activities and which are rejected into the<br>municipal sewerage system without any prior treatment, present a chemical, biological and physical<br>risk for public and environmental health. They cause a degradation of the aquatic ecosystem, and favor<br>the propagation of antibiotic resistant germs. Objective: The aim of this study is to carry out physicochemical<br>and bacteriological analysis of the effluents of the provincial hospital of Sidi Kacem in Rabat-<br>Salé-Kénitra region, Morocco, in order to evaluate the degree of wastewater pollution and to reduce its<br>environmental impact.<br>Methods: 24 samples of wastewater were collected from the Hospital’s main sewer according to<br>Moroccan Norm NM 03.7.059 and transported to the Provincial Laboratory of Epidemiology and<br>Environmental Health (LPEHM) for analysis. These analyses were conducted according to the<br>requirements and methods recommended by Rodier 1996 and 2009.<br>Results: The results of the bacteriological analysis showed a very high bacterial load of fecal coliforms<br>(36,7.104 CFU/100 ml), total coliforms (40.104 CFU/100 ml), and fecal streptococci (21.104 CFU/100<br>ml). The physicochemical parameters revealed a significant load of organic and mineral matter expressed<br>in terms of nitrates (41,59 mg/l), nitrites (0,53 mg/l), sulphates (222,75 mg/l), ammonia (1,95 mg/l),<br>electrical conductivity (3202 μs/cm), hydrogen potential PH (7.82), all of which are well above the<br>upper limit stipulated by the regulations. The COD/BOD5 ratio (7.66) higher than 3 means that these<br>effluents are hardly biodegradable.<br>Conclusion: These results show that hospital effluent is loaded with mineral, organic and bacteriological<br>pollutants and requires</p> Elouakfaoui Aziz Mahjoub Aouane Rouani Abdeljabbar Berrid nabyl Copyright (c) 2021 16 1 408 418 Microbiological Study of Surfaces in the Hospital Environment Case of the Provincial Hospital of Sidi Kacem, Morocco <p>Background: The hospital environment is largely colonized by pathogenic microorganisms. this <br>contamination varies qualitatively and quantitatively according to the services and the capacity of the <br>microorganisms to survive in inert environments, the elimination of these microorganisms requires <br>a well formed staff and well detailed protocols which meet the international requirements. The <br>microbiological monitoring of the hospital surfaces is a key factor to prevent nosocomial infections, it <br>allows us to elaborate a diagnosis of the microbial ecology in order to lead preventive and corrective <br>actions. Objective: The aim of our study is to identify the present bacteria on the surfaces of the <br>provincial hospital of Sidi Kacem in Rabat-Salé-Kénitra region, Morocco, in order to reduce the rate <br>of nosocomial infections.<br>Methods: 167 samples were taken from different sites in the hospital wards, using the swabbing <br>technique, according to ISO/DIS 14698-1, the identification of the isolated germs has been realized by <br>the classical biochemical gallery and the API (Biomerieux, France).<br>Results: A total of ten (10) bacterial species were isolated with a predominance of Bacillus sp (27%) and <br>coagulase-negative staphylococci (29%), Staphylococcus aureus (18%), and Klebsiella pneumoniae <br>(13%) followed. Thirteen (13) samples were a negative culture with a positivity rate of 92%. The <br>distribution of isolated strains by department shows a predominance of bacterial strains in the intensive <br>care unit (19%) and the emergency department (17%).Conclusion: These results show the importance <br>of developing a risk management approach based on cleaning and disinfection protocols and procedures, <br>as well as training and awareness programmers.</p> Elouakfaoui Aziz Mahjoub aouane Rouani Abdeljabbar Berrid Nabyl Copyright (c) 2021 16 1 419 426 Predicting Pandemic Curve Distribution Using Statistical Models <p>This article discusses the distribution of pandemic in the world and pandemic curve in Jordan and <br>how the science of probability and statistics predict when active cases tend to zero by determining the <br>shape of epidemic curve and relating it to a special probability distribution that has specific measures <br>and properties. At the beginning of the outbreak of any virus in a society, reliable data describing it <br>and its spread will be rare, hence researchers set up statistical models that have the ability to predict <br>the spreads’ shape, where the prospected people hosting such viruses will go to and the likelihood of <br>transmitting it to places they travel. Those models use known statistical measures that estimate the <br>probability of disease transmission from infected people to others. In addition, the factors related to <br>roads and people’s movement, taking into consideration, public health interventions, such as wearing <br>masks, closing places of people’s aggregations like schools, universities mosques and churches and <br>quarantine make difference in numbers of infected people. The fundamental differences between the <br>“Spanish flu” that attacked the world a hundred years ago and “Coronavirus” the world facing since <br>the beginning of the current year 2020 is the amount of huge data concluded from scientific studies and <br>reports related to virology and epidemiology.</p> Eman Almuhur Mona Khandaqji Manal Al-labadi Anwar Alboustanji Copyright (c) 2021 16 1 427 432 Steeping Tin Leaves (Ficus carica) Improves Sperm Quality of Male Mice (Mus musculus) Exposed to Lead Acetate <p>Introduction: Lead can induce lipid oxidation in cell membrans, thus forming free radicals. The <br>process of imbalance of free radicals and antioxidants will disrupt the normal function of cells, <br>causing cell death and decreased sperm quality. Purpose: The purpose of this research is to explain the <br>mechanism of steeping tin leaves (Ficus carica) increase sperm quality in male mice (Mus musculus) <br>exposed to lead acetate. Methods: This type of research was true experimental design with posttest <br>only control group design with the number of replications of 10 male mice, the experimental unit will <br>be distributed proportionally to 5 groups. Steeping tin leaves will be given with a dose of Pb + Tin <br>Leaf 1.664 mg (P1) and Pb + Tin Leaf 3.328 mg (P2), while for lead acetate dose 0.5 mg and quercetin <br>dose 0.7 mg. The analyzed variables included spermatozoa motility, spermatozoa morphology, and <br>spermatozoa concentration. Data analysis was conducted including the Shapiro-Wilks normality test, <br>and the homogeneity test used the Levene test. If the data were not homogeneous, the group average <br>test would use the Brown-Forsythe test, then continued with a different test for each group using the <br>Post Hoc Games-Howell test. If the Levene test data were homogeneous, the group average test would <br>use Oneway Anova. Findings: The results showed that giving of steeping tin leaves with a dose of <br>Pb + Tin leaves 3.328 mg (P2) is able to increase spermatozoa motility and spermatozoa morphology. <br>Conclusion: The steeping tin leaves increase sperm quality</p> Emi Kusumawardani Budi Santoso Widjiati Hari Basuki Notobroto Heru Santoso Wahito Nugroho Copyright (c) 2021 16 1 433 440 Causes of Post Surgery Disputes between Plastic Reconstructive and Aesthetic Surgeons with Patients <p>Advances in science and technology and the ability, skills, and soul of the art of Plastic Reconstructive<br>and Aesthetic Surgeons can change human organs according to the patient’s wishes to improve one’s<br>appearance to become more beautiful or handsome. Aesthetic plastic surgery is not performed to<br>treat physical disabilities, in contrast to reconstructive plastic surgery, which aims to treat physical<br>disabilities. However, misunderstandings or failures can occur because Plastic Reconstructive and<br>Aesthetic Surgeons are also human, so it does not give satisfaction to the results expected by the patient.<br>Not infrequently, the misunderstanding peaked, resulting in a dispute between the doctor of Plastic<br>Reconstructive and Aesthetic Surgeons with the patient. This research method is normative juridical<br>research empirical. The research specification in this study is descriptive-analytical. Research conducted<br>using secondary data sources that include primary legal materials in norms, basic rules, laws, and<br>regulations. The results of this study explain that Plastic Reconstructive and Aesthetic Surgeons should<br>not give an appointment or guarantee success on the surgical efforts that have been done because there<br>are other factors beyond their power as a doctor. The doctor should explain the risks and complications<br>that may occur. In addition, before surgery, it is recommended that a complete agreement be made<br>with the patient, and the patient understands and understands the risks or possibilities that can occur<br>postoperatively in the future. The doctor and patient agreement are made in full and detailed in written<br>form before medical action is carried out by involving a notary public to ensure legal certainty, fairness,<br>and benefit.</p> Endang Sri Sarastri Liliana Tedjosaputro M.C. Inge Hartini Copyright (c) 2021 16 1 441 447 Evaluation of Biomarkers in Workers Exposed to Air Pollutants in Oil Refineries <p>Air pollution is nowadays a complex problem due to industrial prosperity. Among the chemical industry,<br>oil refineries have been identified as major emitters of a wide range of pollutants, the workers of the oil<br>refinery are exposed to a great variety of toxic compounds. Air pollution is the main environmental cause<br>of human disease and death. Therefore, it is necessary to develop early warning signals or biomarkers<br>that convincingly reflect adverse biological responses towards anthropogenic environmental toxins<br>even at minute concentrations. This work aims to study the effects of exposure to the air pollution of oil<br>refinery, on the parameter blood, TNF-a, antioxidant glutathione peroxidase(GPx), and oxidative stress<br>malondialdehyde (MDA), in workers of the oil refinery. Results showed that exposure to air pollution<br>in the oil refinery lead to( a significant increase in levels Hb, WBC, Lymphocyte, TNF-a, and MDA,<br>decrease levels of GPx) P&lt;0.05. And non –significant in( RBC, HCT, Neutrophils ) P&gt;0.05 in workers,<br>compared to healthy control.</p> Esraa H. mohammed Adel M. Rabee Copyright (c) 2021 16 1 448 454 Extraction and Purification of Resveratrol from Grape Waste <p>The current study aimed to extract and purify the phenolic compound Resveratrol from dried black<br>grape residues, Vitis vinifera, which were purchased from the local market in Iraq. Resveratrol was<br>extracted from sun-dried grape residues with 2.5 liters of 80% ethanol. Then the compound resveratrol<br>was concentrated using a rotary evaporator and dried in very high freezing conditions after being<br>filtered with animal charcoal. A partially purified material was obtained after a column chromatography<br>process, where 9 grams were obtained for every 600 grams of grape residues as a result of these steps.<br>Chemical tests were conducted to detect resveratrol, and they included: general tests for polyphenols,<br>detection of unsaturated cyclic compounds, high-efficiency liquid chromatography (HPLC) method.<br>The results showed the appearance of two peaks at a wavelength of 280 nm for the compound resveratrol<br>extracted from grape residues, where the time of its appearance was at 4.267 /min compared with the<br>standard compound resveratrol which was at 4.356 /min. The concentration of the resveratrol extract<br>was 107.6 ppm. The total antioxidant activity of resveratrol extracted from grape residues and the<br>standard compound resveratrol was estimated. The total antioxidant activity of resveratrol extracted<br>from grape residues was 71.14%, while it was 62.21% for the standard compound resveratrol. The<br>results showed that the resveratrol compound extracted from grape residues was purified in the dark<br>to prevent the conversion of resveratrol from trans to cis. The study also shed light on the quantities of<br>resveratrol contained in grape residues, and this depends on the extraction steps as well as the purpose<br>of its applications.</p> Esraa Shanan Jabbar Al-Jubouri Wedad Fadhil Abas Azhar Jawad Al- Mousawi Copyright (c) 2021 16 1 455 461 A Comparative Study on the Diagnostic Value of Conventional Spin Echo Proton Density and Fast Spin Echo Proton Density Sequences of Magnetic Resonance Imaging in Diagnosis of Meniscal Tear <p>Background &amp; Objectives: Knee is the largest synovial joint in the body. Although FSE PD (fast<br>spin echo proton density) imaging technique for the diagnosis of meniscal tear has replaced CSE PD<br>(conventional spin echo proton density) technique in many MRI centers, several studies have questioned<br>the effectiveness of FSE PD technique in diagnosis of meniscal tear. In this study, the diagnostic values<br>of CSE PD and FSE PD techniques in evaluation of meniscus tear are compared.<br>Materials: In this study, using CSE PD and FSE PD techniques, MRI was performed on 67 knees of<br>patients with suspected meniscal tear referring to the MRI Center of Imam Reza Hospital (Kermanshah,<br>Iran). Diagnostic arthroscopy was also performed for all patients. The data were entered SPSS version<br>20, and finally the results of MRI reports of the two techniques were compared in evaluation of meniscal<br>tear taking into account the arthroscopic findings as the gold standard.<br>Results: According to the results of this study, no significant difference was found in specificity and<br>positive predictive value of the two techniques. However, the sensitivity and negative predictive values<br>were significantly different, in such a way that the related values were 97% and 97% in the CSE PD<br>technique and 69% and 73% in the FSE PD technique, respectively.<br>Conclusion: Due to low sensitivity and high false negative results, MRI using FSE PD technique is not<br>recommended as an alternative for CSE PD technique in evaluation of meniscal tear.</p> Farhad Nalaini Mahdi Mohammadi Somayeh Mahdavikian Nazanin Farshchian Copyright (c) 2021 16 1 462 471 A Study of Chronic Disease Management in Indonesian Primary Health Care <p>Chronic disease management program in Indonesia(Prolanis) is a preventive and promotive program<br>developed by Indonesian national health insurance. The initial survey showed thatonly 37.04% of<br>primary health careperformchronic disease management programsoptimally. Prolanis can succeed and<br>be sustained if health care services included health care teams effectively address patient needs as well<br>as increasing the quality of health services.For this reason, physicians as key roles in primary health care<br>should enhance their competencies to deliver high-quality care. This study aimed to identify the impact<br>of physician competencies on patient satisfaction in Indonesian primary health care. This study used<br>a cross-sectional designwith multistage random sampling which included 90 chronic disease patients<br>in primary health care. The results revealed that the average physician competencies in providing<br>health services to patients were 73.57%. In addition to this, as many as 73.64% of patients expressed<br>satisfaction with physician skills. Lambda correlation test obtained a value of r = 0.76, so it was stated<br>that the physician competencies had a strong influence on chronic disease patient satisfaction. It can<br>be concluded that the more physicians master their competencies,the more confident patients seek<br>treatment at primaryhealth care.</p> Febri Endra Budi Setyawan Retno Lestari Copyright (c) 2021 16 1 472 479 Diabetic Ketoacidosis in Pregnancy: A Case Report <p>A 31-year-old pregnant woman complained of vomiting, shortness of breath, fever, general weakness,<br>painful and frequent urination with sign of hypertension, tachycardia, Kussmaul breathing. Laboratory<br>studies showed neutrophilia, leukocytosis, hyperglycemia, hypokalemia, ketonuria, metabolic acidosis,<br>low C-peptide, low Thyroid Stimulating Hormone, high FT4 and Staphylococcus in blood culture<br>was diagnosed with Diabetic Ketoacidosis, pregestational Type 1 Diabetes Mellitus, hyperemesis<br>gravidarum, 14 weeks of pregnancy, suspect Urinary Tract Infection, hypokalemia, hypertension, and<br>subclinical hyperthyroidism. Besides, the patient blamed the fetus on causing the disease and financial<br>problem so that the patient also was diagnosed with episode of moderate depression. The patient received<br>KVT1 diet therapy, fluid replacement therapy, insulin therapy, correction of hypokalemia, correction<br>of acidosis metabolic antibiotic and anti-hypertension. The therapies aimed to prevent maternal and<br>fetal morbidity. Supportive psychotherapy therapy, relaxation therapy, and family psychoeducation<br>were also needed to improve patient’s compliant. The patient was also suggested to consult for family<br>planning and glucose control before conception.</p> Febrian Daru Setiawan Hermina Novida Copyright (c) 2021 16 1 480 486 In Vitro Antibacterial Activity of Waste Palm Cooking Oil Against Staphylococcus Aureus <p>Background: Staphylococcus aureus is a Gram-positive coccus which acts as a pathogen causing a<br>wide range of infectious diseases. In recent years, several strains of S. aureus have been found to show<br>resistance to several antibiotics. Waste cooking oil may be considered as an alternative antibacterial<br>product, as it contains long-chain fatty acids whose antibacterial effectiveness against S. aureus has<br>been known for years. In addition, oxidative biocides produced during the frying process have many<br>targets for antibacterial activity in the cell and affect almost every biomolecule. Nonetheless, there is<br>no literature that is able to prove the antimicrobial effects of the waste palm cooking oil. Objective: To<br>examine the in vitro antibacterial effect of waste palm cooking oil against S. aureus. Method: a twofold<br>serial dilution method to set the minimum level of both inhibitory and bactericidal concentrations.<br>Conclusion: This study showed that waste palm cooking oil did not show antibacterial effects against<br>S. aureus, indicating that waste palm cooking oil is not possibly to be applied as an antibacterial agent<br>against S. aureus.</p> Fiqih Faizara Ustadi Agung Dwi Wahyu Widodo Yuani Setiawati Copyright (c) 2021 16 1 487 493 The Implementation of Fraud Prevention on the National Health Insurance at Salewangan Maros Hospital, Indonesia: A Qualitative Study <p>Background: Various fraud control methods are designed to overcome potential fraud that occurs by<br>every element that involved in the National Social Health Insurance System in Indonesia. This study<br>aims to analyze how the implementation of fraud prevention efforts that have been carried out by the<br>National Health Insurance (JKN) Fraud Prevention Team which was formed at the SalewanganMaros<br>Regional Hospital. Method: This study used a descriptive qualitative approach with data collection<br>techniques through in-depth interviews and observation. The informants were the Head of the Service<br>Division, the Chair of the Hospital Medical Committee, the Head of the Nursing Sub-Division, the Head<br>of the Finance Sub-Division, and the Casemix team.Results:Efforts to increase the fraud prevention is<br>still weak, efforts to detect and resolve fraud are already underway, but efforts to detect fraud have not<br>been continuous, detection through observation at service locations is not routinely carried out, while<br>detection efforts through data analysis still rely on service data feedback obtained from BPJS, as well<br>as monitoring and evaluation by the Fraud Prevention Team at SalewanganMaros Regional Hospital<br>has been implemented but is still very poor.Conclusion: Fraud prevention efforts must be carried out<br>comprehensively and involve all individuals. There must be an automated integrated system at each<br>service point so that fraud prevention can be optimized.</p> Fitri Indayani Reza Aril Ahri A. Rizki Amelia Fatmah Afriyanti Gobel Fairus Prihatin Idris Copyright (c) 2021 16 1 494 501 Comparative Determination of Chlorpromazine in Pharmaceutical Injectable Veterinary and Human Formulations by Spectrophotometric and High Performance Liquid Chromatographic Methods <p>Background: Chlorpromazine (CPZ) is a phenothiazine tranquilizer used in humans and animals. Rapid determination<br>of the drug in pharmaceutical preparations is often needed. The aim of the study was to further examine and ascertain<br>asimple spectrophotometric method in comparison with a high performance liquid chromatographic (HPLC) method<br>for the determination of CPZ concentrations in injectable pharmaceutical formulations used in man and animals.<br>Methods: Concentrations of CPZ in injectable pharmaceutical formulations for human and veterinary uses were<br>determined by a modified spectrophotometric method and by an HPLC method with appropriate standard calibration<br>curves. The spectrophotometric method of CPZ determinationwas conducted by diluting 0.1 ml of the veterinary<br>(5%) or 0.3 ml of human (0.5%) formulations to 200 ml of 0.1N sulfuric acid. Four ml of the diluted CPZ samples or<br>the standard solutions were mixed with 2 ml of 50% sulfuric acid. Then an aliquot of 0.2 ml of 2% ferric nitrate was<br>added to the mixture. After 15 minutes, the absorbance was measured at 530 nm against water and vehicle blanks<br>using a spectrophotometer. The HPLC method applied in the present study consisted of reversed phase gradient<br>chromatography with a C18 column and the eluent was (A) 50 mmol NaH2PO4, pH 2.5 and (B) acetonitrile - 50<br>mmol NaH2PO4, pH 2.5 (60:40 v/v), flow rate at 1 ml/min, with a gradient of 15-55% B in 10 min, to 100% B in<br>20 min, and 280-nm UV detection. From the calibration curves of CPZ standards, the following were calculated:<br>Limit of detection limit (LOD) = 3.3 x SD/slope; Limit of quantitation (LOQ) = 10 x SD/slope, where SD is the<br>standard deviation of response of CPZ concentrations of the calibration curves.Linear regression analysis and related<br>coefficients of correlations were applied on the calibration curves. Results: The calibration curves of CPZ against<br>water or vehicle blanks as determined by the spectrophotometric method or by the HPLC method were linear with<br>strong correlations (r = and / or &gt;0.99). Based on the calibration curves, limit of detection and limit of quantitation the<br>spectrophotometric method were comparable to those of the HPLC one. The contents CPZ in human and veterinary<br>injectable formulations as determined by the spectrophotometricmethod were in accordance (100.6% and 102%,<br>respectively)to the concentrations claimed on the labels of the formulations.<br>Conclusion: The present results introduce a simple spectrophotometric method that could be used for routine<br>measurement of CPZ concentrations in pharmaceutical formulations, with the added benefits of linearity, precision<br>and cost effectiveness.</p> Fouad K. Mohammad Lubna A. Kafi Nabaa K. Al-Hayani Fereal M. Mahdi Ahmed J. Essa Copyright (c) 2021 16 1 502 508 Protective Effect of Peppermint on the Toxicity Induced by Blue Green Algae in Poultry <p>This study was done on 5 groups of poultry chicks from one day up to 45 days of age. We used<br>blue green algae as source of feed additives added to the water and ration in addition to peppermint<br>to evaluate the protective effect of peppermint against the toxicity induced by the blue green algae.<br>The administration of blue green algae in chicken food and water caused hepato- and cardio toxicity<br>indicated by significant increase in liver (ALT and AST) and heart enzymes (CK and LDH) and decrease<br>in MDA and CAT. The algae showed histopathological alterations in the liver in form of congestion in<br>the central vein, degeneration in the hepatic cords and circumscribed areas of lymphocytic infiltrations<br>between the hepatic cords. While it was mild in heart tissues as it showed also lymphocytic infiltration<br>and congestion of myocardial blood vessels. The biochemical parameters were corrected except the CK<br>and LDH. The histopathological alterations were corrected by the addition of peppermint.</p> Gehan B. A.Youssef Elzoghby R.R Reda EL Kammar Walaa S ElDin Rania M Waheed Copyright (c) 2021 16 1 509 519 Studying of Some Physiological Parameters in Patients with Inflammatory Bowel Disease ( IBD ) in Al-Anbar Province <p>This study was carried out to determine some hematological, parameters in patients with IBD. the total number were 100 blood samples, 60 samples from patients with IBD (cases), while the remaining 40 samples from persons without IBD (control), Ages ranged from 15 to 60 years. who attended general teaching hospital in Ramadi city in Al-Anbar governorate. a comparison in hematological parameters was carried between the two groups with each other showed that there was significant difference between patients and control with (p&lt;0.05). and the means levels for hemoglobin HB (10.09 g/dl), (13.18 g/dl) \ there was significant difference between patients and control with (p&lt;0.05). and the means levels for red blood cells RBC (3.194 X 106 c/ mm3), (5.291X 106 c/ mm3) \ there was significant difference between patients and control with (p&lt;0.05). and the means levels for white blood cells WBC (12.39X 103 c/ mm3), (7.300X 103 c/ mm3) there was significant difference between patients and control with (p&lt;0.05). and the means levels for \platelet (561.2X 103 c/ mm3), (258.4X 103 c/ mm3).</p> Thikra Majid Muhammed AL-Obaidy Hasan Ali Mutar Thaer Abdulqader Salih Copyright (c) 2021 16 1 520 529 Coronavirus (COVID-19) and Online Studying Cas’s Study Alasala University KAS Law School <p>The first quarter of 2020 is one of the most difficult times for the region and whole world. Where<br>the epidemic (COVID-19) invaded the world and thus affected many aspects of human aspects: in<br>terms of low industrial production, the global economy stopping work, and educational aspects closed<br>to students. All educational institutions modified their academic assessments, and then educational<br>programs were modified during this period. As stakeholders and management of higher education<br>institutions do not have another option is to take advantage of Internet and new technologies, and<br>therefore go to online learning to continue academic activities at all levels of education around the<br>region and the whole world.<br>The study aims at assess whether students in KSA, especially Alasala University in general, and in<br>particular the College of Law, if they are satisfied with the “group” online learning experience in higher<br>education institutions, therefore, the study used an online survey to investigate the level of satisfaction<br>with online learning and how students adapt to these “new initiatives”.<br>The study undertakes a case study of a law school within a leading university such as Alasala, which has<br>implemented a quality system. The study reviews the development of the quality system and examines<br>the concept of service quality in law education. The aim of this study is to address the paucity of service<br>quality research in law education in this region. Empirical research is used to determine the factors<br>that influence student evaluation of service quality. With data collected from 664 students, the study<br>identifies six factors that influence students’ evaluations of service quality. Research implications of the<br>study are then discussed. The study results indicate that the implementation of online learning programs<br>was a very impressive idea as the majority of students included in the sample supported the initiative.</p> Hala Ali Copyright (c) 2021 16 1 530 539 Human Papillomavirus DNA in a Sample of Iraqi Women with Positive Visual Inspection by Acetic Acid <p>Background: This study has conducted in Baghdad Teaching Hospital, Department of Obstetrics<br>and Gyanecology, Al-Habebyia H. outpatient,Ibn-Albalady H. outpatient and 6 Primary Health Care<br>Centers in Baghdad between June 2019 to March 2020.A Prospective and multicentric study.<br>Aim of the Study: To asses the prevalence of HPV in a sample of Iraqi women.<br>Patients and methods: The study include 268 married women between the age of 30 years old and<br>more, who were attending the outpatient department. Both screening tests; naked eye visual inspection<br>with acetic acid &amp;HPV test were performed.<br>Results: The study included 268 women.The positivity rate of HPV for all women survived was 8.9%<br>,19 % of women with positive VIA ,81% with negative VIA.All the positive VIA cases(19 %)and some<br>ofnegative VIA cases(18.6%) were randomly selected(because of their symptoms) underwentHPV test.<br>After comparing the results of HPV test and VIA results, the sensitivity of VIA 95.8 %The specificity of<br>VIAwas 63.6%. Positive predictive values was 45.1%. Negative predictive values was 98%.Accuracy<br>rate 71.3%.<br>Conclusions:<br>1. The prevalence of HPV infection among a sample of Iraqis women was very low.<br>2. Estimation of HPV infection would provide valuable data particularly to introduce the strategies for<br>the screening of cervical cancer and HPV vaccination in Iraq.<br>3.VIA with HPV DNA test may be a suitable substitute to Pap. smear as a screening tests for premalignant<br>and malignant disease of the cervix.</p> Halah Abdulwahhab Mohammed Wasan Fawzi Sanad Buthaina Ahmed Alwan Copyright (c) 2021 16 1 540 548 Soluble Cluster of Differentiation 25 (sCD25) as a Predictor of Mortality of COVID-19 Patients in Surabaya, Indonesia <p>The purpose of this study was to analyze and determine the cut-off level of sCD25 as a predictor of<br>mortality in COVID-19 patients. In an observational analytic study with a prospective cohort design, the<br>study population was COVID-19 patients who were hospitalized at RIK RSUD Dr. Soetomo Surabaya<br>for the period July 2020-December 2020. Sampling was taken by consecutive sampling, divided into<br>two groups, mild-moderate and severe-critical groups. The examination of sCD25 levels in both groups<br>was carried out on day-0 and day-6 of hospitalization using the sandwich ELISA method. The paired<br>group statistical analysis used the Wilcoxon range test, the unpaired group used the Mann Withney<br>U test. ROC curve analysis to determine the cut off level of sCD25 as a predictor of mortality. There<br>were a total of 83 study patients consisting of 36 patients in the mild-moderate group, 47 patients in<br>the severe-critical group. There was a difference in sCD25 levels between mild-moderate COVID-19<br>patients who were treated on day-6 compared to day-0, whereas in the severe-critical group there was<br>no difference in sCD25 levels. There was a difference in sCD25 levels in COVID-19 patients between<br>the mild-moderate group by severe-critical. The level of sCD25 with a cut off of 3.14 ng/mL (AUC<br>0.719, p = 0.001) can be used as a predictor of mortality in COVID-19 patients with a sensitivity of<br>96.2%, a specificity of 47.4%. Levels of sCD25 &gt;3.14 ng/mL can be used as a predictor of mortality in<br>COVID-19 patients</p> Harida Zahraini Betty Agustina Tambunan Bambang Pujo Semedi Copyright (c) 2021 16 1 549 556 Post Traumatic Tuberculous Tenosynovitis in a Patient that Manifests as Soft Tissue Tumor: A Case Report <p>Mycobacterium tuberculosis infection is one of the oldest diseases of the human race. This bacteria<br>can attack any organ in the human body. Extra Pulmonary Tuberculosis (EPTB) infection diagnosis are<br>rarely straightforward, and in many cases, delayed due to various reasons. Tuberculous tenosynovitis<br>(inflammation of the tendon and its capsule because of Mycobacterium tuberculosis complex infection)<br>is a rare form of EPTB. Tuberculosis infection at sites of previous trauma have been reported consistently<br>though rarely. We present the case of a 48 years old male with complains of lumps on his lower left arm<br>(with prior history of blunt trauma on the location) and progressive inability to flex the fingers of his left<br>hand. Early examinations suggest the diagnosis to be a soft tissue tumour. However, tissue biopsy later<br>showed that the patient was actually suffering from tuberculosis infection. The patient later showed<br>satisfying response to tuberculosis medication on subsequent follow ups.