Upaya Guru Bimbingan Konseling dalam Mengatasi Perilaku Menyimpang Siswa SMK Wawo Kecamatan Wawo Kabupaten Kolaka Utara

Hasil penelitian menunjukkan bahwa upaya guru bimbingan konseling dalam mengatasi perilaku menyimpang siswa SMK Wawo Kecamatan Wawo Kabupaten Kolaka Utara yaitu dengan memberikan peringatan kepada siswa, memberikan bimbingan secara individu maupun kelompok, dan memberikan hukuman yang bersifat mendidik kepada siswa. Faktor pendukung bagi guru bimbingan konseling dalam mengatasi perilaku menyimpang siswa yaitu adanya kerjasama antar guru, motivasi dari siswa, kerjasama dari lingkungan sekitar, pemanggilan orang tua siswa, dan pembiasaan yang diterapkan dalam intrakurikuler maupun ekstrakurikuler. Faktor penghambat guru bimbingan konseling dalam mengatasi perilaku menyimpang siswa yaitu latar belakang siswa yang berbeda, lingkungan sekitar yang tidak bersahabat, dan kurangnya kesadaran dari siswa

Tethered Cord Syndrome Causing Chronic Kidney Disease in a Child: A rare event

The fixing of the spinal cord, regardless of the underlying cause of the fixation, is called a tethered cord. Tethered cord syndrome is a group of diseases that develops as a result of the regression of the spinal cord due to congenital or acquired causes and is characterized by evaluative neurologic losses. In stretched tethered cord syndrome which is observed during childhood usually manifested by skin symptoms, motor losses, urologic symptoms, and evaluative spinal cord deformations such as scoliosis are more frequently observed while perinea and primal pain, urologic symptoms, and motor losses are more frequent in adults. Tethered cord complicating a neurogenic bladder in childhood is a rare disease. So, this case report is presented.                                   Keywords: Tethered cord; Child; Chronic Kidney Disease; Neurogenic Bladder

Environmental bacteriophages active on biofilms and planktonic forms of toxigenic Vibrio cholerae: Potential relevance in cholera epidemiology.

METHODS: Phages isolated from environmental waters in Bangladesh were tested for their host specificity towards V. cholerae O1 and O139, and the ability to disperse V. cholerae biofilms formed in the laboratory. Representative phages were further characterized by electron microscopy and whole genome sequencing. Selected phages were then introduced in various combinations to biofilms of toxigenic V. cholerae added to samples of river water, and the dispersion of biofilms as well as the growth kinetics of V. cholerae and the phages were monitored. RESULTS: A phage cocktail composed of three different phages isolated from surface waters in Bangladesh and designated as JSF7, JSF4, and JSF3 could significantly influence the distribution and concentration of the active planktonic form and biofilm associated form of toxigenic V. cholerae in water. While JSF7 showed a biofilm degrading activity and dispersed cells from both V. cholerae O1 and O139 derived biofilms thus increasing the concentration of planktonic V. cholerae in water, JSF4 and JSF3 showed strong bactericidal activity against V. cholerae O1 and O139 respectively. A mixture of all three phages could effectively reduce both biofilm-associated and planktonic V. cholerae in river water microcosms. SIGNIFICANCE: Besides potential applicability in phage-mediated control of cholera, our results have relevance in appreciating possible intricate role of diverse environmental phages in the epidemiology of the disease, since both biofilms and phages influence the prevalence and infectivity of V. cholerae in a variety of ways

Case Report: Hyperbilirubinemia in Gilbert Syndrome Attenuates Covid-19-Induced Metabolic Disturbances

Gilbert syndrome (GS) is a liver disorder characterized by non-hemolytic unconjugated hyperbilirubinemia. On the other hand, Coronavirus disease 2019 (Covid-19) is a recent viral infectious disease presented as clusters of pneumonia, triggered by the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2). Little is known on the association between SARS-CoV-2 and GS, despite different studies have recently stated a link between hyperbilirubinemia and SARS-CoV-2 severity. In this case-report study we described a 47-year-old man, a known case of GS since the age of 4, presented to the emergency department with fever (39.8°C), dry cough, dyspnea, headache, myalgia, sweating and jaundice diagnosed with Covid-19-induced pneumonia. Interestingly, GS patient exhibited a rapid clinical recovery and short hospital stay compared to other SARS-CoV-2 positive patient, seeming that hyperbilirubinemia may exert a protective effect of against Covid-19 induced-cardiometabolic disturbances. Data obtained here underlines that the higher resistance against Covid-19 evidenced by the GS patient seems to be due to the antioxidant, anti-inflammatory, and antiviral effects of unconjugated bilirubin.To all members in College of Medicine, Al-Mustansiyria University. NC-M acknowledges the Portuguese Foundation for Science and Technology under the Horizon 2020 Program (PTDC/PSI-GER/28076/2017)

"A contradiction between our state and the tobacco company":Conflicts of interest and institutional constraints as barriers to implementation of Article 5.3 in Bangladesh.

