Analisis pengaruh Capital Adequacy Ratio (CAR), Financing Todeposite Ratio (FDR), Dannon Perfoaming Financing (NPF) terhadap Return on Asset (ROA) pada bank Muamalat Indonesia

Bank Muamalat Indonesia yang merupakan Bank Umum Islam pertama yang beroperasi di Indonesia. Sejak awal berdirinya bank syari’ah di Indonesia. Untuk mengetahui seberapa besar pengaruh rasio keuangan pada tingkat profitabilitas perbankan di Indonesia, maka dalam penelitian ini mengambil kasus pada bank Muamalat Indonesia dari tahun 2008 sampai dengan tahun 2015 triwulan III dengan menganalisis pengaruh kinerja keuangannya untuk mengetahui seberapa besar tingkat profitabilitas di masa yang akan datang. Berdasarkan latar belakang masalah, maka tujuan penelitian adalah (1) Untuk mengetahui pengaruh Capital Adequacy Ratio (CAR) terhadap Profitabilitas (ROA) pada bank Muamalat Indonesia. (2) Untuk mengetahui pengaruh Financing to Deposit Ratio (FDR) terhadap Profitabilitas (ROA) pada bank Muamalat Indonesia (3) Untuk mengetahui pengaruh Non perfoaming financinng (NPF) terhadap Profitabilitas (ROA) pada bank Muamalat Indonesia. (4) Untuk mengetahui pengaruh CAR, FDR dan NPF terhadap Profitabilitas (ROA) pada bank Muamalat Indonesia. Metodologi yang digunakan adalah :Pertama, penelitian ini merupakan penelitian dengan menggunakan pendekatan kuantitatif. Kedua, objek penelitian adalah CAR, FDR, NPF dan Profitabilitas (ROA), sebagai unit yang dianalisis. Sampel penelitian adalah data sekunder berupa laporan-laporan keuangan Bank Muamalat Indonesia periode tahun 2010 sampai 2015 dengan menggunakan metode purposive sampling. Ketiga, untuk menganalisis dapat digunakan alat analisis antara lain: untuk CAR, FDR dan NPF dan Profitabilitas (ROA) Bank Muamalat Indonesia digunakan analisis deskriptif kuantitatif. Untuk menguji pengaruh CAR, FDR, dan NPF terhadap Profitabilitas (ROA) digunakan analisis multiple regression. Hasil Pengujian hipotesis menunjukkan bahwa F hitung 7,641 dengan nilai signifikansi sebesar 0.001, karena nilai signifikansi lebih kecil dari 0.05 maka Ha ditolakdan Ho diterima, artinya semua koefisien regresi secara simultan atau serentak signifikan dalam model, hasil penelitian, diketahui bahwa koefisien determinasi yang dinotasikan dengan Adjusted R2 besarnya 0,599 ini berarti variabel ROA yang dapat dijelaskan oleh variabel CAR (X1), FDR (X2), dan NPF (X3) yang diturunkan dalam model sebesar 5,99%

Industrial Water Management Policy Comparative Analysis & Comparison of Water Pricing

This study contributes comparative analysis and comparison of current water policy  in the industrial sector. Current water policies fail to adequately address water use and pricing issue. This study concentrates on industry perspective questionnaires method; next we calculate water use in the industry during specific year plan from 1988 to 2013.Understanding the interactions of industry & water policies is crucial for achieving efficient management of water resources.  Increasing population and economic growth continue to drive industries demand water resources. The interaction of these resources is particularly important in a textile sector where water resources are unevenly distributed, with limited availability in specific regions. The “3 Red Lines” water policies were introduced in 2011; one of their aims is to reduce industrial water use. Water is currently not valued correctly by stakeholders; this is a major problem in itself and contributes to misuse. This paper analyses current water withdrawals and consumption for China, Japan, Bangladesh, UK, USA and assesses the water pricing with the industrial water policy under different scenarios, considering potential future policy. It is therefore, an imperative for policy makers to coordinate their activities in such a way that adequate supply of water is provided and efficient use of it is made and to respond quickly and timely to the structural changes of the economy and to prevent a water crisis in the country. The purpose of this paper is to undertake a in the industry in order to understand this potential policy conflict. The paper aims to illustrate appropriate policy direction and management practices. Keywords: Industry, textile industry, water management policy, water pricing, water conservation, water demand