</p> Haryo N. Yahya Hadi, Usman Copyright (c) 2021 16 1 557 562 COVID-19 Outbreak and Health literacy of Health Institutions: The Role of Strategic Theory <p>The local outbreak of COVID-19 and its development into a global pandemic in a short time have made health<br>literacy more critical than ever in facing these global health threats. The main objective of the research is to<br>know the reflection of the strategic theory in health literacy and the relationship and impact statement, and then<br>it is possible to know the determinants of the health institution’s success in managing health literacy efforts as<br>the Department of Health of Najaf was the organization in question. The researcher surveyed the opinions of<br>a number of its employees, as the research community was (248) employees, and the research sample reached<br>(155) responses on which the analysis can be performed. A set of specialized descriptive and inferential tests<br>and methods were conducted on the data obtained by using (SPSS v.26) program. The results show that the<br>health institution’s interest in strategic theory will contribute to achieving health literacy by demonstrating the<br>relationship and impact between the two research variables. The research extracts a set of recommendations,<br>the most important of which is to increase the interest of the departments in the Najaf Health Department in the<br>concept of strategic theory and make health literacy programs a priority that must be implemented even in light<br>of the scarcity of financial resources.</p> Hashim Fawzi Alabadi Ehsan Amori Almomen Copyright (c) 2021 16 1 563 569 Qualitative Analysis of Cinnamomum burmannii Content using GCMS (Gas Chromatography Mass Spectometry) Method <p>To identify the bioactive compounds in Cinnamomum burmannii and their biological activity. Cinnamon<br>bark originating from Batu Malang, East Java, which was located 700-1300 meters above sea level, was<br>processed into dry extract by maceration method with 96% ethanol solvent. Furthermore, cinnamon<br>ethanol extract was analyzed using the GCMS method to look at the content of the bioactive component<br>for further testing biological activity with the server Way2Drug PASS. GCMS results showed 40 active<br>compounds such as trans-cinnamaldehyde, trans-anethole, cinnamyl acetate, calacorene, cadina-1,<br>4-diene, delta-cadinene. Furthermore, of the 40 compounds, the biological activity potential was tested<br>for 29 bioactive compounds based on PA (probable to be active) values predicted by the Way2Drug<br>PASS server. Cinnamomum was tested against the potential as anti-fungi, anti-bacterial, anti-oxidant,<br>anti-inflammatory, anti-diabetic, anti-neoplastic. Trans-cinnamaldehyde showed PA 0,583 as anti<br>inflammatory, L-limonene PA0,818 as anti neoplastic, Tans-anethole PA 0,614 as anti neoplastic,<br>Cinnamyl acetate PA 0,669 as anti inflammatory, calacorene PA 0,698 as anti inflammatory, Deltacadinene<br>PA 0,651 as anti neoplastic, , Cathechin PA 0,828 as anti oxidant, alpha.-Cubebene PA 0,888 as<br>anti inflammatory and PA 0,837 as anti neoplastic, melilotin PA 0,929 as anti neoplastic, Caryophyllene<br>PA0,915 as anti neoplastic. Cinnamomum burmannii had biological potency based on potential activity<br>(PA) 0,432 (+0,117) as antifungi, PA 0,335 (+0,090) as antibacterial, PA 0,304 (+0,199) as antioxidan,<br>PA 0,561 (+0,190) as anti inflammatory, PA 0,373 (+0,170) as antidiabetic, PA 0,584 (+0,234) as<br>antineoplastic.</p> Hayati Jusak Nugraha Bambang Purwanto Hari Basuki Notobroto Yoes Prijatna Dachlan Hari Setiono Idha Kusumawati Copyright (c) 2021 16 1 570 575 Niclosamide as a Prospective Therapeutic in L-Arginine Induced Acute Pancreatitis in Rats; Concerning Autophagic p62/ NF-kB signaling pathway <p>Autophagic flux impairment is recently reported as a cardinal factor in acute pancreatitis (AP)<br>pathogenesis. Niclosamide, an anthelmintic drug, has been lately proved to be a potent autophagy<br>enhancer. The diminution of the various inflammatory factors unrestrained release via autophagy<br>improvement may be helpful to improve the prognosis of AP. This study spots on investigating the<br>potential ameliorative effect of niclosamide on autophagic flux and its consequent curative outcome<br>on L-arginine-induced AP in rats. Thirty male wistar rats were divided into three groups. The first one<br>is the control one, the second is L-arginine induced AP group, the third group is niclosamide treated<br>L-arginine induced AP. Serum lipase, amylase, pancreatic tissue homogenate IL6, IL1β, TNFα, NF-kB,<br>oxidative stress biomarkers; glutathione peroxidase activity, Hydroxy-2’-Deoxy-Guanosine and total<br>antioxidant capacity levels were evaluated. Besides, the DNA-binding activity of nuclear erythroid<br>related factor 2 (Nrf-2) was assessed using a pancreatic tissue nuclear extract. Both LC3-II subunit &amp;<br>P62 mRNA were quantified using PCR technique. Morphometric analysis of histopathological changes<br>was done. The obtained data showed that niclosamide improved L-arginine induced AP as evidenced<br>by significantly reduced serum lipase and amylase levels, which could be related to improvement of<br>autophagy flux impairment as evidenced by decreased levels of LC3-II and p62 expression in pancreatic<br>cells, in addition to anti-inflammatory effect as evidenced by decreased NF-kB and proinflammatory<br>cytokines levels, along with improving the antioxidant capacity of the pancreatic tissue. As manifested<br>by elevation of Nrf-2- DNA binding activity and normalization of oxidative stress biomarkers levels.<br>These results could pave the way for niclosamide as a potential therapeutic role in acute pancreatitis.</p> Heba A. Mahmoud Rowida Raafat Ibrahim Remon S Estfanous Rasha Osama El-Esawy Copyright (c) 2021 16 1 576 588 Relationship between Neutrophil-Lymphocyte Ratio and Disease Severity in COVID-19 Patients in Isolation Ward of Dr. Soetomo General Teaching Hospital <p>This study was conducted to prove the relationship between the neutrophil-lymphocyte ratio and the<br>severity of COVID-19. A retrospective cohort study using medical record data of inpatients from June<br>to July 2020. Analysis of the NLR relationship and the degree of severity using the Mann Whitney test<br>if the data had an abnormal distribution. Significant if p&lt;0.05 and 95% confidence interval. If there were<br>significant results, we try to measure the cut-off of NLR value to predict severe and non-severe clinical<br>symptoms. Total study subjects were 110 patients, with a male as many as 65 (59.1%), the median age<br>was 53.5 years (range 20-88). Most of the comorbidities were diabetes mellitus (35.5%), followed by<br>hypertension (30%). The severity of clinical symptoms was 50% in the non-severe and severe groups,<br>respectively. The NLR value was higher in the severe group. Mann-Whitney test showed significant<br>differences in the value of NLR between the severe group and the not severe group with the p-value<br>&lt;0.001. Receiver operating characteristic (ROC) curve analysis area under the curve (AUC) of NLR<br>on day-1 was 0.716 (CI 95%: 0.605 - 0.826), and the cut-off point of the prediction severity disease<br>at day-7 was ≥ 6.14 with a sensitivity of 71% and a specificity of 69.1%. The neutrophil-lymphocyte<br>ratio value with severe symptoms was higher than the neutrophil ratio value for lymphocytes with nonsevere<br>symptoms in patients with COVID-19.</p> Heri Krisnata Ginting M. Vitanata Arfijanto Tri Pudy Asmarawati S. Ugroseno Yudho Bintoro Copyright (c) 2021 16 1 589 597 Effect of Work Stress on the Productivity of Shift Workers in Production Department at Pt.x Makassar City <p>Productivity can be defined as worker’s performance in terms of quantity, quality and timeliness. There<br>are several factors that can affect productivity. This study aims to determine the effect of monotony<br>and work stress on production department’s shift workers at PT. X wirh age, sex, years of service and<br>quality of sleep as a control variables.<br>This study was an analytic observational study with cross sectional design. The number of respondents<br>was 49 people which were determined using purposive sampling technique. Data were obtained using<br>online questionnaires. Chi square was used for bivariate data analysis and multiple logistic regression<br>for multivariate data analysis.<br>From the results of bivariate data analysis, it was found that work stress had an effect on productivity<br>with a value of p = 0.001 (&lt;0.05). For the analysis of work stress based on age, it affected older workers<br>with a value of p = 0.004, while based on gender, it affected the female workers with a value of p =<br>0.001, based on years service, it had effect on long service years with a value of p = 0.018 and based<br>on sleep quality, it affected on poor sleep quality with a value of p = 0.003. The results of multivariate<br>analysis showed that work stress affected the productivity with a value of p = 0.001 (p &lt;0.05) with<br>gender and sleep quality as variable controls. It was suggested for workers to maximize the rest time<br>after serviced a night shift in order to restore their physical condition and for company leaders to<br>establish good communication towards workers in order to find out critics or suggestion related to the<br>job.</p> Herlin Manga Lambo Rafael Djajakusli Masyitha Muis Atjo Wahyu Apik Indarty Moedjiono Darmawansyah Copyright (c) 2021 16 1 598 603 Cardiac Tamponade in a Patient With Hypothyroidism: A Case Report <p>Cardiac tamponade as a manifestation in newly diagnosed hypothyroidism is a rare condition because<br>fluid accumulate slowly. We present a 38-year-old woman with massive pericardial effusion with<br>cardiac tamponade findings in echocardiography without hemodynamic disturbance. Pericardiocentesis<br>was done, but pericardial effusion was not improved. Other secondary causes of pericardial effusion<br>including inflammation, infection, autoimmune disease, and malignancy were ruled out. The patient<br>had a history of thyroidectomy 4 years prior and thyroid function test confirm the diagnosis of<br>hypothyroidism. The patient was given levothyroxine with initial dose of 400 mcg and continued with<br>100 mcg daily. The pericardial effusion significantly improved in a week.</p> Hermifa Dwi Aninnaimah Sony Wibisono Copyright (c) 2021 16 1 604 608 Deep Vein Thrombosis and Diabetes Mellitus Type 2 as Complications of Psoriatic Arthritis: A Case Report <p>A woman, 45 years old, complained of low back pain that improves with activity or analgesic and<br>reoccurs when resting. The patient also complained of swollen joints, fever, shortness of breath, flaky<br>skin and fragile nails. Physical examination found multiple inflamed joints, thickened and fragile<br>nails, fever, limited range of movement of knee and ankle and positive Homan sign. Workup found<br>negative anti-rheumatoid factor, increased blood sugar level, increased erythrocyte sedimentation rate,<br>increased C-reactive protein, bacteria in urine, increased D-dimer, and imaging of lumbar spondylosis<br>and sacroiliitis, and deep vein thrombosis in the left inferior limb using Doppler ultrasonography. The<br>patient was diagnosed as psoriatic arthritis, deep vein thrombosis, type 2 diabetes mellitus, and urinary<br>tract infection. The patient was given sulfasalazin, fondaparinux, warfarin, insulin, and antibiotic. On<br>the 15th day of treatment, the patient experienced sudden shortness of breath and chest pain. The patient<br>died due to suspected cardiovascular event.</p> Hersih Srinowati Lita Diah Rahmawati Copyright (c) 2021 16 1 609 614 Hikmawati Mas’ud1, Asmarudin Pakhri1, Siti Nur Rochimiwati1, Adriyani Adam <p>Background : Malnutrition problems such as underweight was unhealthy (pathological) conditions<br>that arise from not enough eating or consuming less energy and protein for a certain period of time.<br>The results of monitoring the nutritional status of toddlers (0-59 months) in 2018 from Basic Health<br>Research with WAZ Index, 17,6% children in underweight status. MISUKE (vegetable oil, milk &amp;<br>soybean) is a nutrient-dense supplement made from vegetable oil, skim milk and soybeans which are a<br>high source of energy and protein but in small volume and in powder form.<br>Objective : The aims of this study was to determine the effect of MISUKE formula on the nutritional<br>status of underweight children.<br>Methods : This research design was quasi-experimental research with pretest and posttest approaches.<br>Samples taken by 30 underweight children under five. This research was carried out in working area of<br>Sudiang Raya Health Center in Makassar city.<br>Results : The results showed that there was an increase in body weight before and after consume<br>MISUKE around 0.25 grams with a p value of 0,000, besides that there was a significant increase in<br>energy and carbohydrate intake after giving misuke with p values respectively (0,000 and 0.001), and<br>for There was also an increase in fat protein intake, but not significantly with p values (0.56) and (0.51),<br>respectively. Thus, MISUKE can be used as an alternative food for malnourished children.<br>Conclusion : MISUKE formulation used consists of 12 grams of vegetable oil, 6 grams of skimmed<br>milk, 12 grams of soy bean flour, 4 grams of granulated sugar. The nutritional value of MISUKE is<br>190.8 kcal energy, 6.5 grams of protein, 14.5 grams of fat, and 10.7 grams of carbohydrates, while the<br>change in nutritional status for weight before ranging from 10.48 grams and the increase of 0.25 grams<br>after MISUKE treatment with an average body weight range of 10.73.<br><br></p> Hikmawati Mas’ud Asmarudin Pakhri Siti Nur Rochimiwati Adriyani Adam Copyright (c) 2021 16 1 615 620 Evaluation of the Effect of the Activity of Gum Arabic Aqueous Solution and Ozonated Water on the Chemical and Organoleptic Properties of Locally Produced Soft Cheese in Baghdad City <p>Evaluated the effects of Gum Arabic (GA) combined with ozonated water (OW) at refrigeration (4oC)<br>storage temperature on the chemical and organoleptic properties of bovine locally produced Cows<br>and buffalos’, Fifty Soft cheese (25 for each kinds ) were collected from homemade local producers<br>in the different regions of Abu-Ghraib villages/Baghdad city. Soft cheese samples were analyzed for<br>Moisture percentage %, Total solids, pH levels, Protein, Fat as dry matters and ash contents before and<br>after immersion in mixture decontamination solution of (GA) at concentration of (3% and 5%) with<br>ozonated water (0.5) ppm during (30) minutes of exposure time at refrigeration (4oC) temperature. The<br>results showed that the moisture, fat as dry matter and ash content increased, while total solids (TS) and<br>protein decrease after subjecting to natural decontamination solution. pH value was non significantly<br>affected by the washing treatment. In conclusion evaluation of sensory properties showed that local<br>cows soft cheese demonstrates higher values for sensory parameter compared to local buffalo’s soft<br>cheese.</p> Hind Suhail Zina Saab Khudhir Copyright (c) 2021 16 1 621 627 Diagnosis of Fungi Associated with Wounds from Lying Patients at Al-Hussein Teaching Hospital in Dhi Qar Governorate <p>About 30 samples were collected from burn areas from patients attending Al-Hussein Teaching<br>Hospital in Dhi Qar governorate for the period between 2-4 for the year 2020. 7 types of fungi and<br>yeasts, represented by the following fungi, have been isolated candida kruzei, candida tropicalis, and<br>Rhizopus, candida albican, candida glabrata, Aspirgillus spp, rhodotorella. The results showed that<br>Aspergillus spp. Was dominant over the rest of the fungi, with a rate of 36.36% over the rest of the fungi<br>species, while candida albican yeast appeared with a frequency of 28.18% compared to the rest of the<br>other fungi, and the rate of appearance of other fungi was about 12-3% compared to the rest of the other<br>fungi. The fungi were distinguished by the fact that they are all of the opportunistic type, which begins<br>to infect the body when there is a weakening of immunity or infection with the associated burns and<br>ulcers.</p> Iman Hadi Alfayyadh Kadhim Mohan Manhil Copyright (c) 2021 16 1 628 631 Investigation for Endemic Bacteria in the Intestine of Common Carp (Cyprinus Carpio L.) Feeding on Various Formulated Powders Fortified Diets <p>The study was conducted in Fish Laboratory / College of Agriculture / University of Tikrit with the<br>aim of investigating the effect of adding powders prepared from chicken meat and fish waste (mixed<br>and carp) and added to diets on the performance of common carp Cyprinus carpio L. and the endemic<br>bacteria in its intestine. 70 cuffs were used with an initial weight of 240 ± 1.60 g / fish and distributed<br>randomly into 7 treatments (diets) at the rate of two repetitions for each treatment (5 fish per repeater)<br>in 14 glass basins with dimensions of 30 x 40 x 30 cm. 7 experimental diets were prepared close to<br>each other in protein and energy content. The parameters T1 included the commercial powder, T2 the<br>powder prepared from raw chicken waste, T3 raw mixed fish waste powder, T4 common carp fish<br>waste powder, T5 the chicken meat powder fortified with 1% lactic acid. , T6 fish powder mixed with<br>lactic acid by 1%, T7 fish powder of common carp with lactic acid by 1%, the results of the statistical<br>analysis showed a significant superiority (P≤0.05) for the parameters T5 and T7 in the percentage of<br>protein and no significant differences in the percentage of fat were recorded for the treatments. T3, T4,<br>T6 and T7, the treatment T4 recorded the highest percentage of humidity. The treatments T2, T3 and T5<br>recorded the highest rates of protein percentage in fish bodies after the end of the experiment, and there<br>were no significant differences for the percentage of fat in fish bodies for the treatments T1, T2 and T4<br>and it reached (4.20, 4.20 and 4.12%), respectively. Several bacterial strains colonized in fish gut were<br>isolated: 10 S.aureus isolates, 12 Aeromonas hydrophilia, 5 Aeromonas S isolates, 8 E.oli bacteria, 3<br>Pseudomonas bacteria, 5 Bacillus isolates, 7 isolates. Flavobacterium isolates.</p> Intisar Abduljabbar Shamkhi Nuha Hameed Sadiq Marwa Muzahim Mahdi Al-Doori Afrah Mustafa Mohammed Copyright (c) 2021 16 1 632 638 The Role of Vitamin D in Metabolic Syndrome in Polycystic Ovary Syndrome <p>Objective: The aim of this study was to assess the women complaining from polycystic ovary syndrome<br>and the relation of serum vitamin D levels according to the different phenotypes of the disease by a<br>retrospective study.<br>Methods: Records for 242 infertile women diagnosed with PCOS have been examined. In this<br>retrospective study, 100 of them have been randomly recorded for 4 PCOS phenotypes. 40 normal<br>ovulation women with a male factor history were selected as the control group.<br>In four phenotype types including: age, BMIs, the infertility duration, the hormonal profile and the<br>serum vitamin D, the P value of 0.05 was found to be statistically significant.<br>Results: In comparison with PCOS patients (P&lt;0.001), the data showed a serum vitamin D level of<br>statistically importance in the control group. Also, four PCOS phenotypes had no significant variation in<br>the serum vitamin D levels.<br>Conclusions: There were no significant differences between the serum vitamin D levels of the different<br>PCOS phenotypes. The additional studies of large samples are recommended for determining the role<br>of the serum vitamin D level in PCOS patients.</p> Intisar Younis Mohammed Ibrahim Copyright (c) 2021 16 1 639 646 The Multifactorial Causes of Neonatal Mortality: A Literature Review <p>The reduction of neonatal mortality is part of the third goal of the Sustainable Development Goals that<br>by the end of 2030 it is expected that neonatal mortality will decrease to 12 per 1000 live births. This<br>study aims to organize risk factors for neonatal mortality through a traditional review. Information was<br>obtained from previous studies around the world, from 2009 to 2021. The selection of articles was based<br>on the researchers’ justification, followed by a comparison of the articles and ending with a synthesis<br>in order to answer the research questions. The study results show that the risk factors associated with<br>pregnancy included: age, height, parity, interval between pregnancies, antenatal care, past pregnancy<br>and childbirth (giving birth to dead babies, cesarean section, hypertension, abortion, bleeding),<br>problems in pregnancy (anemia, tuberculosis, asthma, hyperthyroidism, hypertension, malnutrition)<br>and pregnancy complications (hyperemesis gravidarum, abortion, degenation of trophoblast disease,<br>ectopic pregnancy, prematurity, antepartum hemorrhage, premature rupture of membranes, fetal death<br>in utero, pre-eclampsia / eclampsia, post date, meconeal membranes, fetal position abnormalities,<br>multiple pregnancies and prolonged labor); while the factors related to childbirth were place, mode and<br>assistant of delivery.</p> Irene Kathreen L. A. Davidz Kuntoro Hermanto Tri Joewono Irwanto Heru Santoso Wahito Nugroho Copyright (c) 2021 16 1 647 654 Malaria Infection Effect to Haemoglobin and Haematocrit in Pregnant Mus Musculus <p>Malaria is a disease that is caused by Plasmodium Sp. And infected by Anopheles mosquitos. Kalimantan<br>is one of endemic places for malaria. Prevalence of malaria is 2-76% depent to the places.Effect of<br>malaria to pregnant women can be anemia, renal failure, cerebral oedema and death. Prevamence of<br>anemia because of malaria in pregnant women is about 3-15%. This research was done by using animal<br>model to show malaria in pregnant. Goal of this research was to analyze malaria infection effect to<br>haemoglobin and haematocrit in pregnant Mus musculus. Research design was experimental using<br>posttest only with control group design. It consisted of K0 for control (20 samples) and K1 for infected<br>group (19 samples).Pregnant Mus musculus was injected P. berghei to infect plasmodium using 0,2 ml<br>infected serum intraperioteal in the first day of pregnant. Mus musculus was terminated in 19th day of<br>pregnant and took cardial blood to examine Hb and Ht of pregnant Mus musculus.The result was Hb<br>level mean for K0= 12,69 gr/dl and K1=12,832 dr/dl. Mean of Ht for K0=38,070% and K1=38,495%.<br>Statistical anayzes used U-Mann Whitney test, with p value for Hb level was 0,574 and Ht was 0,574.<br>The conclusion was malaria infection could not effect yet to Hb dan Ht level in pregnant Mus musculus.</p> Istiana Widya Nursantari Edi Hartoyo Meitria Syahadatina Noor Copyright (c) 2021 16 1 655 657 Diagnostic Value of Mid Regional Proadrenomedullin as a Sepsis Biomarker in Pediatric Patients with Cancer-Related Chemotherapy <p>The aim of this study was to analyze the diagnostic value of mid regional proadrenomedullin as a sepsis<br>biomarker in pediatric patients with cancer-related chemotherapy. This cross-sectional observational<br>study was located in General Hospital Dr. Soetomo Surabaya from September until December 2020.<br>International Pediatric Sepsis Consensus Conference criteria was used to define sepsis term on 2 study<br>groups. Serum mid regional proadrenomedullin has been drawn from 60 subjects (41 in-ward pediatric<br>patients) and measured on sandwich enzyme-linked immunosorbent assay from Elabscience® Human<br>Mid Regional Proadrenomedullin. Humareader Single Plus® was used to measure the optical density.<br>ROC analysis was used to find out cut off value, sensitivity, specificity, positive predictive value, negative<br>predictive value, negative likelihood ratio, positive likelihood ratio, and accuracy, respectively. Statistics<br>declared significant if p&lt;0.05 (95% CI). Between groups, temperature and heart rate were statistically<br>different (p&lt;0.001; 95% CI). The median difference of mid regional proadrenomedullin between groups<br>was significant (p&lt;0.05; 95% CI). Cut off value 2,88 nmol/L, sensitivity 60.0%, specificity 56.67%,<br>positive predictive value 58.06%, negative predictive value 58.62%, positive likelihood ratio 1.38,<br>negative likelihood ratio 0.71 and diagnostic accuracy 59.33% was obtained while area under curve<br>was 0.707, respectively. Sepsis in children with cancer –related chemotherapy has not well diagnosed<br>by serum mid regional proadrenomedullin.</p> Joko Susanto Muhammad Robiul Fuadi Mia Ratwita Andarsini Copyright (c) 2021 16 1 658 663 The Effect of Adiponectin Recombinant in Rattus Norvegicus with Polycystic Ovarium Syndrome Model on Anti-Müellerian Hormone Expression <p>Background: Polycystic Ovary Syndrome (PCOS) is an important disease that causes various health<br>problems in women. Ovulation - infertility disorders are found in 60-85% woman with PCOS. Anti-<br>Muellerian Hormone (AMH), a protein from Transforming Growth-b Family, often increased in patient<br>with PCOS and associated with severity and poor prognosis for assisted reproductive outcome. Dietary<br>and lifestyle changes are the first-line therapies but consistent application of this method is difficult to<br>attain for people with PCOS. Adiponectin, a product by adipose cells have a significant reduction in<br>obese and women with PCOS. The purpose of this study was to see the differences in AMH expression<br>between mice with polycystic ovary model treated with adiponectin recombinant and mice with<br>polycystic ovary model treated with placebo and control.<br>Method: This research is an experimental study with a Post Test Only Control Group design. The<br>sample of this study was 3 months female Rattus norvegicus Wistar strain weighing 110-120 g. The<br>sample size was 36, which were divided into three groups, K0 (control group of mice with polycystic<br>ovary model), K1 (group of mice with polycystic ovary model that received placebo injection), and K2<br>(group of mice with polycystic ovary model that received 5 μg/ml injection of recombinant adiponectin).<br>Polycystic ovary model made by injecting 10 mg/Kg body weight testosterone propionate for 14 days.<br>The injection is carried out at the proestrous stage. The three groups of mice in a period of 3 weeks after<br>treatment, were surgically removed according to the sampling procedure, then the ovaries were given a<br>code and immunohistochemical staining was performed to see the AMH expression in the ovaries. The<br>data were collected, then statistical analysis was carried out using SPSS software.</p> Joseph Chandra Relmasira Jimmy Yanur Annas Widjiati Copyright (c) 2021 16 1 664 669 Demographic Profile of Deaths Due to Drowning in and Around Vijayawada, Andhra Pradesh <p>Drowning is a leading and preventable cause of death that has suffered an attention deficit. The World<br>Health Organization identifies data collection as a key strategy underpinning effective interventions.<br>The circumstances leading to drowning are complex. People interact with water primarily for recreation<br>and often interact with water due to daily life or occupational endeavours. A Significant reduction<br>the number of drowning deaths among young children in private swimming pools has been achieved<br>through over 30 years of focused work on the epidemiology and risk factors for drowning in private<br>swimming pools among young children. Proposed contributory factors for drowning in rivers include<br>a lack of barriers controlling access to water, an absence of adult supervision for young children, poor<br>swimming skills, minimal awareness of the dangers, the consumption of alcohol, transportation on<br>water, a lack of safe water supply, and disasters related to flooding.</p> K. Ravimuni K. Usha Rani Copyright (c) 2021 16 1 670 676 The Role of K and Ca Channels in Hydrogen Sulfide Induced Relaxation in Arteries Feeding Human Colorectal Cancer <p>This study was designed to find out the vasorelaxant effects of hydrogen sulfide (H2S) on arteries feeding<br>human colon cancer. In addition, it also included the study of the possible roles of potassium (K+) and<br>calcium (Ca2+) channel types in H2S-induced relaxation in the isolated arteries. Sodium sulfide (Na2S)<br>showed a potent dose-dependent relaxant effect on Norepinephrine (1X10-5 M) precontracted arteries.<br>The use of different specific K+ channel blockers (BaCl2, 4-AP, GLIB, and TEA) individually indicated<br>H2S-induced relaxation was affected by all K channel types participated to a various extent, except Kv<br>channels. Both Kca2+ and Kir channels played a major role in the induced relaxation, while KATP played<br>a minor and non-significant role. On the other hand, Kv channel played no direct role, and the induced<br>response curve was very close to that of the control. Possible combinations of K channel blockers<br>showed that some produced synergistic effect to different extent, whereas others produced mild and<br>non-significant effect except at the highest doses used on dose-response curves. Thus, combinations of<br>(GLIB+4-AP), (GLIB+BaCl2) and (BaCl2+TEA) caused a highly significant blocking in the induced<br>response curve, while (BaCl2 +4-AP) and (TEA+4-AP) produced a mild inhibition except at the highest<br>doses used in which the inhibition was significant.</p> Kamaran. H. Mohammed Omar A. M. Al-Habib Sardar H. Arif Copyright (c) 2021 16 1 677 686 The Influence of Safety Management Practices on Safety Performance in Nurses of Emergency Installation on The Government Hospital of Surabaya <p>Introduction: Hospital is one of the high-risk workplaces in terms of safety and health. Nurses are<br>the most vulnerable health workers to work accidents because they have the most number in a hospital<br>and most often interact with patients. Safety performance is very important for the prevention of work<br>accidents. This research aimed to analyze the influence of safety management practices on safety<br>performance in nurses of the emergency installation at X Hospital of Surabaya.