Cost effectiveness analysis of using different monitoring modalities in treating severe traumatic brain injury (CESTBI) in neuro-ICU, HUSM, Kelantan

Introduction: There are two schools of thought in practicing neurotrauma monitoring for patients with severe traumatic brain injury (TBI); the application of the baseline neuro-monitoring (BNM) and the use of multiple modalities neurotrauma monitoring (M3) which is very expensive. The answer of which of the two monitoring systems is more eflicient and worth doing should be sought. Objective: To determine the cost effectiveness analysis between BNM and M3 monitoring modalities in the management of severe TBI. Methodology: Sixty-two patients with severe TBI admitted to Neuro-ICU, USM who fulfilled the predetermined criteria were selected using systematic random sampling. The macro and micro costing were performed on each of patient. Barthel Index was used to measure physical performance as an outcome six months after discharge. The analyses used were the Independent t- test, ANCOVA, and Repeated Measure ANOVA. Results: The mean total equipment cost of M3 was significantly higher at p = 0.049 (mean difference of RM23.74) after controlling other variables. The mean difference in Barthel Index after six months was significance between the two groups (p = 0.031), patients that were treated with M3 had higher score 163.7 (SD 30.03)J compared to those who were treated with BNM 146.83 (SD 30.36)]. However, the cost-effectiveness ratio of using M3 was significantly lowered (p=O.031) with a mean of RM476.29 was needed to increase a unit improvement in mean Barthel Index compared to RM629.12 if we used BNM. Conclusion: Although M3 is more costly, the outcome of patients treated with M3 was better than that of BNM. Therefore we can conclude that the used of multiple neuro-monitoring was more cost effective than the use of only baseline neuro-monitoring in treating severe traumatic brain injury

Some physical properties of the muscle lipid of two freshwater teleosts, Ophicephalus striatus (Bloch.) and Clarias batrachus (Linn.)

Various physical properties (viscosity, fluidity, surface tension and specific gravity) have been determined for muscle lipids of Ophicephalus striatus and Clarias batrachus. Results are presented and the methods used in determination noted. The physical parameters studied are found to be species-specific

New Positive Inotropic Agents

Current therapy for heart failure remains inadequate. New positive inotropic agents that augment myocardial contractility have been introduced. The positive inotropic effects of these nonglycoside, nonsympathomimetic agents are due, at least in part, to inhibition of cardiac phosphodiesterase activity and hence to an increase in myocardial cyclic AMP levels. These agents also have vasodilator properties through their effects on the enzyme phosphodiesterase in the vascular smooth muscle. Recent developments in the preclinical pharmacology, mechanism of action, and clinical experience with these new inotrope vasodilators are presented in this review. The role these drugs will play in revising our therapeutic strategy in congestive heart failure remains to be defined

OPTIMALISASI PENERIMAAN INTENSITAS CAHAYA MATAHARI PADA PERMUKAAN PANEL SURYA (SOLAR CELL) MENGGUNAKAN CERMIN

Abstrak Energi surya merupakan salah satu energi yang bias dikonversi menjadi energi listrik dengan menggunakan panel surya (photovoltaic solar). Pada penelitian ini, dirancang panel surya dengan cermin datar sebagai reflektor scanning dengan empat buah reflektor pada empat sisi panel surya. Tujuan yang ingin dicapai dalam penelitian ini yaitu untuk mendapatkan keluaran panel surya yang optimal menggunakan cemin sebagai media reflektornya dan mendapatkan konfigurasi penempatan cermin untuk meningkatkan keluaran arus dan tegangan panel surya. Metode yang digunakan dalam penelitian ini adalah metode eksperimen dengan melakukan percobaan terhadap objek bahan penelitian dengan kemiringan reflektor cermin 30o, 45o, dan 60o. Dengan penambahan reflector cermin pada panel surya menyebabkan peningkatan keluaran panel surya pada pukul 12.00 Wita. Panel tanpa reflektor mengahasilkan Arus 2,1 Ampere, Tegangan 6,52 Volt. Panel reflektor 30o menghasilkan Arus 1,89 Ampere, Tegangan 6,25 Volt, Panel reflektor 45o, Arus 2,33 Ampere, Tegangan 6,15 Volt dan Panel reflektor Arus 3,02 Ampere, dan Tegangan 6,41 Volt.Kata kunci: Energi; fotovoltaik; panel surya; cermin. Abstract Solar energy is one of the energies that can be converted into electrical energy using solar panels (photovoltaic solar). In this study, a solar panel with a flat mirror as a scanning reflector was designed with four reflectors on the four sides of the solar panel. The objectives to be achieved in this study are to obtain optimal solar panel output using the mirror as a reflector medium and obtain a mirror placement configuration to increase the current and voltage output of the solar panels. The method used in this research is an experimental method by conducting experiments on the object of the research material with a mirror reflector tilt of 30o, 45o, and 60o. With the addition of a mirror reflector on the solar panel, it causes an increase in the output of the solar panel at 12.00 GMT+08. The panel without a reflector produces a current of 2.1 Ampere, a voltage of 6.52 volts. The 30o-reflector panel produces a current of 1.89 Amperes, a Voltage of 6.25 Volts, a 450 Reflector Panel, a Current of 2.33 Amperes, a Voltage of 6.15 Volts and a Current 3.02 Amperes of Reflector Panel, and a Voltage of 6.41 Volts. Keywords: Energy; photovoltaic; solar panel; mirro

