Perencanaan Gerbang Tol Ciawi Sukabumi

Kemacetan lalu lintas menjadi permasalahan sehari – hari dalam ruas jalan nasional Ciawi – Sukabumi. Hal ini mendorong Pemerintah Pusat untuk membangun jaringan jalan bebas hambatan atau jalan tol Ciawi – Sukabumi. Jalan tol ini dibangun untuk membantu meningkatkan konektivitas dan mengembangkan potensi ekonomi daerah sekitar untuk Provinsi Jawa Barat. Jalan tol ini diharapkan dapat mendukung program pemerintah yang telah ditetapkan didalam Peraturan Daerah Kota Sukabumi Nomor 8 tahun 2008 tengang Rencana Pembangunan Jangka Panjang Daerah (RPJPD) Kota Sukabumi Tahun 2005 – 2025 tentang pembangunan jalan tol yang berdampak pada upaya pertumbuhan ekonomi kota. Jalan tol merupakan fasilitas transportasi dengan tujuan untuk memperlancar lalu lintas daerah dan meningkatkan mobilitas orang dan barang. Jalan tol sendiri memiliki gerbang tol yang merupakan tempat proses pelayanan transaksi tol terjadi. Gerbang tol terdiri dari beberapa gardu tol. Sistem yang dapat digunakan pada gerbang tol yaitu sistem gardu tol otomatis (GTO), On Board Unit (OBU), dan Multi Lane Free Flow (MLFF). Perencanaan ini akan merencanakan Gerbang Tol Ciawi - Sukabumi pada tahun 2021, 2026, dan 2031.Metodologi yang digunakan sebagai disiplin antrian adalah First In First Out untuk disiplin antrian dan Single Channel – Single Phase sebagai struktur dasar antrian pada perencanaan gerbang tol ini. Serta mempertimbangkan gerbang tol otomatis dan On Board Unit, dan Multi Lane Free Flow (MLFF). Setelah dilakukan pengolahan data, didapatkan hasil untuk perencanaan gerbang tol pada tahun 2021 untuk gerbang tol Ciawi hingga Sukabumi Timur terdapat 1 GTO Khusus, 1 GTO, dan 1 OBU. Pada perencanaan gerbang tol tahun 2026 untuk gerbang tol Ciawi terdapat 2 GTO Khusus, 2 GTO, dan 1 OBU dan Pada perencanaan gerbang tol tahun 2031 untuk gerbang tol Ciawi terdapat 2 GTO Khusus, 3 GTO, dan 1 OBU. Hasil perencanaan MLFF pada tahun 2021 untuk gerbang tol Ciawi didapatkan nilai derajat kejenuhan sebesar 0,172

Large-eddy simulation of Rayleigh-B\'enard convection for extreme Rayleigh numbers

We adopt the stretched spiral vortex sub-grid model for large-eddy simulation (LES) of turbulent convection at extreme Rayleigh numbers. We simulate Rayleigh-B\'enard convection (RBC) for Rayleigh numbers ranging from $10^6$ to $10^13$ and for Prandtl numbers 0.768 and 1. We choose a box of dimensions 1:1:10 to reduce computational cost. Our LES yields Nusselt and Reynolds numbers that are in good agreement with the direct-numerical simulation (DNS) results of Iyer et al. (Proc. Natl. Acad. Sci., vol 117 (14), 2020, pp. 7594-7598), albeit with a smaller grid size and at significantly reduced computational expense. For example, in our simulations at $Ra = 10^13$, we use grids that are 1/120 times the grid-resolution as that of the DNS (Iyer et al., Proc. Natl. Acad. Sci., vol 117 (14), 2020, pp. 7594-7598). The Reynolds numbers in our simulations range from 1,000 to 200,000. Consistent with the literature, we obtain scaling relations for Nusselt and Reynolds numbers as $Nu \sim Ra^{0.322}$ and $Re \sim Ra^{0.502}$. We also perform LES of RBC with periodic side-walls, for which we obtain the corresponding scaling exponents as 0.343 and 0.477 respectively. Our LES is a promising tool to push simulations of thermal convection to extreme Rayleigh numbers, and hence enable us to test the transition to ultimate convection regime.Comment: 26 pages, 15 figures. Submitted to Journal of Fluid Mechanic

