A study to analyse the effects of hold relax technique in increasing shoulder range of motion and quality of life in chronic COPD patients having secondary postural deformities: An Experimental study

INTRODUCTION: Chronic Obstructive Lung Disease (COPD) is a lung disease characterized by chronic obstruction of lung air flow that interferes with normal breathing and it is not fully reversible. GOLD(Global initiative for Chronic Obstructive Lung Disease), defines COPD as a “preventable and treatable disease with some significant extra pulmonary effects that may contribute to the severity in individual patients. Its pulmonary component is characterized by airflow limitation that is not fully reversible. The airflow limitation is usually both progressive and associated with abnormal inflammatory response of lungs to noxious particles or gases”. COPD is common worldwide, contributes to major disability as well as economic and social burden. By 2020 COPD is expected to be the third leading cause of death. 14 Million Indians are suffering from COPD (Indian Journal Chest Disability and Allied Sciences). In India the 5% of Adults are affected and men are affected more than women. OBJECTIVES: The objective of my study is to determine: 1. Whether the specific H-R technique is capable of reversing the effect of pectorals major muscle tightness by increasing shoulder horizontal extension range of motion. 2. Whether the specific H-R technique is capable of reducing the secondary postural deformities, thereby improving Quality of Life in the same population. 3. Whether the free exercises of upper limb are capable of increasing shoulder range of motion and quality of life. METHODOLOGY: Study Design: Two group Pre & Post test Experimental study design. Study Setting: Study was conducted at the Department of Pulmonology, K.G Hospital, Coimbatore. Study Duration: Study was conducted for a period of 3 months (12 weeks). Sampling Technique: Simple Random Sampling by lot method. Criteria for Selection Inclusion Criteria: • Patients classified as having mild COPD by the physicians were taken for the study. • Ability to perform exercises. • Both sexes. • Patient in age group between 40-55years. Exclusion Criteria: • Patients with any associated problems of COPD. • Recent acute exacerbation of disease. • Conditions that contraindicate the application of hold and relax techniques. • Secondary musculoskeletal disorders. • Recent fractures or injury to the ribs, clavicle or upper limb. • Recurrent subluxation or dislocation of either shoulder. • Inability to perform isometric contraction. • Connective tissue disorder. • Ischemic heart diseases. • Uncontrolled hyper tension. • Moderate to severe osteoporosis. • Addtional conditions restricting chest expansion (e.g. Obesity, severe scoliosis, ankylosing spondylitis). • Systemic disease muscles and joints (e.g. Rheumatoid arthritis). • Radical mastectomy with removal of the pectoralis major muscle. • Recent chest or abdominal surgery. RESULT AND CONCLUSION: This study was focused on analyzing the effects of hold – relax technique in improving the restrictive component of COPD, and extensibility of pectoralis major muscle and possibly overcome some of the postural change of COPD. About 30 subjects after fulfilling the inclusive criteria were divided into experimental and control group with 15 subjects in each group. Experimental group subjects underwent hold – relax technique and control group underwent free exercises. Based on statistical analysis, Student ‘t’ test at 5% level of significance P value is less than 0.05 and calculated value is greater than the tabulated value thereby showing significant improvement in shoulder extension range of motion and quality of life. The demographic representations of the groups are given in Table I (Pg-30). Age group of the participants varies from 40 years to 55 years and about 20 % from 40—43 years, 23% from 44—47 years, 33% from 48—52 years and 24% from 53—55 years. The first Paired ‘t’ test analysis for the pre test and post test variable for measuring the Right Shoulder horizontal extension range of motion in Group A and Group B is shown in Table II (pg-32) and III (pg-34). Both the groups shows a significant difference between the pre test and post test values. The ‘t’ value for the Group A is 16.58 the ‘t’ value for the Group B is 15.28 and it shows a significant percentile difference of 64% and 27% in Group A and B respectively. The Paired ‘t’ test analysis for the pre test and post test variable for measuring the Left Shoulder horizontal extension range of motion in Group A and Group B is shown in table V (pg-39) and VI (pg-41). Both the groups shows a significant difference between the pre test and post test values. The ‘t’ value for the Group A is 22.20 the ‘t’ value for the Group B is 21.37 and it shows a significant percentile difference of 53% and 26% in Group A and B respectively. The unpaired ‘t’ test analysis for the Post test variables for Both groups for the Shoulder horizontal extension Range Of Motion is shown in the table IV (right side) (pg-36) and table VII (left side) (pg-43). There was a significant difference shown between the Groups. Group B subjects show improvement than Group A. The ‘t’ value for the post test variables for both groups is 4.1583 (Right shoulder ROM) and 4.1275 (Left shoulder ROM). The second Paired ‘t’ test analysis for the pre test and post test variable for measuring the Quality of Life in Group A and Group B is shown in table VIII (pg-45) and IX (pg-47). Both the groups shows a significant difference between the pre test and post test values. The ‘t’ value for the Group A is 13.048 the ‘t’ value for the Group B is 11.521 and it shows a significant percentile difference of 29% and 14% in Group A and B respectively. The unpaired ‘t’ test analysis for the Post test variables for Both groups for the Quality of Life is shown in the table X(pg-50). There was a significant difference shown between the Groups. Group B subjects show improvement than Group A. The ‘t’ value for the post test variables for both groups is 3.4774 This study therefore rejects the null hypothesis and accepts the alternate hypothesis . Compared to Group B : Group A showed significant improvement in shoulder horizontal extension range of motion and quality of life in subjects with chronic COPD. This study concluded that hold – relax technique , based on PNF given to chronic COPD patients having secondary postural deformity reversed the effect of tight chest wall muscles by increasing shoulder horizontal extension range of motion and this in turn helped the subjects in improving their quality of life