<br>Methods: This research was an observational research with the cross-sectional design. It was conducted<br>in May to June 2019. The population in this study was 208 nurses and the sample obtained using a<br>simple random sampling technique involving 68 nurses. In assessing safety management practices and<br>safety performance, the researcher used questionnaires, observation, and interviews.<br>Results: The results presented that safety training which was a dimension of safety management<br>practices affected on the safety performance with a p-value 0.000. Suggestions in this research, to<br>improve safety performance, management can conduct specific and periodic safety training, holding<br>safety briefing and safety talk on a regular basis, and implementing a safety award by applying a system<br>of reward and punishment.<br>Conclusion: Hospital management still needs to schedule a specific and periodic safety training for<br>nurses. Furthermore, to improve safety performance, management can holding safety briefing and<br>safety talk on a regular</p> Khaulah Syahidah Noeroel Widajati Nurhayati Saridewi Copyright (c) 2021 16 1 687 692 Immediate Postoperative Radiographic Assessment of Hip Arthroplasty <p>Radiograph is the keystone in the assessment of hip arthroplasty, as it is available with no metal<br>artifact , at a low cost, and facilitating longitudinal comparison. Pelvic radiograph is significant to<br>assess post-operative hip arthroplasty. So we aim to assess the outcome of the operation through<br>immediate radiography for hip arthroplasty and to determine the different types of hip arthroplasty.<br>This prospective study were conducted at surgical specialized hospital and nursing home hospital /<br>medical city complex / Iraq-Baghdad at radiological departments by seimens x.ray machines , in the<br>period between ( October 2020 – march 2021) . Fifty patients were included . The results showed<br>after radiographic evaluation of hip arthroplasty , 90.0% of cases was Equal Leg length. The higher<br>percentage of vertical center was (90.0 %) for similar compared to lower percentage was(10.0%) non<br>similar , (96.0%) of horizontal center was similar compared (4.0%) non similar .The higher percentage<br>of acetabular inclination was (78.0%) for angle 45degree compared to lower percentage was(6.0%) for<br>angle 50 degree , the higher percentage of acetabular anterversion was (30.0%) for angle 25 degree<br>compared to lower percentage was(2.0%) for angle 30 degree. The percentage for femoral stem position<br>was (100.0%) for neutral alignment . (90.0%) not used of cement mantle compared to (10.0%) used<br>cement mantle , the thickness in range 2-3mm . (94.0%) was no any early complications compared to<br>(6.0%) was Superficial infection.</p> Khitam Hamid Kamil Safwan Saeed Mohammad Mohammad Saeed Mohammad Copyright (c) 2021 16 1 693 699 Phytotherapy in Renal Failure Due to Blood Pressure and Diabetes: A Systematic Review Study in Iram Ethnobotanical Documents <p>Kidney failure is an irreversible condition and an important cause of morbidity and mortality in children<br>worldwide. In conventional medicine, the methods of controlling these disorders and the existing<br>treatments in many cases seem inadequate and sometimes ineffective. Due to the growing popularity of<br>society in the use of knowledge and traditional medicine and herbal medicine, the potential of Iranian<br>ethnobotanical knowledge can be used to find more effective treatment strategies. The aim of this study<br>was to extract medicinal plants used in Iranian ethnobotanical knowledge in order to identify medicinal<br>plants affecting renal failure. In this review study, keywords such as renal failure, renal impairment,<br>hypertension, diabetes, herbs, ethnobotanics, and Iran were used. Databases such as ISI, Web of<br>Science, PubMed, Scopus, ISC, SID and Google Scholar were used to review articles and resources.<br>Finally, 23 articles containing ethnobotanical information for the treatment of renal failure were used to<br>review the literature. Medicinal plants such as Lamium album L., Origanum vulgare, Allium sativum L.,<br>Berberis vulgaris L., Ecbalium elaterium, Crataegus monogyna, Paliurus spina-christi Miller., Rheum<br>ribes L., Olea europea, Silybum marianum L., Teucrium polium L., Nigella sativa L., Ziziphus jujuba<br>(L) H.Karst, Centaurea bruguieriana Hand. Mzt., Juglans regia L., Brassica Napus L. and some other<br>herbs. are the most important medicinal plants used to treat kidney failure and disorders.</p> Khojasteh Hoseinynejad Fatemeh Amini Erfane Hasanloo Shokouh Shayanpour Pouladzadeh Mohammadreza Nazer Copyright (c) 2021 16 1 700 708 The Effects of Chemicals Used For Suicide on Insect Succession, Diversity and Development: An Animal Model <p>It has proven that the presence of different chemicals can affect the succession patterns of necrophagous<br>insects. A comprehensive study was designed on the effects of nortriptyline, diazinon, and aluminum<br>phosphate on arthropod’s succession and diversity on cadavers.<br>Sixteen rabbits in two groups were used as a model in this study, 12 of them were treated with the drugs<br>and were placed in two habitats (sun and shade) based on the study design. For each group, one cage<br>was considered as control. Insects were collected twice a day from the cadavers and identified.<br>In total, 549 necrophagous insects from five families, were collected from all the carcasses. Chrysomya<br>albiceps was the dominant insect on all cadavers, expect for one treated with diazinon, in which it was<br>displaced by Dermestes frischii. The highest number of insects were collected on the sixth day for all<br>cadavers. The majority were collected from the shaded cages.<br>Generally, the species diversity was higher for all the cadavers treated with the drugs compared to the<br>control cadavers. The results showed that the presence of diazinon in the cadaver can repel necrophagous<br>insects, on the contrary nortriptyline seems to attract more species/specimen.</p> Kianoush Ghiasvand Niloofar Soltanian Maryam Naghshzan Simin Pouladian Amin Hoseinpour Aboozar Soltani Copyright (c) 2021 16 1 709 719 Hippocampal Volume and Entorhinal Cortex Thickness in Alzheimer’s Disease <p>Magnetic Resonance Imaging (MRI) is the standard imaging evaluations in Alzheimer’s Disease (AD).<br>Information regarding hippocampus and entorhinal cortex sizes plays an important role in Alzheimer’s<br>disease. This study aims to determine hippocampal volume and entorhinal cortex thickness in<br>Alzheimer’s disease obtained from a group of patients who underwent head MRI.<br>This study was an observational study with retrospective approach in patients who were diagnosed<br>with AD and had available head MRI examination results. A total of 14 patients were diagnosed by a<br>neurologist with AD using MMSE, Hachinsky, and NIA-AA criteria.<br>From head MRI measurement in AD patients, we found that the mean volume of right, left, and<br>total hippocampal was 1700±0.395 cm3; 1.670±0.349 cm3; and 3.370±0.725 cm3, respectively. The<br>mean thickness of right, left, and total entorhinal cortex was 1.821±0.459 mm; 1.463±0.369 mm; and<br>3.285±0.791 mm, respectively. There is a possible difference between the early and late stages of AD in<br>the same patient. Further studies with larger cohorts are needed to examine these correlations.</p> Leon Agung Manurung Widiana Ferriastuti Bambang Soeprijanto Hartono Yudi Sarastika Copyright (c) 2021 16 1 720 726 The Higher Level of Neutrophil – Lymphocyte Ratio (NLR) and Serum Syndecan-1 Based on Timeline (First, Sixth, and Twenty-Fourth Hour) in Sepsis-Induced Acute Kidney Injury <p>This study aims to analyze the difference between the NLR and serum syndecan-1 level at the first,<br>sixth, and twenty-fourth hours with the incidence of acute kidney injury (AKI) and non-AKI in sepsis.<br>We observed thirty-one adult sepsis patients who admitted to the emergency room and ICU of Dr.<br>Soetomo General Academic Hospital, Surabaya, Indonesia from March 30, 2020, to July 5, 2020 (fourmonth),<br>and differentiated into two groups, AKI group (n=14) and non-AKI group (n=17). All septic<br>patients have been given the standard treatment based on Survival Sepsis Campaign 2018. The results<br>showed that the NLR at 1st-hours, 6th-hours, and 24th-hours in the non-AKI group were lower than<br>those in the AKI group (1st: 15.9±2.6 vs 33.0±11.3; 6th: 14.2±1.8 vs 19.3±3.8; and 24th: 11.6±1.3 vs<br>19.9±3.8) (p &lt;0.00). Almost NLR at every groups based on serial hours were decreasing, except in the<br>AKI group, the NLR at the 24th-hour group was higher than the NLR at 6-hour group, but still lower<br>than the NLR at 1st-hours. Serum syndecan-1 levels were lower in the non-AKI group than in the<br>AKI group, at 1st, 6th, and 24th-hours, (1st: 532.5±72.0 ng/mL vs 597.2±85.8 ng/mL; 6th: 557.6±71.6<br>ng/mL vs 612.0±73.9 ng/mL; and 24th: 548.4±76.6 ng/mL vs 586.4±84.6 ng/mL) (p &lt;0.05). It can<br>be concluded that the neutrophil-lymphocyte ratio (NLR) and serum syndecan-1 levels at 1st, 6th,<br>and 24th hours is higher in the AKI compared to non-AKI groups in sepsis. Hence, NLR and serum<br>syndecan-1 have a potential biomarkers for sepsis-induced AKI.</p> Lila Tri Harjana Eddy Rahardjo Windhu Purnomo Lilik Herawati Nancy Margarita Rehatta Copyright (c) 2021 16 1 727 733 The Potential of A Balinese Traditional Medicine Kelor Leaves (Moringa oleifera) For Male Infertility Treatment : A Mini Review <p>Infertility is one of the causes of reproductive welfare disorders of married couples around the world.<br>One of the causes of infertility at the molecular level is Oxidative Stress (OS) because the products of<br>Reactive Oxygen Species (ROS), both endogenous and exogenous, exceed the levels of antioxidants in<br>the body. The aims of this review is to find out the potential of traditional medicinal from Bali, Indonesia<br>with local name Kelor (Moringa oleifera) leaves in preventing the occurrence of potential infertility<br>in men based on the results of research in vivo using animal trials. The method used by the writer is a<br>literature study.The results of this literature review found that kelor/moringa had a positive effect on<br>sexual behavior, especially an increase in libido. In addition, it has a positive effect on spermatogenesis,<br>the quality of spermatozoa especially increases sperm motility, sperm count/volume, germ cell count,<br>renews endogenous antioxidant enzyme activity, reduces levels of ROS, and provides a protective<br>effect on the testes from damage. Moringa oleifera contains many free radical blocking molecules.<br>Some phytochemical test results show that moringa contains powerful antioxidants, including alkaloids,<br>flavonoids, saponins, triterpenoids/steroids, tannins.</p> Luh Putu Widiastini I. G. Agung Manik Karuniadi I Nyoman Mangku Karmaya I Gede Widhiantara Copyright (c) 2021 16 1 734 742 The Effect of Plyometric Training on Improving Values of Some Biokinematics Variables of High-Jump Shooting Skill with the Accuracy in Handball <p>This study aimed to find out the effect of plyometric training on improving values of some kinematics<br>variables of high-jump shooting skill and accuracy in Handball.<br>The researcher used the single group experimental design. The research sample was the players of Naft<br>Al-Janoob Club, season 2020- 2021, they were chosen intentionally. The researcher photographed the<br>research sample using a camera. “Sony” (250 images/sec), And he conducted the kinematic analysis<br>using the “dart-fish” program. The implementation of the proposed training curriculum continued for<br>(8) weeks at (24) training units and a rate of (3) training units per week. The researcher took into<br>account the time specified for each training unit and the number of training units per week, and the<br>general capabilities of the players, as well as the availability of devices and tools, as the researcher was<br>ensured that the curriculum vocabulary is consistent with the scheduled exercises prepared previously<br>for the team. the researcher concluded that there was an improvement in the values of kinematics<br>variables while applying the plyometric training through the results of pre and posttests and for the<br>favor of posttest, as well as the used training method that included plyometric training improved the<br>shooting accuracy performance in high shooting in the post-test due to the use of the same exercises<br>of the motor pathway. The researcher recommended using plyometric training to develop the values of<br>kinematics variables of high-jump shooting skill.</p> Maged Hassan Ali Falah Abd Al-Hassan Yousef Mahdi Lafta Rahi Copyright (c) 2021 16 1 743 750 The Impact of Local Attitudes on the Development of Health Tourism <p>Introduction: Marketing techniques such as positive imaging of health tourism destinations can be <br>a powerful tool in attracting users of health tourism services. The presence of satisfied citizens who <br>create a stable identity for the city and strongly defend the city’s brand can guarantee the success of <br>branding programs.The aim of this study was to identify the effect of local attitudes of citizens about <br>development of health tourism in their city and offer suggestions to improve attitudes and align the <br>interests of citizens as stakeholders in this industry.<br>Methods: we have used aqualitative approach based on conventional content analysis by semi-structured <br>interviews. Content analysis was used as a systematic method to describe a specificphenomenonin-depth, <br>which leads to revision, valid conclusions from information, and the production of new knowledge and <br>insights, and to examine people’s experiences and attitudes toward the specific subject.<br>Results: The results of the analysis of interview data revealed three main themes include hygiene <br>concerns, economic concerns, and safety concerns.<br>Conclusion: According to the concerns of citizens extracted from this study, it is suggested that policy <br>makers in the field of health tourism, along with other relevant organs and organizations, take steps <br>to plan to reduce this concerns. In regard to provide,health services tourism attractionsby supporting <br>citizens in creating a positive image of destination.</p> Mahboobeh Asadzadeh Soudabeh Vatankhah Aidin Aryankhesal Vahid Bay Copyright (c) 2021 16 1 751 756 The Effect of Feeding Punicum Mombasa on The Production of Total Gas, Methane and Digestion Factor in Vitro <p>This study was conducted in the Animal Production Department of the College of Agriculture - Baghdad <br>University. This study included the addition of Ponicom Mombasa as a form of green roughage to the <br>ration of concentrated ratio of 25, 50 and 75% of coarse fodder to study it is effect on the total gas <br>production, methane gas and digestibility. The results indicated a significant decrease in the production <br>of total gas and methane gas by 75% of coarse fodder and the rates during the period of 12, 24 and 48 <br>hours. It also gave the best effect in the characteristic of the dry matter digestibility, the digestion of <br>organic matter and the energy exchanged.</p> Majid Hameed Rashid Copyright (c) 2021 16 1 757 762 Galactooligosaccharide (GOS) Fortified Formula Feeding in Premature Infants <p>Background: Nutritional problems are one of the serious problems in low birth weight or preterm <br>infants. This causes medical and nutrition management of premature infants to be more individual. <br>Objective: To evaluate the outcome of the premature infants with Galactooligosaccharides (GOS) <br>fortified formula feeding<br>Methods: This was prospective, open label cohort study that conducted during March- December 2019 <br>in Neonatology Unit at the one of the main referral hospitals in East Java, Indonesia. The population <br>of the study was very low birth weight infants (1,000 g - ≤1,500g) who needed formula feeding. Weight, <br>body length, head circumference, fecal models and the incidence of diarrhea, colic, regurgitation, and <br>vomiting was observed. Patients were observed for 28 days or adjusted according to length of stay.<br>Results: Totally, 20 infants were included. Mean birth weight was 1236.2±148.5 grams. Mean total <br>volume Galactooligosaccharides fortified formula at the start of recruitment was 209.4±46.1 ml and <br>at the end of observation was 267.9±41.2 ml. There were change in amount and consistency of feces <br>before and after intervention. No patient experienced adverse events (diarrhea, colic, regurgitation or <br>vomiting) while consuming Galactooligosaccharides fortified formula.</p> <p>Conclusion: Galactooligosaccharides fortified formula in premature infant formula did not have a <br>detrimental effect on premature infants and did not cause intolerance</p> Martono Tri Utomo Muhammad Reza Risa Etika Talitha Y. Aden Iwan S. Handoko Ruth A. Alexander Copyright (c) 2021 16 1 763 770 revalence of Cryptosporidium spp. among Patients with Diarrhea at Wasit Province/ Iraq <p>Cryptosporidium is an important obligate enteric protozon parasite that infects humans and wild range <br>of animals with morbidity and mortality especially amongimmuno-suppressed individuals[1]This study <br>carried out in al-kut city /Iraq in two major hospital Al- kut hospital for gynecology ,obstetric and <br>pediatric and al-Karamma teaching hospital which included collection of stool samples from diarrheal <br>patients from October / 2020 – January / 2021 , (109) stool samples taken from patients with different <br>ages to both gender examined by microscopic examination(Modified ziehl nelson) and multiplex PCR <br>technique, the results showed the percentage of cryptosporidium spp. infection by using M.Z.N stain <br>was 44(40.4%) while by using PCR technique was 38(39.6%) and 4(4.2%) for C.parvum and C.hominis <br>respectively .<br>The rate of infection is significantly associated with residence when using M.Z.N stain and PCR for <br>C.parvum, also significant associate among those who &gt;5 years old. water source for drinking were <br>significant associated factors, other factors (gender, education level) Showed no significant association <br>with infection, the present study aimed to detection of Cryptosporidium spp. and possible association <br>between the infection and some risk factors by using microscopic examination and detecting DNA of <br>Cryptosporidium parasite by multiplex PCR technique.</p> May Naji Alkhanaq Ghadeer Thamer Copyright (c) 2021 16 1 771 780 International Outsourcing of Quality Healthcare Through Tele-Medicine: Binding Arbitration Makes Tele-Medical Dream a Reality <p>The development of communication technologies has a dramatic influence on culture. The internet, cell <br>phones and e-mail are different domains, and if health care professionals want to join this space, they will <br>be careful to do so. Telemedicine has medical-legal implications for aspects of identification, licensing, <br>insurance, protection, privacy and confidentiality, as well as other risks related to online healthcare <br>communication. The International Advisory Group of the World Health Organization (WHO), which <br>met in Geneva in 1997, identified telemedicine as providing healthcare services, where distance is a <br>critical factor, to health care providers, who use the information and communications technologies to <br>exchange relevant information for the diagnosis, treatment and prevention of diseases and injuries, and <br>to continue to do so. <br>In the context of the COVID-19 Pandemic Lockdown, the Indian Government has authorized <br>telemedicine legal status. The Governing board, established by the Government at a meeting of the <br>Indian Medical Council with the Ministry of Health and Family Welfare’s approval, published a notice <br>dated 25 March 2020 (‘Amendment’) modifying Guidelines of the Indian Medical Council 2002 on <br>telemedicine in India. The amendment introduced ‘Telemedicine consultation’ to the law. <br>A basic knowledge of how medical negligence compensation is calculated and adjudicated in the <br>judicial courts of India. The paper concludes with an assessment of the rules. This paper will seek to <br>determine whether binding arbitration is the best possible solution to resolving malpractice disputes, or <br>whether traditional litigation, while costly, is the safest choice. To do this, the paper will examine both <br>the advantages and the disadvantages associated with using arbitration as opposed to litigation</p> Meenakshi Kalra Vikas Gupta Copyright (c) 2021 16 1 781 786 Psychosocial Impact and Protective Factor of COVID-19 Confirmed Patient During Isolation Enactment: A Systematic Review <p>Background: An individual who is positively confirmed COVID-19 is required to undergo a longterm isolation. As a consequence, this condition can cause physical and psychosocial impacts. This <br>review article aims to identify psychosocial impacts COVID-19 patients and protective factors the <br>patients during isolation enactment. Method: This article is a systematic review by doing article <br>identification from four data bases (ScienceDirect, ProQuest, EBSCO and PubMed) published between <br>January to October 2020. The articles were selected using PRISMA based on assigned inclusion and <br>exclusion, keywords on psychological impact, COVID-19, and confirmed patient. Results: Based on <br>the 28 article analysis divides psychosocial domain into four aspects; they are emotional impact, social, <br>and behavior. Protective factor was divided into four aspects, they are social support (family, social, <br>medical team, and government support), personal ability (religious, cognitive, affective, psychomotor <br>aspects), positive belief (internal and external), and material asset (facility and financial). Conclusion: <br>Psychosocial impacts of confirmed COVID-19 patients during isolation enactment can be minimized <br>through psychologist intervention by increasing patients’ protective factors. Based on the finding, the <br>suggestion was the part of nursing in isolation COVID-19 important to increase health condition of <br>mental patients undergo isolation.</p> Mira Wahyu Kusumawati Setyawati Soeharto Heni Dwi Windarwati Copyright (c) 2021 16 1 787 799 Factors Related to Exclusive Breastfeeding in East Java – Indonesia <p>Exclusive Breast Feeding (EBF) is very crucial for the growth and development of toddlers in the future, both physically and mentally. The study aims to analyze factors related to EBF in East Java, Indonesia. The analysis material for the study was the 2017 Indonesian Nutritional Status Monitoring, a cross-sectional survey. In East Java, the study obtained 3977 toddlers using the multi-stage cluster random sampling process. The study used binary Logistic Regression tests to interpret the data. The results show for toddlers living in cities have a 0.951 times lower probability of experiencing EBF than toddlers residing in rural areas. Toddler age (in months) is one of the determinants of EBF. All categories of maternal marital status are more likely than mothers who are never married to having an EBF toddler. All maternal education levels have a better chance than mothers who have no education to have EBF children. Except for mothers in the senior high school category, which has no significant relationship with the incidence of EBF in children under five in East Java, Indonesia. The study also found toddler’s age associated with the incidence of EBF in children under five in East Java, Indonesia. Finally, the toddler boy has a probability of 0.943 times compared to the toddler girl to experience EBF in East Java in Indonesia. The study concluded that six variables were related to the incidence of EBF in East Java - Indonesia, namely residence, mother’s age, mother’s marital, mother’s education, toddler’s age, and toddler’s gender.</p> Mohamad Yoto Hario Megatsari Azizah Andzar Ridwanah Agung Dwi Laksono Copyright (c) 2021 16 1 800 806 Production and Purification of aflatoxin b1 from Local Isolate of Aspergillus flavus <p>Background and Objective: Aflatoxins are cancerogenic compounds produced predominantly by certain strains of the Aspergillus genus. Food and feed contamination by aflatoxin (AF)B1&nbsp;has adverse economic and health consequences. Unfortunately, these contaminants can never be completely removed, and on that account, many studies have been carried out to explore an effective process of their detoxification to a threshold level. Results: A thermostable enzyme purified from the boiled supernatant was designated as Horseradish aflatoxin-degrading enzyme (HADE). An overall 9.55-fold purification of HADE with a recovery of 39.92% and an activity of 3.85 × 103&nbsp;U·mg−1&nbsp;was obtained using chromatography on DEAE-Sepharose. peroxidase had an estimated molecular mass of 34 kDa and exhibited the highest activity at 25 °C and pH 7.0. peroxidase is the major protein involved in AFB1&nbsp;detoxification. Conclusion: PTLC It is reliable as it is a good and reliable method for separating compounds and toxins. It is necessary to study the other compounds that the Aspergillus fungus secretes, as they are likely to cause harms more dangerous than aflatoxin B1.</p> Mohammed Abdullah Zayer Rafid Abdalwahd Essam Fadel al-jumaili Copyright (c) 2021 16 1 807 814 Comparative Anatomical Study of Kidney in adult Male Squirrel (Sciurus anomalus) and Mice (Mus musculus) <p>The current study aimed to investigate the anatomical, morphological, morphometrical data of the kidney in two types of rodent, the squirrel and mice. A total number of 80 kidneys were obtaining from two species which include 40 specimens from squirrels and same number of specimens from mice.<br>Current study showed that the kidneys in two species lay in the abdominal cavity lying retroperitoneal against upper dorsal wall rear of abdominal cavity on either side of vertebral column.<br>The left kidney in squirrel was longer and thicker than right kidney while in mice was reversible and in both animal the left kidney more distant from the median plane than the right but the left kidney in squirrel was larger than right kidney the value.<br>Shape of kidneys in squirrel appeared semi bean like structure but in mice the shape was typical bean like structure, and in both animals the kidneys have smooth surface. Both kidneys of squirrel were by relatively solid texture in contrast with mice kidney.<br>The biometrical measurements of the kidney revealed that the mean weight in squirrel was significantly larger than that of mice.&nbsp;Whereas all micro measurements recorded showed a significant differences between squirrel and mice where the means in squirrel appeared higher than those of mice.<br>Renal artery which arises from abdominal aorta divided to the right branches, the right artery appeared shorter than the left artery, because the left kidney being more distant from the median plane than the right one. The renal artery in mice divided into 3 branches called anterior renal artery, intermediate renal artery and posterior renal artery but in squirrel divided to 2 branches anterior and posterior renal artery. in both animals the 2nd order of artery branches intermediate renal artery divided in mice in 4 inerlober branches but in squirrel the interlober divided into 6 branches</p> Mohammed H. Abed Shakir M. Mirhish Copyright (c) 2021 16 1 815 824 Review of the Professional Ethics of Doctors as Chemical Castration Sanctions in Indonesia <p>This study aims to determine the view of the medical ethics code regarding the doctor’s profession as the chemical castor of child sexual offenders who has been decided by the court as mandated by Article 82 A paragraph (2) of Law Number 17 of 2016 concerning Child Protection in conjunction with Article 9 of Government Regulation Number 70 of 2020 concerning Procedures for Implementing Chemical Castration, Installing Electronic Detection Devices, Rehabilitation and Announcement of the Identity of Perpetrators of Sexual Violence Against Children. This research is a normative legal research. Based on the results, it is known that theoretically related to the authority of the medical profession as a party ordered by law to carry out the castration process for perpetrators of sexual abuse against children who have been decided by the court is contrary to the principles contained in the medical code of ethics and oaths. doctor, in this case the presence of such a thing makes the doctor feel that he is not doing his profession in accordance with the Code of Medical Ethics which has been agreed upon and highly upholds moral values, one of which is “informed consent” or consent from family or patient. all actions that result in a decrease in the patient’s physical endurance, although not necessarily reduce his psychological endurance. Second, that chemical castration is not a type of medical service but a punishment, so it is not the domain of medical or health personnel to do it.</p> Muhammad Bagus Adi Wicaksono Itok Dwi Kurniawan Copyright (c) 2021 Muhammad Bagus Adi Wicaksono, Itok Dwi Kurniawan 16 1 825 830 Height-for-age in Children under 5 Years Old with Down Syndrome and Hypothyroidism <p>Background: Children with Down syndrome tend to have accompanying comorbidities, such as hypothyroidism, and late detection of this ailment leads to reduced growth of the child. This study aimed to assess the growth patterns in children with Down Syndrome and hypothyroidism at diagnosis.<br>Methods: This cross-sectional study was conducted from September to December 2020 with 56 subjects at the Pediatric Endocrine Outpatient Clinic of Dr. Soetomo Hospital. Diagnosis of Down Syndrome was confirmed by karyotyping, while the weights and heights were assessed using a standardized curve for children with Down Syndrome and then calculated using Peditools. Fifty-six children with Down Syndrome and hypothyroidism were included, comprising 32 boys and 24 girls (mean age, 37.75&nbsp;±&nbsp;34.26&nbsp;months). Majority of the subjects had normal weight, height, and Body Mass Index (36/56 [mean z-score, −1.62 ± 2.36], 33/56 [mean height-z-score, −0.43 ± 2.74], and 30/56 [mean z-score, −2.00 ± 2.06], respectively). Furthermore, the mean onset of diagnosis was 17.07 ± 32.23 months, where 23 out of the 56 children had short stature and had gotten diagnosed at over 12 months of age.<br>Conclusion: From the results obtained, hypothyroidism can be said to be associated with reduced growth in children with DS.</p> Muhammad Faizi Nur Rochmah Yuni Hisbiyah Anang Endaryanto Soetjipto Copyright (c) 2021 16 1 831 837 Determinants of Quality of Life Air Traffic Controller in AirNav Surabaya <p>The quality of work life is affected by the quality of the work environment. A positive work atmosphere will create a conducive work life. This study aims to determine the factors that affect the quality of life of air traffic controller at AirNav Surabaya. This is a quantitative research with a cross sectional study method. Interviews were conducted on 38 workers who were drawn based on the purposive sampling method. Then, from these results a logistic regression test was carried out which showed that blood pressure, position, and workload had a significant relationship. To determine the effect of individual characteristics, work fatigue and quality of life were measured using a questionnaire, blood pressure using a tensimeter and workload using an oximeter. Data were analyzed using the SPSS 25 application with the chi-square test. Results of the chi-square test analysis showed that there was a relationship between age and quality of life (p = 0.009), blood pressure with quality of life (p = 0.032), years of service with quality of life (p = 0.031), position and quality of life (p = 0.029), fatigue with quality of life (p = 0.012) and workload with quality of life (p = 0.005), while there was no relationship between sex and quality of life (0.279) and marital status with quality of life (p = 0.560). From these results, a logistic regression test was carried out which showed that blood pressure, position, and workload had a significant relationship. This research suggests AirNav Surabaya to pay more attention to the quality of life of air traffic controller, maintain the nutritional intake, exercise regularly, and pay attention to rest times.