A study on Prevalence of Drug Resistance in Drug Default Pulmonary Tuberculosis

Background: The emergence of resistance to drugs used to treat tuberculosis (TB), and particularly multidrug-resistant TB (MDR-TB), has become a significant public health problem in a number of countries and an obstacle to effective global TB control.Method: This is a prospective randomized cross sectional study to estimate the magnitude of MDR tuberculosis in two hospitals in Khartoum, Sudan. 111 patients who had defaulted their tuberculosis treatment on previous occasions and had presented to the hospital with several symptoms were studied. All patients provided sputum, which was examined for the presence of acid fast bacilli (AFB) by Ziehl- Neelsen stain. Sputa were also sent to the reference laboratory for mycobacterial culture and drug susceptibility testing. All culture positive sputa had drug sensitivity tested to the first line anti-TB drugs used in Sudan namely Streptomycin, Isoniazid, Rifampicin and Ethambutol.Results: Out of the 111 patients, 29.7% (n=33) were AFB sputum smear positive and 40.5% (n=45) were sputum culture positive for  mycobacterium. Sensitivity testing revealed that 48.9% (n=22) were resistant to Streptomycin, 62.2% (n=28) were resistant to Isoniazid, 55.6% (n=25) were resistant to Rifampicin and 37.8% (n=17) were resistantto Ethambutol. 42% ( n=19) of the patients were resistant to Rifampicin and Isoniazid only, while 26.6% (n=12) were resistant to all the first line drugs (Streptomycin, Isoniazid, Rifampicin and Ethambutol).Conclusion: This study showed that the prevalence of MDR tuberculosis among the defaulters in Khartoum is much higher than what was reported previously. This study highlights the extent of the problem of drug resistance in Khartoum and emphasises the need for proper treatment andstrengthening of the short course direct observed therapy strategy

Profile of Egyptian Patients with Mucopolysaccharidosis

Background: Mucopolysaccharidoses (MPS) are chronic progressive lysosomal disorders (Six distinct types) which are inherited as autosomal recessive except MPS II which is inherited as X-linked recessive disorder Patients and Methods: This study is designed to investigate a group of Egyptian patients with MPS biochemically using screening test by electrophoretic separation of glycosaminoglycans and enzymatic assay in order to establish the diagnosis of the disorder and its subtypes, to prepare patients for enzyme replacement therapy. Also this will help in proper genetic counseling and prenatal diagnosis. Establishing a reliable rapid screening test for MPS is another aim of the study. The present study included 20 index cases suspected clinically as mucopolysaccardioses at the Medical Genetics Center, Ain Shams University (ASUMGC).They were subjected to full history taking, thorough clinical examination, family pedigree construction, skeletal survey, abdominal ultrasound and echocardiography, quatitative assay of glycosaminoglycans (GAGs) by diemethylmethlene blue (DMB) is done. Results: The level of urinary GAGs by two dimentional electrophoresis (DMB) test was high in all patients tested. After that the patients were subjected to 2-DEP to determine the pattern of GAGs for probable type of MPS. 11 cases (55%) showed big dermatan sulfate spot (Type I, II or VI). Seven cases (35%) showed hepran sulfate spot (Type III), 2 cases (10%) showed keratan sulfate spot (Type IV). Finally patients were subjected to enzyme analysis specific for each type of MPS to confirm diagnosis. Reaching a specific diagnosis is of importance for genetic counseling and prenatal diognosis which is possible for all types of MPS. Conclusion: Prenatal diagnosis was done by 2-DEP of the amniotic fluid for four mothers of affected patients of MPS. One fetus was proved to be affected with MPS III. Another fetus was affected with MPSII. The others fetuses were normal. Keywords: Mucopolysaccharidosis, Egypt. Egypt. J. Hum. Genet Vol. 9 (1) 2008: pp. 11-2

Serum amino acid abnormalities in pediatric patients with chronic renal failure with and without history of thromboembolic manifestations