Pembentukan Konsep Pengaturan Upah di Atas Upah Minimum Yang Berkeadilan Bagi Pengusaha dan Pekerja

This research aims to propose ideal pattern of wages above minimum wage which could bring justice for entrepreneurs and labors. This research used normative research which examine the existing legal norms with conceptual approach, proposing a solutive concept on the problem of the wages above the minimum wage. The results show that the recent concept of wage above minimum wage is difficult to be implemented because it is strictly based on consensus. Thus, there must be determination of minimum value of the increase made by the government. The ideal amount should be as much as the percentage of the increase of minimum wage from the recent to the coming year, or if there is no increase by the coming year, as much as 50 percents of inflation. This concept must be governed in the implementing regulation such as government regulation

KEWENANGAN MEMBERI SANKSI ADMINISTRATIF KEPADA ORGANISASI OLAHRAGA DI INDONESIA (STUDI KASUS MENTERI PEMUDA DAN OLAHRAGA (MENPORA) VERSUS PERSATUAN SEPAK BOLA SELURUH INDONESIA (PSSI))

Menteri Pemuda dan Olahraga telah mengelurakan Surat Keputusan Menpora Nomor 01307 Tahun2015 yang kemudian menimbulkan polemik antara Menpora dan PSSI.PSSI kemudian juga menerimasanksi administratif dari FIFA karena dianggap telah mendapat intervensi dari pihak ketiga. PSSIkemudian menggugat SK Menpora tersebut ke Pengadilan Tata Usaha Negara karena menganggapMenpora tidak punya wewenang menjatuhkan sanksi administratif kepada PSSI. Permasalahan dalampenelitian ini adalah bagaimana kedudukan PSSI sebagai organisai olahraga serta bagaimanakewenangan memberi sanksi administratif kepada PSSI. Hasil penelitian menunjukkan bahwa PSSIadalah organisasi olahraga yang tunduk kepada peraturan nasional Indonesia dan peraturan FIFA secarabersamaan. Hal ini berarti, kedua lembaga tersebut memiliki kewenangan untuk memberi sanksiadministratif kepada PSSI apabila PSSI melanggar ketentuan yang ditetapkan oleh Menpora atauFIFA.Menteri Pemuda dan Olahraga telah mengelurakan Surat Keputusan Menpora Nomor 01307 Tahun2015 yang kemudian menimbulkan polemik antara Menpora dan PSSI.PSSI kemudian juga menerimasanksi administratif dari FIFA karena dianggap telah mendapat intervensi dari pihak ketiga. PSSIkemudian menggugat SK Menpora tersebut ke Pengadilan Tata Usaha Negara karena menganggapMenpora tidak punya wewenang menjatuhkan sanksi administratif kepada PSSI. Permasalahan dalampenelitian ini adalah bagaimana kedudukan PSSI sebagai organisai olahraga serta bagaimanakewenangan memberi sanksi administratif kepada PSSI. Hasil penelitian menunjukkan bahwa PSSIadalah organisasi olahraga yang tunduk kepada peraturan nasional Indonesia dan peraturan FIFA secarabersamaan. Hal ini berarti, kedua lembaga tersebut memiliki kewenangan untuk memberi sanksiadministratif kepada PSSI apabila PSSI melanggar ketentuan yang ditetapkan oleh Menpora atauFIFA