INTRODUCTION: Bangladesh has not yet adopted measures to implement Article 5.3 of the WHO Framework Convention on Tobacco Control. The National Tobacco Control Cell (NTCC) has drafted a guideline for implementation, but progress has stalled amid high levels of tobacco industry interference in public policy. This paper examines the barriers to minimising industry interference in a context of close relationships between government officials and tobacco companies. METHODS: In-depth interviews were conducted with government officials, representatives from civil society, think tank and media organisations, and academic researchers. The data were analysed using a ‘3 Is’ framework developed within the political sciences, emphasising the interactive role of ideas, interests and institutions in policy change. RESULTS: The findings indicate that policy ideas about protecting public health policy making from tobacco industry interests are largely restricted to the Ministry of Health and Family Welfare, and the NTCC specifically. Both individual and institutional conflicts of interest emerge as key barriers to progress to minimising industry interference and for tobacco control governance more broadly. The data also suggest that development of an Article 5.3 guideline has been shaped by the perceived interests of political actors and institutions, and the institutional position of the NTCC, constrained by limits on its resources, authority and isolation from other ministries. CONCLUSION: NTCC’s initiatives towards implementing Article 5.3 constitute an important opportunity to address conflicts of interest that restrict tobacco control in Bangladesh. Progress in minimising industry interference is essential to realising the commitment to being smoke free by 2040

Compliance of smokeless tobacco supply chain actors and products with tobacco control laws in Bangladesh, India and Pakistan: protocol for a multicentre sequential mixed-methods study

Introduction: South Asia is home to more than 300 million smokeless tobacco (ST) users. Bangladesh, India and Pakistan as signatories to the Framework Convention for Tobacco Control (FCTC) have developed policies aimed at curbing the use of tobacco. The objective of this study is to assess the compliance of ST point-of-sale (POS) vendors and the supply chain with the articles of the FCTC and specifically with national tobacco control laws. We also aim to assess disparities in compliance with tobacco control laws between ST and smoked tobacco products. Methods and analysis: The study will be carried out at two sites each in Bangladesh, India and Pakistan. We will conduct a sequential mixed-methods study with five components: (1) mapping of ST POS, (2) analyses of ST samples packaging, (3) observation, (4) survey interviews of POS and (5) in-depth interviews with wholesale dealers/suppliers/manufacturers of ST. We aim to conduct at least 300 POS survey interviews and observations, and 6-10 in-depth interviews in each of the three countries. Data collection will be done by trained data collectors. The main statistical analysis will report the frequencies and proportions of shops that comply with the FCTC and local tobacco control policies, and provide a 95% CI of these estimates. The qualitative in-depth interview data will be analysed using the framework approach. The findings will be connected, each component informing the focus and/or design of the next component. Ethics and dissemination: Ethical approvals for the study have been received from the Health Sciences Research Governance Committee at the University of York, UK. In-country approvals were taken from the National Bioethics Committee in Pakistan, the Bangladesh Medical Research Council and the Indian Medical Research Council. Our results will be disseminated via scientific conferences, peer-reviewed research publications and press releases

Dietary geranylgeraniol can limit the activity of pitavastatin as a potential treatment for drug-resistant ovarian cancer

Pre-clinical and retrospective studies of patients using statins to reduce plasma cholesterol have suggested that statins may be useful to treat cancer. However, prospective clinical trials have yet to demonstrate significant efficacy. We have previously shown that this is in part because a hydrophobic statin with a long half-life is necessary. Pitavastatin, the only statin with this profile, has not undergone clinical evaluation in oncology. The target of pitavastatin, hydroxymethylglutarate coenzyme-A reductase (HMGCR), was found to be over-expressed in all ovarian cancer cell lines examined and upregulated by mutated TP53, a gene commonly altered in ovarian cancer. Pitavastatin-induced apoptosis was blocked by geranylgeraniol and mevalonate, products of the HMGCR pathway, confirming that pitavastatin causes cell death through inhibition of HMGCR. Solvent extracts of human and mouse food were also able to block pitavastatin-induced apoptosis, suggesting diet might influence the outcome of clinical trials. When nude mice were maintained on a diet lacking geranylgeraniol, oral pitavastatin caused regression of Ovcar-4 tumour xenografts. However, when the animal diet was supplemented with geranylgeraniol, pitavastatin failed to prevent tumour growth. This suggests that a diet containing geranylgeraniol can limit the anti-tumour activity of pitavastatin and diet should be controlled in clinical trials of statins

A casemix: congestive heart failure readmission rate and its associated factors in a tertiary teaching hospital in Kuala Lumpur

Cardiovascular mortality is within the top five causes of death from non-communicable disease based on World Health Organization profile. Around 20% of heart failure patients are readmitted within 30 days worldwide. Readmission within 30 days for congestive heart failure often related to non-compliant to fluid restriction, natural progression of the disease or pre-mature discharge. The study aims to evaluate the 30 days readmission rate of congestive heart failure in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) from the year 2016-2017 using casemix data and to determine the associated factors related to it. Based on the data coding, cost of readmission incurred was calculated. The 30-days readmission rate of heart failure to UKMMC in the year 2016-2017 was 53.5% & 43.5%, higher than the developed countries standard but similar to that of local teaching hospitals. After adjustment, age and level of severity are the only significant associated factors for the 30-days readmission rate. Shorter average length of stay (ALOS) & lower extra-tariff were achieved for readmission of heart failure. Total of RM80,329.73 was saved in the year 2017 from prompt treatment and comprehensive care plan of treating 19.3% level 3 severity patients at level 1 ALOS and tariff-cost. The 30-days readmission rate for heart failure in UKMMC was comparable to local teaching hospitals. The reduction of 30-days readmission rate in 2017 saved much cost, shows good clinical governance and advanced treatment strategy. Casemix can be used to guide budget allocation for the cardiology department of UKMMC