Background: Plasma amino acid concentrations have been reported to be abnormal in patients with chronic renal failure. L-Arginine has been used to improve endothelial function by increasing nitric oxide (NO) bioavailability. The present study aim at investigating the status of plasma amino acids in pediatric patients with chronic renal failure (CRF) on regular hemodialysis (HD) with and without history of thromboembolic manifestations.Methods: The study included 21 hemodialysis patients subdivided into two groups (those with no history of thromboembolic manifestations and those with positive history of thromboembolic manifestations) The control group included 13 age and sex matched apparently healthy subjects, After careful history taking, clinical examination, the following laboratory investigations were performed: serum calcium, phosphate, albumin, and creatinine (for controls only), complete blood count (CBC) and serum amino acid analysis.Results: HD patients had a significantly lower concentration of threonine, valine, methionine, leucine, tyrosine, phenylalanine and tryptophane than the control group (p= 0.032, 0.020, 0.046, 0.011, 0.000, 0.022, and 0.004 respectively). There was no significant difference between HD patients and the control group as regard aspartic acid, serine, asparagine, glutamic acid, proline, glycine, alanine, cystine, isoleucine, lysine, histidine, and arginine. The mean serum L-arginine level was lower in 61.9% of HD patients than the mean of the controls with no significant difference. L-Arginine concentration was not significantly different between HD patients with and without history of thromboembolic manifestations.Conclusion: Several abnormalities in amino acids were present in HD patients compared to controls. The mean serum L-arginine level was lower in 61.9% of HD patients than the mean of the controls with no significant difference. L-Arginine concentration was not significantly different between HD patients with and without history of thromboembolic manifestations. HD patients without history of thromboembolic manifestations had significantly lower glutamic acid concentrations and significantly higher phenylalanine concentrations than HD patients with history of thromboembolic manifestations.Keywords: Serum amino acid; Chronic renal failure; L-Arginin

Kepatuhan Wajib Pajak (Studi Empiris Di Kantor Pelayanan Pajak Pratama Batu

Penelitian ini bertujuan untuk menguji pengaruh sikap atas kepatuhan, norma subjektif, kontrol perilaku persepsian, kewajiban moral, religiusitas, persepsi Wajib Pajak atas pemerintah terhadap niat untuk patuh dan menguji pengaruh niat untuk patuh terhadap kepatuhan pajak. Jenis penelitian ini adalah explanatory research dengan pendekatan kuantitatif. Pengumpulan data dilakukan melalui survey dengan kuesioner yang disebar kepada Wajib Pajak Orang Pribadi yang melakukan pekerjaan bebas di KPP Pratama Batu. Analisis data menggunakan Partial Least Square (PLS). Hasil penelitian ini menunjukkan bahwa kepatuhan Wajib Pajak Orang Pribadi yang melakukan pekerjaan bebas meningkat karena norma subjektif yang kuat, religiusitas yang tinggi, dan memiliki persepsi atas pemerintah yang lebih baik akan memiliki niat untuk patuh yang lebih tinggi. Selanjutnya, perilaku kepatuhan Wajib Pajak ditentukan oleh niat untuk patuh. Penelitian ini tidak dapat membuktikan secara empiris bahwa sikap atas kepatuhan, kontrol perilaku persepsian dan kewajiban moral berpengaruh terhadap niat untuk patuh

Penggunaan Sistem Informasi Manajemen Daerah Suatu Pendekatan Dual Factor Theory Studi Kabupaten Jember