To Identify Drug-Drug Interaction in Cardiac Patients in Tertiary Care Hospitals

The potential for drug-drug interactions (pDDIs) is higher with cardiac medications, and reports of pDDIs in cardiovascular patients are more common. Multimorbidity, a greater number of drugs prescribed, longer hospital stays, complexity of disease, physiological changes with advancing age or conditions like renal failure, shock, hepatic disease like cirrhosis or acute viral hepatitis, stages of disease, and the influence of heart disease on drug metabolism make patients with CVD especially susceptible to DDIs. Our research found that pDDIs occurred at a much higher rate than expected in the Cardiology Division. Incidence of pDDIs was observed to rise with age, polypharmacy, and duration of hospital stay; pDDIs were also more common in males than females. Most of the interactions were of a pharmacodynamic character and were considered to be quite serious. Most pDDIs involved aspirin and clopidogrel, then aspirin and enalapril, and finally enalapril and enalapril. The surveillance of pDDIs in cardiac inpatients may benefit from the creation of such a database in hospitals

Clinical Pharmacology & Therapeutic uses of Diuretic Agents: A Review

The osmolarity of both blood and urine will increase if the kidneys are unable to eliminate excess water and electrolytes. NPS can be treated by restricting salt intake and using diuretics. Loop diuretics. Salt and water are flushed out of the body by diuretics. Medications have a sodium-lowering effect. arteries parched with salt BP-lowering. Albumin and diuretics both have the effect of decreasing sensitivity. Furosemide inhibits albumin. Fail-safe. Albuminuria, coagulopathy, dyslipidemia, edema. Diuretics are used to treat both edema and non-edema. Diuretics are used to treat heart failure, high blood pressure, and ascites (and other disorders when applicable). Treatment of heart failure, side effects, off-label usage, dose, pharmacokinetics, monitoring, and interactions are all topics that will be covered in this article. Thiazide diuretics that are authorized by the FDA impede between 3 and 5 percent of nephron DCT sodium reabsorption. Thiazides cause a person to urinate more often. Nephron trafficking is slowed down when diuretics are used. Furosemide, bumetanide, torsemide inhibit Na-K-2Cl (SLC12A1). Chloride-binding proteins can only be bound to by anions. Perform the initial dose once again. Bronchodilators that open up the airways. The administrator of the test will be able to tell if your airways constrict (spirometry). Chemicals that because inflammation weaken smooth muscle. Drops of 15 percent in the forced expiratory volume in one second (FEV1) suggest airway hyperreactivity and inflammation

Fallopian tube as a cause of intestinal obstruction: a rare case report with review of literature

Adhesive Intestinal obstruction is the most common cause of intestinal obstruction in post-operative period. Diagnosis is based on history, clinical examination, plain X-ray abdomen. Authors here report an interesting case of intestinal obstruction after surgery for chronic calcific pancreatitis with pancreatic duct stone with intractable pain. In post-operative period patient developed features of intestinal obstruction, patient was planned for re- exploration and it was found that band was formed by left fallopian tube with transition point at terminal ileum and treated successfully with left Salpingectomy. Very few cases of fallopian tube as cause of intestinal obstruction have been reported in literature and it should be considered as one of the cause of intestinal obstruction in females presenting with acute abdomen

Vaginoplasty in vaginal agenesis associated with MRKH syndrome with tabularized peritoneal pull-through

In this paper, a 16 year old girl who was  diagnosed as a case of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, underwent a combined laparotomy-peritoneal approach to create a neovagina by using tubularized peritoneal graft with uneventful postoperative period. Vaginal dilation was maintained with a vaginal mould daily for six months and three to four times weekly thereafter. She was followed-up after 2 and 4 weeks in the first month and three monthly for a duration of six months. On second follow-up, adequate vaginal length of 6-7 cm and width of 2.5-3 cm were achieved with healthy vaginal tissue. Hence, the laparotomy-peritoneal approach of using a peritoneal graft for creations of a neovagina can be  an effective approach  with  minimal  surgical morbidity to  create  a passageway for satisfactory intercourse

