Profiles of Diabetic Ketoacidosis in Multiethnic Diabetic Population of Malaysia

Purpose: To outline first-time patient profiles of diabetic ketoacidosis (DKA) in the absence of reported incidence and mortality rates of DKA in Malaysian diabetic population.Methods: A retrospective cross-sectional study was designed and all medical records of patients with a discharge note of DKA were reviewed. Admissions from January 2009 to December 2011 were included. Data were analyzed in terms of socio-demographic variables in order to provide incidence and mortality rates. Medical history, as well as physical and biochemical characteristics were analyzed to report epidemiology of DKA patients.Results: Out of a total of 207 admissions for DKA, 132 were selected for the present study. Female (62.9 %), Malay ethnic (47.0 %) and the elderly (45.1 years and above) contributed most to DKA episodes. Type 2 diabetes mellitus (51.1 %) patients were prone to develop DKA. Most patients experienced mild to moderate episode of DKA by the time they sought medical attention. Although, there was no significant relationship between chronic co-morbidity and occurrence of DKA, hypertension (54.5 %), dyslipidemia (43.0 %) and cardiac disorders (35.6 %) were, however, the most frequently observed co-morbidities. Non-adherence (43.2 %), sepsis (31.9 %) and respiratory tract infection (12.2 %) were the most encountered precipitating factors for DKA episode. Mortality rate was as high as 17.6 %.Conclusion: With a higher incidence and mortality rate of DKA in Malaysia, the patterns observed in this study seem to be different from those of developed nations. Further extended studies need to be undertaken to elaborate regional and national patterns of DKA.Keywords: Incidence, Mortality, Diabetic ketoacidosis, Diabetes, Hypertension, Cardiac disorders, Dyslipidemia, Comorbidit

Improvement of Food Industry Business Continuity in Sulawesi through Islamic Business Approach

Since 2012-2016 there are 124 units of food industry business unable to maintain its business survival (Department of Industry and Trade of Southeast Sulawesi Province, 2017). Besides, has not been applied consistently Islamic business morals. This study aims to know and analyze: (1) The influence of business morals on business performance, (2) Implications of business performance against business continuity, (3) Effect of government policy of Southeast Sulawesi Province in strengthening the influence of business morals on business performance. The method used in the achievement of the objective is the survey method that is to conduct field visits to the food industry as the respondents of the research of 150 business actors distributed in Kendari City as many as 86 business units and the City of Bau-Bau as many as 64 business units. Data collection using questionnaires and documentation studies. Data analysis techniques use (1) descriptive statistics,(2) quantitative analysis with professional PLS Smart program aids. The study concluded that (1) Islamic business morals can improve the performance of the food industry business but exemplary and consistency in business has not been maximized by business actors, (2) Good business performance has positive implications for improving business continuity from economic aspect, social, environmental and fiscal aspect. However, the growth of capital, profit and labor has not been optimal in business actors, (3) The Provincial Government of Southeast Sulawesi can take over the congregational prayer in the mosque or at work through regulation to strengthen the improvement of business actor business, besides maximizing the expansion of business base with mediation to syariah financial institutions and providing technical training programmed food production and free sustainable for business actor. Keywords: morals Islamic business, goverment support, business performance, business continuity

Sensitivity and Specificity of Cystatin C in Detecting Early Renal Impairment in Hypertensive Pregnancies

Purpose: To determine the cutoff point of cystatin C for the detection of renal impairment in hypertensive pregnancies.Methods: A cross-sectional study was conducted in an antenatal clinic and ward at Hospital Universiti Sains Malaysia, Kelantan, Malaysia from January 2009 until January 2010. Sixty four pregnant patients beginning at 2nd trimester, aged of 16 to 55 years and hypertensive, including gestational hypertension, chronic hypertension with superimposed preeclampsia, preeclampsia and unclassified hypertension, were included in the study. Consenting patients were required to provide 5 ml of blood and 24-h urine. Serum and reagent, N Latex cystatin C, were equilibrated at room temperature and measured by particle-enhanced nephelometric immunoassay (PENIA) using a BN II Dade Behring Nephelometer SystemResults: The mean age of the patients was 37.06 ±4.32 (range: 24 to 46 years). A majority (64.1 %) of the patients were in the second trimester of pregnancy and delivered in the gestational period of 38 - 40 weeks (54.7 %). The number of patients in chronic kidney disease (CKD) stages I, II, III, IV and V were 25 (39.1 %), 18 (28.1 %), 18 (28.1 %), 2 (3.1 %) and 1 (1.6 %), respectively. The mean systolic blood pressure was 149.59 ± 18.79 mm Hg, and diastolic blood pressure 91.53 ± 10.33 mm Hg. The cutoff point in detecting renal impairment using cystatin C was > 0.74 with 84.6 % sensitivity and 86.7 % specificity for second trimester and > 0.81 with sensitivity of 76.9 % and specificity of 60.0 % in detecting renal impairment for third trimester.Conclusion: The cutoff point in detecting renal impairment for second trimester is better than for third trimester since it maximizes the value of sensitivity and specificity.Keywords: Cystatin C, Sensitivity, Specificity, Renal impairment, Hypertension; Pregnanc

