High-grade cervical dysplasia in pregnancy – psychological and medical challenges

Despite being rare, the incidence of pregnancy-related cancer is expected to rise as women continue to delay childbearing and give birth later in their reproductive years. In this broad category, tumors like breast cancer, dermatological neoplasia and cervical cancer are most common and tend to arise in women of childbearing age. All pregnant women with clinical and cytologic suspicion of cervical cancer, except for squamous atypia or low-grade squamous intraepithelial lesions, should undergo colposcopy, with or without biopsy, the latter being avoided if possible due to possible complications which, although rare, may involve preterm labor initiation. Some studies have attempted to assimilate comparable results of USG with MRI during the gestational period by determining the sensitivity, specificity, and accuracy of trans-rectal ultrasound (TRUS) in comparison to magnetic resonance imaging (MRI). In order to identify the proper way to diagnose and treat the disease, because of the complexity due to pregnancy, a multidisciplinary team consisting of a gynecologist, medical and surgical oncologist, and radiologist should be assembled. Both maternal and fetal wellbeing should be taken into consideration when the medical team must choose among termination of pregnancy, delay of maternal treatment, and iatrogenic preterm delivery. Psychological counseling also plays an important role and due to the sensitivity of the issue, should continue through gestation and the postpartum. In order to develop optimal guidelines for diagnosis, treatment, and outcome issues, large scale prospective studies are needed, but feasibility may be limited due to the scarcity of cervical cancer cases associated with pregnancy

Effects of scalp block with bupivacaine versus levobupivacaine on haemodynamic response to head pinning and comparative efficacies in postoperative analgesia: A randomized controlled trial

Objective This study was performed to determine the effects of scalp blocks with bupivacaine versus levobupivacaine on the haemodynamic response during craniotomy and the efficacies and analgesic requirements of these drugs postoperatively. Methods This randomized, prospective, placebo-controlled, double-blind study included 90 patients (age, 18-85 years; American Society of Anesthesiologists physical status, I or II). The patients were randomly divided into three groups: those who received 20mL of 0.5% bupivacaine (Group B, n=30), 20mL of 0.5% levobupivacaine (Group L, n=30), or saline as a placebo (Group C, n=30). Scalp blocks were performed 5min before head pinning. The primary outcome was the mean arterial pressure (MAP), and the secondary outcomes were the heart rate (HR), visual analogue scale (VAS) scores, and additional intraoperative and postoperative drug use. Postoperative pain was evaluated using a 10-cm VAS. Results During head pinning and incision, the MAP and HR were significantly higher in Group C. The additional drug requirement for intraoperative hypertension and tachycardia was significantly higher in Group C. There were no significant differences in MAP, HR, or VAS scores between Groups B and L. Conclusion Both bupivacaine and levobupivacaine can be effectively and safely used for scalp blocks to control haemodynamic responses and postoperative pain

EVALUASI TEKNIS PENGGUNAAN KOLOM KOMPOSIT BAJA BETON PADA BANGUNAN BERTINGKAT BANYAK

 Saat ini kolom pada bangunan tinggi banyak menggunakan material beton bertulang. Seiring berkembangnya teknologi, kayu dan beton yang selama ini digunakan penuh dalam setiap pembangunan gedung, kini sudah mulai beralih menggunakan material baja. Pada akhirnya terciptalah berbagai metode dalam desain struktur salah satunya struktur komposit yang terdiri dari gabungan baja dan beton. Dengan menggunakan material baja ini selain dapat mengurangi masalah bagi lingkungan juga proses pengerjaannya yang terbilang lebih cepat dari konstruksi beton bertulang biasa. Pada penelitian ini didesain 3 model gedung lantai 15 dengan dimensi bangunan 24x36 m2 dimana masing-masing model kolom materialnya menggunakan beton bertulang, baja dan komposit baja-beton. Didesain dengan fungsi gedung, wilayah gempa dan pembebanan yang sama, yang nantinya akan dibandingkan ketiga kolom tersebut. Hasil penelitian menunjukkan bahwa kolom komposit baja-beton lebih optimal untuk digunakan pada struktur gedung yang direncanakan. Hal ini ditunjukkan dengan dimensi yang lebih kecil, kebutuhan materialnya lebih rendah juga memiliki kelebihan struktur yang cenderung menyerupai kolom baja serta memiliki ketahanan terhadap bahaya kebakaran. Kata Kunci: Bangunan bertingkat, Kolom Komposit, Kolom Beton Bertulang, SAP 200

Microbial Water Quality Assessment of Packaged Drinking Water of Pre-School Children in some Parts of Accra