Analisis Ketersediaan Obat Antihipertensi Dan Pengaruhnya Terhadap Pengobatan Pasien Hipertensi Di Puskesmas Kota Bandar Lampung

Hipertensi adalah peningkatan tekanan darah sistolik lebih dari 140 mmHg dan tekanan darah diastolik lebih dari 90 mmHg pada dua kali pengukuran dengan selang waktu lima menit dalam keadaan cukup istirahat / tenang. Tujuan penelitian ini adalah untuk mengetahui kesesuaian jenis dan jumlah obat antihipertensi dengan standar pengobatan hipertensi, untuk mengetahui ketersediaan obat antihipertensi sesuai dengan jenis dan jumlahnya serta untuk mengetahui pengaruh ketersediaan obat antihipertensi terhadap pengobatan pasien hipertensi di puskesmas Kota Bandar Lampung. Penelitian ini menggunakan studi expost facto atau observasional yang bersifat deskriptif dengan teknik pengumpulan data secara retrospektif dan prospektif selama tahun 2017  pada 23 puskesmas di Kota Bandar Lampung. Analisa data menggunakan analisis deskriptif, analisis chi square dan analisis multivariat. Hasil uji chi square pada tingkat pendidikan dokter dan tenaga kefarmasian nilai Asymptotic Significance (2-sided) < 0,05 yaitu 0,027 dan 0,047, ketersediaan obat antihipertensi nilai Asymptotic Significance (2-sided) 0,005 dan 0,001 < 0,05, artinya variabel tersebut ada dengan kebutuhan jenis dan jumlah obat antihipertensi untuk pasien hipertensi. Pada analisis multivariat secara stimultan, ketersediaan obat antihipertensi paling berpengaruh atau dominan terhadap kebutuhan jenis dan jumlah obat antihipertensi untuk pasien hipertensi dilihat dari nilai significance yang paling kecil yaitu 0,005 dan dilihat dari nilai OR yang terbesar yaitu 5,588 .Dapat disimpulkan bahwa secara stimultan dan bersama-sama  ketersediaan obat antihipertensi berpengaruh terhadap pengobatan pasien hipertensi. Kata Kunci : Ketersediaan Obat Antihipertensi, Pasien hipertensi, Pengobata

Molecular and genetic characterization of emerging carbapenemase-producing Acinetobacter baumannii strains from patients and hospital environments in Bangladesh

Background Carbapenemase-producing multidrug-resistant (MDR) Acinetobacter baumannii is a global health care problem. MDR A. baumannii has emerged as an important nosocomial pathogen, costing many lives worldwide including Bangladesh. Aim To investigate the detailed molecular epidemiology of carbapenem-resistant A. baumannii (CRAB) both from patients and the hospital environment, to shed light on genetic characteristics and transmission dynamics. Methods A set of 49 clinical A. baumannii strains collected during early 2015 was received from the clinical microbiology laboratory of Dhaka Medical College Hospital (DMCH) in Bangladesh. Additionaly, 100 environmental samples were also collected from the hospital surfaces of Dhaka Medical College Hospital and analyzed for carbapenamase-producing A. baumannii. CRAB were identified by culture on selective plates, biochemical testing and MALDI-TOF. All isolates were characterized by susceptibility testing, realtime-PCRs, conventional PCR, MLST and sequencing. Findings Clinical A. baumannii were resistant to ciprofloxacin (100%), imipenem (91.8%), meropenem (91.8%), gentamicin (91.8%), amikacin (87.7%), and trimethoprim-sulfamethoxazole (61.2%). The majority (59%) of the isolates were MDR. All environmental A. baumannii (n=10) were resistant to imipenem, meropenem, gentamicin, amikacin, and ciprofloxacin. Strains carried the following antibiotic resistant genes; blaOXA-23, blaOXA-58, blaPER-7, qnrB1, qnrC1, aac(6′)1b-cr and armA. A total of 36 different clones were identified by rep-PCR and common clonal clusters were found both in patients and hospital environments. MLST analysis revealed different sequence types (ST2, ST10, ST149, ST575, ST1063 and ST1065). In clinical and environmental settings. A. baumannii ST2 dominated in both clinical and environmental settings. Both clinical and environmental A. baumannii strains with known STs carried several biofilm-related genes; bap, csuE, and pgaB. Conclusion Widespread dissemination of MDR A. baumannii in the DMC hospital of Bangladesh is a serious problem