</p> Muhammad Fandi Ahmad Lalu Muhammad Saleh Yahya Thamrin Syamsiar S. Russeng Saifuddin Sirajuddin Agus Bintara Birawida Copyright (c) 2021 16 1 838 845 Characteristics and Outcome of Hospitalized Children with COVID-19: A Single Center Experience <p>Objectives: Are to describe the clinical, and laboratory features of patients hospitalized with COVID-19 and to compare some of these parameters between patients with and without MIS-C.<br>Methods: A cross sectional study, undertaken over a 10 months period from 1st of march to 31 of December 2020 at child’s central teaching hospital in Baghdad city , Iraq.<br>Results: In total, 80 children hospitalized with a diagnosis of COVID-19. The mean age of the patients was 6.05±5.1years.60% were male and 46.35% had no comorbidities . Different types of malignancies were the most common comorbidity accounting for 22.5% of the patients. A history of contact with infected person was reported in 27.5% of the patients. Chest X-ray revealed that 52.5% of the patients had normal findings. 11.25% developed multi systemic inflammatory syndrome. Only two hematological abnormalities were significant in pediatric COVID-19 cases for development of MIS-C which is elevated NLR and CRP. In this study, there were no deaths linked to COVID-19 admission..<br>Conclusions : The majority of children admitted to the hospital with confirmed COVID-19 have a mild course and a good outcome. malignancy is the commonest comorbidity associated with COVID-19 admissions. Elevated Neutrophil: lymphocyte ratio and CRP are independently associated with development of MIS-C in pediatric COVID-19.</p> Nabeeha N. Akram Copyright (c) 2021 16 1 846 857 Mung Bean Sprouts (Vigna radiata) Ethanol Extract on Alanine Aminotransferase (ALT) Activity and Malondialdehyde (MDA) Levels in Toluene-Induced Rats <p>Objective –This study aimed to evaluate the effect ofethanol extract from mung bean sprouts on alanine aminotransferase (ALT) activity and malondialdehyde levels in toluene-induced white rats.<br>Methods–This research is an experimental laboratory with a research design that is post-test only control group design using 40 rats (Rattus norvegicus) which were divided randomly into 5 groups, G1 (control without toluene), G2 (900 mg/kg toluene), G3 (mung bean sprouts extract 250 mg/kg + 900 mg/kg toluene), G4 (mung bean sprouts extract 500 mg/kg + 900 mg/kg toluene), G5 (mung bean sprouts extract 1000 mg/kg + 900 mg/kg toluene). ALT measurement using spectrophotometer method. Measurement of MDA using the ELISA method. The data collected will be statistically tested with the help of SPSS with a significant (p &lt;0.05).<br>Results–The results of the measurement of ALT activity (p=0.972) and MDA levels (p=0.190) in each group had no significant effect (p&gt;0.05) in each treatment.<br>Conclusion–It can be concluded that there was no significant effect of ethanol extract of sprouts on alanine aminotransferase (ALT) activity and malondialdehyde levels in white rats (Rattus norvegicus) induced by oral toluene.</p> Putu Bayu Agus S.Si Siti Khaerunnisa M.Si Lina Lukitasari, M.Si Copyright (c) 2021 16 1 858 864 Workers Knowledge about First Aids of Emergency Accidents at Industrial Sector of Al-Najaf City in Iraq <p>Unintentional accidents and sudden illnesses are two of the most common causes of disability and death among workers, especially those under the age of forty . Using a simple random sample, twenty workers in the industrial workshops were randomly selected . A questionnaire consisting of two main groups was used. The result revealed that out of a total of 201 workshop workers included in the study, 59 (29.4%) of them had overall fair knowledge and 125 (62.2%) of the participating workers had poor knowledge, in addition to none having good knowledge. The results showed that only 17 (8.5%) of the workers had a positive attitude towards first aid. With regard to the relationship between the social and demographic data of the participants and their levels of knowledge, no an important correlation was not identified except for the monthly income, number of children and age, while with regard to workers’ attitudes towards first aid, residency in urban areas, years of experience, marital status, education level and receiving information about first aid showed significant correlation with their social relationships - demographic data.</p> Tamim Yakoob AI-Sallami Fatima Wanas Khudair Copyright (c) 2021 16 1 865 871 Self-Efficacy with the Quality of Life of Pulmonary Tb Patients <p>Aim: It is known that the relationship between self-efficacy and quality of life in patients with pulmonary tuberculosisat Pertamina Bintang Amin Hospital in Bandar Lampung 2020.Methods: This type of research was quantitative with a cross sectional approach. The population was all pulmonary TB patients at the Pertamina Bintang Amin Hospital Bandar Lampung, with a sample size of 62 people. Data analysis in this study used the chi-square test.Results: The results of the univariate analysis showed that most of the respondents’ self-efficacy was in poor condition, namely as many as 33 people (53.2%). Most of the respondents’ quality of life was in the medium category, namely 27 people (43.5%). The results of the bivariate analysis showed that the p-value = 0.001). 1) demographic factors such as the type of education level are an indicator of the potential vulnerability of pulmonary TB infection, 2) Most of the respondents’ self-efficacy was in poor condition, namely 33 people (53.2%). Most of the respondents’ quality of life was in the medium category, namely 27 people (43.5%), and 3) there was a relationship between self-efficacy and the quality of life of patients with pulmonary tuberculosis.</p> Usastiawaty C.A.S Isnainy Ridwan Ridwan Rias Tusianah M. Arifki Zainaro Albet Maydiyantoro Tubagus Ali Rachman Puja Kesuma Copyright (c) 2021 16 1 872 884 Ultrasound Assessment for Thyroid Examination in Patients with Hypothyroidism <p>Patients with overt hypothyroidism show decreased echogenicity of the thyroid at ultrasonography . The purpose of the present study was to evaluate the effectiveness of ultrasonography for diagnosing the most common hypothyroidism and to guide patients to appropriate treatment show decreased echogenicity of the thyroid by ultrasonography. This study have been conducted on 80Patients, the age group between 20-70 years, in the period of January 2020 to October 2021. Thyroid ultrasonography was carried out by the type of ultrasound (US) machine used in the study is a sameness -X300 ultrasound device with 7.5MHz probe. The volume of the thyroid lobe noticed calculations according to the formula of the: width x length x thickness. The assessment of the 80 patients with hypothyroidism who were included in our study, (57) patients with decreased echogenicity, 23 patients had been with normal echogenicity, the lowest was found in patients homogenous enhancement 42.5%, non- homogenous 57.5%, thyroid the gland has a medium gray scale homogeneous echo pattern and the level of echogenicity is higher than Size of thyroid, The higher percentage of nodules (51.3%) of the size of the thyroid was normal. But the higher percentage of nodules type (40.0%) for the study group was solid compared to the lower percentage (2.5%) was solid and cystic. Ultrasound had high specificity and more accuracy to assess patients with hypothyroidism. An association between hypo echogenicity at thyroid US and high level of thyroid stimulation hormone (TSH suggesting decreased echogenicity at the ultrasonography diagnostic.</p> Yours Abdel Hassan Safwan Saeed Maha Taha Idrees Copyright (c) 2021 16 1 885 892 Alpha-Mangostin and Gamma-Mangostin Isolated from Mangosteen (Garcinia mangostana L.) as Promising Candidates against SARS-CoV-2: A Bioinformatics Approach <p>The world is endangered by the COVID‐19 pandemic caused by SARS‐CoV‐2, people are dying in thousands every day, and without an actual treatment, it seems that bringing this global health problem to a quit is impossible. Natural products have been in constant use since ancient times and are proven by time to be effective. Medicinal plants from Indonesia may lead to the discovery of the novel drugs. Mangosteen or Garcinia mangostana L. is a native tropical fruit from Southeast Asia and is known to contain bioactive compounds. Interestingly, the main xanthone derivatives are alpha-mangostin and gamma-mangostin, these compounds have a variety of pharmacological activities such as antiviral activity. In summary, this study showed potential pharmacological benefits of alpha-mangostin and gamma-mangostin isolated from mangosteen against SARS-CoV-2. Thus, mangosteen exhibits as a valuable plant and a candidate for future drug development to fight SARS-CoV-2. However, further trials, such as in vitro and in vivo evaluation, are needed to prove the validity of these findings.</p> Arif Nur Muhammad Ansori Copyright (c) 2021 16 1 893 899 Comparative Evaluation of Dexmeditomidine & Fentanyl in Terms of Cardiovascular Stress Response During Anesthetic Airway Management in Major Surgical Procedures <p>Background- airway management both in operation theatre and during emergencies remains challenge because of cardiovascular stress response &amp; inflammatory mediators during procedure exhilarating the stress response itself leading to catastrophic events. This study is aimed to evaluate comparative efficacy of dexmedetomidine over fentanyl because of it have not only as sympatholytic also as anti-inflammatory properties. Study was orchestrated at tertiary care centre in western India after approval of institutional scientific &amp; ethical committee. Methodology Study group include 50 patients of either sex aged between 18 to 55 years who were admitted for major surgical procedure and given consent for inclusion. Study group divided in two group for record &amp; statistical analysis of parameters like heartrate, mean arterial pressure at various interval during surgery to ascertain the superiority of dexmedetomidine vs fentanyl in stabilizing cardiovascular stress response.</p> Niraj Rathod Sunil Valand Seema Rawat Komal Makwana Copyright (c) 2021 16 1 900 907 A Tear Inflammatory Biomarker in Dry Eye Disease <p>Background: Dry eye disease is a chronic ocular condition and significantly impacts visual function with multifactorial origin. It is characterized by tear instability and inflammation on the ocular surface. The inflammatory response initiates by synthesis and release of cytokines, Recently, there has been increasing scientific interest using tear film biomarkers that play a role in pathophysiology of dry eye disease. The objective of this study to explain relationship of tear film biomarker in dry eye.<br>Methods: The research design of this study used literature review. The data was collected from electronic database in PubMed, Google Scholar, and website of science and predominantly published in the last 10 years.<br>Result: The defect on the tear film component due to oxidative stress lead to ocular surface epithelial exposure, and intracellular signaling pathways are triggered, involving an inflammatory mediator which plays a role in the pathophysiology of dry eye. Using biomarker lead to better diagnosis, drug development, and effective management for dry eye disease.<br>Conclusion: In conclusion, TNF-a, IL-6, IL-8, IL-1 by number studies to consistently reflect disease severity and strong correlation with schirmer tear test and another test for the ocular surface in dry eye disease.</p> Ni Made Inten Lestari Evelyn Komaratih Yuyun Rindiastuti Cita Rosita Sigit Prakoeswa Copyright (c) 2021 16 1 908 912 Serum Preptin Level in Iraqi Beta Major Thalassemic Patients <p>Background Beta thalassemia syndromes are a set of hereditary blood disorders marked by a deficiency of beta-globin chain synthesis, result in decrease hemoglobin in red blood cells, anemia, and a reduced RBC production. Iron overload is a common finding in chronically transfused beta thalassemia major patients with possible effect on beta cell function and secretion. This study aimed to assess preptin level in the serum in beta major thalassemic patients, in order to indicate the effect of oxidative stress on preptin secretion. And explain preptin effect on bone cells. Subject and methods; A case-control study that was performed in the&nbsp;Ibn Albaladi Hospital (during the period from 1st of September 2020 to the end of January 2021. It included 48 beta major thalassemic patients and 36 subject as healthy control. Information was taken from each subject including age, diseases. Subjects with any cardiovascular diseases, hyperemesis gravidram, liver diseases, kidney diseases, bone disease, diabetes mellitus, and patients take corticosteroid as well as patients in childhood were excluded in this study. The biomarkers studied were: fasting serum preptin, insulin were assessed. Serum preptin and insulin were measured by ELISA technique. Results; The mean values of (Preptin, Insulin) in patients group were less than control group. There was a moderate direct significant correlation P&lt;0.01 between preptin and insulin. Conclusion; The mean value of serum preptin was less in thalassemic major group than control group. And direct correlated with insulin level which is also reduced in thalassemic patients.</p> Noor Haidar Talib Hedef .D. Al-Yaseen Ali Mohammed Jwad Copyright (c) 2021 16 1 913 919 Effect of KI on SDF Treated Cavities <p>Background: Dental caries is the most frequent chronic disease worldwide. However, Dental caries can be prevented or arrested. Recently interest in the use of silver diamine fluoride (SDF) has been growing. (SDF) is a solution containing ionic silver, fluoride, and ammonia that arrests the progress of carious lesions and prevents the development of future caries. In Vitro studies demonstrated that SDF increases the pH of biofilm, reduces dentin demineralization, and has antimicrobial action against cariogenic bacteria. But it produces a lesion darker (brown to black) than the original, which is the major criticism of the material. To counter the staining, many studies have tested SDF treatment immediately followed with a saturated solution of potassium iodide.<br>Material and Methods: A vitro study done in Qassim University, with sample of 30 extracted premolars, divided into 3 groups, (Group A): received silver diamine fluoride, followed by application of Potassium iodide. (Group B): cavity preparation 1 mm in enamel then Received silver diamine fluoride followed by application of Potassium Iodide. And (Group C): cavity preparation 1 mm beyond dentoenamel junction then Received silver diamine fluoride followed by application of Potassium Iodide.<br>Result: There was a statistically significant differences between three groups on color measurement p= (0.020), this means that the prevalence for group c-based change color teeth compared to group A and B.<br>Conclusion: SDF + KI treatment showed a low intensity staining in superficial and deep cavities. The intensity of staining decreased significantly in dentin prepared cavities.</p> Ola Mohamed Ismail Sakr Mashail Abdullah Alsaikhan Copyright (c) 2021 16 1 920 928 The Cytotoxic Effect of Iraqi Rumex Acetosella against Breast and Esophagus Cancer Cells <p>Background: cell lines derived from cancer cells are frequently used in research, including use as a model to understand cancer and to identify potential new treatments. The aim of this article has been prepared to evaluate the anticancer effect of Rumex Acetosella that has been studied for their anticancer activity on esophagus and breast cancer cell line. Method: AMJ13 (new breast cancer&nbsp;cell line&nbsp;(AMJ13) has been established from an Iraqi breast cancer patient and SK-GT-4 cells (Human esophageal adenocarcinoma&nbsp;cell line) were treated with whole methanolic extract of the leaves of Rumex acetosella. the MTT assay to determine the anticancer activity was done using 96-well plates where cell lines were seeded at 1 × 104cells/well after 24 hrs.m the cells were treated with tested compounds at different concentrations. Cell viability was measured after 72 hrs of treatment by removing the medium, adding 28 μL of 2 mg/mL solution of MTT, and incubating the cells for 2.5 h at 37 °C. After removing the MTT solution, the crystals remaining in the wells were solubilized by the addition of 130 μL of DMSO (Dimethyl Sulphoxide) followed by 37 °C incubation for 15 min with shaking. The absorbency was determined on a microplate reader at 492 nm. Conclusion: Plant extract from Rumex Acetosella showed particularly strong anticancer capabilities since it inhibited actual tumor progression in a breast adenocarcinoma mouse model. Our results suggest that whole plant extracts are promising anticancer reagents.</p> Omar Hussein Ahmed Ali Jabbar Abdulhussein Enas Jawad Kadhim Copyright (c) 2021 16 1 929 940 A molecular Study of the Microsporum Canis and Trichophyton Mentagrophytes Associated Fungal Infection: Athlete’s Foot among Farmers <p>Athlete’s foot (Tinea pedis) and toe nails infection (onychomycosis) are disease conditions caused by dermatophytes; both diseases are prevalent in adults, especially in farmers who often wear robber shoes during farming. Proper treatment of dermatophytes related skin diseases needs a proper understanding of susceptibility of the causative agents to the intended treatment option. This knowledge can only be derived from proper identification and characterization of the related fungi. In the present study, both traditional and molecular identification approaches were applied on cultured samples for detection and identification of Tinea pedis. From the PCR analysis, Microsporum canis and Trichophyton mentagrophytes were identified as the two commonest species implicated in Tinea pedis basing on their DNA banding patterns. From the fifty two identified dermatophyte isolates via the conventional identification methods, only 45 isolates were confirmed via molecular approach, with 25 isolated being confirmed as M. canis while 20 isolates were T. mentagrophytes. The same was confirmed with real time PCR quantification.</p> Omar Sadik Shalal Qahtan Adnan Rasheed Dunya Abdulrazzaq Alkurjiya Copyright (c) 2021 16 1 941 950 Features of Teleroentgenographic Indicators of the Position of the Teeth and the Profile of the Soft Tissues of the Face in Adolescents with Different Profiles and Types of Faces According to Schwarz A.M. <p>One of the most relevant areas of research in biomedical anthropology is the establishment of morphometric parameters of the human body, individual organs and structures of the body, in particular cephalometric indicators and indicators of the jaw-facial apparatus. Such research is important from the point of view of practical medicine, first of all improvement of methods of identification of the person in forensic medicine and for creation of a normative database for diagnostics of dental deformities and improvement of consequences of surgical, orthopedic and orthodontic interventions. One of the most accurate and effective methods for determining cephalometric parameters is the method of lateral teleroentgenography. The object: to establish teleroentgenographic indicators that characterize the position of teeth and the profile of facial soft tissues and determine their sexual characteristics in Ukrainian young men and young women with orthognathic occlusion depending on the profiles and types of faces according to Schwarz A.&nbsp;M. Conclusions: the results prove the need to consider not only age, but also sex, type and profile of the face for an individualized approach in determining the normative teleroentgenographic indicators of human, are important in forensic medicine to improve the efficiency of identification and in practical dentistry to assess the condition of the dental apparatus and ensure effective therapeutic and aesthetic results of orthopedic and orthodontic dentistry.</p> Prokopenko O.S Gunas I. V Beliaiev E. V Kotsyura O. O Kovalchuk V. V Copyright (c) 2021 16 1 951 959 Study of Genetic Variation of the gene NOS3 and Cadmium Concentrations in a Sample of Iraqi Patients with Essential Hypertension <p>High blood pressure is defined as a systolic blood pressure of 140 mm Hg or more, or a diastolic blood pressure of 90 mm Hg or more. Blood pressure is the force exerted by the circulation of blood on the walls of the body’s arteries, which are the main blood vessels in the body. High blood pressure is classified into normal, first stage, second stage, or third stage. Risk factors include lifestyle factors, environmental factors, and genetics. There are two types of high blood pressure, essential hypertension and non-essential hypertension. samples were collected, representing 50 samples from welding laborers patients with high blood pressure, in addition to 50 healthy samples. This study was conducted with the aim of studying the relationship between genetic variation of some genes and environmental factors associated with basic blood pressure in Iraqi patients. The studies were conducted in the laboratories of the Institute of Genetic Engineering - University of Baghdad, as well as in the research laboratories of the Ministry of Science and Technology. Total genomic DNA was extracted using a special kit (Geneaid) from fresh unfrozen blood samples, and then normal polymerase chain reaction and PCR-RFLP were used to detect mutations in the gene NOS3 rs1799983 T&gt;G (Glu 298 Asp) using primers and specialized severing enzyme is MboI. The results of the wild-type TT of NOS3 gene showed a bundle (206 bp), while the heterozygous TG genotypes showed (206, 119 and 87 bp), respectively, and for the mutant GG genotypes (119 and 87 bp). Nitrogenous base sequence analysis (Sequencing) was conducted for both infected and healthy samples. The results of the study showed that the incidence of hypertension in the age group (20-65) years was higher in males than in females, reaching (60% and 40%), respectively. The study showed that stress, smoking and exposure to pollution all have a clear and dangerous effect on the percentage of people with high blood pressure. The results also showed that mutations between patients and healthy subjects in the NOS3 gene for wild-type TT is (60%) versus (40%), respectively, at a significant level (p&lt;0.01), while for the heterozygous TG it is (28)% versus (32%) found not significant. As for the GG homozygous mutant, the results were (12%) versus (28%) found to be significant at (p&lt;0.05) and these results indicate that genetic variation (T&gt;G) may be a risk factor (TT) for high blood pressure. The results of the NOS3 gene also showed the relationship between the TT genotype of the NOS3 gene and the cadmium concentration between patients and healthy subjects for the wild-type TT is 4.82 ± 0.09 versus 0.388 ± 0.025 with a level (p&lt;0.01) while for the heterozygous TG is 4.96 ± 0.10 versus 0.371 ± 0.035 with a level (p&lt;0.01). The homozygous mutant GG is 5.02 ± 0.08 versus 0.356 ± 0.025 with a level (p&lt;0.01). These results indicate that the high level of cadmium in welding laborers has an effect on high blood pressure.</p> Qusay A. Abdulameer Ismail H. Aziz Abdul-jabbar A Ali Ismail A. Abdulhassan Copyright (c) 2021 16 1 960 966 Environmental Analysis of Massive Mask Waste due to the Covid-19 Pandemic in Indonesia <p>The Covid-19 pandemic has a big impact. The requirement to use masks to prevent the spread of the virus increases the amount of mask waste. This study aims to analyze the environment due to the accumulation of mask waste during the Covid-19 pandemic in Indonesia. This research uses the literature study method from various literature references and qualitative analysis. Medical waste that is not managed with proper procedures has the potential to transmit the virus to other people. In addition, the pile of mask waste is also bad for the environment. Various appropriate designs and technologies are made for more appropriate and environmentally friendly management of mask waste.</p> Rahmad Agus Dwianto Tulus Haryono Rianto Copyright (c) 2021 16 1 967 972 Immunohistochemical Characterization of Hepatic Nuclear Factor 4 Alpha Expression in the Choroid Plexus of the lateral and 4th ventricles of adult Male Rat Brain <p>The choroid plexus (CP) is present in brain ventricles. It is responsible for cerebrospinal fluid (CSF) secretion and various vital functions. Special proteins present in choroidal epithelium play important roles in CSF production and energy metabolism.<br>This study aims to compare between the lateral and fourth ventricles CPs using hepatocyte nuclear factor 4 alpha (HNF4α), metabolism marker, to evaluate the functional activity of this tissue in the two regions.<br>Ten adult male albino rats were used to study the histological features of the CPs and to study the functional activity by quantitative immunohistochemical labeling with HNF4α marker.<br>The CP of the fourth ventricle had more functional activity than the CP of the lateral ventricle. A quantitative assessment of HNF4α using Aperio ImageScope Software Analysis showed that the lateral ventricle CP mean positivity 0.264 ± 0.083 pixel/micron² while the fourth ventricle CP have mean positivity 0.297 ± 0.043 pixel/micron². The immunohistochemical expression of marker in the fourth ventricle CP were significantly, P ≤ 0.05 higher than those in the lateral ventricle at P ≤ 0.05. Immunohistochemical detection of metabolism marker went along with findings of other histological and biochemical studies to define the CP as a highly dynamic structure with regional variations forming a continuum of one entity tissue capable of functional adaptation according to body needs.</p> Rasha A. Salman Taghreed Abdulrsool Ali Duaa AL Musawi Copyright (c) 2021 16 1 973 978 Profile Study of Motorcyclists Victims in Road Traffic Accidents at Jaipur Region- An Observational Antemortem Study <p>World Health Organization defined accidents as ‘’ an unexpected, unplanned occurrence which may involve injury’’1.Only 28 countries, covering 7% of the world’s population, have comprehensive road safety laws on all five key risk factors: drinking and driving, speeding, and failing to use helmets, seat-belts, and child restraints as per the global status report on Road Safety 2013 by World Health Organization1. India is undergoing major economic and demographic transition coupled with increasing urbanization and motorization. Injuries on roads, at homes, and in the workplace have increased due to lack of safety-related policies and programs. The health sector bears the maximum brunt in terms of provision of acute care, and short-term and long term rehabilitation service. This study describes profile of motorcyclists’ victims in road traffic accidents observation done and they were compared with the previous studies.This study was conducted toanalyzethe sociodemographic profile of motorcycle&nbsp;crashes&nbsp;among&nbsp;total cases of RTA.During study period, a total number of 22618 patients were admitted to trauma centre, from which 10564 were road traffic accident cases, from which 25 % were two wheeler clashes.</p> Ravindra Kumar R.K.Punia Copyright (c) 2021 16 1 979 985 The Effectiveness of Zinc Micronutrients From Pumpkin (Cucurbita moschata D) Extract on the Testosterone Levels of Mice (Mus musculus L) <p>Various factors cause disharmony in the household. One of them is erectile dysfunction. This can be treated by providing aphrodisiacs and some minerals such as zinc to increase libido. One of the plants that contain zinc is pumpkin (Cucurbita morchata D ). This study was conducted to determine the differences in giving pumpkin skin, meat, and seed extracts to testosterone levels. This study uses a laboratory experimental research type. This study, using extract variables from the skin, meat and seeds of pumpkin (Cucurbita moschata D) and levels of the hormone testosterone. The sample used was male mice (Mus musculus) divided into control groups and three treatment groups. Data were analyzed using the One-way ANOVA statistical test.There were differences in testosterone levels in mice between the control group and the group of mice given extracts of meat, skin and seeds (p-value &lt;0.05).The highest testosterone level in mice was in mice given pumpkin seed extract.</p> Risa Purnamasari Nova Lusiana Linda Prasetyaning Widayanti Mei Lina Fitri Kumalasari Copyright (c) 2021 16 1 986 993 The Overview of Health Protocols for Preventing and Controlling of COVID-19 ; A Qualitative Exploration from Rural Area in Indonesia <p>Background: The COVID-19 has been spread to all over the world. Numerous people still not obey the health protocols that imposed by government. This study aisms to examine in depth the application of health protocols in preventing and controlling of COVID-19 in Muna District. Methods: This research employed an descriptve qualitative research design using semistructed interviews and a purposive sampling approach. The data collection methods was included indept interviews with some key-persons that responsible for COVID-19 prevention and control programs in Muna Regency of Souteast Sulawesi Province of Indonesia and community members. The informants of this study were the the head of COVID-19 task force as key informant; the head of law deparment, a member of the legislative commission for health, a military member and a police, as well as the public. The data was analysed thematically using Nvivo V.12 Plus Software. Results: 1) The role of militery and police as supervisors in implementing health protocol has been carried out well. 2) The implementation of individual health protocols has been carried out, however people with low level of awareness was still lacking about the importance of implementing health protocols such as washing hands, maintaining distance and wearing masks. 3) The application of health protocols for business actors has been carried out, however business owners may still open their businesses (finances matter) but they are required to apply health protocols. 4) The implementation of health protocols in community groups has been carried out and there are some members of the community who care about handling the acceleration of COVID-19, together with local governments to assist with the implementation of health protocols. 5) The regional government provides guidance to the community to participate in efforts to prevent and control Covid-19, conduct security/surveillance in every day, target mass crowds in some areas. Conclusion: Supervision and implementation among citizen in rural area must be regulated strictly and community empowerment is crucial.