Tujuan dari penelitian ini adalah untuk menyelidiki enabler dan inhibitor termasuk teori dual factor theory penggunaan sistem informasi manajemen daerah berbasis clouds. Teknik pemilihan sample dalam penelitian ini menggunakan purposive sampling dan analisis data menggunakan regresi berganda. Hasil menunjukkan, pertama masalah infrastruktur IT berpengaruh negatif terhadap persepsi kegunaan. Kedua, masalah infrastruktur IT berpengaruh negatif terhadap persepsi kemudahan penggunaan. Ketiga, masalah infrastruktur IT berpengaruh negatif terhadap penggunaan sistem informasi daerah berbasis clouds. Keempat, masalah kompetensi sumber daya manusia berpengaruh negatif terhadap persepsi kegunaan. Kelima, masalah kompetensi sumber daya manusia berpengaruh negatif terhadap persepsi kemudahan penggunaan. Keenam, masalah kompetensi sumber daya manusia berpengaruh negatif terhadap penggunaan sistem informasi daerah berbasis clouds. Ketujuh, persepsi kegunaan berpengaruh positif terhadap penggunaan sistem informasi daerah berbasis clouds. Kedelapan, persepsi kemudahan penggunaan berpengaruh positif terhadap penggunaan sistem informasi daerah berbasis clouds

Dilema Etis Konsultan Pajak Dalam Tax Planning: Studi Fenomenologi

Konsultan pajak memiliki fungsi membantu wajib pajak terkait masalah- masalah di bidang perpajakan yang dihadapi wajib pajak. Namun terkadang perbedaan tujuan antara wajib pajak dan konsultan pajak menimbulkan dilema. Wajib pajak yang menganggap pajak itu sebagai beban berusaha mengecilkan pajak yang harus dibayar. Wajib pajak meminta bantuan konsultan pajak untuk melakukan tax planning secara legal hingga ke arah illegal. Konsutlan pajak harus mematuhi peraturan perpajakan yang berlaku, namun disisi lain adanya suatu kondisi dan imbalan yang diberikan klien membuat konsultan pajak mengalami dilema. Konsultan pajak harus mempunyai cara untuk menghilangkan dilema yang dirasakan. Maka dari itu tujuan dari penelitian ini adalah mengetahui, mendalami serta mengupas bagaimana bentuk dilema etis yang di alami konsultan pajak dan bagaimana pengalaman konsultan pajak dalam mengatasi dilema yang dirasakan ketika melakukan tax planning. Metode penelitian yang digunakan yaitu metode penelitian kualitatif dengan paradigma intepretif dan pendekatan fenomenologi transendental Husserl. Informan dalam penelitian ini adalah konsultan pajak IKPI Kota Denpasar. Informan dipilih menggunakan teknik snowball sampling. Berdasarkan teknik analisis dari Moustakas (1994), dapat diperoleh hasil penelitian yang mengungkap bentuk-bentuk dilema konsultan pajak, seperti dilema yang muncul akibat adanya “area abu-abu” atau celah dalam peraturan yang menyebabkan ketidakjelasan dari peraturan tersebut, dilema akibat konsultan pajak memiliki kepedulian terhadap kliennya dan dilema akibat konsultan pajak memikirkan keberlangsungan bisnis jasanya. Bentuk-bentuk dilema tersebut menghasilkan pengalaman konsultan pajak dalam mengatasi dilema yang dirasakan yaitu dengan cara memunculkan rasa sadar bahwa sebagai seorang konsultan pajak harus memahami peraturan dengan baik untuk menghindarinya dari rasa dilema. Selain itu konsultan pajak harus membangun kesadaran dari wajib pajaknya (klien), serta harus mempunyai kesadaran profesi sebagai konsultan pajak yang terikat dengan kode etik. Membangun kesadaran wajib pajak dan mempunyai prinsip harus mematuhi kode etik, dilema yang dirasakan dapat teratas

Association of statin use in older people primary prevention group with risk of cardiovascular events and mortality: a systematic review and meta-analysis of observational studies