Identification of culturable vaginal Lactobacillus species among reproductive age women in Mysore, India

A healthy vaginal environment is predominated by certain Lactobacillus species, which lead to the prevention of infections of the reproductive tract. This study examined the characteristics of cultivable Lactobacillus species in both healthy women and women with bacterial vaginosis (BV). Between November 2011 and September 2013, 139 women attending a women\u27s clinic in Mysore, India, were evaluated for BV in a cross-sectional study. BV was diagnosed using Amsel\u27s criteria: homogeneous vaginal discharge, vaginal pH \u3e4.5, production of amines, and presence of “clue” cells. Those with three or more of the characteristics were considered to have BV. Vaginal swabs were then cultured in Rogosa agar and de Man-Rogosa-Sharpe broth. Gram-positive lactobacilli generating 600–800 bp amplicons by16 sRNA were further characterized by sequencing. Cultivable vaginal samples were obtained from 132 women (94.9 %). According to the Amsel criteria, 83 women (62.1 %) were healthy, and 49 (37.1 %) had BV. Eleven different Lactobacillus species were isolated from 47 women. The common lactobacilli species found in this sample included L. crispatus (39.6 %), L. gasseri (45.8 %), and L. jensenii (14.6 %). Lactobacilli were isolated from 39 healthy women and eight with BV. L. gasseri was cultured from 18.8 % of healthy women and 6.1 % with BV. The presence of L. reuteri was significantly associated with normal vaginal microbiota (P-value = 0.026). These results further our understanding of vaginal lactobacilli colonization and richness in this particular population. Our findings showed that lactobacilli species present in the vaginas of healthy women in India do not differ from those reported from other countries

Management of Treatment and Prevention of Acute OP Pesticide Poisoning by Medical Informatics, Telemedicine and Nanomedicine

Acute organophosphorous pesticide (OP) poisoning kills a lot of people each year. Treatment of acute OP poisoning is of very difficult task and is a time taking event. Present day informatics methods (telemedicine), bioinformatics methods (data mining, molecular modeling, docking, cheminformatics), and nanotechnology (nanomedicine) should be applied in combination or separately to combat the rise of death rate due to OP poisoning. Use of informatics method such as Java enabled camera mobiles will enable us early detection of insecticidal poisoning. Even the patients who are severely intoxicated (suicidal attempts) can be diagnosed early. Telemedicine can take care for early diagnosis and early treatment. Simultaneously efforts must be taken with regard to nanotechnology to find lesser toxic compounds (use less dose of nanoparticle mediated compounds: nano-malathion) as insecticides and find better efficacy of lesser dose of compounds for treatment (nano-atropine) of OP poisoning. Nano-apitropine (atropine oxide) may be a better choice for OP poisoning treatment as the anticholinergic agent; apitropine and hyoscyamine have exhibited higher binding affinity than atropine sulfate. Synthesis of insecticides (malathion) with an antidote (atropine, apitropine) in nanoscale range will prevent the lethal effect of insecticides

Microarray-Based Analysis of Differential Gene Expression between Infective and Noninfective Larvae of Strongyloides stercoralis

Strongyloides stercoralis is a soil-transmitted helminth that affects an estimated 30–100 million people worldwide. Chronically infected persons who are exposed to corticosteroids can develop disseminated disease, which carries a high mortality (87–100%) if untreated. Despite this, little is known about the fundamental biology of this parasite, including the features that enable infection. We developed the first DNA microarray for this parasite and used it to compare infective third-stage larvae (L3i) with non-infective first stage larvae (L1). Using this method, we identified 935 differentially expressed genes. Functional characterization of these genes revealed L3i biased expression of heat shock proteins and genes with products that have previously been shown to be immunoreactive in infected humans. Genes putatively involved in transcription were found to have L1 biased expression. Potential chemotherapeutic and vaccine targets such as far-1, ucr 2.1 and hsp-90 were identified for further study