PEMAHAMAN STANDAR PROSES: TANTANGAN BAGI GURU PAI DI MADRASAH ALIYAH YAPIKA KERSAMANAH GARUT

Standar proses merupakan sumber pada perkembangan proses belajar yang berlaku untuk peserta didik dalam mencapai kompetensi standar proses. Standar proses adalah salah satu dari standar nasional pendidikan(SNP), ketentuan aplikasi dalam aturan yang diberlakukan pemerintah dalam kurikulum. Dalam penelitian ini menggunakan metode penelitian deskriptif kualitatif yaitu metode penelitian yang mendeskripsikan data dikuti dengan penafsiran atau pemaparan dari ketercapaian standar proses  di madrasah. Madrasah Aliyah YAPIKA Kersamanah Garut, merupakan salah satu madrasah di bawah Pemerintah Kementrian Agama Kabupaten Garut. Madrasah Aliyah YAPIKA Kersamanah Garut memiliki pendidik yang konsen mengajar dalam mata pelajaran Pendidikan Agama Islam(PAI) dan mata pelajaran non Pendidikan Agama Islam(PAI). Dalam pemeliharaan kualitas pendidikan, ketetapan pada fungsi dan tujuan pendidikan, maka dari itu kurikulum, proses belajar, ataupun pengelolaan yang ada di Madrasah Aliyah YAPIKA Kersamanah semuanya harus bersandar pada Standar Nasional Pendidikan(SNP). Oleh karena itu, karena standar proses merupakan salah satu standar nasional pendidikan(SNP), untuk mencapai hal tersebut perlu adanya analisa pencapaian standar proses yang dilakukan terhadap guru PAI dan non PAI di MA YAPIKA Kersamanah. Artikel ini memiliki tujuan untuk mengetahui ketercapaian standar proses pendidikan di Madrasah Aliyah Kersamanah Garut, penelitian ini berpusat dalam mengkaji indikator-indikator yang pada saat ini belum berjalan secara optimal

Biomechanical analysis of posterior lumbar interbody aages

A popular yet effective surgical treatment used in medical field to treat degenerative disc disease related to low back pain is known as the lumbar interbody fusion procedure. One of the main aims of posterior lumbar interbody fusion (PLIF), using cages or bone grafts are to provide stability during body movements and mechanical support between two vertebrae, maintain disc height and to help out with the fusion process. This procedure restores disc height, enlarges the stenotic foramen, stabilises the spine, and provides mechanical strength between vertebrae

DESAIN KOMUNIKASI VISUAL SEBAGAI MEDIA DALAM UPAYA MEMBANGUN SINERGISITAS DI YAYASAN BUNGA BALI DENGAN MASYARAKAT LUAS

Sebagai pusat rehabilitasi dan pemberdayaan sosial, Yayasan Bunga Bali memberikan pelatihan keterampilan seperti menjahit, memasak, melukis, pelatihan komputer, menari dan pelatihan lainnya. Namun salah satu bentuk usaha pelayanan tersebut adalah Pemebelajaran software computer maupun alat desain grafis Dalam Membangun Sinergisitas Di Yayasan Bunga Bali Dengan Masyarakat luas. Maka dengan begitu, melalui pengabdian masyarakat ini penulis sebagai mahasiswa DKV memiliki kesempatan untuk ikut serta dan berkonstribusi langsung dalam kegiatan yang dilakukan oleh Yayayasan Bunga Bali melalui pelayanan keterampilan dan pemberdayaan Pengoperasian Komputer dan pembelanjaran Media melalui Desain Komunikasi visual di Yayasan Bunga Bali dengan Masyarakat luas. Kata kunci: Pengabdian Masyarakat, Pemberdayaan Masyarakat, Difabel, Yayasan Bunga Bali, Bunga Bali Craf

Efficacy, safety and persistence of Ustekinumab versus Infliximab in bionaive patients with moderate to severe Crohn disease patients: a real world experience