Episodes of Cholera outbreaks are still common in most developing countries and children usually are at the greatest risk. This study assessed the importance of diarrhoea-related illnesses among children five years of age or less at the University Hospital, Legon and the importance of packaged water handling in the contamination of drinking water of pre-school children. Diarrhea-related diseases (DRD) accounted for 6.3% of cases involving children five years and below reporting at the University Hospital, Legon during the period of the study. Generally, greater number of cases (DRD) were reported among males (6.9%) than among females (5.6%). High counts above recommended levels of either Total Heterotrophic Bacteria, Pseudomonas or Total Coliforms were observed in 88% of the water samples tested. Inadequate cleaning of water bottles and in some instances the use of inappropriate water bottles (reusing PET mineral water containers) contributed to the poor quality of the drinking water of the preschool children. A greater part of the contamination of the drinking water occurred at home and not at the schools. Parents therefore need to be targeted with water, sanitation and hygiene related health education

Effects of conjugated linoleic acid and exercise on bone mass in young male Balb/C mice

There is an increase in obesity among the population of industrialized countries, and dietary supplementation with Conjugated Linoleic Acid (CLA) has been reported to lower body fat mass. However, weight loss is generally associated with negative effects on bone mass, but CLA is reported to have beneficial effects on bone. Furthermore, another factor that is well established to have a beneficial effect on bone is exercise (EX). However, a combination therapy of CLA and EX on bone health has not been studied. In this paper, we report the beneficial effects of CLA and EX on bone, in four different groups of Balb-C young, male mice. There were 4 groups in our study: 1. Safflower oil (SFO) sedentary (SED); 2. SFO EX; 3. CLA SED; 4. CLA EX. Two months old mice, under their respective treatment regimens were followed for 14 weeks. Mice were scanned in vivo using a DEXA scanner before and after treatment. At the end of the treatment period, the animals were sacrificed, the left tibia was removed and scanned using peripheral quantitative computerized tomography (pQCT). The results showed that although CLA decreased gain in body weight by 35%, it however increased bone mass by both reducing bone resorption and increasing bone formation. EX also decreased gain in body weight by 21% and increased bone mass; but a combination of CLA and EX, however, did not show any further increase in bone mass. In conclusion, CLA increases bone mass in both cancellous and cortical bones, and the effects of CLA on bone is not further improved by EX in pure cortical bone of young male mice

Photoreactivation of total heterotrophic bacteria in bottled drinking water after inactivation with pulsed ultra-violet light

Bacteria which cause opportunistic infections such as Pseudomonas can self resuscitate incircumstances where effective UV disinfection is compromised and is exposed to sunlight. The study investigated the effect of sub-lethal doses of pulsed ultra-violet (PUV) light on total heterotrophic bacteria (THB) in three brands of bottled water packed in glass and plastic bottles and how photoreactivation and dark repair occurred. The effect of exposure time on photoreactivation of Escherichia coli and Pseudomonas aeruginosa after inactivation with PUV was also investigated. THB in brands 1, 2 and 3 were completely inactivated by 7, 3 and 5 pulses of UV light respectively. Light repair of THB varied in the three brands of bottled water due perhaps to differences in the ionic composition of the three brands. Brands 1, 2 and 3 having 0.4, 0.7 and 1.7 log units of repair. respectively. Evidence of dark repair was not significant. Photo-repair in E. coli and Pseudomonas aeruginosa increased gradually with continual exposure to irradiating light for a period after which there was a decrease, suggesting that for a particular bacterium and illuminating source, an optimum time of exposure exist during which maximum photo-repair occur

PERENCANAAN ULANG BANGUNAN STRUKTUR BAJA RUMAH SAKIT UMUM RATUMBUYSANG DI KOTA MANADO

Perencanaan ulang bangunan struktur baja Rumah Sakit Umum Ratumbuysang di Kota Manado dilakukan untuk mendapatkan dimensi yang optimal dan efisien dari elemen-elemen strukturnya, sesuai dengan beban rencana agar bangunan tersebut dapat berfungsi sebagaimana mestinya.Metode yang digunakan dalam mendesain atau menganalisa struktur baja pada pada bangunan ini adalah Direct Analisys Method (DAM), untuk mendapatkan gaya–gaya dalam, sedangkan kapasitas nominal dari penampang dan sambungan–sambungan diperoleh menggunakan metode LRFD atau DFBK sesuai SNI 1729-2015. Pembebanan sesuai dengan SNI 1727-2013 untuk beban gravitasi dan sesuai SNI 1726-2012 untuk beban lateral (gempa). Konfigurasi rangka struktur terdiri dari rangka sistem penahan beban gaya lateral dan rangka sistem penahan beban gravitasi. Elemen struktur menggunakan profil baja yang memenuhi syarat SNI 1729-2015.Dari hasil disain ulang struktur baja ini maka profil–profil yang digunakan untuk kolom 400 x 400 x 13 x 21, balok 400 x 200 x 8 x 13, Balok anak 300 x 150 x 6.5 x 9, serta sambungannya bervariasi sesuai dengan konfigurasi rangka.  Kata Kunci: Perencanaan, Struktur Baja, DAM, Gempa, LRF