THE LEGAL CONSEQUENCES OF INCOMPLETE BUILDING LICENSE TO THE SALES AND PURCHASE AGREEMENT OF APARTMENTS (CASE STUDY OF MEIKARTA’S INCOMPLETE BUILDING LICENSE)

The construction of Meikarta, a place which is claimed as The New Jakartaon an Approximately 500 acres (ha) land has attracted public attention.There have been 117.797 reservation for apartments unit of Meikarta.However, the rejection from the government due to the incomplete buildinglicense of Meikarta has caused 2 main problems regarding the validity of theagreement of the apartment and its legal consequences caused by theincomplete building license. The purpose of this research are to examine thelegal validity of sales and purchase agreement of apartment which itsconstructing license is incomplete and To determine and describe the legalconsequences of it. This research will be conducted using normative legalresearch method. Normative Legal Research Method is a legal researchconducted by examining literacy sources or secondary sources.An Agreementof an apartment like Meikarta which its building license incomplete is nulland void.The status of an agreement that is null and void brings legalconsequences for each parties to restore themselves to the previous positionbefore the agreement was conducted, so that each parties should return backright of other party and vice versa

LC-MS/MS CHARACTERIZATION OF FORCED DEGRADATION PRODUCTS OF TUCATINIB, A NOVEL TYROSINE KINASE INHIBITOR: DEVELOPMENT AND VALIDATION OF RP-HPLC METHOD

Objective: The current study focused on the development, validation, and characterization of forced degradation products using LC-MS/MS. Methods: A simple, selective, validated and well-defined isocratic HPLC methodology for the quantitative determination of Tucatinib at a wavelength of 239 nm. An isocratic elution of samples was performed on an Inertsil ODS (250x4.6 mm, 5m) column with a mobile phase of 70:30v/v Acetonitrile and formic acid (0.1%) delivered at a flow rate of 1.0 ml/min. MS/MS was used to characterize degradation products formed in the forced degradation study. The validation and characterization of forced degradation products were performed in accordance with ICH guidelines. Results: Over the concentration range of 5-100μg/ml, a good linear response was obtained. Tucatinib's LOD and LOQ were determined to be 0.05 and 0.5, respectively. According to standard guidelines, the method was quantitatively evaluated in terms of system suitability, linearity, precision, accuracy, and robustness, and the results were found to be within acceptable limits. The drug was degraded under acidic, alkaline, and reduction conditions in forced degradation studies. Conclusion: The method was found to be applicable for routine tucatinib analysis. Because no LC-MS/MS method for estimating tucatinib and its degradation products has been reported in the literature. There is a need to develop a method for studying the entire tucatinib degradation pathway

The Implementation of Well-Known Trademarks Doctrine in Indonesian Commercial and Supreme Court

The implementation of well-known trademark in indonesia is still unsatisfying especially for foreign trademarks since many foreign trademarks that claimed themselves as well-known trademarks were not admitted for the trademarks were not yet registered or based on judges assessment, not fulfilling the criteria. This research aim is to analyse the implementation of well-known trademarks doctrine in Indonesian commercial and supreme court. The method used is normative-juridical with  statute and case study approach. The result shows that the commercial and supreme court have used the criteria of well-known trademarks as stipulated in Law no. 20 Year 2016 and Permenkumham no. 67 Year 2016 as well as WIPO Joint Recommendation in identifying a well-known trademark. However, the implementation is inconsistent. it is inconsistent because in one case (STARCO case), court prior to the first to file principle while in other case (Alexander Mcqueen case), court admit the trademark as a well-known trademark though it is not registered yet. The second case is coherence with the well-known trademark doctrine which the idea to protect a high reputed trademark even it is not registered. Secondly, the emptiness of the detailed criteria has made the judgement on well-known trademarks becomes widely opened for interpretation. Thus, the next convention and regulation must set aside the first to file principle and prior to the criteria only in identifying a well-known trademark. Moreover, the criteria of minimum number of registration or application should be revised by requiring the trademark to be registered or applied in at least 6 out of 10 countries with the biggest population in the world so that it is proven that the trademark is exist among the most world population. In addition, the standard level of legal enforcement must entail minimum two verdicts so that the enforcement has obtained a re-confirmation

Etnografi Komunikasi pada Tiga Generasi Anggota Perkumpulan Marga Ang di Bagansiapi-Api