Baseline and On-Treatment High-Density Lipoprotein Cholesterol and the Risk of Cancer in Randomized Controlled Trials of Lipid-Altering Therapy

ObjectivesWe sought to examine the relationship between high-density lipoprotein cholesterol (HDL-C) levels and the risk of the development of cancer in large randomized controlled trials (RCTs) of lipid-altering interventions.BackgroundEpidemiologic data demonstrate an inverse relationship between serum total cholesterol levels and incident cancer. We recently reported that lower levels of low-density lipoprotein cholesterol are associated with a significantly higher risk of incident cancer in a meta-analysis of large RCTs of statin therapy. However, little is known about the relationship between HDL-C levels and cancer risk.MethodsA systematic MEDLINE search identified lipid intervention RCTs with ≥1,000 person-years of follow-up, providing baseline HDL-C levels and rates of incident cancer. Using random-effects meta-regressions, we evaluated the relationship between baseline HDL-C and incident cancer in each RCT arm.ResultsA total of 24 eligible RCTs were identified (28 pharmacologic intervention arms and 23 control arms), with 625,477 person-years of follow-up and 8,185 incident cancers. There was a significant inverse association between baseline HDL-C levels and the rate of incident cancer (p = 0.018). The inverse association persisted after adjusting for baseline low-density lipoprotein cholesterol, age, body mass index (BMI), diabetes, sex, and smoking status, such that for every 10-mg/dl increment in HDL-C, there was a 36% (95% confidence interval: 24% to 47%) relatively lower rate of the development of cancer (p < 0.001).ConclusionsThere is a significant inverse association between HDL-C and the risk of incident cancer that is independent of LDL-C, age, BMI, diabetes, sex, and smoking

Pengaruh Sudut Kaca Penutup Dan Jenis Kaca Terhadap Efisiensi Kolektor Surya Pada Proses Destilasi Air Laut

Distillation system in terms of filtering sea water using solar power, the absorption of radiation plays important role for it functions is as solar radiation absorber and is to convert the radiation into heat energy. Glass cover that will be used on the solar collector is transparent glass and frosted glass. Have ben research, the writer would like to analyze the effects of angles of the glass cover and of the glass types toward the efficiency of the heat collector during the process of sea water distillations with the variant angel of 25o, 35o and 55o. The result shown that the variation on angel and the types of the glass covers, both transparent glass and frosted glass is different each other. The obtained result is that the highest efficiency is on the transparent glass cover with the glass angle declivity of 55o and the average value is of 46,78 % and the lowest is on the frosted glass cover with the angle glass declivity of 25o and the average value is of 42.60 %. While the highest amount of water distillations is on the transparent glass with the angle glass declivity of 25o and the average value is of 92.20 mL and the lowest of water amount is on the frosted glass with angle glass declivity of 55o and the average value is of 32.13 mL. Therefore, in the process of sea water distillations, it is better to use transparent glass cover as the collector with the angle glass declivity of 25o. However, the distance of plate absorber and the glass cover should be high so that the volume of heat room is large and the total amount of heat loss thrown from the solar collector is little to the surrounding

Studi Sifat Fisik Tanah Organik Yang Distabilisasi Menggunakan Cornice Adhesive

Analysis of the data in this study is focused on a comparison of the results of direct testingdeflection field with SAP 2000 analysis and manual calculation of loading field and standard(RSNI T-02-2005) with a maximum deflection limit bridge.Based on the results obtained by calculation of loading field: percentage reduction of deflectiontest results without the GFRP reinforcement compared to after given the GFRP reinforcement ondirect testing field, SAP 2000 analysis, and manual calculation respectively, they are obtained4.934 %, 0.7097%, and -0,6804 %. Based on the results of the calculation deflection of theloading standard: percentage reduction of deflection test results without the GFRP reinforcementcompared to after given the GFRP reinforcement on SAP 2000 analysis and manual calculationrespectively, they are obtained 2,0212 % and -0.17557 %. The Values of deflection are calculatedstill below 18.75 cm as deflection limit L/240