</p> Riky Ristanto Gari Rezky Aulia Yusuf Reza Aril Ahri Sitti Patimah Haeruddin Copyright (c) 2021 16 1 994 1004 Alteration of Iron, Zinc, Vitamin A Breast Milk Levels During Lactation Period Among Mothers of Low Birth Weight Infant Born at Preterm and Term <p>Background: Duration of lactation and preterm delivery were noticed as dominant factors affecting breast milk composition, including its micronutrient particularly iron, zinc and vitamin A. This study was to analyze the alteration of iron, zinc, vitamin A levels within colostrum and mature breast milk among mothers of low birth weight (LBW) preterm and term infants.<br>Methods: This cross-sectional study was conducted between July 2019 and April 2020 among mothers of LBW infant delivered at preterm and term at Dr. Soetomo hospital. Seventeen samples of breast milk were enrolled on each group. Respectively, colostrum and mature milk were collected between day 2 and 4, between day 15 and 20 after delivery.<br>Results: The iron levels on both groups did not change significantly during lactation period (respectively p=0,266 and p=0,845). Zinc levels were found significantly higher in colostrum of both groups, as well as vitamin A levels within colostrum in LBW preterm group (p&lt;0,05).<br>Conclusions: Higher levels were found in zinc within colostrum of both groups, similar to vitamin A in LBW preterm group. In contrast, iron did not differ significantly during lactation period.</p> Rizky Arisanti Maharani Roedi Irawan Risa Etika Copyright (c) 2021 16 1 1005 1010 The Effectiveness of Family Support Program based on Clean and Healthy Behaviour (CLHB) Indicators <p>A clean and healthy lifestyle behavior (CHLB) in the household structure is essential to maintain and improve the health of family members. However, in its implementation, consistency is needed so that clean and healthy lifestyle behavior can be carried out optimally based on ten indicators of a CHLB of household arrangements that the government has set. Therefore, this research was conducted using a cross-sectional design with a quantitative descriptive study design—population in the sub-district of Banguntapan, Bantul District, consisting of 826 households. The sample of this study was collected using a technique with a random sampling sample of 100 families and data collection using primary data and secondary data, and field observations. Based on the ten indicators of a clean and healthy lifestyle in the household structure, four indicators have not been appropriately implemented, namely giving exclusive breastfeeding (21%), weighing babies and toddlers every month (14%), doing physical activities every day (34%), and not smoking in the home (23%), with clean and healthy lifestyle coverage in the excellent category (66%). Therefore, it can be concluded that the application of a clean and healthy lifestyle in the Banguntapan, Bantul, household characteristics is good (66%) but has not met the government’s target because four indicators of a clean and healthy lifestyle have not been implemented optimally.</p> Rochana Ruliyandari Bambang Purwanto AA Subiyanto Suwarto Copyright (c) 2021 16 1 1011 1016 Reduction Surgery of Giant Hemifacial Neurofibromas: A Case Report <p>Neurofibromatosis type 1 (NF-1), first described by Von Recklinghausen (1882), is an autosomal dominant disease caused by a spectrum of mutations in NF-1 gene. We reported a case of giant facial neurofibromas in 26 years old male patient without family history of neurofibromatosis type 1. Features typical of neurofibroma, including an enlarged nerve fascicle composed of elongated nuclei and scant cytoplasmic cells, were identified. Excision was performed with preservation of parotid duct. The mass weight was about 5,5 kg. There were some challenges during the procedure, such as bleeding, hypovolemia, and preservation of vital structure.</p> Ruby Riana A Sitti Rizaliyana Radias Dwi Padmani Retno Handajani S. Perdanakusuma Copyright (c) 2021 16 1 1017 1020 Difference in DNA Methylation between Cleft Lip and Cleft Lip and Palate <p>It is suspected that environmental exposure to non-syndromic oral clefts, which includes cleft lip (CL), cleft lip and palate (CLP) has an effect on epigenetic mechanisms, particularly deoxyribonucleic acid (DNA) methylation. DNA methylation will be expressed during facial morphogenesis and have an impact on facial development. This study aimed to observe differences in DNA methylation between CL and CLP, between CL mothers and CLP mothers, and correlation between CL and CL mothers, CLP and CLP mothers.<br>This observational study used a sample of 13 patients diagnosed with CL and 14 patients diagnosed with CLP and their respective mothers. The test was performed using ELISA MethylFlashTM Global DNA Methylation (5-mC) ELISA Easy Kit (Colorimetric).<br>The median DNA methylation at CLP was 1.92 (0.23 - 14.07) and CL was 1.71 (0.08 - 8.47) (p 0.752 &gt; 0.05)). Median DNA methylation in CLP mothers was 0.997 (0.03 - 6.14) and in CL mothers 0.72 (0.23 - 6.16) (p 0.798 (p&gt; 0.05). Correlation test for DNA methylation of CLP with CLP mother r = -0.259 and (p = 0.394 &gt;0.05). Correlation test for DNA methylation of CL patients with CL mothers revealed r = -0.492 and (p = 0.087 &gt; 0.05).<br>The results of this study showed no difference in methylation between CL and CLP. This study found that DNA methylation between CL mothers and CLP mothers was relatively the same. This study also found no correlation between DNA methylation of CL and CL mothers, and between CLP and CLP mothers.</p> Ruby Riana Asparini David S. Perdanakusuma Retno Handajani Henydhar Bramastivira Mahdani Sulistyo Mulyo Agustini Copyright (c) 2021 16 1 1021 1025 Non-Communicable Diseases among the Elderly in Indonesia in 2018 <p>Non-Communicable Disease (NCD) is closely related to the aging process, social development, and increased risk factors. The study aims to analyze the prevalence of NCD among the elderly in Indonesia based on demographic characteristics. The study employed the 2018 Indonesia Basic Health Survey data. The survey used the multi-stage cluster random sampling method; it was a weighted sample of 85,358 elderly. In this analysis, the NCDs prevalence in the elderly includes hypertension, heart disease, bronchial asthma, chronic renal failure, diabetes mellitus (DM), stroke, and cancer determined based on a doctor’s diagnosis. The study result shows the prevalence of NCD in the elderly population in Indonesia, most of which are hypertension, mental-emotional disorders, depression, DM, and heart disease. Based on age group, the prevalence of hypertension, mental-health disorders, and depression tends to increase with increasing age, stroke and bronchial asthma are higher in the 70-79. DM and cancer were higher in the 60-69. Heart disease and kidney failure did not differ relatively between age groups. The prevalence of hypertension, mental-emotional disorders, depression, DM, heart disease, and cancer was higher in women. Still, asthma, stroke, and chronic kidney failure tended to be more in men. The study concluded that the most prevalent NCDs among older people in Indonesia were hypertension, mental, emotional disorders, depression, DM, and heart disease. NCDs have demographic characteristics.</p> Rukmini Rukmini Adianti Handajani Astridya Paramita Pramita Andarwati Agung Dwi Laksono Copyright (c) 2021 16 1 1026 1036 The Motivation of Preclinical Students to be A Doctor: A Turkish Perspective in the Private Educational Sector <p>Global estimates confirm the future need for more health cadres, including doctors. The study aims to investigate reasons to choose medicine as a career among students at a Turkish private medical school. A web-based cross-sectional study was conducted among the first-, second-and third-class medical students receiving education in the second semester of the 2017-2018 academic year at the BezmialemVakif University, Istanbul, Turkey. The universal sampling technique using a semi-structured questionnaire was recruited to collect the data. The SPSS 16.0 package used to analyze the data, and the statistically significant was considered at less than 0.05. The mean age of students was 20.3 + 4.3 years (range 18-23 years). More than half (57.3%) were females, and most of them (76.5%) lived with their parents. The majority (87.5%) of them inquired about medical college, and 85.1% of them won the medical school in the first trial. The main reasons to study medicine were personal preference(75.7%), studying medicine is appealing(52.4%),humanitarian profession(52.2%), the ready availability of work for physicians(42.2%), challenging carrier providing an opportunity to solve mysteries(40.8%), childhood dream(39.2%), profiting profession(35.7%), my parents’ vision and choice(31.8%), respectively. Almost the motives behind choosing to study medicine are similar across societies but different in the priorities.</p> Saad Ahmed Ali Jadoo Adil Hassan Alhusseiny ShukrMahmood Yaseen Ali Mustafa Al-Samarrai Copyright (c) 2021 16 1 1037 1045 Fluvoxamine Provide a Gastro-Protection Against Vitiated Insult <p>The etiology of peptic ulcer disease is multifactorial and remains an enigma over the last decades. The central parameter is the acid secretion; whose control is under the coordination of gastrin, acetylcholine, histamine, and prostaglandin. The treatment of peptic ulcers is a bi-armed tool, directed toward fighting microbial growth alongside acid suppression. However recent studies reported failure of the therapy due to recurrence of symptoms. Therefore, additional parameters should be considered including patient mood and psychological status. The present study aimed to introduce a new approach to the therapeutic regimen of ulcer disease using commonly used antidepressant drugs (fluvoxamine and fluoxetine) in a laboratory animal model of peptic ulcer induced by stress insult to act as a mood upset model in an attempt to mimic mood changes in human. The study was conducted on 4 groups of laboratory animals using control negative and control positive (misoprostol) against the tested drugs group (fluvoxamine and fluoxetine group). The result confirmed that fluvoxamine confers gastroprotective effects against ulcer insult compared to both fluoxetine or misoprostol groups. These results might significantly mean that antidepressant drugs could be utilized in peptic ulcer diseases or added at low doses to prevent ulcer insults due to whatever precipitating factors, such as, infection, alcohol, smoking, NSAIDs, and stress ulcer.</p> Sada W. Abdulqader Ibrahim M. Faisal M. G. Saeed Marwan M. Merkhan Copyright (c) 2021 16 1 1046 1052 The Effect of TROP2 Expression on Papillary Thyroid Carcinoma Development in Iraqi Patients <p>Background : Papillary Thyroid Carcinoma (PTC) is common type of the thyroid cancers, it’s onset in female at 30-50 years more than male and account for about 80% of all thyroid cancer cases . PTC diagnosis depend on histo-pathological finds of abnormal papillary architectures in the tissue as golden standerd of PTC diagnosis . Trophoblast cell surface antigen 2 (TROP2) is trans-membrane glycoprotein receptor ,encoded by Tacstd2 gene , observe in various cancer types specially epithelial cancers . TROP2 has the up-regulation ( overexpression) in cancer cells such as pancreatic , thyroid and ovarian cancers. Objective of the Study:It’s shown up-regulation of TROP 2 in PTC Iraqi patients by Immunohistochemical method.<br>Materials and Methods: The current study done in Al-Yarmook Teaching Hospital from March 2020 to January 2021 , was included 30 cases of PTC patients and 30 healthy subjects , all of subject’s age were more than 30 years . This study depend on collect of paraffin embedded PTC biopsies then used Immunohistochemical method to examined the present of TROP2 in all cases.<br>Results: This qualitative study shows significant expression of TROP2 in PTC patients compare with control groups .<br>Conclusion: The current study demonstrate effect of TROP2 expression on PTC development</p> Sadik A. Abdullah Copyright (c) 2021 16 1 1053 1055 Study of Asphervon Gum Effect on Diuresis, Spermatogenesis and Its Effect on Testosterone Level in Rat Male Blood <p>The effect of Asphervon resin gum on spermatogenesis, on the level of testosterone in the blood of rats was studied, and the effect of two dosages of the drug on diuresis of rats with an aqueous load was also considered. Data have been obtained on the quantitative change of sperm in the rat ejaculate, on the ability of Asfervon to reduce testosterone levels in the rat’s blood, and also, a pronounced dose has been revealed - the dependent diuretic effect of the drug Asfervon.</p> Samedinov Rustem Selyametovich Nabiev Abduvali Nabievich Tulyaganov Sattar Khakimovich Copyright (c) 2021 16 1 1056 1063 Long-Term Consequences of Intraoperative Spillage of Bile and Gallstones During Laparoscopic Cholecystectomy <p>Compared to open cholecystectomy, laparoscopic cholecystectomy is linked to a greater rate of iatrogenic gallbladder perforation. The long-term effects of gallstones and spilled bile are unknown. Over a three-year period, data were gathered prospectively from 1059 patients who had laparoscopic cholecystectomy. The operating techniques and postoperative outcomes of individuals who had gallbladder perforation were examined in detail. Long-term follow-up (varying from 24 to 59 months) was available for 92 % of patients. The gallbladder was perforated in 306 patients (29%); it was more prevalent in men and was linked to increasing age, body weight, and the presence of omental adhesions (all P less than 0.001). Patients with acute cholecystitis had no higher risk (P = 0.13). Pyrexia was more likely postoperatively in individuals who had gallbladder contents spilled (18% vs. 9%; P less than 0.001). Intra-abdominal abscesses formed in 1 (0.6%) of 177 patients with just bile leakage and 3 (2.9 %) of 102 patients with both gallstones and bile spilling, but no intra-abdominal abscesses formed in the 696 patients in whom the gallbladder was removed intact (P less than 0.001). During laparoscopic cholecystectomy, intraperitoneal leakage of gallbladder contents is linked to an increased risk of intra-abdominal abscess. Attempts should be undertaken to irrigate the operating field in order to drain spilt bile and retrieve all gallstones that may have been spilled during the process.</p> Rafa’a Sami Mahmood Al- Hayali Copyright (c) 2021 16 1 1064 1073 Medical Negligence Pertaining to Medical Records: A Retrospective Study <p>Background: Medical record is a vital document, and the doctor/hospital has to maintain these records properly. Most medical negligence cases rely heavily on medical records to establish a case of negligence against the doctor. Poorly filled or incomplete medical records will usually work against the favour of the treating doctor. Methods: A total of 242 cases of medical negligence cases decided by the National Consumer Disputes Redressal Commission (NCDRC) from 2015 to 2019 (5 years) were analysed, and negligence/deficiency in service was proven in 126 cases of these lacunae in the medical records were found in 37 cases. Results: Some of the common mistakes were missed entry in the medical records (37%), deficient consent form (20%) and missing medical records (17%). Conclusion: Medical records play a vital role in medical negligence cases. Not maintaining proper medical records can leave the doctors/hospital vulnerable in liability cases.</p> Sanjay Sukumar Copyright (c) 2021 16 1 1074 1079 Antibacterial effects of Ceftriaxone/Zinc Oxide Nanoparticles Combination Against Ceftriaxone resistant Escherichia coli isolated from Urinary Tract Infections <p>This study was designed to shed light on the issue of pathogenic bacteria resistance to antibiotic, and to overcome it by taking the advantages of nanotechnology. A hundred and twenty urine samples were collected from patients of different ages and of both genders who showed symptoms of urinary tract infections, from three hospitals in Baghdad. Ceftriaxone E. coli was detected and isolated from these samples. More recently, nanotechnology application has grown in importance in this problem. In this study, we used Zinc oxide nanoparticle to enhance the activity of ceftriaxone. Zinc oxide nanoparticle (ZnO NP) was prepared by biological method of processing of a fresh leaf aloe vera plants. Further characterization methods, which are Fourier, transform infra-red Spectroscopy (FTIR), and Atomic Force Microscopy (AFM) (which showed that the average diameter of the newly created ZnO NP is 45.55 nm) were applied for checking the created nanoparticle. Antimicrobial ability of ZnO NP showed an inhibition zone with a 13 mm in diameter. The isolates of E. coli showed a resistance to ceftriaxone at a concentration of 100 μg/ml. The results of inhibition activity of ceftriaxone antibiotic against Escherichia coli isolates of the current study showed a remarkable change when mixed with ZnO NP, in which ceftriaxone became affective in inhibiting Escherichia coli growth.</p> Sarah F. Al-Taie Dhafar N. Al-Ugaili Khawla A. Kasar Laith A. Yaaqoob Copyright (c) 2021 16 1 1080 1088 Effectiveness of Mixed Clove Flower Extract (Syzygium Aromaticum) And Sweet Wood (Cinnamon Burmanni) on the Growth of Enterococcus Faecalis <p>Failed root canal treatment can cause problems such as recurring pain and leave persistent bacteria in the root canal. One of the bacteria that often causes root canal treatment failure is Enterococcus faecalis. The use of a root canal irrigation agent such as sodium hypochlorite (NaOCl) can help inhibit the growth of bacteria in the root canal. The use of materials derived from nature can be used as an alternative material for root canal irrigation because they inhibit growth and kill bacteria and have fewer side effects than chemicals. Several studies have tried to prove the use of ingredients of natural origin in the form of a mixture and the results obtained are higher when compared to single use. Natural ingredients that are often used as herbal medicine include cloves and cinnamon. Objective. To determine the effectiveness of a mixture of clove flower extract (Syzygium aromaticum) and cinnamon (Cinnamon burmanni) on the growth of Enterococcus faecalis. Methods. Using experimental laboratory methods, with a research design in the form of Post Test Only Control Design, sampling by random sampling using 5 treatments and 5 repetitions. Statistical test using One Way Anova. Results. This study showed the diameter of the inhibition zone of Enterococcus faecalis bacteria in a mixture of clove flower (Syzygium aromaticum) and cinnamon (Cinnamon burmanni) extract at 5% concentration of 10.84 ± 0.73, 10% concentration of 15.00 ± 0.80 mm. The concentration of 15% was 16.32 ± 1.04 mm and based on statistical tests obtained a significant value of P &lt;0.01. Conclusion. The alternative hypothesis of this study is accepted and this study shows that there is an effectiveness of a mixture of clove flower extract (Syzygium aromaticum) and cinnamon (Cinnamon burmanni) concentrations of 5%, 10%, and 15% in inhibiting the growth of Enterococcus faecalis.</p> Sarahfin Aslan Masriadi Nur Rahmah Hasanuddin Andi Tenri Biba Mallombasang Nur Azizah A.R Copyright (c) 2021 16 1 1089 1094 Efficacy of Serum Levels of Antioxidants in Oral Submucous Fibrosis Patients <p>Background and Aim: Serum total protein, albumin and uric acid are plasma’s potent antioxidant defense; it comes out convincing enough to be used as a reliable marker of oxidative stress in the body and could be helpful in the early identification of oral submucous fibrosis (OSMF), against the other invasive and not so cost effective diagnostic adjuncts. Hence the present study was aimed to compare the serum levels of total protein, albumin and uric acid in oral submucous fibrosis patients.<br>Material &amp; Methods: Patients were assigned to one of three groups: Group one consisted of 25 healthy individuals, Group two consisted of 25 individuals with chewing tobacco habit without OSMF, Group three consisted of 25 patients with chewing tobacco habit with OSMF. Participants were instructed to fast overnight. On the following day between 8 and 10 AM, 5 ml of venous blood was drawn from each subject using a sterile disposable syringe taking care to prevent hemolysis. Assay of albumin &amp; total protein were carried out using the bromocresol green method and that for uric acid was carried out by biuret method.<br>Results: Mean serum levels of Total protein decreased from group I to group III; difference was not found to be statistically significant. Serum levels of Albumin decreased from group I to group III; difference was found to be statistically significant (p &lt; 0.05). Serum levels of Uric acid decreased from group I to group II; difference was found to be statistically significant (p &lt; 0.05).<br>Conclusion: Our findings suggest that the degree of oxidative damage in OSMF can be assessed by estimation of serum Total Protein, Albumin &amp; Uric Acid levels in affected patients. Underlying deficiency of antioxidants can be corrected by dietary supplementation of these antioxidants. This may be helpful for successful management of OSMF and for avoiding the consequences of malignancy.</p> Satyam Joshi Khushboo Desai Hemal Joshi Darshan Patel Neha Verma Riya Shah Copyright (c) 2021 16 1 1095 1102 The Differential Pattern in Skeletal-Dental Age and Duration of Growth Spurt based on Chronological Age and Gender Types (A Comparison Study Between Indonesian and Malaysian Children Populations) <p>Context: Growth and development is a continuous process that occurs intrauterine and continues until adulthood. In the process of reaching adulthood, children must go through various stages of growth and development, Growth is influenced by two main factors, namely internal (genetic) factors and external (environmental) factors. Internal factors include gender, obstetrics and race or ethnicity. Based on the background pattern above, the researcher wants to compare the difference in the duration of growth spurt between the Malaysian and Indonesian populations in terms of the Cervical Vertebrae Maturation (CVM) seen on the lateral cefalogram<br>Aims: to compare the differences in the duration of growth spurt between girl and boy in Indonesian and Malaysia Population based on Cervical Vertebrae Maturation (CVM) seen in the lateral cephalogram to determine the right time and orthodontic treatment plan in order to get maximum treatment results.<br>Methods and Material: The study was conducted in June 2020. The research variables were divided into 3 types, namely independent variables (chronological age), dependent variables (skeletal age and growth spurt duration) and controlled variables (Indonesian population children, Gender, CVM CS3 - CS4). Every sample that met the criteria was performed skeletal maturity analysis using Cervical Vertebrae Maturation.<br>Results: The boy sample required a duration of age to reach maturity, 17.93 months in Indonesia and 17.91 months in Malaysia. Meanwhile, the girs sample only required the duration of growth spurt, namely 6.59 months in Indonesia and 6.64 months in Malaysia<br>Conclusion: There is no significant difference between the duration of growth spurt in Indonesian Boy and Malaysian Boy and so does the duration of growth spurt for Indonesian and Malaysian girl.</p> Seno Pradopo Sindy Cornelia Nelwan Ardianti Maartrina Dewi Amalia Wimarizky Achmad Nadian Permana Diana Md Zahid Syiral Mastura Abdullah Copyright (c) 2021 16 1 1103 1110 Effects of Motivational Interviewing on the Self-Efficacy of Type 2 Diabetes Mellitus Patients <p>Diabetes mellitus is a metabolic disease that cannot be fully cured, thereby needing continuous treatment. As poor lifestyles increase in number and variation, the prevalence of diabetes mellitus is increasing every year. The purpose of this study is to determine the effects of motivational interviewing on the self-efficacy of type 2 diabetes mellitus patients. This study is an experimental study using Non-Randomized Control Group Pretest Posttest Design. The population was type 2 diabetes mellitus patients receiving treatment at Polres Tuban Polyclinic. Sample collection was performed purposively with a sample size of 58 patients. This study utilized univariate and bivariate analyses using the t-test for two dependent means. The results of statistical analyses showed the effects of motivational interviewing on the self-efficacy of type 2 diabetes mellitus patients in which there was an increase in the mean score of the intervention group from 27.3 to 36.8 (p=0.000). We concluded that motivational interviewing has an effect on improving the self-efficacy of type 2 diabetes mellitus patients.</p> Siska Puji Lestari Titin Andri Wihastuti Dina Dewi Sartika Lestari Ismail Copyright (c) 2021 16 1 1111 1117 Is there a Relationship between the Characteristics and Attitudes of Adolescents with Premarital Sex? <p>Background: Premarital sex is one of the high-risk behaviors of adolescents today. The characteristics of adolescents can also be a triggering factor for premarital sex. The purpose of this study was to analyze the relationship between characteristics and attitudes of adolescents towards premarital sex in East Java Province.<br>Methods: This is a quantitative research with a cross sectional research design. The data used were taken from Program Performance and Accountability Survey (2018) on adolescents aged 15-24 years in East Java Province. The sample of this study was 2796 adolescents after normal weight adolescents were carried out. The dependent variable in this study is the attitude of adolescents, while the independent variables are place of residence, age, gender, education, and economic status. Data collection using smartphones and instruments that refer to the IDHS and PMA. The data were analyzed descriptively and tested using chi-square with a significance level of 0.05.<br>Result and Conclusion: The results showed that the characteristics associated with the attitude of female adolescent was the place of residence with a significance value of 0.026. Age was related to the attitude of male adolescent with a significance value of 0.014. Education was related to the attitude of female adolescent (p-vaue = 0.000) and attitudes of male adolescent (p-value = 0.016). Economic status was related to the attitude of female adolescent (p-value = 0.000) and attitudes of male adolescents (p-value = 0.035). Characteristics had a relationship with adolescent attitudes in conducting pre-primary sex behavior. Therefore, it is necessary to have appropriate efforts to prevent adolescent risk behavior in accordance with the characteristics and needs of today’s youth</p> SiwiRizki Utami Muthmainnah Oedojo Soedirham YuliPuspita Devi Copyright (c) 2021 16 1 1118 1125 Inappropriate Use of Antibiotics among Children Under Five in Rural and Urban Communities of Cambodia <p>Background: Inappropriate use of antibiotics is a major treat especially in low- and middle-income countries with antibiotic resistant. Cambodia with high prevalence of infectious diseases among children under five, antibiotics use in urban and rural setting has not been clearly identified. Therefore, this study aimed to investigate the situation of inappropriate antibiotic use among children under five in urban and rural communities of Cambodia.<br>Methods: An analytical cross-sectional study was carried out in both urban and rural communities in Cambodia from September to November 2020 by structured questionnaire interviewed among 512 Cambodian caregivers on antibiotic use for the under 5 children.<br>Results: Among 512 children, majority were males both in urban (55.6 %) and rural (50.3%) settings, with the median age of 29.5 (3:59) months in urban and 30.0 (3:59) months in rural. The prevalence of inappropriate use of antibiotics among children under five was 79.3% (95% CI = 75.55 to 82.60), of which it was 26.0 % in urban and 53.3% in rural. Most of the rural respondents (82.1%) use antibiotics for bacterial infection diagnosed by doctors. However, it was only 52.6% in rural areas. Similar proportion of 58.6 % in urban and 61.1 % rural used antibiotics for fewer days than prescription.<br>Conclusions: Inappropriate use of antibiotics were found in more than 3 quarters of children under five, of which the proportion in rural areas were much higher than urban. The further investigation on factors contributing to inappropriate use of antibiotics should be conducted.</p> Sokontheavy Yong Kittipong Sornlorm Wongsa Laohasiriwong Copyright (c) 2021 16 1 1126 1135 Healthcare Facilities Choice for Maternity Care in Indonesia: Do Socioeconomic Factors Affects? <p>The government encourages maternity care in health facilities to reduce maternal mortality. The study aims to analyze the impact of socioeconomic factors on healthcare facilities’ choice for maternity care in Indonesia. The study used secondary data from the official report of the Indonesia Ministry of Health. The study takes all provinces as samples. Moreover, the study used the proportion of maternity care in health facilities as a dependent variable. On the other hand, the research analyzed four other variables as independent variables: percentage of the poor population, percentage of the population having health insurance, literacy percentage of population &gt;15 years, and the unemployment rate for population &gt;15 years. The study analyzed the data using a scatter plot. The study results show the lower the poor population in the province, the higher the proportion of maternity care in health facilities in that province. The higher the percentage of the population having health insurance in an area, the higher the proportion of maternity care in health facilities in that area. Meanwhile, the higher the literacy percentage of population &gt;15 years in a province, the higher the proportion of maternity care in health facilities in that province. Moreover, the higher the unemployment rate for population &gt;15 years in a province, the higher the proportion of maternity care in health facilities in that province. The study concluded that the four independent variables analyzed ecologically were associated with maternity care in health facilities.</p> Stefanus Supriyanto Ratna Dwi Wulandari Nikmatur Rohmah Agung Dwi Laksono Copyright (c) 2021 16 1 1136 1144 Echocardiographic Study in Preterm Infant with Hemodynamic Significant Patent Ductus Arteriosus <p>Background: Potential complications of hemodynamic significant patent ductus arteriosus (hsPDA) after birth include heart failure, need for respiratory support, renal disfunction, intraventricular hemorrhage, as well as long term altered growth and development. Nevertheless, clinical signs of patent ductus arteriosus (PDA) are not sensitive and specific enough. Therefore, echocardiography still remains the preferred method to evaluate the ductal patency in preterm infant. The present study aimed to evaluate the echocardiography characteristic in preterm infant with hsPDA.<br>Methods: A cross-sectional study was conducted on preterm infants aged 3-7 days with 24-336/7 weeks of gestation. Data taken were demographic, clinical and echocardiography. Diagnosis of hsPDA was carried out by echocardiography; defined as &gt;1.5mm diameter of ductus and &gt;1.4 left pulmonal artery and aorta (La/Ao) ratio. The statistical analysis was undertaken using SPSS 21.0.