Penelitian ini bertujuan untuk mencari tahu mengenai interaksi dan pola komunikasi yang terjadi dalam perkumpulan marga Ang sebagai klan keluarga terbanyak dan yang pertama menemukan kota Bagansiapi-api. Penelitian ini dilakukan dengan pendekatan kualitatif dan menggunakan metode etnografi komunikasi. Studi ini diperkuat oleh teori Interaksi Fisher (dalam Morissan, 2014) dan pola komunikasi oleh Effendy (1989) untuk membahas hasil penelitian. Subjek penelitian yang dilibatkan antara lain seorang key informant dan empat informan yang merupakan anggota aktif serta empat informan yang merupakan anggota pasif dari perkumpulan marga Ang. Melalui hasil penelitian ini ditemukan seluruh tahapan interaksi Fisher hanya terjadi pada generasi ketiga pada kelompok aktif dan generasi pertama kelompok pasif. Pada kelompok aktif menggunakan pola komunikasi multi arah, hanya generasi ketiga yang menerapkan pola komunikasi dua arah. Di sisi lain, pada kelompok pasif hanya terdapat pola komunikasi satu arah di generasi pertama dan tidak ada pola komunikasi yang terjadi pada generasi muda

Program Application Page Web Browser to Display Using the Internet in Delphi 5

The Internet is an unlimited source of information, information on the Internet arepresented in various forms. One form of information available on the Internet is theWorld Wide Web (WWW). WWW is a form of multimedia information preparedusing language that is Hypertaxt Markup Language (HTML).To access the WWW needed a web browser. Web Browser works as a client Dimanclient requested a file from a server in the form of HTML and also displaysinformation to the desktop in the form of multimedia.To create a Web Browser needed an object-oriented programming language calledObject Oriented Program (OOP). One of these programming languages are Delphi 5.With Delphi 5 is very possible someone can make a web browser, since Delphi 5support in the Internet-based programming

Percobaan Perbaikan Campuran "Tempe Fish Rice"

Telah dilakukan percobaan perbaikan "Tempe Fish Rice" (TFR) sebagai sumber protein untuk anak pra sekolah, dengan menggunakan bahan-bahan yang dipakai untuk membuat TFR lama, tetapi dalam susunan yang berbeda. Mutu TFR yang dibuat dalam penelitian ini lebih baik dari pada mutu TFR lama. Susunanzat gizinya tidak banyak berubah. Mutu protein diukur dengan NPU menunjukkan nilai agak tinggi. Penyimpanan selama 10 minggu tidak mengakibatkan Perubahan dalam aroma, rasa dan warna

RECONCEPTUALIZATION OF THE INDEMNIFICATION FOR STATE FINANCIAL LOSS BY CORRUPTORS ON THE BASIS OF PROPORTIONALITY, EFFECTIVENESS, EFFICIENCY, AND FUTURE REACH

ABSTRACTIn Indonesia, the concept of indemnification for state loss by corruptor has not met the elements of proportionality, effectiveness, efficiency, and future reach. Therefore, re-conceptualization of indemnification for state loss by corruptor is necessary to confront the cunning corruptor in hiding the proceeds of corruption. The re-conceptualization can be constructed by determining remedy sanction for every legal subject sentenced guilty to corruption. The remedy sanction should not only consider the amount of money corrupted, but also the time value of the money, the budget spent to handle the case, and the potential profits obtained when the money is used well as it should be. By this sanction, the amount of money determined as remedy sanction would be proportional and would not only cover as maximum as property acquired for the result of corruption as regulated by the current regulation. In addition, by this sanction, a civil lawsuit for the properties considered as the result of corruption that could spend much money and time would be no longer necessary. Someone convicted on corruption suppose to be automatically considered did default to his promise to the state. The default could be based on his failure in acting according to his official duty or based on an agreement in business relation between the legal subject and state. Should the corruptor couldn’t pay the remedy of state loss in full or partly, the remedy should not be replaced by prison sentence, but the remedy or the difference money should be reckoned as a debt to the state loss. Thus, the debt would be attached to the corruptor and would be a lifetime responsibility for the corruptor as long as he could not pay the debt to the state. The debt even would be continued by the heirs if the corruptor were pass away. Furthermore, this concept could reach the possibility that the wealth resulted of corruption would be used in the future because under these provisions, the future wealth gained by the corruptor could be executed as a part of the extinguishment of debt without considering whether the wealth were the result of corruption or not