ANALISA PENINGKATAN KAPASITAS JALAN AMPERA KOTA PONTIANAK UNTUK PERGERAKAN LALU LINTAS TAHUN 2025

Growth and development of the city is what brings the impact of problems on the traffic system. Where the increasing number of vehicles passing that is not comparable with the infrastructure and facilities that have been available. St. Ampera stretches along 2.9 km with a width of 6 meters road is one of the main roads located in the city of Pontianak. St. Ampera is categorized as the Secondary Arterial Road Network and is included in the upgrading of the inner ring road network in Pontianak. The government is building a new line of St. Ampera which is under construction. Although it is hampered by social problems, the government will continue to gradually build up 400 to 500 meters of roads annually and promise to complete the new route in an undetermined time. Therefore, this condition causes the need for performance analysis and how big the role of the new path in distributing traffic flow to St. Ampera based on the degree of saturation and speed of traffic flow at present (year 2015) up to 10 (ten) years to be coming (year 2025).In analyzing the effect of road capacity change, it is necessary to have traffic data in the form of traffic volume, side barrier and road geometry before and after the new road is constructed so that it can be seen and compared how big the influence of the new road to the performance on St. Ampera. And the need for an overview of changes in vehicle volume so it can be known how much influence the increase in road capacity to the degree of saturation and speed.Based on the comparison data can be seen in 2015 from traffic pattern survey results in 2015, seen peak hour flow for segment A occurred at 11:00 to 12:00 pm by 666 smp / hour and for segment B occurred at 17:00 to 18:00 WIB of 808 smp / hour. From the comparison of degree of saturation based on vehicle volume change in 2015 can be seen that St. Ampera is said to be not jammed that is the degree of saturation 0.85, this illustrates that in 2025 the level of service at St. Ampera is already very bad, level E ie traffic volume close to capacity, unstable current, speed sometimes stalled. For comparison of degree of saturation of projection result 2025 (2/2 UD) with change of road capacity (4/2 D) it can be seen there is decrease 59,33% for segment A and 59,31% for segment B. Based on the increase can be seen service level changes, by 2025 the projected service level is E turns to B where the current is stable, the speed begins to be limited by traffic conditions, the driver has enough freedom to choose speed.Keywords: Capacity Building, Congestion, Performance, Service Leve

Effect of Inhibitors β-Lactamase on Recovery Effectiveness of Some β-Lactam Antibioticis Against Pseudomonas Aeruginosa

Thirty-four samples with position Pseudomonas aeruginosa cultures isolated from bourns, wounds urinary tract infection and Otities media were collected from Baquba General Hospital during September-December 2010. The sensitivily of these isolates were tested against (16) antibiotics. The results showed that the highest resistances were for Amoxicillin, Ampicillin, CO-Trimoxazole and Nitroforautoin with 100%, while the lowest resistance was for Ofloxacin with 3% .The results of minimum inhibitory concentration (M.I.C) toward eleven antibiotics showed different range among isolates, some were able to resist high concentration of Ampicillin and Amoxicillin reach to 1024µg/ml, while others were inhibited by 2µg/ml of Ciprofloxacin. The isolates showed low sensitivity for combination Ampicillin-Sulbactam with 0%, while it shwed high sensitivity toward combination of Piperacillin-Tazobactam and Ceftazidime-Clavulanic acid 91.17, 100% respectively. The results of plasmid content was studied indicate that all isolates contain single large plasmid band, while the study of plasmid curing appear the plasmid loss at concentration 512 µg/ml of acridin orange

The GB Virus C (GBV-C) NS3 Serine Protease Inhibits HIV-1 Replication in a CD4+ T Lymphocyte Cell Line without Decreasing HIV Receptor Expression

Introduction: Persistent infection with GBV-C (GB Virus C), a non-pathogenic virus related to hepatitis C virus (HCV), prolongs survival in HIV infection. Two GBV-C proteins, NS5A and E2, have been shown previously to inhibit HIV replication in vitro. We investigated whether the GBV-C NS3 serine protease affects HIV replication. Results: GBV-C NS3 protease expressed in a human CD4+ T lymphocyte cell line significantly inhibited HIV replication. Addition of NS4A or NS4A/4B coding sequence to GBV-C NS3 increased the effect on HIV replication. Inhibition of HI

A qualitative study exploring perceptions and attitudes of community pharmacists about extended pharmacy services in Lahore, Pakistan

Background In recent decades, community pharmacies reported a change of business model, whereby a shift from traditional services to the provision of extended roles was observed. However, such delivery of extended pharmacy services (EPS) is reported from the developed world, and there is scarcity of information from the developing nations. Within this context, the present study was aimed to explore knowledge, perception and attitude of community pharmacists (CPs) about EPS and their readiness and acceptance for practice change in the city of Lahore, Pakistan. Methods A qualitative approach was used to gain an in-depth knowledge of the issues. By using a semi-structured interview guide, 12 CPs practicing in the city of Lahore, Pakistan were conveniently selected. All interviews were audio-taped, transcribed verbatim, and were then analyzed for thematic contents by the standard content analysis framework. Results Thematic content analysis yielded five major themes. (1) Familiarity with EPS, (2) current practice of EPS, (3) training needed to provide EPS, (4) acceptance of EPS and (5) barriers toward EPS. Majority of the CPs were unaware of EPS and only a handful had the concept of extended services. Although majority of our study respondents were unaware of pharmaceutical care, they were ready to accept practice change if provided with the required skills and training. Lack of personal knowledge, poor public awareness, inadequate physician-pharmacist collaboration and deprived salary structures were reported as barriers towards the provision of EPS at the practice settings. Conclusion Although the study reported poor awareness towards EPS, the findings indicated a number of key themes that can be used in establishing the concept of EPS in Pakistan. Over all, CPs reported a positive attitude toward practice change provided to the support and facilitation of health and community based agencies in Pakistan