<br>Results: There were 11 out of 52 preterm infants diagnosed hsPDA. Mean birth weight was 1213±293 gram; Mean gestational age was 30.72±2.01 weeks. In hsPDA group, mean ductus diameter was 2.84±0.93 mm, mean La/Ao ratio was 1.56±0.26, and mean ejection fraction (EF) was 71.55±5.72%.<br>Conclusion: Echocardiographic evaluation is important for addressing hsPDA in preterm infants.</p> Sunny Mariana Samosir Martono Tri Utomo Mahrus A. Rahman Risa Etika Dina Angelika Kartika Darma Handayani Agus Harianto Copyright (c) 2021 16 1 1145 1150 Laser Application for Management of Traumatic Ulcers Following Local Anesthesia in Children <p>Prolonged local anaesthesia in soft perioral tissues may sometimes lead to accidental lip biting in small children forming a traumatic ulcer. Healing of such ulcers has been reported to enhance with treatment using low level laser therapy (LLLT). This case report describe two cases of traumatic ulcers due to lip bite following inferior alveolar nerve block caused during post anaesthesia period that were treated by LLLT. It resulted in better healing and lower pain, thus helping in healing and repair of the tissue.</p> Tanya Agarwal Needhika Registrar Sania Pranav Gupta Deepak Kurup Srishti Copyright (c) 2021 16 1 1151 1154 Critical Success Factor For E-learning in the Covid -19 Pandemic: A Case Study in Jordan <p>The questionnaire was in three parts. Part A was Availability of E-learning requirements related to technical, administrative and financial aspects Part B was Disadvantages of E-learning and Part C E-learning obstacles. And It was written using Google Forms, and the link was shared through multimedia. The reliability of instrument was determined. Data collected were analyzed using simple percentage and t_test and Anova was used to test the hypotheses. The result collected and analyzed showed that; the majority of study (84.0%) respondents were in the middle age between 29 to 48 years old. Males were accounted for less than one fifth (18.0%) of sample. And we found out through the results teachers with 12 to 22 years of experience found of obstacles of E- learning in comparison with those with the lowest number of years of experience, and that state schools have more obstacles than private schools.</p> Tasneem Alayed Tala. H. Sasa Nawal Bahtiti Eman Al Muhur Copyright (c) 2021 16 1 1155 1164 Relationship between Media Access and Social Support with Contraception Plans in East Java, Indonesia <p>Objectives: The percentage of contraceptive prevalence rate (CPR) and total fertility rate (TFR) of woman were indicators of the 2015-2019 National Medium Term Development Plan (RPJMN). Total fertility rates in East Java had decreased significantly from 1971 to 2018. The achievement of the prevalence of modern contraceptive use (CPR) in East Java was 63.1 percent based on the results of the Program Performance and Accountability Survey (PPAS, 2018). This achievement was far better than the national achievement which only reached 57 percent. However, this target cannot be achieved by all districts and cities in East Java. According to Green’s theory, the factors of predisposing, enabling and reinforcing are factors that can be related to behavior. The purpose of this study was to analyze the relationship between enabling factors (media access) and reinforcing factors (social support) related to contraceptive plans in women of childbearing age in East Java, Indonesia.<br>Study Design: This research was a non-reactive study using data from the IDHS (Indonesia Demographic and Health Survey) 2017. The unit of analysis in this study was all teenage respondents in East Java who met the requirements of the 2017 IDHS respondents.<br>Results: The results showed that the enabling factor associated with contraception selection plans was listening to information about contraception through radio (sig = 0.038), television (sig &lt; 0.001) and newspapers (sig &lt; 0.001). While the reinforcing factor associated with contraceptive selection plans was supports from health facilities (sig = 0.000) and from farmacy (sig = 0.023). The role of health workers was very minimal in providing information access to woman in the process of selecting contraception. It can be seen that almost all of the woman said that they did not get information either from field officers (41.91%), from health facilities (39.45%), from village clinics (42.52%), and from pharmacists (38.00%).<br>Implication to the fields: Based on the results of this study, there is a need for equal distribution of education in the selection of contraceptive methods to woman through optimizing the role of various health facilities, one of them through contraception officers, optimizing the use of mass media, especially television, radio and newspapers and magazines in disseminating information related to family planning.</p> Tasya Azelya Putri Andiani Muthmainnah, Muthmainnah Iswari Hariastuti Yuli Puspita Devi Copyright (c) 2021 16 1 1165 1172 Successful Treatment of Cerebral Tuberculoma and Tuberculous Lymphadenitis in an HIV/AIDS Patient: A Case Report <p>Tuberculosis is one opportunistic infection that may occur in HIV/AIDS patients. Its clinical presentation may depend on infected organs. A 37-years old man complained of left limb weakness followed by mild fever, weight loss of more than 10 kgs within two months, and swelling in his left submandibular region. Laboratory tests showed mild anemia, hypoalbuminemia, and positive serology HIV test. Histopathological examination of neck swelling showed inflammation of chronic granulomatous tuberculous with acid-fast bacilli positive in Ziehl Nielsen staining. Head CT scan with contrast, showed multiple isodense lesions with rim contrast enhancement accompanied by perifocal edema. Anti-Tuberculosis Drug and Anti-Retroviral Therapy were given as a combination treatment for this patient. Clinical and radiological improvement in the patient indicated good outcome and successful treatment.</p> Tenta Hartian Hendyatama Usman Hadi Copyright (c) 2021 16 1 1173 1180 The Balanced Score Card in Improving Performance in the Health Care Sector: A Literature Review <p>This paper is a literature review that discusses the use of the Blanced Score Card (BSC) to improve organizational performance, especially in the field of health services. The purpose of this study is to explore and connect theories from various studies. This paper identifies 21 articles with related topics published in the last decade. The results in this study indicate that BSC has been used in the health sector but is mostly used in the hospital sector, amounting to 87.5% (measuring performance against national standards and guidelines in the essential package of hospital services, assessing the quality of health services to strengthen health services in developing a country, integrated health care in hospitals, measuring service quality with the cost of patient care in the hospital, evaluate hospital performance, evaluation of the main performance of the hospital as an effort to achieve the hospital’s strategic goals efficiently) and in part small bada in the field of pharmaceutical services by 12.5% (measuring and evaluating the performance of pharmacies and stressing patient-centered services). While in other health service sectors there has not been any research that causes this cause based on this research it can be used to develop other research to examine the effectiveness of the use of BSC in the broader health service sector such as national health insurance, basic health services, or at the ministry or agency health.</p> Tirtana Brachnata Nur Wening Copyright (c) 2021 16 1 1181 1185 A Patient with AIDS and Embolic Stroke: A Case Report <p>Human immunodeficiency virus (HIV) infection is a global concern. Globally, 36.7 million people are living with HIV and 1 million people died at the end of 2016. There is an association between human immunodeficiency virus (HIV) infection with neurological manifestations. Between 1% and 5% of patients with HIV develop stroke. The pathogenesis of AIDS with stroke is still controversial. A 37-year-old male patient with AIDS had an embolic stroke. The diagnosis of the patient was based on clinical condition and the CT scan results of the head with contrast. The stroke-causing mechanism in patients is HIV-associated vasculopathy that results from accelerated atherosclerosis. After administration of antiplatelet and statin, the patient’s condition improves.</p> Troy Fonda Usman Hadi Copyright (c) 2021 16 1 1186 1190 Association between Cortisol and Infection Risk of Children with Acute Lymphoblastic Receiving Induction and Consolidation Chemotherapy in Dr. Soetomo General Hospital Surabaya <p>Background: Mortality due to Infection associated therapy in acute lymphoblastic leukemia (ALL) children remains high, although therapeutic success and survival rate are substantially improving.<br>Methods: This study used a pre and post-test group design for children aged less than 18 years with ALL newly diagnosed and receiving chemotherapy in pediatric patient of Dr. Soetomo hospital Surabaya.<br>Results: The study involved 25 subjects, 10 subjects were male, average age ranged from 3 to 9 years. The high risk-ALL subjects were 15 (60%), hyperleukocytosis 4 (16%) subjects and 7 (28%) subjects with leukopenia. Statistical analysis showed a significant difference in decreasing cortisol levels in week-4 compared to week-0 (p &lt;0.001) and an increased in cortisol levels between week-12 compared to week-10. The incidence of infection during induction phase is higher than the consolidation phase (40vs15). The relationship between the mean cortisol levels and the incidence of infection in general showed a significant difference in the induction phase of week-0 (p=0.029), week-4 (p=0.041), and week-6 (p=0.005).<br>Conclusion: In the induction phase, there is an association between mean cortisol levels and the risk of infection, but there is no such association in the consolidation phase.</p> Tutwuri Handayani Dewa Gede Ugrasena Mia Ratwita Andarsini Copyright (c) 2021 16 1 1191 1197 Mastoid Canals and Grooves in Human Skulls: A Dry Bone Study <p>Background: The mastoid canals and mastoid grooves are formed within the mastoid part of temporal bones of skull, these are present on the external surface of mastoid region, anterior to the occipitomastoid suture, behind and parallel to the petrosquamous suture and anteroinferior to the asterion. The study was conducted to observe the incidence of mastoid canals and grooves in dry adult human skulls.<br>Methods: Total of 120 dry adult human skulls consisting of 80 male &amp; 40 female were examined to determine the incidence of mastoid canals and grooves. The mastoid parts of both sides were examined for the presence of mastoid canals and grooves. Then length of mastoid canals was measured.<br>Conclusion: Out of the total of 120 skulls, mastoid canals were observed in 8.75% of skulls. The incidence of mastoid canals was 10% in females and 8.12% in males. The incidence of mastoid grooves was 10.42% of total skulls. It was 11.88 % in male skulls and in female skulls, it was 7.55%. The knowledge of mastoid canals and grooves of the temporal bones is very useful to the neurosurgeons and ENT surgeons while doing surgery to avoid severe bleeding.</p> UshaVerma Shavi Garg Amit Kumar Saxena Ritu Singroha Prachi SAneja Suresh KantaRathee Copyright (c) 2021 16 1 1198 1202 Predictor of Mortality COVID-19 in Two Referral Hospital in Surabaya, Indonesia <p>Introduction: World Health Organization had identified COVID-19 in January 2019. This disease is caused by SARS-CoV-2, which spread throughout the world and became a pandemic on March 20, 2020. COVID-19 is still a health problem because it has not clear whether the patients will be cured and survive from the disease or not. This study aims to determine the predictors of mortality from COVID-19 at Dr. Soetomo General Academic Hospital and Universitas Airlangga Hospital in Surabaya, Indonesia.<br>Method: This study was conducted in Dr. Soetomo General Academic Hospital (referral hospital for COVID-19, 1500 beds) and Universitas Airlangga Hospital (Referal Hospital for COVID-19, 600 beds). The study used data on patients with confirmed COVID-19 who were hospitalized at these two referral hospitals. Predictors of mortality were analyzed using logistic regressions.<br>Result: There were 247 COVID-19 patients enrolled in this study, all patients were tested positive PCR SARS-CoV-2. The main complaints were cough, nasal congestion, dyspnea, and fever. Significant predictor mortality in this study were age &gt;60 years old (OR: 3.24, 95% CI, 1.36 - 7.70), chronic kidney disease (OR: 5.71, 95% CI, 2.05 - 15.89), obesity (OR: 8.22, 95% CI,1.5 - 54.17), malignancy (OR: 6.025, 95% CI, 1.1- 33.00), coronary heart disease (OR: 5.31, 95% CI, 1.28 - 21.98) , and C-reactive protein &gt;10 mg/L (OR 4.603, 95% CI, 2.03 - 10.44).<br>Conclusions: Obesity and the presence of malignancy, chronic kidney disease, heart disease and age &gt;60 yearsold are the strongest predictors of mortality in people with COVID-19, despite high CRP results.</p> Usman Hadi Bramanton Tri Pudy Asmarawati Musofa Rusli Nasronudin Brian Eka Rachman M. Vitanata Arfijanto Copyright (c) 2021 16 1 1203 1209 Assessment of Patients’ Satisfaction with Fixed Partial Denture and its Correlation with Patients’ Evaluation of Clinicians <p>Introduction: Patient satisfaction affects clinical outcomes, patient retention, and patient-centered delivery of quality health care. It is a very effective indicator to measure the success of doctors and healthcare organizations. Hence, the present study was designed to investigate the relationship between patients’ satisfaction with Fixed Partial Denture and their perception regarding their clinicians’ in a dental school in India.<br>Methods: A cross-sectional survey was carried out among 250 patients attending the OPD of the Department of Prosthodontics of a dental college in Faridabad, India. Patients having atleast3 unit fixed prosthesis were interviewed regarding the demographic details, oral hygiene aids used, and dental care utilization. Patient satisfaction questionnaire and patients’ evaluation of dentist questionnaire was also administered. Data were statistically analysed using SPSS version 21.0 and significance was set at p&lt;0.05<br>Results: The overall PSQ score for the present study was 6.58+0.59. It was higher in males and increased with social class. Most of the patients agreed or strongly agreed with positive dentist conduct. There was a strong positive correlation between patient satisfaction scores and patient agreement with the dentist.<br>Conclusion: The majority of patients were satisfied with the services received at the facility. Social class was associated with a difference in the level of patient satisfaction</p> Uswah Khan Pankaj Dhawan Piyush Tandan Meena Jain Copyright (c) 2021 16 1 1210 1218 Production, Purification and Characterization of Bacteriocin Produced by Novel L. PentosusMW857478 for Enhancement of Food Safety and Shelf-Life of Paneer <p>This research paper is based upon the production, purification and characterization of bacteriocin by <br>L.pentosusMW857478 followed by its enhancement of food safety and shelf life of paneer. In recent <br>year LAB (Lactic acid bacteria) produced bacteriocinattract a great attention of researcher due to <br>their many potential applications. This paper focused on isolation, identification, evaluation of broad <br>spectrum inhibitory activity, production and purification, characterization and evaluation of food safety <br>and shelf life of paneer. Bcateriocin produced byL. pentosusshowedantagonistic activity against food <br>spoiling pathogens in broad range ofBacteriocin production parameter was optimized with pH 5.5 <br>incubated at 35°C forL. pentosus. Bacteriocin was purified by ammonium sulphate precipitation and <br>purified bacteriocin with single band on SDS-PAGE for molecular weight. The purified bacteriocin <br>stableat 2-10 pH and 30-75°C temperatures, suggesting L. pentosusa potent candidates for safety and <br>extending shelf life of paneer for 15 days.</p> Verinder Virk Garima Verma Chand Ram Copyright (c) 2021 16 1 1219 1228 Body Mass Index as an Indicator for Endometrial Biopsy in Premenopausal Women with Heavy Menstrual Bleeding <p>Background: Although Obesity is a risk factor of endometrial hyperplasia/ carcinoma, there is no consensus on using the BMI as a predictor for endometrial biopsy screening in patients with heavy menstrual bleeding in pre-menopausal women. Therefore, it’s clinically important to identify BMI cutoff values as a predictor for endometrial hyperplasia/ carcinoma in premenopausal women with heavy menstrual bleeding.<br>Aim of the Study: To determine the feasibility of using Body Mass Index (BMI) as an indicator to perform endometrial biopsy in premenopausal women presented with heavy menstrual bleeding.<br>Patients &amp; Methods: This is a cross-sectional study that was conducted in Obstetrics and Gynecology Clinic /Al-Emamain Al-Kadhemein teaching medical city in Baghdad where women 150 women who are 40-50 years old with heavy menstrual bleeding where sent for endometrial biopsy. 100 women had abnormal endometrial biopsy results, histopathological results of the abnormal endometrial samples were classified into following groups: hyperplasia without atypia, hyperplasia with atypia, and hyperplasia with atypia and cancer. Statistical analysis conducted to correlate The Body Mass Index (BMI) with the status of endometrial biopsy.<br>Results: 42% of the women with BMI≥30 kg/m2 have hyperplasia with atypia or carcinoma compared to 10% of women who BMI&lt;30 kg/m2 (p&lt;0.001). from 54 women who had hyperplasia with atypia in endometrial sample results; 77.7% of such patients were BMI≥30 kg/m2. Receiver operating characteristic analysis shows that using BMI ≥30 kg/m2 as a predictor of hyperplasia with atypia or carcinoma carries a sensitivity of 80.77 % and specify of 86.00% with area under the curve (AUC) value of 0.83 (CI. 0.75-0.92) and (p&lt;0.001). women with BMI≥30 kg/m2 has a relative risk (RR) of 3.98 of developing endometrial hyperplasia (without atypia or with atypia+carcinoma) and a relative risk (RR) of 4.11 of developing hyperplasia with atypia or carcinoma (p&lt;0.001).<br>Conclusion: Our results indicate that BMI regardless of the age is the highest risk factor for abnormal endometrial hyperplasia premenopausal women. Also, BMI≥30 kg/m2 has highest risk for developing endometrial hyperplasia with atypia or carcinoma. BMI≥30 kg/m2 can be used as predictor of endometrial hyperplasia in premenopausal women with heavy uterine bleeding.</p> Wafaa Salah Abd-Al Amieer Lamees Adnan Shubber Shaymaa Mareai Qaddoori Copyright (c) 2021 16 1 1229 1236 The Experience of Health Services in Handling Covid-19 Pandemic in Nine Provinces of Indonesia <p>Background: Indonesia’s experience in handling the Covid-19 pandemic is essential to prepare for future pandemic.<br>Aim: This research aims to know the experience of health services in handling Covid-19 pandemic in nine provinces of Indonesia.<br>Methods: This research used qualitative and case study approach, with a total of 94 informants coming from all levels of health service agencies from nine provinces in Indonesia. The data collection process was carried out by in-depth interviews, and data analysis were done by means of triangulation of sources between informants.<br>Results: Each province has a variety of local policies with the addition of varying amouns of the budget for handling Covid-19. In addition, the workload of health workers increased after the pandemic, and the availability of facilities, medicines, and single-usage medical materials were deemed inadequate in dealing with the Covid-19 pandemic.<br>Discussions: Accounting for the use of funds for handling Covid-19 as well as increasing surveillance capacity needed to prepare for future pandemic in Indonesia.</p> Wahyu Pudji Nugraheni Risky Kusuma Hartono Hasbullah Thabrany Copyright (c) 2021 16 1 1237 1250 Study Effecting of Hetero Chitosan Mineralization on Structure of Proteus spp <p>DE protection, demineralization, de colorization, and DE acetylation. Protein accesses were used to obtain chitosan from shrimp shell waste. Using FTIR, SEM and XRD. It was characterized. Also analyzed were the physiochemical parameter such as moisture content, hydrogen meter, viscosity, degree of DE acetylation and solubility The age of bacterial culture influenced its susceptibility to chitosan with cells being most prone to chitosan in the late exponential period. Hetero chitosan oligosaccharides were made up of partially DE acetylated chitosan’s 90%, 75%, and 50% DE acetylated chitosan’s. It was clear that in the presence of the hetero chitosan and their oligosaccharides, the growth of gram –negative bacteria is less inhibited than gram positive bacteria. These results revealed that hetero chitosan’s and their oligosaccharide rely on the antibacterial effects degree of DE acetylation, and molecular weight.</p> Walla Shaker Mahmoud Copyright (c) 2021 16 1 1251 1256 Extraction of Mannanase from Bifidobacteria and its Effect On Starvation <p>Any members of the human gut micro biota including members of the gut micro biota that promote health like bifid bacterium bifidbacterium spp. Catabolize manna’s for food. Few informationis available in the gut ecological niche regarding the enzymology of man nan deconstruction, below the biochemical properties if the first 5 subfamily 8 glycoside hydrolase (GH5 8) manna n as e derived from the biochemical properties of probiotic. The relationship between gut micro biota and biochemical metabolism to explore the relationship between gut micro biota. In traycomponents and some substances which are produced by the host, the primary intestinal microbe :bacteria and microbial species associated with dietary carbohydrates metabolism, strictly anaerobic and gram positive strain of specified bifid bacteria known as, B. Lon gum (60 percent of the sample )was the most commonly identified species followed by B. bifida (60 percent of the samples ), while B. Brief (21 percent).</p> Walla Shaker Mahmoud Copyright (c) 2021 16 1 1257 1262 Secondary Syphilis in the Second Trimester Pregnancy : Case Report <p>Background: Syphilis is a sexually transmitted disease caused by Treponema pallidum, which is transmitted through sexual contact, blood transfusion and transplacental from an infected mother to the fetus. Syphilis in pregnancy can cause complications including abortion, low birth weight, premature birth, neonatal death or congenital syphilis infection.<br>Case: A 39-year-old woman, 16 weeks pregnant, presented with a complaint of a small lump on the genitals accompanied by red patches on the palms of the hands and feet. Serological tests showed a reactive VDRL of 1:512 and a reactive TPHA of 1:640. Based on the history, physical examination and serological tests the patient was diagnosed with secondary syphilis in pregnancy. The management of this patient was given a single dose of Benzathine Penicillin G injection of 2.4 million units intramuscularly.<br>Conclusion: Early screening for syphilis in pregnancy isvery important to prevent complications in the fetus. VDRL serological test examination 3 months after therapy was carried out to determine the success of therapy. In this case, there was a decrease in the VDRL titer to 1:4 in the absence of skin lesions 3 months after therapy with benzathine penicillin G 2.4 million units intramuscularly single dose.</p> Wibisono Nugraha Eka Devinta Novi Diana Frieda Alfina Rahma Prasetyadi Mawardi Copyright (c) 2021 16 1 1263 1270 DNA Marker Screening for High-Risk Non-syndromic Hearing Loss Associated to Gene Mutations <p>Background:Congenital hearing loss is a debilitating disease affecting 1–3 out of 1,000 live births. According to WHO’s associated figures, in both ears, 278 million people globally suffer from moderate to extreme hearing loss. Most hearing-loss individuals live in developing countries. Many deafness and hearing problems cases were documented in our region. Those cases’ exact cause is still unknown, so we performed this study and aimed to screen DNA in high-risk Non-syndromic hearing loss patients in Arbil city. Methods: This researchscreened 132 blood samples from (80 newborns and 52 individuals) at (Hiwa Institute for deaf and mutes); their ages patients from 14 to 22 years old.MTRNR1genes were performed for molecular detection of mutant genes. The mutation gene wasamplified by multiplex tetra primer PCR. Result:G- mito-1555-F1, mito-1555-R1 (O), mito-1555-F2 (I), and mito-1555-R2 (I) hearing loss mutations were not observed in 132 blood samples from both classes and genotyped in MTRNR1. For mtDNA 12S rRNA mt.1555A&gt;G, no mutant alleles were detected in all of the tests, and no false-positives were identified.Using all primers, fifty-two samples were easily separated on 2% agarose gel; two were outer primers, and others are inner primers. Two separate bands were observed with 52 molecular samples (wild type at 254bp and control at 341bp).Of 80 samples, 28 have control bands at 341 bp. We did not find any mutation in our 80 samples. Conclusion: MTRNR1 mutation genes were not present in collected samples in deafness-related mutation. Genetic tests for the deafness gene can better diagnose infant congenital NSHL cases than conventional screening procedures.</p> Yasin Kareem Amin Copyright (c) 2021 16 1 1271 1277 The Role of Vitamin D3 in Improving Lipid Profile in Type 2 Diabetes Patients with Cardio Vascular Disease <p>Hyperglycemia is the major risk factor for microvascular complications in patients with type 2 diabetes (T2D). Vitamin D a fat-soluble prohormone, has wide-ranging roles in the regulation of many physiological processes through their interactions with. This aim of this study to investigate the role of Vitamin D3 and other biochemical to associated with the risk of type 2 diabetes with CVD. This study was carried out at the National Diabetes Center (NDC) / Mustansiriyah University during the period from 1/11/2020 to 1/2/2021. group of type2 diabetes with CVD patients, including 80 patients from both sexes (male and female), and apparently healthy control group (n=40) were enrolled. The highest significantly were in values of FBS , HbA1c, TC , TG , LDL) were (195.33 - 89.45 mg/dl, P= 0.001; 8.75 - 4.86 %, P= 0.001; 234.08 158.9 mg/dl, P= 0.001, 221.25 versus 83.37 mg/dl, P= 0.001 and 132.62 - 87.40 mg/dl, P= 0.001 respectively). Vitamin D3 levels were significantly lower for patients group than that in control healthy people were. The conclusion of this study found Vitamin D3 Deficiency showed effective on lipid profile in Type2 diabetes patients with CVD .</p> Yassamen Samer Abd Aon Sanaa Jasim Kadhim Inas Hassan Mohammed Al Khafaji Noor Thiar Tahir Copyright (c) 2021 16 1 1278 1285 The Protection of Traditional Knowledge of Medicinal Herbs for Just Health and Welfare Access for the Traditional Communities: A Comparison between India and Indonesia <p>The purpose of this study is to identify a model in the protection of traditional knowledge (TK) of medicinal herbs by adopting a comprehensive protection instrument, comprising positive and defensive protection. Based on the regulation of TK in international conventions and the national laws, the best practice for the protection of TK of medicinal herbs is by implementing a sui generis regulation that stems from the principle of justice in fulfilling the traditional communities’ rights over access to health and welfare.</p> Yenny Eta Widyanti Rahmi Jened Nurul Barizah Copyright (c) 2021 16 1 1286 1293 How is the Effect of Health Services on Toddler Diarrhea?: Ecological Analysis in Indonesia <p>Background: About 4 billion cases of toddler diarrhea occur worldwide each year. As many as 70% of toddler deaths in the world were caused by diarrheal infections. This study was intended to analyze the relationship of health services factors on the prevalence of diarrhea of infants in Indonesia.<br>Methods: Ecological analysis was conducted using secondary data from the Ministry of Health of the Republic of Indonesia report in 2018. All provinces were taken as samples. Apart from prevalence of children under five with diarrhea, 4 other variables analyzed as independent variables were, the availability of health workers, the coverage of diarrhea services and the coverage of oralit services to the patients, the coverage of zinc services to the patients, and the poverty factors in each provinces. Data were analyzed using cross-tabulation and spearman test.<br>Results: The results show from 34 provinces, the highest prevalence of toddlers is in the Papua Province. The results showed that the higher the percentage of poor people in the province, the higher the prevalence of diarrhea in toddlers (r=0.363). While the low availability of health resources, coverage of oralit use, and coverage of zinc use in patients were mostly occurring in provinces that had a high prevalence of toddler diarrhea. This means that there was an inverse relationship between the availability of health resources (r=-0.430), the coverage of oralit use (r=-0.149) and the coverage of zinc use in patients (r=-0.013) with the prevalence of diarrhea in toddlers.<br>Conclusion: It was concluded that according to bivariate analysis on the prevalence of diarrhea of toddlers showed that increasing availability of health resources in the provinces can help to reduce the prevalence of toddlers by assuming other variables remain.</p> Yuli Puspita Devi Milla Herdayati Muthmainnah Mahdiyyah Husna Nihar Imas Elva Khoiriyah Az-Zahra Helmi Putri Rahayu Copyright (c) 2021 16 1 1294 1304 The Role of Soluble HLA-G Serum Level in Therapeutic Response of Chronic Myeloid Leukemia Patients <p>Human leukocyte antigen-G molecules (HLA-G) have been suggested to play a role in immune evasion and progression of different malignancies by their tolerogenic activity, through interaction with inhibitory receptors on surface of immune cells.<br>The aim is to evaluate the role of the s HLA-G serum level in the prognosis and therapeutic responses to TKIs in CML patients.<br>Serum level of soluble HLA-G was measured for a total of 61 adult patients with CML, who were on regular TKI for at least 6 months whom attended the out-patient’s clinic of the Hematology Center in Basra, compared with 20 apparently healthy controls matched in ages and sexes to the patients using Enzyme Linked Immuno-Sorbent Assay (ELISA) technique.<br>Serum levels of HLA-G in CML patients was significantly higher than that in healthy controls (p=0.006). Elevated serum level of s HLA-G was significantly correlated with sex, BMI, duration of disease, Sokal scoring system.On the other hand, low s HLA-G serum level was significantly correlated with event free status (EF) of CML patients.<br>Lower level of serum soluble HLA-G in CML patients compared to healthy controls and it might be proved as a prognostic biomarker for CML patients.</p> Zainab Khalid Khaleel Hayfaa Salman Al-Hadithi Asaad AbdulAmeer Khalaf Omran Sukar Habib Copyright (c) 2021 16 1 1305 1311 Different Patterns and Distribution of Skull Fractures in Road Traffic Accidents <p>Background: The head is a common site of trauma in road accidents, and despite safety initiatives, the mortality rate for head injuries has not decreased. Despite the existence of a mandatory helmet law, both mortality and morbidity rates are on the rise. Head injuries are also associated with injuries to the neck, spine, stomach, abdomen, and pelvic cavity.