\ud Case Report: Unsuspected Uterine Choriocarcinoma with Lung Metastasis\ud

Choriocarcinoma is a rare form of cancer which commonly occurs in women of reproductive age, rarely in post-menopausal women and in women under 20 years of age. Methods & Results: We report an unsuspected case of uterine choriocarcinoma with lung metastasis in a 27 year-old woman who presented to a medical ward with a history of prominent respiratory, but also genital and gastrointestinal symptoms. Conclusions: The presented case report emphasizes the need for sophisticated diagnostic technology to enable early diagnosis and correct treatment. Furthermore the case highlights the need for healthcare workers to consider rare causes of respiratory signs and symptoms

Analisis Rasio Keuangan pada Perusahaan Manufaktur yang Terdaftar di Bursa Efek Indonesia Sebelum dan Semasa Covid-19

Kasus covid-19 pertama kali di Indonesia diumumkan pada 2 Maret 2020. Penelitian ini bertujuan untuk mengetahui apakah terjadi perbedaan yang signifikan pada rasio keuangan karena adanya pandemi covid-19 (studi kasus pada perusahaan manufaktur yang terdaftar di Bursa Efek Indonesia tahun 2019 dan tahun 2020). Data diolah dengan paired sample t-tes, dengan menggunakan SPSS versi 16.0. Dari hasil pengolah data, menunjukkan Tidak Terdapat Perbedaan Signifikan Rasio Keuangan Berupa Rasio Likuiditas Perusahaan Manufaktur Yang Terdaftar Di BEI Sebelum dan Semasa Covid-19, Tidak Terdapat Perbedaan Signifikan Rasio Keuangan Berupa Rasio Profitabilitas Perusahaan Manufaktur Yang Terdaftar Di BEI Sebelum dan Semasa Covid-19, Tidak Terdapat Perbedaan Signifikan Rasio Keuangan Berupa Rasio Solvabilitas Perusahaan Manufaktur Yang Terdaftar Di BEI Sebelum dan Semasa Covid-19

A cross-country review of strategies of the German development cooperation to strengthen human resources

ABSTRACT: BACKGROUND: Recent years have seen growing awareness of the importance of human resources for health in health systems and with it an intensifying of the international and national policies in place to steer a response. This paper looks at how governments and donors in five countries - Cameroon, Indonesia, Malawi, Rwanda and Tanzania - have translated such policies into action. More detailed information with regard to initiatives of German development cooperation brings additional depth to the range and entry doors of human resources for health initiatives from the perspective of donor cooperation. METHODS: This qualitative study systematically presents different approaches and stages to human resources for health development in a cross-country comparison. An important reference to capture implementation at country level was grey literature such as policy documents and programme reports. In-depth interviews along a predefined grid with national and international stakeholders in the five countries provided information on issues related to human resources for health policy processes and implementation. RESULTS: All five countries have institutional entities in place and have drawn up national policies to address human resources for health. Only some of the countries have translated policies into strategies with defined targets and national programmes with budgets and operational plans. Traditional approaches of supporting training for individual health professionals continue to dominate. In some cases partners have played an advocacy and technical role to promote human resources for health development at the highest political levels, but usually they still focus on the provision of ad hoc training within their programmes, which may not be in line with national human resources for health development efforts or may even be counterproductive to them. Countries that face an emergency, such as Malawi, have intensified their efforts within a relatively short time and by using donor funding support also through new initiatives such as the Global Fund to Fight AIDS, Tuberculosis and Malaria. CONCLUSIONS: The country case studies illustrate the range of initiatives that have surged in recent years and some main trends in terms of donor initiatives. Though attention and priority attributed to human resources for health is increasing, there is still a focus on single initiatives and programmes. This can be explained in part by the complexity of the issue, and in part by its need to be addressed through a long-term approach including public sector and salary reforms that go beyond the health secto

Delayed bilateral fibrinous anterior chamber reaction following autologous bone marrow transplant and cataract surgery