BACKGROUND AND AIM: Ustekinumab was licenced for treatment of moderate to severe Crohn disease (CD) in Malaysia since March 2020 while Infliximab is a well-established treatment for moderate to severe CD. Our objective is to look at real- world data on efficacy, safety and persistence of Ustekinumab versus Infliximab in our population. METHODS: This was a retrospective, single-centre study conducted in a tertiary centre in Malaysia where we recruited all biologic naïve CD patients who were treated with Ustekinumab or Infliximab for at least 3 month duration. Demographic, clinical data and type of biologic therapy used were recorded. Clinical remission at 3-month, 6-month and 1-year were analyst as well as adverse event and persistence of therapy. RESULTS: A total of 73 patients were recruited: 19 from Ustekinumab cohort and 54 from the Infliximab cohort. There were no significant differences in terms of demographics, disease location and behaviour at diagnosis between the two cohort. Clinical remission for Ustekinumab cohort were 63.2%, 63.2% and 73.3% at 3-month, 6-month and 1-year compared to Infliximab cohort 64.8%, 74.1% and 77.8% at 3-month, 6-month and 1-year. 3 (5.5%) patients developed infusion reaction, 1(1.8%) patient developed tuberculosis, 1 (1.8%) patient developed psoriasiform dermatitis, 1 (1.8%) patient developed shingles in Infliximab cohort while no adverse event recorded in Ustekinumab cohort. Persistence was 78.9% and 61.1% for Ustekinumab and Infliximab respectively at 2-year but this was not statistically significant. CONCLUSION: Our early real world data shows that Ustekinumab is efficacious and safe in inducing and maintaining remission of CD and may have a better persistence as compared to Infliximab therapy

Accelerated dose of Ustekinumab as rescue therapy in acute severe ulcerative colitis

We report a first case to our knowledge of acute severe ulcerative colitis (ASUC) which was successfully treated with off label accelerated ustekinumab monotherapy. A 75-year-old man with recently diagnosed ulcerative colitis (UC) on mesalazine, ischemic heart disease, congestive heart failure (CCF), diabetes and chronic obstructive pulmonary disease (COPD) presented with bloody diarrhoea 6 times/day, severe lethargy and fever. On examination, his temperature was 38°C, pulse rate was 90 beats per minute, blood pressure was 128/68 mmHg, abdomen was soft but mildly tender. Haemoglobin was 91 g/dL, albumin was 23 g/L, C-reactive protein was 144 mg/L and CT abdomen showed diffuse colonic thickening but no dilatation. Unprepared left flexible sigmoidoscopy showed severe inflammation with deep ulceration (Figure 1). Clostridioides difficile and Cytomegalovirus (CMV) were ruled out. He was started on intravenous hydrocortisone 100mg qid but did not achieve adequate response and his diabetic control worsened. Although he was referred to the surgeons, he refused surgery. We were reluctant to start him on infliximab or cyclosporin because he has a high risk of infection as well as CCF and opted for ustekinumab in view of the more favorable side effect profile and relatively rapid onset of action. He was given an intravenous loading dose of 390mg followed by 90mg subcutaneous dose at week 2 and 6 with subsequent 8-weekly maintenance. He was in clinical remission by week 4 and repeat colonoscopy at week 24 showed complete mucosal healing with pseudopolyps and scar formation (Figure 2). Although infliximab or cyclosporin is the established rescue therapy for ASUC1, the older adult patient is at risk of significant adverse events from these therapies. Studies have shown that infliximab and cyclosporin can increase risk of infection and mortality in the elderly.2,3 Infliximab is also contraindicated in stage III/IV CCF.3 In view of this, we opted for ustekinumab although there is no data regarding its use in this setting. However, biologic clearance is much higher in ASUC, therefore accelerated therapy in often needed.5,6 We used the accelerated dose ustekinumab based on a few studies which showed that shortened dose interval of 2-weekly was safe.7,8 Our case highlights the potential efficacy of ustekinumab in treatment of ASUC in high-risk groups, but more data is required to recommend this approach over the current established therapies

Pelatihan Dan Pendampingan Pemanfaatan Aplikasi Google Meet Untuk Peningkatan Kompetensi Guru Dalam Proses Belajar Mengajar Di SMP Negeri 2 Tegallalang – Gianyar