<br>Objectives: To study different patterns and distribution of skull fractures in different kinds of road accidents.<br>Methods: In the Department of Forensic Medicine at Osmania General Hospital 4,213 post-mortem Examinations were carried out during the period ( August 2019 to January 2021. In 784 cases, death was attributed to Road Traffic Accidents. Head injury was present in 634 cases. In 471 cases out of 784, skull fractures were found. The data has been collected from PME reports and inquest reports, relatives and friends of the deceased<br>Results: Most frequently noted type of fracture is fissured in 59.8% of the cases. Injuries in RTA’s are almost always due to blunt force on cranial vault. Highest number of fractures are seen in temporal 100 (21%), Fractures occurring in cranial vault alone is 336(71.3%), BOS alone is 28(5.94%). Fractures extending into BOS are 308(65.3%). In the base of skull, overall highest frequency of fracture is found in MCF (alone in BOS) with 109 (23.1%), then in PCF (alone in BOS) is 71 (15%), least in ACF 39(8.28%). Only fracture MCF in all over skull is seen in 11(2.33%) cases, PCF 11(2.33%) cases<br>Conclusion: Commonest fracture of skull in road traffic accidents is the fissured fracture in the cranial vault, mostly in temporal bone. Fractures of cranial vault most frequently extend to middle cranial fossa and posterior cranial fossa till foramen magnum which are responsible for immediate deaths. Victims who survived till hospital admission are almost half in number. Strict enforcement of road safety regulations and improving emergency medical services may prevent untimely deaths and disabilities caused by RTAs.</p> Zameeruddin Ahmed Hashmi G Chandra Deepak Mohammed Taqiuddin Khan Copyright (c) 2021 16 1 1312 1320 lassification Study of Solid Medical Waste in Heet General Hospital <p>Is rated about (10-25 %) Of these wastes as hazardous and can affect the public health environment and pollution in particular, the medical waste m n this hospital if it is not handled properly can cause health problems for health workers in the hospital and for the patients and the community. Medical waste consists of hazardous waste and non - hazardous wastes include waste and hazardous waste infectious , disease, drugs , sharp tools, chemicals, toxic waste genetic and radioactive either non - hazardous waste fats included garbage and general daily waste of residues of food , materials , office and other.</p> Ziad Kamil Mohsen Dhafer F. Alrawi Copyright (c) 2021 16 1 1321 1328 Postoperative Incidence of Iatrogenic Gallbladder Perforation During Laparoscopic Cholecystectomy in Sulaimaniyah Teaching Hospital <p>Background and Objective: Iatrogenic perforation of the gallbladder has been reported in 28% of those patients who undergo laparoscopic cholecystectomy. It has been pointed out that gallbladder perforation can result in formation of gallstones and spillage of bile. The present study was carried out in order to investigate the postoperative incidence of iatrogenic gallbladder perforation during laparoscopic cholecystectomy in SulaimaniTeaching Hospital.<br>Patients and Methods: The present investigation was a single center, retrospective observational study that was carried out in Sulaimani Teaching Hospital in 2018-2019. The study sample included 99 patients who had undergone elective cholecystectomy. Required data on the possible risk factors and early outcomes and the patients’ demographics including age, BMI, and gender were collected. The collected data were analyzed through the Statistical Package for the Social Sciences (version 22.0).<br>Results: The results revealed that 80% of the patients were females. Also, 42.4% had no chronic diseases, while diabetes mellitus (DM), DM along with hypertension (HT), and HT were found to be the most prevalent chronic diseases among them with 18.2%, 16.2%, and 10.1% of prevalence, respectively. Only 17.2% of the patients had abdominal operation before, and acute cholecystitis and chronic cholecystitis were seen respectivelyin 13% and 17% of them. The most common causes of gallbladder perforation (GP) were found to be electrocautery(16.2%) and grasper (7.1%). Moreover, 33.3% of the patients were overweight (BMI between 25 and 29.9), 45.5% were obese (BMI between 30 and 34.9), and 20.2% had BMI of over 35. Most of the patients aged 30 to 49 (62.6%). A majority of the patients (94.9%) were found to have gallstones.<br>Conclusion: Iatrogenic gallbladder perforation is prevalent among patients who undergo laparoscopic cholecystectomy. However, laparoscopic cholecystectomy is still a better choice and associated with fewer complications compared to open cholecystectomy. Required measures need to be adopted for patients with perforated gallbladder in order to minimize spillage and remove as much spilled gallbladder content as possible.</p> Sarkhel Hama Tofiq Seerwan Hama Shareef Copyright (c) 2021 16 1 1329 1337 Esthetic Correction of Gummy Smile by Diode Laser <p>Background: Today, creating the perfect smile is a challenge, as treatment is needed. “gummy smile” (GS) Excessive gingival show (EGD), also known as the gummy smile, is a nonpathological disorder that causes esthetic disharmony in which more than 3 to 4 mm of gingival tissue is exposed while smiling.<br>The Aim: to assess the benefit of diode lasers in soft tissue surgery, including reduced bleeding, discomfort, infection, and scar formation.<br>Methods: A total of 18 patients were studied, including 4 (=22%) males and 14 (=77%) females aged between 18 and 37years, who attended Sumer Dental Specialty hospital, and Private Dental Clinic in ThiQar governorate, Iraq.Painless surgical operation was conducted where only 8 (44.44%) patients experienced mild pain during the first three postoperativedays and bloodless surgical field, which gives us a clear surgical field.<br>Results: Regardless of the procedure or follow-up time, the patient’s grin during therapy received a lot of positive feedback.<br>A gummy smile has a major impact on one’s self-esteem, interpersonal relationships, and physical beauty.The esthetic correction of a gummy smile improves facial beauty, self-esteem, and overall trust in the patient.</p> Hanaa Saleh AbdAl_mahdie Copyright (c) 2021 16 1 1338 1343 The Role of Biochemical Parameters in Prediction of Retinal Diseases and their Relationship to Cataract, Diabetes, and Hypertension, in Ibn Al Haytham Hospital, Baghdad, Iraq <p>This work summarize multiple protective roles serum Zeaxanthin, and Malondialdehyde, in association with metabolic profiles and as a risk of retinal disorder disease with cataract, diabetes, and hypertension, totally thirty healthy control group, and seventy-five patients group for both genders were studied. Retinal disorder disease subdivided after clinical diagnosis, into three major -subgroups, the first cohort was twenty-five patients suffers of cataract, the second twenty-five of diabetic patients, while the third group is twenty-five hypertensive patients. Lipid-profile, Fasting-insulin-levels, serum zeaxanthin and malondialdehyde, have been done to all groups. Important findings presented in the roles of serum zeaxanthin, and malondialdehyde, by similarities and differences, in retinal diseases with cataract, diabetes, and hypertension. The activity levels of serum zeaxanthin in hypertensive retinopathy patients (32.80±30.56 ng/mL), was non-significantly (P&gt;0.01) reduced compared to healthy control (88.85±139.31 ng/mL), in compression with the same patients for serum malondialdehyde MDA which expressed the highest level of MDA (2.456±2.149 μg/mL) among the rest groups, which was significantly higher (P&lt;0.05) than that in control (0.783±0.937 μg/mL), but the differences were non-significant (P&gt;0.05) compared to diabetic retinopathy group (1.839±1.515 μg/mL).<br>The activity levels are negatively associated with malondialdehyde levels in retinal disease patients with cataract, diabetes, and hypertension. Retinal disease patients with cataract, diabetes, and hypertension pathogenesis aren’t legitimately ensured. But multiple protective roles may be adopted in clinical diagnosis of retina, also in response to higher levels of oxidative stress, including serum malondialdehyde, and zeaxanthin, by fasting at least eight hours pre sophisticated lens surgery.</p> Huda H. Hassan Fayhaa M. Khaleel Khuthear A. Al Taee Copyright (c) 2021 16 1 1344 1352 Effect of Thermocycling on Surface Roughness and Shear Bond Strength of Acrylic Soft Liner to the Surface of Thermoplastic Acrylic Treated with Ethyl Acetate <p>Objective: To enhance bonding strength between thermoplastic denture base and acrylic soft liner through ethyl acetate surface treatment.<br>Materials and Methods: Modifications of thermoplastic acrylic denture base surface were investigated with SEM. FTIR was used to detect whether there was a chemical bond between thermoplastic acrylic and the organic solvent. A total of 80 samples were prepared and divided into 20 samples for the surface roughness test and 60 samples for the shear bond strength test. Failure type was assessed visually.<br>Results: Shear bond strength and surface roughness values of un treated samples were lower in comparison to surface treated groups; the greatest post thermocycling bond strength value was recorded for the samples treated with ethyl acetate following 1500 cycles.<br>Conclusions: Bonding strength was improved following ethyl acetate surface treatment.</p> Duha Qais Sabah Bayan S. Khalaf Copyright (c) 2021 16 1 1353 1360 A Comparative Study of Immunological and Molecular Techniques to Diagnose Human Cytomegalovirus in renal Failure Patients in Diyala Governor <p>Background: Cytomegalovirus (CMV)belongsto the herpes virus family, it has the ability to cause systemic infection and serious diseases in immunocompromised patients such as hemodialysis patients. The aim of this study was to investigate the prevalence of CMV infectionamonghemodialysis (HD) patients.. Renal failure is a condition in which the kidneys fail to remove metabolic end-products from the blood and regulate fluid, electrolytes and pH balance of extracellular fluids.Renal failure diesease is a wide dissemination among kidney patients inBa’quba City.<br>Aim: the study was carried out toImmunological andMolecular detection of CMV among renal failure patients whom admitted to IbnSina Center for kidney Dialysis in Baquba Teaching Hospital .<br>Patients and Methods: This study was conducted for the period from 1/12/2019 to 15/6/2020 in Baquba city in Iraq ,The study involved a total of 100 patients (62 males and 38 females) with kidney diseasewith ageand 50 healthy individuals considered as controls.First step includes Human Cytomegalovirus (HCMV) diagnosis in studied groupsbyEnzyme-Linked Immunosorbent Assay technique(ELISA) and second step was detection of Human Cytomegalovirus(HCMV) by Real-time Polymerase Chain Reaction.<br>Results: The obtained results showed that HCMV antibody was detected in renal failure patients by ELISAIgG (100%) while IgM were (15.0%) . Also,Distribution Of Detection of human cytomegalovirus DNA in serum between patients with renal failure and control by using sensitive molecular techniques, The obtainedresults showed that the HCMV DNA was detected in (6 out of 45) or 6 % in patients, while in control group (0 out of 5) or 0.0 %.Also, the HCMV DNA was detected in males 1(16.66) %. while in females was 5(83.34) %, while in control group (0 out of 5) or 0.0 %. with highly precent differences was noticing among both sexes. These results showed the age group 60-70 showed the highest rate of infection among other groups.<br>Conclusions: Real time PCR was rapid, sensitive and useful for diagnosing CMV infection in such patients.The results showed that Cytomegalovirus has relationship with chronic and acute renal failure and can affect the patient’s immune status. our results can provide an advanced diagnosis of viral infections among patients in hospitals in Iraq.</p> Ibtihal Hameed Mohsin IbtesamBadday Hassan Mohammed Abdul Daim Saleh Copyright (c) 2021 16 1 1361 1367 Study the Ability of Pseudomonas Aeruginosa Isolated from Different Clinical Cases to Biofilm Formation and Detection of Algd Gene <p>98 samples were collected from various clinical sources included ( Burns, wounds, urines, sputums, blood ) From the city of Baghdad , After performing the biochemical and microscopic examination, 52 isolates were obtained for Pseudomonas aeruginosa , 17 (32.7 %) isolates from burn infection , 12<br>( 23% ) isolates from Wound infection 11 ( 21.2 % ) isolates from urine infection , 7 ( 13.5 % ) isolates of sputum and 5 ( 9.6 %) isolates from blood . Bacteria susceptibility to form biofilm has been detectedby microtiter plate method, The results showed that 80 % of the bacterial isolates were produced the biofilm with different proportions , alg D gene ( alginate production ) has been detected by polymerase chain reaction ( PCR ) Which plays an essential role in the formation of the biofilm , The PCR results showed that the percentage of gene presence was( 95.4 % )</p> Hussamsalah al-deen Suaad Khalil Ibrahim Copyright (c) 2021 16 1 1368 1374 Association between Diabetes Mellitus Type-1 and Celiac Disease in Growth Retardation Iraqi Patients <p>This study was performed in the ministry of health- Specialized Center for Endocrinology and Diabetes <br>in Baghdad. Measurement of some biochemical parameters in serum of 93 patients with growth <br>retardation divided into two groups: group-1 (G1) control group without diabetes, and group-2 (G2) <br>with diabetes. The results showed that celiac disease reduces weight and consequently body mass <br>index. The Anti-tissue and Anti-Gliadin IgA increase significantly (p˂0.01) in G2 compared with G1, <br>were the Anti-tissue IgA titer reached 6.88 and 65.30 U/ml and Anti-Gliadin IgA titer reached 7.69 and <br>72.29 U/ml in G1 and G2 respectively. In addition, the results express positive linear relationship (p ˂ <br>0.01) among glucose level with Anti-tissue and Anti-Gliadin IgA in G2, using the regression equation of <br>Anti-tissue and Anti-Gliadin y=4.327+0.199 (S. glucose) and y=6.027+0.102 (S. glucose) respectively.</p> Ghuroob Dalil Dhamad Wildan Talal Mahmood Nadya Ghassan Abdul Kareem Ammar Kamal Jafar Copyright (c) 2021 16 1 1375 1379 Risk Factors of Uncontrolled Hyperglycemia in Children and Adolescents with Type 1 Diabetes Mellitus <p>Background: In Iraqi children with type 1 diabetes mellitus, glycemic control levels and risk factors <br>for uncontrolled hyperglycemia are unknown. The aim of the study to assess the factors that increase <br>the risk of uncontrolled hyperglycemia in children and adolescents with type 1 diabetes mellitus, and <br>identify levels of glycemic control in children and adolescents with type 1 diabetes mellitus.<br>Methods: A cross-sectional study was carried out from September 21 2020 until the end of May 2021 to <br>identify levels of glycemic control and assess the risk factors of uncontrolled hyperglycemia in children <br>and adolescents with type 1 diabetes mellitus, for the study sample which was 209 type 1 diabetics, <br>selected randomly from the visitors of a Faiha Specialized Diabetes, Endocrine, and Metabolism Center <br>(FDEMC). The American Diabetes Association assigned target HbA1c levels to patients based on their <br>age groups. Comparison has been made of well-controlled patients and uncontrolled hyperglycemia <br>patients. To assess each risk factor’s role in uncontrolled type 1 diabetes hyperglycemia, the Odds <br>Ratios were calculated.<br>Results: Only 17.2% of children and adolescents with type 1 diabetes mellitus were well-controlled <br>diabetes. Better glycemic control was related to age &lt; 6 years, BMI, and duration of type 1 diabetes &lt;5 <br>years. Glycemic control was not affected by gender, residence, socio-economic status. <br>Conclusion: Type 1 diabetes mellitus glycemic control among children and adolescents in Al-Basra/<br>southern Iraq varies widely, risking microvascular complications. In well-control type 1 diabetes <br>mellitus patients, females were higher than males and in the age group (1-6) years, higher than the <br>other age groups. While in uncontrolled patients with type 1 diabetes, about (57.2%) had an episode <br>of diabetic ketoacidosis (DKA). The major risk factors for uncontrolled hyperglycemia are excessive <br>sweet intake, fast food, and irregular meals</p> Shukur Abdulkareem Mahmood Majid A. Maatook Dhaigham E. Aatwan Copyright (c) 2021 16 1 1380 1387 Evaluating the Effect of Different Mouthwashes on the Titanium and Nickel Ions Released from Ordinary and Blue NiTi Archwires (An In-vitro Study) <p>Objectives: This studywas carried out to evaluate the effect of alcohol present in mouthwash on the Ni <br>and Ti ions release from ordinary andblue NiTiarchwire.<br>Materials and Methods: Sixty specimens of 2cm length from 0.017×0.025 inch maxillary Flexy and <br>Blue Flexy NiTi archwire (30 per each archwires) were immersed in 15 ml. distilled water, alcoholic <br>and alcohol-free Corsodyl mouthwashes (10 per immersing media for each archwire) for one and <br>half hour. After that, Ni and Ti ions released in mouthwashes and distilled waterwere measured using <br>atomic absorption spectrophotometer. Unpaired sample t-test and one way ANOVA test were used for <br>comparison between the archwire types and among different immersion media.<br>Results: Regarding Ni ion, the release of this ion washigher significantly in distilled water followed by <br>alcohol-free Chlorhexidine while the least amount released in alcoholic Chlorhexidine. For Ti ion, the <br>higher amount of Ti ion was released significantly from alcoholic Chlorhexidine followed by alcoholfree Chlorhexidine and the least amount was released in distilled waterin both types of archwires.Both <br>ions were released significantly more from conventional NiTi archwire in all mouthwashes.<br>Conclusions: Ions released from the tested archwires appear to be low with blue NiTi archwire. Ni ion <br>was released more with alcohol-free mouthwash and just the opposite forTiion.</p> Noor Nourie Abbass Abdullah Copyright (c) 2021 Noor Nourie Abbass Abdullah 16 1 1388 1394 Assessment of Soluble PD-1 and PD-L1 in Iraqi Women Patients with Breast Cancer with Toxoplasmosis <p>Toxoplasma gondii is an obligate apicomplexan intracellular protozoan parasite and considered the most <br>common global parasite which infects a wide range of warm-blooded animals and is the etiological <br>agent of one of the most common parasitic infections in humans. Breast cancer is the most common <br>cancer in women worldwide; nearly 1.7 million new cases were diagnosed in 2012, making it the second <br>most common type of cancer. The main objective of the present study was to investigate the seroprevalence of the anti-Toxoplasma gondii IgG antibodies in Iraqi breast cancer patients and to clarify <br>the role of soluble programmed death-1 (sPD-1) and (sPD-L1) in Iraqi Iraqi breast cancer patients with <br>toxoplasmosis. Enzyme Linked Immunosorbent Assay (ELISA) was used to detect anti- T. gondii IgG <br>antibodies in the sera of 108 patients with breast cancer and 50 apparently healthy controls. The results <br>showed that 26(26%) samples of sera patients have been founded breast cancer with toxoplasmosis, <br>80(74%) samples have breast cancer, 10(20%) cases have control toxoplasmosis (those patients were <br>had toxoplasmosis but showing no symptoms) and 40 (80%) cases samples were considered as a control <br>group without any infections. Sera (sPD-1 and sPDL-1) levels were determined by ELISA using a <br>quantitative sandwich enzyme immunoassay technique. The results showed that levels of sPD-1 and <br>sPDL-1 levels were significantly higher in patients group than healthy subjects (P&lt;0.01).</p> Maysoon K. J. Al-Muskakeh Ali N. Yaseen Muhammed A. H. Aldabagh Copyright (c) 2021 16 1 1395 1404 Risk Factors’ estimation of Non Communicable Diseases in Al-Basrah Province/ Iraq During 2020-2021 <p>Background: Non communicable diseases such as cardiovascular disease, cancers, diabetes, and <br>respiratory diseases are the leading causes of morbidity and mortality worldwide. They share risk <br>factors such as unhealthy diet, physical inactivity, smoking, and harmful alcohol use. The share of these <br>risk factors raises the probability of developing non-communicable diseases. The aim of study to assess <br>non communicable diseases risk factors in Al-Basrah province during 2020-2021. <br>Methods: A cross sectional study was implemented among 250 respondents aged from 18 years and <br>above according to random sampling method. Data was collected according to face -face interviews <br>with those attended to different primary health care centers in Al-Basrah province from September <br>2020 to February 2021.<br>Results: The study found 134(53.6%) respondents suffering from at least one of selected non <br>communicable diseases due to higher increase in behavioral risk factors. The proportion of participants <br>with unhealthy diet was 211(84.4%) while for overall salt intake was 207 (82.8%). the prevalence of <br>a currently smoker was 60 (24%) among participants and higher in males than females while for a <br>currently alcohol consumption the prevalence was 1 (0. 4%).the prevalence of physical inactivity was <br>176 (70.4%) and this percentage higher among females. The prevalence of overweight and obesity <br>(BMI&gt;25 kg/m2) was 35.6% and 38% and this proportion was higher among females than males.<br>Conclusion: Non communicable diseases risk factors were alarming increases among population of <br>Al-Basrah and this increase due to social transition and eating habits without any affective programs <br>for prevention of these risk factors and control of non-communicable diseases.</p> Sadiq Abdul Ameer Rahmah Shrouk Abdulrazak Hassan Alibraheem Rajaa Ahmed Mahmoud Copyright (c) 2021 16 1 1405 1413 Eradication of Biofilm Produced by Staphylococcus aureus and Pseudomonas aeruginosa in Wound Infection by Using Proteinase K Enzyme <p>This research is aimed to eradicate the biofilm formed by bacteria causing wound infection through <br>using proteinase K enzyme. For this purpose six different concentrations of proteinase K were used <br>for the degradation of biofilm produced by Staphylococcus aureus and Pseudomonas areuginosa. <br>These two species are the most common abundant bacteria causing infection by biofilm. Each of the <br>concentrations was kept in contact with the pathogenic bacteria for 1, 2 and three hours. After 3 hours <br>of incubation period the concentration (4 µg /ml) resulted in the highest eradication ability against S. <br>aureus biofilm, while the same concentration was no significant in the eradication of Pseudomonas <br>aeruginosa biofilm.</p> Estabraq A. Mahdi Sura S. Hasan Copyright (c) 2021 16 1 1414 1421 Study Some New Metallic Coordination Complexes and their Antibacterial Activity Against Methicillin- Resistant Staphylococcus Aureus <p>The ligands were prepared by condensing aldehydes with aromatic amines, then they were held together <br>with Ruthenium element Ru (III) and gold Au (III). Spectroscopic studies were conducted on them <br>and demonstrated that the gold complex was a good conductor opposite to the ruthenium complex <br>depending on its molar conductivity value. The complex was described by measuring the spectrum of <br>FT. IR (C. MASS JV-VISIBLE and C.H.N). From spectroscopic data, the octahedral geometry of the <br>ruthenium and Square Berner complex has been proposed for the gold ligands nodes. Furthermore, <br>ligands and complexes have been selected for the activity of the methicillin-resistant golden cluster <br>bacterium and the study of gene expression, i.e., the impact of ingested substances on RNA bacteria <br>(MAR).</p> Nevein Nasser Abotreek Mohammed Ahmed Awad Copyright (c) 2021 16 1 1422 1428 Load Deflection Properties of Small Diameter Titanium-Niobium-Tantalum-Zirconium Archwire(An In Vitro Study) <p>Objectives: This study aimed to evaluate the load deflection properties of new niobium-based beta <br />titanium archwire (Gummetal) in comparison with superelasticnickel titanium (SE-NiTi) and copper <br />NiTinickel titanium (Cu-NiTi) archwires.</p> <p>Methods and Material: Gummetal, superelasticNiTiand copper NiTiarchwire segments of 0.014-inch <br />diameter were examined by three point bending test, using Instron testing machine with 10 Newton (N) <br />load cell. Wire segments were tested at 2 and 4 mmdeflections, and at a temperature of 37±1ᵒC. Oneway analysis of variancewas used to compare the means of the groups at a significance of p ˂ 0.05.<br />Results: At 2 mm deflection, the maximum force values and unloading forces of Gummetalwere <br />significantly higher than those of the control (SE-NiTi and Cu-NiTi) archwires. At 4 mm deflection, <br />there was no significant difference between the maximum force values of Gummetal and SENiTiarchwires, however they were significantly higher than those of Cu-NiTiarchwire. Unloading forces <br />of Gummetalarchwire at 4 mmdeflection were initially significantly higher, then became significantly <br />lower than the control wires at 1 mm unloading deflection point.<br />Conclusions: The present study showed that Gummetalarchwirewas less efficient in providing <br />continuous forcesin comparison with SE-NiTi and Cu-NiTiarchwires.Gummetalarchwire cannot be <br />considered superelastic, and its use in the alignment phase may better be limited to mild crowding <br />cases.</p> Saja I. Alani Sami K. Al-joubori Copyright (c) 2021 2021-11-29 2021-11-29 16 1 1429 1436 10.37506/ijfmt.v16i1.17703 Influence of Tannin Extracts on Hematological and Production Properties of Male Rabbits Fed Mycotoxin Diets <p>Tannins, as secondary metabolism of plant products, have several beneficial properties, such as <br>antioxidant, antibacterial, and antifungal capabilities. These features have been used by the industry to <br>improve animal performance.<br>Twenty-eight healthy local male rabbits were weighted (average 1382.7 g) the animals were divided <br>regularly and equally into four groups, which contained control (fed basal diet), Mycotoxin group (fed <br>contaminated diet), the third group was fed mycotoxinsdiets plus giving orally tannin extract (125 mg/<br>ml), and the fourth treatment was given mycotoxinsdiets plus giving orally tannin extract (250 mg/ml).<br>The results demonstrated that tannin extracts, both concentrations of either 125 or 250 mg/ml, caused <br>considerable variations (p≤0.01) in weight growth when compared to the control or the mycotoxin <br>group. The body weight of the groups, however, was unaffected by these concentrations. Furthermore, <br>using these extracts on mycotoxin diets caused a change in the feed conversion ratio and feed intake <br>among rabbit groups, with the tannin groups showing lower values than the others.On the other hand, <br>when compared both groups, the mycotoxin and low dose of the tannin, with a high concentration of <br>tannin extract, 250 mg/ml, revealed significant values in liver enzymes (ALT and AST). Additionally, <br>the same treatment (250 mg/ml) significantly reduced creatinine and urea levels as compared to other <br>groups.<br>In conclusion, a high concentration of tannin extract, from black tea, showed beneficial effects on the <br>productive trials, the biochemical properties in male rabbits that fed contaminated mycotoxin diets.</p> Aseel Adnan Abdulhussein Mohammed Munis Dakheel Copyright (c) 2021 16 1 1437 1444 Tobacco Smoking as A Risk Factor in DNA Methylation of Repair Gene (MLH1) Using Cytobbrush from Lateral Border of the Tongue <p>Objective: The aim of this study was to evaluate the epigenetic effect in the process of oral carcinogenesis <br>by screening the methylation of repair gene in chronic tobacco smokers. <br>Material and Method: Study design: One hundred male volunteers, divided into two groups: the 1st<br>group consisted of 58 smokers, each consumed 20 cigarettes/day for at least 10 years; and the 2nd group <br>consisted of 48non-smokers who were consider as a control group.<br>The samples were taking from lateral border of the tongue by exfoliative cytology, and the extracted <br>DNA was treated with phenol-chloroform gDNA,Screening of methylation was done by Methyl <br>Specific PCR (MSP).<br>Results :- The results of this studyshowed significant effect of tobacco smoking in methylation of <br>MLH1 gene in site 1in comparison to non-smoker group,(P &gt; 0.05), with Odds ratio = 4.957 CI ().</p> Muayad Hashim Matloob Ameena Ryhan Diajil Copyright (c) 2021 2021-11-29 2021-11-29 16 1 1445 1450 10.37506/ijfmt.v16i1.17704 Amelogenin Localization in Periodontium Healing of Glucocorticosteriod-Induced Osteoporosis in Rabbit <p>Several recent studies had focused on impact of the changes in osteoporosis and its relation to the <br>periodontium healing process. The aim of our present study is to evaluate the effect of osteoporosis on <br>the periodontium healing immunohistochemicaly and on amelogenin. A total of twenty female New <br>Zealand rabbits were assigned randomly into two groups, a ten healthy (control), and an other ten <br>were subjected to a glucocorticoid induce osteoporosis. ligatures were haphazardly placed for the 1st <br>mandibular molars in order to induce periodontitis, then animals had been sacrificed after 4 weeks <br>and the specimens were processed routinely for a serial decalcified sections for the histological <br>and the immunohistochemical study on “ amelogenin”. The histological results of our present study <br>had revealed a delay in the process of healing of periodontium of the experimental group as compared <br>to the control group. The immunohistochemical findings had shown a higher immunoreactivity of <br>the periodontium cells of the osteoporotic groups than the control groups. This study found that the <br>osteoporotic state induced by glucocorticoids may cause a delay in the healing by inducing periodontitis <br>with a mild to moderate immunoreactivity to amelogenin as compared to the control group.</p> Nada M. H. Al-Ghaban Nawar Bahjet Kamil BanA.Ghani Jamil Bushra Habeeb Al-Maula Copyright (c) 2021 2021-11-29 2021-11-29 16 1 1451 1457 10.37506/ijfmt.v16i1.17705 Trajectories of Salivary Hormones in Pregnant Women with Anxiety and there Effect on Gingival Health Condition <p>Background: Hormonal fluctuations during pregnancy caused several of the physiological changes <br>designed for promoting growth and delivery of a healthy child. A delicate balance between immune <br>tolerance to fetal antigens and immunity against infectious pathogens needs to be maintained.<br>Aim: Assessing salivary cortisol and progesterone hormones in anxious pregnant women and their <br>impact on gingival health status.<br>Subjects and Method:A sample of 80 womenwith healthy pregnancy divided into two groups <br>including 40 pregnant women with high anxiety levelmatch in age with40 pregnant womenhavea low <br>level of anxietyin Baghdad Teaching Hospital of Baghdad city in Iraq were participated in this study. <br>Plaque index was used for assessing dental plaque accumulations.The gingival conditionwasmeasured <br>by the gingival index.Unstimulated saliva sample was collected for measuringsalivary cortisol and <br>progesterone.