Phenotypic and Genotypic Characteristics of Antimicrobial Resistance in Citrobacter freundii Isolated from Domestic Ducks (Anas platyrhynchos domesticus) in Bangladesh

Antimicrobial resistance (AMR) in Citrobacter freundii poses a serious challenge as this species is one of the sources of nosocomial infection and causes diarrheal infections in humans. Ducks could be the potential source of multidrug-resistant (MDR) C. freundii; however, AMR profiles in C. freundii from non-human sources in Bangladesh have remained elusive. This study aimed to detect C. freundii in domestic ducks (Anas platyrhynchos domesticus) in Bangladesh and to determine their phenotypic and genotypic antibiotic susceptibility patterns. A total of 150 cloacal swabs of diseased domestic ducks were screened using culturing, staining, biochemical, polymerase chain reaction (PCR), and matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) to detect C. freundii. Phenotypic and genotypic antibiotic susceptibility patterns were done by the disk diffusion method and PCR, respectively. In total, 16.67% (25/150) of the samples were positive for C. freundii. C. freundii isolates showed a range of 20% to 96% resistance to cefotaxime, gentamicin, levofloxacin, ciprofloxacin, cotrimoxazole, tetracycline, ampicillin, and cephalexin. More than 60% of the isolates were phenotypically MDR, and the index of multiple antibiotic resistance ranged from 0.07 to 0.79. Genes encoding resistance to beta-lactams [blaTEM-1-88% (22/25), blaCMY-2-56% (14/25), blaCMY-9-8% (2/25), and blaCTX-M-14-20% (5/25)], sulfonamides [sul1-52% (13/25), sul2-24% (6/25)], tetracyclines [tetA-32% (8/25) and tetB-4% (1/25)], aminoglycosides [aacC4-16% (4/25)], and fluoroquinolones [qnrA-4% (1/25), qnrB-12% (3/25), and qnrS-4% (1/25)] were detected in the isolated C. freundii. To the best of our knowledge, this is the first study in Bangladesh to detect MDR C. freundii with their associated resistance genes from duck samples. We suggest addressing the burden of diseases in ducks and humans and associated AMR issues using the One Health approach

Timing of Enteral Feeding in Cerebral Malaria in Resource-Poor Settings: A Randomized Trial

BACKGROUND: Early start of enteral feeding is an established treatment strategy in intubated patients in intensive care since it reduces invasive bacterial infections and length of hospital stay. There is equipoise whether early enteral feeding is also beneficial in non-intubated patients with cerebral malaria in resource poor settings. We hypothesized that the risk of aspiration pneumonia might outweigh the potential benefits of earlier recovery and prevention of hypoglycaemia. METHOD AND FINDINGS: A randomized trial of early (day of admission) versus late (after 60 hours in adults or 36 hours in children) start of enteral feeding was undertaken in patients with cerebral malaria in Chittagong, Bangladesh from May 2008 to August 2009. The primary outcome measures were incidence of aspiration pneumonia, hypoglycaemia and coma recovery time. The trial was terminated after inclusion of 56 patients because of a high incidence of aspiration pneumonia in the early feeding group (9/27 (33%)), compared to the late feeding group (0/29 (0%)), p = 0.001). One patient in the late feeding group, and none in the early group, had hypoglycaemia during admission. There was no significant difference in overall mortality (9/27 (33%) vs 6/29 (21%), p = 0.370), but mortality was 5/9 (56%) in patients with aspiration pneumonia. CONCLUSIONS: In conclusion, early start of enteral feeding is detrimental in non-intubated patients with cerebral malaria in many resource-poor settings. Evidence gathered in resource rich settings is not necessarily transferable to resource-poor settings. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN57488577