KINERJA HIGH STRENGTH SELF COMPACTING CONCRETE DENGAN PENAMBAHAN ADMIXTURE “BETON MIX” TERHADAP KUAT TARIK BELAH

Peningkatan kekuatan beton adalah salah satu faktor yang utama yang diharapkan dalam teknologi beton. Dalam proses pengerjaan beton bertulang cukup sulit apabila dibandingkan dengan beton biasa apalagi bila jarak tulangan yang rapat sehingga sulit untuk dijangkau bila menggunakan alat vibrator atau alat pemadat dan pengecoran beton menjadi tidak sempurna. Dalam penelitian ini digunakan beton mutu tinggi memadat sendiri atau high strength self compacting concrete (HSSCC) dengan variasi persentase superplasticizer berupa Beton mix 1,5%; 1,6%; 1,7% dan dibandingkan dengan beton mutu tinggi tanpa penambahan superplasticizer dan pengurangan air sebesar 15%. Benda uji yang dibuat berbentuk silinder diameter 10 cm dan tinggi 20 cm. Pengujian beton segar meliputi uji slump flow, L-Shaped Box dan V-Funnel dan umur 28 hari uji kuat tekan dan kuat tarik belah. Tes workability menunjukan bahwa Beton Mix dengan persentase 1,6% mampu pencapai kriteria scc. Dari hasil pengujian kuat tekan dengan variasi 0% mencapai 57,63 MPa, 1,5% mencapai 47,18 MPa, 1,6% mencapai 54,68 MPa dan 1,7% mencapai 49,21 MPa. Kata kunci : HSSCC,Superplasticizer,Kuat Tekan, Kuat Tarik Bela

Pengaruh Dosis Pupuk Mitra Flora dan Ekstrak Daun Kelor (Moringa oleifera) Terhadap Pertumbuhan dan Hasil Tanaman Sawi (Brassica juncea L.)

This study aims to determine the effect of liquid fertilizer Mitra Flora and moringa leaf extract on the growth and yield of mustard and to know the dose of liquid fertilizer Mitra Flora and moringa leaf extract that is appropriate for the growth and yield of mustard greens. The design used was factorial randomized block design with 3 replications. The first factor is Mitra Flora fertilizer dosage consists of three levels ie without liquid fertilizer Mitra Flora, 60 ml/plant, 120 ml/plant. The second factor is Moringa leaf extract consists of three levels, without extract of Moringa leaves, 75 ml/plant, 150 ml/plant. The result showed that there was no influence of interaction between Mitra Flora fertilizer and moringa leaf extract on all parameters observed, as well as the main influence of each factor of treatment either Mitra Flora fertilizer dosage or moringa leaf extract also did not occur on all parameters observed. Fertilizer dosage of Mitra Flora 60 ml per plant is the optimum dosage that gives the yield of mustard weighs 149.1 g per plant. The dose of moringa leaf extract of 150 ml per plant gives the best weave yield weighing 153 g per plant. Penelitian ini bertujuan untuk mengetahui pengaruh pupuk cair Mitra Flora dan ekstrak daun kelor terhadap pertumbuhan dan hasil sawi serta mengetahui dosis  pupuk cair Mitra Flora dan ekstrak daun kelor yang tepat bagi pertumbuhan dan hasil sawi. Penelitian menggunakan Rancangan Acak Kelompok (RAK) faktorial 3 x 3 yang diulang 3 kali. Faktor pertama adalah dosis pupuk Mitra Flora terdiri dari tiga aras yaitu tanpa pupuk cair Mitra Flora, 60 ml/tanaman, 120 ml/tanaman. Faktor kedua adalah ekstrak daun kelor terdiri dari tiga  aras yaitu tanpa ekstrak daun kelor, 75 ml/tanaman, 150 ml/tanaman. Hasil penelitian menunjukkan bahwa tidak terjadi pengaruh interaksi antara pupuk Mitra Flora dan ekstrak daun kelor terhadap semua parameter yang diamati, demikian juga pengaruh utama masing-masing faktor perlakuan baik dosis pupuk Mitra Flora maupun ekstrak daun kelor juga tidak terjadi terhadap semua parameter yang diamati. Dosis pupuk Mitra Flora 60 ml per tanaman merupakan dosis yang optimum yang memberikan hasil sawi seberat 149,1 g per tanaman. Dosis ektrak daun kelor 150 ml per tanaman memberikan hasil sawi terbaik seberat 153 g per tanaman.&nbsp