<br>Result: The strong validity and reliability of Beck Anxiety Inventory (BAI) Arabic translationscale <br>make ita good indicator for measuring anxiety in Iraqi pregnant women.Data analysis of this study <br>revealed high anxiety group has an elevated level of salivary cortisol, decrease salivary progesterone <br>withsignificant differences. The correlations coefficients between salivary cortisol and progesterone <br>among the high anxiety group was negative strong significant correlation while non-significant <br>correlation in low anxiety group.The plaque indexwas higher among the high anxiety group with <br>significantdifferences. Concerning the gingival index; there isno significant differences among two <br>group. Positive strong significant correlation between plaque and gingival indices in high anxiety <br>group.Regarding the correlation between gingival index and salivary progesterone in low anxiety <br>group, it waspositive strong significant.While a positive significant correlation between plaque index <br>and salivary cortisol in both groups.<br>Conclusion: This study reported increase stress-hormone cortisol among a high anxiety pregnant <br>women which hasan effect ongingival health subsequently. Gingival inflammation in the high anxiety <br>group was a plaque induce gingivitis, while a pregnancy gingivitis was found among the low anxiety <br>group</p> Noor Majid Hameed Athraa Mustafa Alwaheb Copyright (c) 2021 2021-11-29 2021-11-29 16 1 1458 1465 10.37506/ijfmt.v16i1.17706 Male Children Sexual Abuse in the Transkei Region of South Africa <p>Background: Reporting of male-to-male sexual abuse is associated with stigma and discrimination. <br>It is not only trauma to a child but also to a family. It is under researched and under estimated in a <br>community. Even when abused children have grown up and become adults the abuse remains a painful <br>secret in their lives. This scar of child sexual abuse stays for a life time. It also fuels the spread of HIV/<br>AIDS in society. <br>Objective: To study the sexual abuse among male children in the Transkei region of South Africa. <br>Method: This is a retrospective study, carried out between 2007 and 2011 at the Sinawe Centre of <br>Mthatha General Hospital, Mthatha, South Africa. <br>Results: There were 38 cases of male child sexual abuse (MCSA) reported between 2007 and 2011. <br>There was only 1 case reported in 2007, 3 in 2008, 6 in 2009, 10 in 2010 and 18 in the year 2011. Of <br>these, 3 (7.9%) were 5 years old, 17 (44.7%) were 10 or less years, and 9 (23.7%) were between the age <br>of 11 and 15 years of age. Of the perpetrators 20 (52.6%) were known to the victims, 16 (42.1%) were <br>unknown 2 (5.2%) were family member of the victims. There was delay in reporting. Genital injuries <br>were observed in 8 (21%) cases, and physical injury in only 2 (5.2%) cases. All the victims were HIV <br>negative and post-exposure prophylaxis compliant. <br>Conclusion: There is an increasing trend of male children sexual abuse in the Transkei region of South <br>Africa. It requires urgent attention by the law enforcement authorities</p> B Meel Copyright (c) 2021 2021-11-29 2021-11-29 16 1 1466 1471 10.37506/ijfmt.v16i1.17707 An Experience on Facts about Teaching Forensic Medicine to Undergraduate Medical Students in South Africa <p>South Africa is struggling with an enormous amount of forensic pathology services because there is <br>an extreme pressure on forensic pathologists to deal with the high number of medicolegal autopsies <br>in the country. There are only five dozen forensic pathologists in South Africa who have to handle at <br>least 80 000 autopsies per year. Medical officers, who have only received training as undergraduates in <br>medical school, are expected to conduct these autopsies. Therefore, undergraduate teaching and training <br>must be strong enough so that these young graduates can handle cases without any compromise in the <br>quality of the outcome.This report is going to highlight the necessity of teaching forensic medicine at <br>undergraduate level in South African medical schools. It will also discuss the shortcomings in medical <br>school teaching programmes.</p> B Meel Copyright (c) 2021 2021-11-29 2021-11-29 16 1 1472 1476 10.37506/ijfmt.v16i1.17708 Repeated Sexual Assault and HIV Seropositivity: A Case Report <p>Background: Sexual assaults are on an epidemic level in the Transkei region of South Africa, despite <br>the government efforts to bring it down. Human Immuno-deficiency Virus (HIV) is also proportionally <br>high in this region of South Africa. <br>Objective: To highlight the problem of sexual assault and HIV infection in the Transkei region of South <br>Africa. <br>Case history: This is a case report of 15-year-old teenagers (SD) who was a schoolgirl in standard <br>6 when she was assaulted. SD was sexually assaulted repeatedly by an older man of 28 years. She <br>was found sero-converted on HIV testing. On physical examination the introitus was red and bruised. <br>A copious amount semen-like infected fluid was observed in her vagina. The case history, findings, <br>beliefs, and compliance with HIV drugs are discussed. <br>Conclusion: There is high risk of repeated sexual assault and HIV infection in the Transkei region of <br>South Africa. Government must look deeper to prevent these rape attacks as well as HIV infection</p> B Meel Copyright (c) 2021 2021-11-29 2021-11-29 16 1 1477 1480 10.37506/ijfmt.v16i1.17709 Ethical Issue Related to ‘Save the Life of the Patient’ at Mthatha General Hospital in South Africa <p>Background: Resuscitation of a patient with life threatening conditions, before referral to another <br>department or hospital, is a legal obligation on the part of the health professionals. Several deaths occur <br>every year in hospitals and health care centres without an emergency management. <br>Objective: To highlight the ethical issue related to ‘Save the Life of the Patient’ at Mthatha hospital in <br>South Africa. <br>Case History: This is the case (AM) report of a 16-year-old Grade 10 learner who was assaulted <br>physically as well as sexually. She was bleeding from a stab wound to her when she was brought to the <br>Mthatha General Hospital’s (MGH) casualty. She was then referred to the Bedford hospital for repair of <br>the tendon of her right wrist as recommended by the doctor on duty. The patient was referred to Sinawe <br>Centre for forensic management, where she collapsed during an interview. The patient was taken on <br>a stretcher to the MGH casualty for an emergency treatment of her blood pressure. The history of the <br>patient and the care duty of the health professionals are discussed. Ethical issues are also highlighted in <br>relation to the ‘preserve the life first’ principle in this case report.</p> <p>Conclusion: There was a serious breach in duty of care by medical officers in the Mthatha hospital, <br>South Africa. It is an ethical priority to save the life of the patient.</p> B Meel Copyright (c) 2021 2021-11-29 2021-11-29 16 1 1481 1485 10.37506/ijfmt.v16i1.17710 Guilty of Unnatural Death but HIV Positive in Transkei Region of South Africa <p>Background: HIV infections and crime have a complex relationship. It is difficult to understand its <br>unnatural causation. HIV positivity has never accounted as an underlying cause of death in persons who <br>have died unnaturally. <br>Objective: To correlate HIV infection with non-natural deaths in the Transkei region of South Africa.<br>Method: This is a record of a review study at Mthatha (Umtata) General Hospital. The data was <br>collected from the office of medical superintendent and from the forensic pathology laboratory. <br>Results: There has been an increase in the Mthatha General Hospital mortality rate by almost two- fold <br>in last five years. Suicidal deaths like hanging have increased by one and half times. Fatal poisoning, <br>possibly suicidal, has increased about five to sixtimes. Gunshot injuries, which may or may not be <br>suicidal, have increased by one and half times. The accurate estimate of the prevalence of the HIV/<br>AIDS is a necessity to measure the costs of disease for effective strategic planning. <br>Conclusion: The HIV infection is increasing along with natural and non-natural deaths in the Transkei <br>region of South Africa. It must be considered in the category of diminished responsibility as a mentally <br>sick.</p> B Meel Copyright (c) 2021 2021-11-29 2021-11-29 16 1 1486 1491 10.37506/ijfmt.v16i1.17711 Post-retrenchment and Retirement of Mineworkers: A Poor Quality of Life in Transkei Region of South Africa <p>Background: Former mineworkers are sandwiched between scare resources and little hope of getting <br>re-employment. They do not have enough savings to maintain their families. The expenditure is at its <br>highest when they return from the mines, as the children are grown up and are in secondary or senior <br>secondary school. Many are not re-employable because of poor health, and some are disabled.<br>Objective: To highlight the problem of retrenched mineworkers in the Transkei region of South Africa.<br>Method: The case histories of these mineworkers were recorded either at Benefit Examination Clinic <br>(BEC) or at the forensic pathology laboratory which is situated in the chest section of the Mthatha <br>Hospital, Mthatha.<br>Results: There were 2027 former mineworkers examined at BEC between 1997 and 2000. Of these, <br>172 (8.48%) were re-examined and only 51 (2.5%) received compensated over the period of four years. <br>The examination of mineworkers has decreased from 1997 (29.6%) to 2000 (3.94%). There were 55 <br>(2.71%) died before they received their benefit of examination.<br>Conclusion: Retrenched mineworkers are frequently under psychosocial pressure, including their <br>families and the community. Extreme poverty, sickness, and disabilities co-exist among these retrenched, <br>retired mineworkers in the Transkei region of South Africa.</p> B Meel Copyright (c) 2021 2021-11-29 2021-11-29 16 1 1494 1497 10.37506/ijfmt.v16i1.17712 An Unusual Case Report on Co-Morbidity with Sexual Assault in the Mthatha Hospital, South Africa <p>Background: Comorbidity or the co-occurrence of mental disorders and substance abuse disorders is <br>common among victims of sexual assault. Occasionally life-threatening conditions have been observed <br>in these patients which need immediate medical attention. <br>Objective: To highlight the unusual case report of co-morbidity with sexual assault in a rural hospital <br>in South Africa. <br>Case History: A seven-year-old girl was referred from a health center to a rural hospital with a history <br>of sexual assault over four days by an unknown man. She was threatened to be killed in the case of <br>disclosure. Her aunt suspected that she had a problem as she was not walking normally. Then she <br>opened and described the whole incident. She was having a history of vaginal discharge with vomiting <br>and diarrhea along with mild fever. She was also depressed. On physical examination, genital injuries <br>including a ruptured hymen were confirmed. She was having muscle guarding of abdominal muscles. <br>The victim was refused admittance as she was labeled a case of rape, but after persistent persuasion of <br>the staff, she was admitted and later operated on for acute appendicitis. This case history, her physical <br>examination, and the difficulty in getting admission to a surgical ward are discussed in this report. <br>Conclusion: Sexual assault may be associated with co-morbidity like acute appendicitis. Doctors must <br>be vigilant in identifying such life-threatening co-morbidity to save the life of a patient.</p> B Meel Copyright (c) 2021 2021-11-29 2021-11-29 16 1 1498 1502 10.37506/ijfmt.v16i1.17713 Sexual Assault, Pregnancy and HIV Infection among Young Girls in the Transkei Region of South Africa. Case Reports <p>Background: Rape continues to be one of the biggest challenges facing South Africa, alongside <br>poverty &amp; joblessness that the government is trying hard to eradicate. Transkei region of the Eastern <br>Cape can best be described as deeply rural with bad roads, unclean water supply, limited electricity, few <br>telephone connections, very limited access to transport and health services. Violence including sexual <br>assaults is a common problem in this region. <br>Objective: To highlight the problem of sexual assault, pregnancy, and HIV infection among young <br>girls in Transkei region of South Africa. <br>Case History: This is a retrospective case report from the register of sexual assault at Sinawe Center <br>of Mthatha General Hospital, Mthatha, South Africa.These are reports of two young girls who were <br>repeatedly raped. Histories and findings of the physical examinations are described. Consequences of <br>teenage pregnancies and HIV transmission are discussed. The issue of consent and teenagers’ partners’ <br>responsibility is highlighted. Solutions to reduce re-victimisation are suggested. <br>Conclusion: There is problem of sexual assaults, pregnancy, and HIV infection among young girls <br>in the Transkei region of South Africa. There is a need to control this epidemic of sexual assaults to <br>prevent HIV spread, and to prevent unwanted pregnancies</p> B Meel Copyright (c) 2021 2021-11-29 2021-11-29 16 1 1503 1506 10.37506/ijfmt.v16i1.17714 External Examiner’s Report for the 4th Year Medical Examination in Forensic Medicine: Is It A Magician With a Wand? <p>Background: Externalexaminers are generally considered people of integrity, and honesty. The right <br>to pass or fail students is within their discretion. The examination report that they produce must be <br>congruent with their actions. The post examination comment by the external examiner for the 4th year <br>medical examination in Forensic Medicine stating that students were weak in Forensic Medicine was <br>not consistent, however, with the marks he awarded to the students. <br>Objective: To validate the report of external examiner with his action. <br>Method: Every year an external examiner is invited to conduct an examination of 4th year MB. ChB <br>students in Forensic Medicine. There were three specialist examiners who conducted an examination <br>of medical students. The external examiner (Mr. X) has been invited from a pioneer institute for the <br>last three years. Mr. X also made changes, and approved course contents at the beginning of the year. <br>Results: There were 97 students who sat for the examination. Of these, 93 (96%) passed and none of <br>them failed. Only 4% were required to write a supplementary examination. All scripts were marked by <br>all three examiners. One third of the students (31/32%) who received the lowest marks were exposed to <br>the external examiner for an oral examination, together with their scripts. The external examiner made <br>no change of marks in six cases. Of the other 24 students, six students marked were decreased up to 4%, <br>while the remaining 18 students’ marks were increased by up to 20%20%. One student has awarded a <br>distinction (75%) by the external examiner (increased from 55% to 75%). <br>Conclusion: The comment of an external examiner was, however, not congruent with his actions. <br>Therefore, the external examiner is a magician, but without a magic wand.</p> B Meel Copyright (c) 2021 2021-11-29 2021-11-29 16 1 1507 1511 10.37506/ijfmt.v16i1.17716 Poverty and Non-Natural Deaths among Former Mineworkers and in their Families in Transkei Region of South Africa <p>Background: Thousands of former mineworkers across former Transkei have already passed on, are <br>disabled, or died due to either mining related diseases or non-natural ways of dying such as accidents, <br>suicide, or homicide. Many ex-mineworkers have died prematurely, placing a strain on their families. <br>This has led to dysfunctional families and has created the conditions for children from these families to <br>commit crime. Compensation could be claimed for mining related maladies, but the non-natural deaths <br>are unbearable for a resource-stricken family. <br>Objective: To highlight the problem of poverty and non-natural deaths among former mineworkers, <br>and to relate the impact on their families. <br>Method and Material: This research, a retrospective qualitative study on former mineworkers and their <br>children, was carried out in 2000-01 at the forensic pathology laboratory of Umtata General Hospital <br>complex, Mthatha, Eastern Cape, South Africa. The records of interviews performed during medicolegal autopsies in 2000 and 2001were reviewed at Umtata (Mthatha) General Hospital mortuary. The <br>interviews were routinely performed in relation to victims who were admitted at the Umtata (Mthatha) <br>General Hospital mortuary.<br>Results: Eighty-four family records were analysed. Of these, 21 (25%) were found to be former <br>mineworkers and their immediate family members. There were five mineworkers and 15 children of <br>mineworkers. Only one was the spouse of a mineworker who had died unnaturally, and one person <br>was unaccounted for in these numbers. Three mineworkers died because of firearm injuries, one was <br>assaulted by someone with a knobkerrie, and another one died because of alcoholic intoxication. Two <br>of them had heavy drinking habits. Three mineworkers were unemployed. The causes of unnatural <br>deaths were as follows: five stabbed, two from firearm injuries, one from a motor vehicle accident, <br>one assaulted with blunt object, and three committed suicides by hanging and poisoning. Most of the <br>victims consumed alcohol. <br>Conclusion: A high number of former mineworkers died an unnatural death. Poverty could be an <br>associated as an underlying cause of death.</p> B Meel Copyright (c) 2021 2021-11-29 2021-11-29 16 1 1512 1517 10.37506/ijfmt.v16i1.17717 A case Report on the Obstacles in Research Publications in a Rural University, South Africa <p>Background: Universities are the powerhouse; they generate knowledge through research all over <br>the world. A university without research is a black hole that swallows the taxpayers’ money without <br>contributing much to them. <br>Objective: To highlight the obstacles to carry out research in a rural university of South Africa. <br>Case History: Ms. X was enthusiastic to carry out the research in the university She had so far produced <br>about 100 research articles in peer reviewed journals, despite all odds. She was appreciated nationally <br>and internationally for her work, but the university under study has humiliated and victimized her. This <br>report on Ms. X highlights how this rural university is being disadvantaged by not allowing people to <br>go further. The author will try to present his personal views after informal discussions with various <br>academics and researchers. The highlights of the de-motivating and inhibitory factors are discussed in <br>this manuscript. <br>Conclusion: The main obstacle is lack of transparency and abuse of power at this rural university. The <br>university functions like a secretive society.</p> B Meel Copyright (c) 2021 2021-11-29 2021-11-29 16 1 1518 1524 10.37506/ijfmt.v16i1.17718 Prevalence of Tobacco Smoking Among Ex-Mineworkers of Transkei, South Africa <p>Background: The smoking of tobacco is one of the most important confounding factors contributing to lung pathology. It is therefore essential to know the degree of prevalence of smoking in the community of former mineworkers of the Transkei, who constitute one of the groups in South Africa most affected by smoking. Objective: Prevalence study of smoking among former mineworkers of Transkei, South Africa Method: This is a record review study from the Benefit Examination Clinic, which was carried out once a week at the chest section of Mthatha Hospital in Transkei. Results: 466 ex-mineworkers were studied for their smoking habits. Non-smokers were lower in number at 97 (21%), the number of ex-smokers was 226 (48%) and smokers numbered 143 (31%). Little more than three-fifth were smokers - 89 (20%) - and ex-smokers - 142 (30%) - who were in their middle age (40-59yrs). Between 1% and 5% were observed to be in the extreme ends of their age groups (&lt;40 &amp;&gt;60). It was observed that among the ex-miners who had worked in the mines for a period of 10 to 19 years, the ex-smokers constituted 26%, the smokers 17% and non-smokers 9%. The ex-smokers, smokers and non-smokers were in a proportion of about 5:3:2. The population of smokers peaked from 15% for those with a mining history of nine or fewer year’s underground to 42% for those who had been mining for 10 to 19 years and fell almost at the same rate from 42% to 22% in the group with 20 or more years of mining. Non-smokers among the sample increased from 5% (nine or fewer years) to 9% in the 10 to 19 years group, and ultimately settled at 7% when they had worked 20 years or more. Conclusion: The prevalence of smoking among ex-mineworkers is high (79%) in the Transkei region of South Africa.</p> B Meel Copyright (c) 2021 2021-11-29 2021-11-29 16 1 1525 1530 10.37506/ijfmt.v16i1.17715 A case report on alcohol and crime in the Transkei region of South Africa <p>Background: Alcohol and crime are two-in-one, inseparable from each other as most of the crime <br>in South Africa is carried out under the influence of alcohol. Many deaths as well in South Africa are <br>attributed to alcohol consumption but, despite that, alcohol is available everywhere in country. <br>Objective: To highlight the problem of alcohol and crime in the Transkei region of South Africa. <br>Method: This case study is based on the case report histories which were obtained from the Mthatha <br>Forensic Pathology Laboratory. <br>Results: These are ten cases that provide examples of alcohol related deaths. All these deaths were <br>caused by stabbing (except one) where the perpetrator or victim or both were intoxicated. The primary <br>underlying cause of these fight was either money or girlfriends. The history, culture and circumstances <br>of these deaths are discussed in this manuscript. <br>Conclusion: Alcohol is a major cause of crime in the Transkei region of South Africa.</p> BL Meel Copyright (c) 2021 2021-11-29 2021-11-29 16 1 1531 1535 10.37506/ijfmt.v16i1.17719 Why Do Women Not to Go for Abortion in a Designated Legal Abortion Facility in Transkei Region of South Africa? <p>Background: The implementation of choice arising from the Termination of Pregnancy Act of 1996 <br>(Act 92 of 1996) is a challenge in South Africa as there are many abortions that are still carried out <br>by illegal abortionists in the Transkei region. This raises the serious question as to why the women do <br>not prefer to go instead to a designated legal abortion clinic which carries out safe abortions in South <br>Africa.<br>Objective: To study the underlying factors which prevent women from going for an abortion to <br>designated legal abortion facilities.<br>Method: This qualitative research was carried out by medical students who visited both the legal and <br>illegal facilities in Mthatha in 2015 for their assignment during the rotation of their subject of speciality.<br>Result: The legal clinics are not user-friendly, the staff misbehave with the girls, they cast doubt on <br>their confidentiality, and they take a long time to do the abortions, while the illegal abortionists charge <br>money for their services but they are quick and keep confidentiality.<br>Conclusion: Legal abortion clinics are not user friendly.</p> BL Meel Copyright (c) 2021 2021-11-29 2021-11-29 16 1 1536 1541 10.37506/ijfmt.v16i1.17720 A Study on Chronic Obstructive Lung Disease (COPD) in Ex-mineworkers of the Transkei. A Misunderstood Clinical Condition <p>Background: There is no diagnostic indicative mark for chronic obstructive pulmonary disease <br>(COPD). It is a general assessment of the patient leading to a diagnose as COPD. In most cases, there <br>is a mixed picture of severe lung diseases including fibrosis, tuberculosis, silicosis, etc. In fact, COPD <br>is the commonest and terminal entity in the majority of ex-mineworkers who were suffering primarily <br>from the dust-lung-disease which is complex in origin. <br>Objectives: To establish the prevalence of chronic obstructive pulmonary diseases in ex-mineworkers <br>of the Transkei, South Africa. <br>Methodology: During the period of 28 May 1997 to 27 May 1999, 2080, ex-mineworkers were <br>examined at the Benefit Examination Clinic (BEC) in the chest section of Umtata (Mthatha) General <br>Hospital (UGH). Physical examination along with standard chest x-rays were carried out; the mining <br>history of each worker was taken, and identification forms were completed. <br>Results: There were 13% of ex-mineworkers suffering from chronic obstructive pulmonary disease. <br>Out of them, 56% of the subjects (COPD) were associated with conditions like chronic bronchitis, <br>emphysema, and bronchial asthma. The rest (44%) were associated with other lung diseases like <br>tuberculosis and silicosis. Out of this number, 33% were associated with tuberculosis and 11% with <br>silicosis. Most of the ex-mineworkers were suffering from an association of diseases ranging from <br>simple tuberculosis to silicosis and their secondary effects. <br>Conclusion: Every seventh ex-mineworkers were suffering from chronic obstructive pulmonary <br>disease. About half of them were having associated parenchymal diseases like tuberculosis and silicosis.</p> B Meel Copyright (c) 2021 2021-11-29 2021-11-29 16 1 1542 1546 10.37506/ijfmt.v16i1.17721 A case Report on the Estimation of Contractual Damage Caused by a Health and Rural University, South Africa <p>Background: Contractual claims are mandatory for an employee who has either resigned/died or <br>finished his or her contractual obligations. It is legally binding to an institution according to labor law. <br>Case History: BM was such a victim who has been admired nationally and internationally but <br>dehumanized in his own university through the process of three malicious disciplinary enquiries, two <br>suspensions, forensic auditing, and stoppage of salary and birthday bonus. He was not allowed to go to <br>the forensic pathology laboratory despite of the fact that he was all along a forensic pathologist. <br>The harassment of BM became more rigorous in 2008, although he was victim long before that. The <br>head of faculty was promoted later to a position of a university head. BM had an interest in research <br>so he was publishing prolifically, but that disturbed the balance of the faculty staff as the rest of them <br>contributed very little as per the report of the external assessor.1<br>The harassment was not limited only <br>to mental harassment but also at the same time financial losses to Mr. BM occurred. The Occupational <br>Specific Dispensation (OSD) scale is supposed to be given to every health professional in South Africa <br>who is working in the public sector and registered in Health Professions Council. The OSD scale started <br>in 2009 but was not implemented for Mr. BM. Instead, Mr. BM, underwent a series of disciplinary <br>enquiries. He was cleared all the charges and retired in 2018. The history of his research, contractual <br>damages and other collateral losses are discussed in this report. <br>Conclusion: There is heavy contractual damage which the Department of health and rural university <br>has to pay from 1996 to 2018. This damage refers mainly to the short fall of salary and bonuses along <br>with financial losses related to research.</p> BL Meel Copyright (c) 2021 2021-11-29 2021-11-29 16 1 1547 1553 10.37506/ijfmt.v16i1.17722 A Study on the Characteristic Features of Covid-19 Deaths in a Regional Hospital in Mthatha in the Eastern Cape, South Africa <p>Background: Covid-19 is an acute health emergency to human beings all over the world. This pandemic <br>has destabilised the day-to-day life of almost everyone. It is a challenge to scientists and politicians to <br>initiate a return to normal human life from the grip of Covid-19 so that the economies of countries do <br>not stop growing.<br>Objective: To study the characteristics of Covid-19 deaths in a regional hospital in Mthatha in the <br>Eastern Cape, South Africa.<br>Method: It is a retrospective record review study of the cases of patients in Mthatha Regional Hospital <br>(MRH) in South Africa who were not able to be saved.<br>Results: There were 100 deaths in MRH. Of these 57 (57%) were females and 43 (43%) males. The <br>average age was 63.3 years. Shortness of breath was the most common presenting symptom followed <br>by weakness, a cough and fever. More than half of the Covid-19 cases had associated co-morbidity such <br>as hypertension (50%), diabetes (37%) and HIV (15%). The mean oxygen saturation (SpO2) at the time <br>of admission was 75.5±17 on pulse oximetry. <br>Conclusion: The covid-19 mortality was 1.3 times higher among females in the regional hospital under <br>study. The majority of the victims were suffering hypertension and diabetes.</p> Kaswa RP B Meel Copyright (c) 2021 2021-11-29 2021-11-29 16 1 1554 1559 10.37506/ijfmt.v16i1.17723 Correlation of Oral Health Status with Chronic Obstructive Pulmonary Disease in a Tertiary Care Hospital <p>Background: Oral health is considered to be an important factor in respiratory diseases like Pneumonia <br>and chronic obstructive pulmonary disease (COPD). Poor oral health and abusive habits like smoking <br>have been implicated as an independent risk factor for the development of COPD, but few studies have <br>evaluated the association between oral health and COPD.<br>Aim: To assess the oral health and habits of COPD individuals visiting our OPD for their regular <br>checkups. <br>Subjects and Methods: We performed a case-control study of oral health among patients with COPD <br>exacerbators and healthy non COPD controls. Cases had experienced ≥1 exacerbation in the previous 12 <br>months, while controls were healthy patients reporting to the dental OPD for a regular dental checkup. <br>We evaluated oral health status, recorded dental symptoms/habits, and Pulmonary Function Test (PFT). <br>In a subset, we performed blinded dental exams to measure bleeding on probing, probing depth, clinical <br>attachment loss, periodontitis severity, plaque index, gingival index, and carries risk. We evaluated <br>associations between oral health and COPD using logistic regression. <br>Result: Self-reported oral health status and objective dental findings had variations between cases and <br>controls. Participants with COPD had multiple missing teeth, a higher amount of plaque, and calculus <br>indicating poor dental health. Oral candidiasis, keratotic white lesions, and oral melanosis were also <br>present. <br>Conclusion: In the present observational study, we found that participants with COPD have poor oral <br>health that compromised their quality of life probably precipitating an acute exacerbation. The incidence <br>of COPD can be reduced by good oral hygiene measures and preventive oral care.</p> Nandita Shenoy Alisha Ono Idris Vishak Acharya Junaid Ahmed Ashok Shenoy Suchitra Shenoy Copyright (c) 2021 2021-11-29 2021-11-29 16 1 1560 1569 10.37506/ijfmt.v16i1.17724