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Rainfall Climatology of Jammu and Kashmir State, India

We have written a number of articles on various aspects of weather characterization and forecast verification under temperate environments of Jammu and Kashmir (India). We have also touched on some of the approaches that might help in solving climatically triggered problems (Hasan and Kanth 1997). Fortunately, we were lucky enough to make significant progress in some (if not all) of the approaches. The present article focuses on an analysis of rainfall/ precipitation in this state of the Indian Union under different agroclimatic zones, with an update on forecast verification analysis of temperate Kashmir (India) during 1997–98. India is classified into agroclimatic zones or major agro-ecological regions (Figures 1 and 2). By definition, an agroclimatic zone is a land unit, in terms of major climate and growing period, that is climatically suitable for a certain range of crops and cultivars (FAO, 1983). An ecological region is characterized by distinct ecological responses to macroclimate as expressed in vegetation and reflected in soils, fauna, and aquatic systems. Several attempts have been made to classify our land area into climatic regions or zones, and these are well documented (Sehgal et al., 1992). The important point is the degree of recognition that has been given to these various approaches and their use in promoting the objectives of effective agriculture, macrolevel land use planning, and effective transfer of agrotechnology. Two approaches seem to meet these objectives—the National Agricultural Research Project (NARP) approach (Figure 1) and the recent Agro-Ecological Region approach (Figure 2). In the NARP approach, state universities were advised to divide each zone/state into subzones; accordingly, 129 subzones were delineated for India, based primarily on rainfall, existing cropping patterns, and administrative units. The Jammu and Kashmir state was thus divided into 4 zones (Figure 1). In the agro-ecological region-based approach, recognition was given to the climatic conditions, length of growing period, land form, and soils (Sehgal et al., 1992) (Figure 2). Thus India has been divided into 20 agro-ecoregions. The Jammu and Kashmir state comprises 3 regions, as depicted in Figure 2. The crop distribution in the state is shown in Figure 3

Agrometeorological Aspects of Crop Production in Temperate Kashmir

In our recent article on forecasting uncertain weather over temperate Kashmir (India) (Drought Network News, Vol. 9, No. 1, pp. 12–14), we tried to characterize the crop-growing environments by giving long-term means of various agrometeorological parameters (such as air temperature, relative humidity, precipitation, and hours of bright sunshine). Forecast analysis for changes in temperature and precipitation events indicated an overall reliability of about 50%. Changes in minimum temperature could be forecasted relatively more accurately than changes in maximum temperature. Precipitation events were more uncertain during summer (May to October), which happens to be an important season from the standpoint of crop production. The present article focuses on the variability of Kashmir weather and its possible impact on summer and winter crops of the region. Historical weather data has been analyzed on a “weekly/monthly mean” basis to depict the ranges between which they might have fluctuated. The analysis is based on calculation of standard deviations. Results of one such analysis are depicted in Figure 1, which shows substantial variability in all weather elements. With the exception of one or two months, the parameters of precipitation and weekly duration of sunshine are quite inconsistent. A similar graph (Figure 2) has been prepared on a weekly mean basis wherein the means of air temperature (maximum and minimum) and weekly totals of precipitation/sunshine hours are depicted. The phenological stages of some important crops have also been worked out