SMP Negeri 2 Tegalalang Gianyar berlokasi di Br. Jasan Sebatu dengan status akreditasi A dan berdiri pada tahun 1986. SMP Negeri 2 Tegalalang memiliki jumlah guru 37 dan jumlah siswa aktif 598. Alumni yang telah diluluskan oleh SMP Negeri 2 Tegallalang pada tahun 2020 adalah 190 siswa. Permasalahan yang diangkat berdasarkan kondisi kegiatan belajar mengajar pada masa Pandemi Covid-19, adalah adanya ketidakmaksimalan pengajaran dari para guru kepada siswanya, dimana para guru belum secara optimal menerapkan pembelajaran secara daring dikarenakan keterbatasan pengetahuan. Kondisi saat ini komunikasi yang terjadi antara guru dan siswa hanya melalui aplikasi whatsapp, penyampaian materi berupa bahan bacaan, sehingga proses belajar mengajar dirasa kurang interaktif. Berdasarkan permasalahan tersebut, maka melalui kegiatan pengabdian masyarakat dilaksanakan kegiatan pelatihan dan penggunaan media online pendukung pembelajaran dengan mengenalkan aplikasi komunikasi konferensi yaitu google meet. Pelatihan penggunaan aplikasi ini bisa memberikan fasilitas untuk melakukan proses pembelajaran secara daring antara guru dengan siswa tanpa adanya pembatasan waktu dan kemudahan fitur aplikasi yang mudah digunakan. Hasil dari kegiatan yang dilaksanakan menunjukkan bahwa para guru telah mampu menggunakan dan menerapkan penggunaan aplikasi google meet sebagai media pengajaran kepada para siswanya, dengan jumlah pembuatan kelas ajar sebanyak 28 pertemuan

Biologic exposure of short duration results in a marked reduction in cumulative surgical rates in Malaysian patients with inflammatory bowel disease

INTRODUCTION: Crohn disease (CD) is a chronic progressive disease that is associated with high surgical rates. In view of our recent practice is starting biologic therapy early, we sought to determine whether there were differences in surgical rates between patients who were exposed or not exposed to biologic therapy. METHODOLOGY: This was a retrospective, single-centre study conducted in a tertiary centre in Malaysia. The biologic- exposed group was defined as any patient with exposure for at least 6-8 weeks. Demographics, clinical characteristics and time to significant surgical intervention (ie bowel resection) were recorded and cumulative surgical rates were calculated. RESULT: A total of 158 patients were recruited: 85 from the biologic-exposed cohort and 73 from the non-biologic cohort. Baseline demography was as follows: Male 56.3% Female 43.7%; Malays 21.5% Chinese 33.5% Indians 43.0%. Median duration of disease was 11.9 years (1.4, 30.4). Differences seen in terms demographics, disease location and behavior at diagnosis between the two cohorts were not significant. For the biologic group, median time to commencing therapy was 26.4 months (0.0, 165.6) and median duration of therapy was 13 months (IQR 1.5,130.0). The biologic-exposed group had significantly lower cumulative surgical rates compared to the non-biologic group; 2.3% versus 21.9% at 1 year; 7.3% versus 31.5% at 5 years and 15.6% versus 39.7% at ten years. CONCLUSION: Surgical rates were significantly lower in CD patients who are biologic-exposed even for a short duration. This confirms that the role of biologic therapy in altering the disease progression of CD, even in a limited resource setting

Impact of early versus late use of biologic therapy on cumulative surgical rates in patients with IBD

OBJECTIVE: A treat-to-target therapy in IBD by the early initiation of biologic therapy may impact disease progression and avoidance of surgical-related events. This study aims to identify differences in surgical rates between patients who received early versus late biologic therapy. METHODOLOGY: This was a retrospective study from the UMMC IBD database from January 2009 until January 2022. All biologic experienced patients were included. The time of IBD diagnosis, the time of initiation of biologic therapy from disease onset, the duration of biologic therapy and the time to surgery were collected. Kaplan-Meier curve was used to determine the surgical survival rate with a significant p-value < 0.05. RESULTS: The study included 100 patients bionaïve patients with Crohn’s disease of which n=34, 34% had penetrating and/ or stricturing disease and (n=66, 66%) had non-stricturing non-penetrating disease Patients received Infliximab (n=57, 57%), Ustekunimab (n=16, 16%), Vedolizumab (n=17, 17%) and Adalimumab (n=10, 10%). However, 14% patients had a diagnosis of IBD post-surgery. 69.4% (n=52) patients received early biologic therapy (<2 years from diagnosis) and 39.6% (n=34) patients received late biologic therapy. Cumulative survival surgical rates at 1, 3 and 5 years in the early biologic group were 95%, 90% and 80% (p=0.382) and 85%, 80% and 75% in the late biologic group. CONCLUSION: Although the overall surgical rates were low in patients on biologic therapy, our study failed to show that early biologic therapy had lower cumulative surgical rates probably due to small numbers