Background: Current evidence from randomized controlled trials on statins for primary prevention of cardiovascular disease (CVD) in older people, especially those aged > 75 years, is still lacking. We conducted a systematic review and meta-analysis of observational studies to extend the current evidence about the association of statin use in older people primary prevention group with risk of CVD and mortality. Methods: PubMed, Scopus, and Embase were searched from inception until March 18, 2021. We included observational studies (cohort or nested case-control) that compared statin use vs non-use for primary prevention of CVD in older people aged ≥ 65 years; provided that each of them reported the risk estimate on at least one of the following primary outcomes: all cause-mortality, CVD death, myocardial infarction (MI), and stroke. Risk estimates of each relevant outcome were pooled as a hazard ratio (HR) with a 95% confidence interval (CI) using the random-effects meta-analysis model. The quality of the evidence was rated using the GRADE approach. Results: Ten observational studies (9 cohorts and one case-control study; n = 815,667) fulfilled our criteria. The overall combined estimate suggested that statin therapy was associated with a significantly lower risk of all-cause mortality (HR: 0.86 [95% CI 0.79 to 0.93]), CVD death (HR: 0.80 [95% CI 0.78 to 0.81]), and stroke (HR: 0.85 [95% CI 0.76 to 0.94]) and a non-significant association with risk of MI (HR 0.74 [95% CI 0.53 to 1.02]). The beneficial association of statins with the risk of all-cause mortality remained significant even at higher ages (> 75 years old; HR 0.88 [95% CI 0.81 to 0.96]) and in both men (HR: 0.75 [95% CI: 0.74 to 0.76]) and women (HR 0.85 [95% CI 0.72 to 0.99]). However, this association with the risk of all-cause mortality remained significant only in those with diabetes mellitus (DM) (HR 0.82 [95% CI 0.68 to 0.98]) but not in those without DM. The level of evidence of all the primary outcomes was rated as "very low." Conclusions: Statin therapy in older people (aged ≥ 65 years) without CVD was associated with a 14%, 20%, and 15% lower risk of all-cause mortality, CVD death, and stroke, respectively. The beneficial association with the risk of all-cause mortality remained significant even at higher ages (> 75 years old), in both men and women, and in individuals with DM, but not in those without DM. These observational findings support the need for trials to test the benefits of statins in those above 75 years of age

Efficient Enumeration of Bipartite Subgraphs in Graphs

Subgraph enumeration problems ask to output all subgraphs of an input graph that belongs to the specified graph class or satisfy the given constraint. These problems have been widely studied in theoretical computer science. As far, many efficient enumeration algorithms for the fundamental substructures such as spanning trees, cycles, and paths, have been developed. This paper addresses the enumeration problem of bipartite subgraphs. Even though bipartite graphs are quite fundamental and have numerous applications in both theory and application, its enumeration algorithms have not been intensively studied, to the best of our knowledge. We propose the first non-trivial algorithms for enumerating all bipartite subgraphs in a given graph. As the main results, we develop two efficient algorithms: the one enumerates all bipartite induced subgraphs of a graph with degeneracy $k$ in $O(k)$ time per solution. The other enumerates all bipartite subgraphs in $O(1)$ time per solution

NLRP6 negatively regulates innate immunity and host defence against bacterial pathogens

Members of the intracellular nucleotide-binding and oligomerization domain (NOD)-like receptor (NLR) family contribute to immune responses through activation of nuclear factor-kappa B (NF-kappa B), type I interferon and inflammasome signalling(1). Mice lacking the NLR family member NLRP6 were recently shown to be susceptible to colitis and colorectal tumorigenesis(2-4), but the role of NLRP6 in microbial infections and the nature of the inflammatory signalling pathways regulated by NLRP6 remain unclear. Here we show that Nlrp6-deficient mice are highly resistant to infection with the bacterial pathogens Listeria monocytogenes, Salmonella typhimurium and Escherichia coli. Infected Nlrp6-deficient mice had increased numbers of monocytes and neutrophils in circulation, and NLRP6 signalling in both haematopoietic and radioresistant cells contributed to increased susceptibility. Nlrp6 deficiency enhanced activation of mitogen-activated protein kinase (MAPK) and the canonical NF-kappa B pathway after Toll-like receptor ligation, but not cytosolic NOD1/2 ligation, in vitro. Consequently, infected Nlrp6-deficient cells produced increased levels of NF-kappa B-and MAPK-dependent cytokines and chemokines. Thus, our results reveal NLRP6 as a negative regulator of inflammatory signalling, and demonstrate a role for this NLR in impeding clearance of both Gram-positive and -negative bacterial pathogens