Purpose: Immune reconstitution uveitis (IRU) is a well-described phenomenon that by definition occurs in patients with AIDS who undergo highly active antiretroviral therapy resulting in a rebound inflammatory response to the presence of clinically latent cytomegalovirus (CMV). We hypothesize that similar phenomena may exist in other cohorts who undergo transient immunosuppression with rapid white blood cell count recovery. Observations: A patient developed rebound inflammation a few months after cataract surgery with intraocular lens placement characterized by photophobia, significant anterior chamber cell and fibrinous deposits. She had a history of multiple myeloma treated with chemotherapy and a recovery of white blood cell counts following autologous bone marrow transplant. She underwent a thorough work-up for infectious etiologies, as well as the presence of intraocular CMV, which were negative. Her vision and symptoms improved to baseline with the use of topical steroids and at one year her exam remained stable. Conclusions and Importance: With a negative work-up for infectious etiologies, and the timing and clinical presentation, the patient's inflammation was likely the result of rapid white blood cell count recovery following iatrogenic immunosuppression similar to the mechanism described for IRU

Diversity of used plant species for producing charcoal and its trade-off in Far-North Region, Cameroon

 The Northern Regions of Cameroon belong to sudano-zambesian region. In these regions, woody species are scarce compared to Guinean-Congolese Region and they undergo the human pressure like abusive exploitation of plants. In order to contribute to valorization of phytogenetic resources and contribute to struggle desert progression in sahelian region, a study on plants diversity which are used to produce charcoal and its trade-off was carried out in Far-North Region of Cameroon. Census of plants species was made on the basis of semi-structured surveys through the producers of charcoal and identification of tree trunks on the sites of charcoal production. Data of trade of charcoal was collected by direct observation and a semi-structured survey questionnaire in Maroua. In total, 25 species grouped in 17 genera and 8 families have been recorded. Acacia and Combretum were the richest genera with four species each. They were quoted as multipurpose species which can be used elsewhere as fruits, timbers, medicinal plants or essential oils and exudates. In Maroua almost, 98 % of households use charcoal for heating. In the absence of the charcoal, up to 60 % of those use firewood, 18.46 % use domestic gas and 18.46% use kerosene. Because of poverty and unemployment, people of primary education are mostly charcoal sellers.  INTERNATIONAL JOURNAL OF ENVIRONMENTVolume-6, Issue-2, Mar-May 2017, Page: 19-29</p

HIV care engagement and ART adherence among Kenyan gay, bisexual, and other men who have sex with men: a multi-level model informed by qualitative research

Gay, bisexual, and other men who have sex with men (GBMSM) are highly stigmatized and male-male sex is often criminalized in sub-Saharan Africa, impeding access to quality care for sexual health, HIV prevention, and treatment. To better understand HIV care engagement and antiretroviral therapy (ART) adherence among GBMSM in this context, a conceptual model incorporating sociocultural factors is needed. We conducted a qualitative study of barriers to and facilitators of HIV care engagement and ART adherence among Kenyan GBMSM, informed by a conceptual model based on an access, information, motivation, and behavioral skills (access-IMB) model, with trust in providers and stigma and discrimination as a priori factors of interest. We conducted 30 semi-structured interviews with HIV-positive Kenyan GBMSM, of whom 20 were taking ART and 10 had not yet initiated treatment. A deductive approach was used to confirm the relevance of basic concepts of the access-IMB model, while an inductive approach was used to identify content that emerged from men's lived experiences. Access-related information, motivation, and behavioral skills appeared relevant to HIV care engagement and ART adherence, with stigma and discrimination appearing consistently across discourse exploring facilitators and barriers. Trusted providers and supportive family and friends helped many men, and resilience-related concepts such as selective disclosure of GBMSM status, connection to lesbian, gay, bisexual, and transgender (LGBT) organizations, self-acceptance, goal-setting, social identity and altruism emerged as important facilitators. Findings suggest a need to increase support from providers and peers for Kenyan GBMSM living with HIV infection. In addition, they point toward the potential value of interventions that provide opportunities to build or enhance one's sense of community belonging in order to improve HIV care engagement and promote ART adherence for this vulnerable population