The prevalence of the duodenal ulcer promoting gene (dupA) in Helicobacter pylori isolates varies by ethnic group and is not universally associated with disease development: a case-control study

<p>Abstract</p> <p>Background</p> <p>The putative <it>H. pylori </it>pathogenicity-associated factor <it>dupA </it>has been associated with IL-8 induction <it>in vitro</it>, and duodenal ulcer (DU) and gastric cancer (GC) development in certain populations, but this association is inconsistent between studies. We aimed to investigate <it>dupA </it>prevalence in clinical isolates from Sweden, Australia and from ethnic Chinese, Indians and Malays resident in Malaysia and Singapore and to examine the association with DU and GC. In addition we investigated the sequence diversity between isolates from these diverse groups and compared the level of IL-8 secretion in isolates possessing and lacking <it>dupA</it>.</p> <p>Methods</p> <p>PCR primers were designed to amplify over the C/T insertion denoting a continuous <it>dupA</it>. PCR products from 29 clinical isolates were sequenced and compared with sequences from three additional strains obtained from GenBank. Clinical isolates from 21 Malaysian patients (8 <it>dupA</it>-positive, 14 <it>dupA</it>-negative) were assessed for their ability to induce IL-8 in AGS cells <it>in vitro</it>. Statistical analysis was performed using Fisher's exact test.</p> <p>Results</p> <p>The prevalence of <it>dupA </it>in isolates from Swedish functional dyspepsia (FD) control patients (65%, 13/20) was higher and in isolates from Indian FD patients (7.1%, 3/42) was lower as compared with isolates from Chinese (28.9%, 13/49, P = 0.005, P = 0.025), Malay (35.7%, 5/14, P = 0.16, P = 0.018) and Australian (37.8%, 17/45, P = 0.060, P < 0.001) FD patients. <it>dupA </it>was associated with DU and GC development in Chinese with 62.5% (10/16) and 54.6% (12/22) of isolates possessing <it>dupA </it>respectively as compared with FD controls (28.9%) (P = 0.015, P = 0.032). No significant difference in prevalence of <it>dupA </it>between FD controls, DU (63.6%, 7/11) and GC (61.9%, 13/21) cases (P = 1.000) was observed in the Swedish population. Sequence analysis revealed a pairwise variation of 1.9% and all isolates possessed the C/T insertion. The average IL-8 induction was 1330 pg/mL for <it>dupA</it>-positive isolates and 1378 pg/mL for <it>dupA</it>-negative isolates.</p> <p>Conclusion</p> <p>Although <it>dupA </it>is highly conserved when present, we identified no consistent association between <it>dupA </it>and DU or GC development across the ethnic groups investigated, with the <it>dupA </it>prevalence in control groups varying significantly. Our results would suggest that in the clinical isolates investigated <it>dupA </it>is not associated with IL-8 induction <it>in vitro</it>.</p

Biomechanical evaluation of two different types of interbody cages in posterior lumbar interbody fusion

Posterior lumbar interbody fusion (PLIF) related complications such as cage instability, cage subsidence and pedicle screws loosening are among the most prevalent cases reported postoperatively. These conditions are highly related to mechanical factors (PLIF design and material), patient health condition as well as activities conducted by the patient after undergone the surgery. Latest advancement on PLIF technology has created a new technique that allows the application of unilateral cage insertion in an oblique orientation. This solution has potentially overcome the problem related to an unintended mechanical and clinical shortcoming, provided that a bilateral posterior instrumentation (PI) is instrumented to the construct and the cage is fabricated from a material that is closely imitate the modulus elasticity of the cortical bone. In order to prove these statements, an image based finite element analysis (FEA) was conducted to assess the phenomena of cage subsidence and screw loosening by examining the stress profile on the cage construct and the vertebral bodies. Obliquely-placed unilateral PLIF with PI showed the most promising results. It showed the most minimal stress distortion at cage-endplate and pedicle screw-bone interface. In conclusion, the selection of a biocompatible cage material is the most crucial factors that has to be considered in achieving biomechanical superiority in PLIF surgery