Perencanaan Jembatan “Berdikari” Kali Garang

This final project consists of redesign of Berdikari-Kali Garang Bridge by using Prestressed Box Girder Concrete. The construction method that is used in this project is segmental box girder. And for the prestressed system, the type of cantilever is based on the consideration of the length of this bridge which has 240 meters length, and is devided into 3 quarters, which are : 60 m + 120 m + 60 m. The design of this bridge begins with the explaination of the background for the choice of the bridge type, the purpose for this study is followed with the fundamental of design, which is analyzed is based on the BMS '92. from the original data, the preliminary design is done by determining the main dimension of the bridge. In the initial phase, the design of load analyzed are used. Load analyze are self weight, dead load, additional weight, traffic load, and time analyze because of creep, and loss of prestressed. From the analyze, than did the allowable stress control. After, did the box reinforcement calculation, allowable deflection, shear calculation, strength and stability calculation which are crack moment control, limit moment, divided force, and torque. At the end of design stage is did the support design. Upon completion stage box, then do the structural design under the initial step to determine cross-sectional dimensions of the pillars and abutments plan which will be calculated ultimate load that will be used to analyze the strength of pillars and abutments. Recent stages of planning the foundation pillars and abutments. The end result of this planning and cross section shape. Where that will be calculated from the price of the building to be used

Perencanaan Jalur Ganda (Double Track) Jalan Rel Ruas Semarang – Gubug

Based on National Railways Master Plan (RIPNAS) of Directorate General of Railways Ministry of Transportation (2011), in 2030, number of railway pessangers in Java increased in the amount of 858.5 million people / year and freight in Java amounted to 534 million tons / year. Therefore, the government planed to develop the railway network in Java with Double Track program or multiple pathways in order to achieve optimal service, the development of a single track to double track between Semarang Tawang Station in Semarang until Gubug station in Grobogan were included. From the design performed, the double track alignment will be placed on the right side of the existed alignment in direction from Semarang to Gubug where there are more open land availability, with the new lines elevation as high as the existed lines elevation. Railway constructed in accordance with the first class railway classification with R54 rails type, double elastic\u27s fastening system using Pandrol e-clip type with rubber pad, PT.WIKA Beton prestressed concrete sleppers N-67 type , upper ballast thickness of 30 cm and 15 cm thick sub ballast. Double track railway\u27s subgrade situated more on the fill positions between 30 cm to 165 cm height using retaining wall reinforcement. Side channel surface drainage with a rectangular cross section from reinforced concrete

THE COMPARISON OF CONFIGURATION, DEGREE AND SITES OF OBSTRUCTION IN PATIENTS WITH SLEEP DISORDERED BREATHING: EXAMINATION USING DRUG-INDUCED SLEEP ENDOSCOPY, MUELLER MANEUVER AND POLYSOMNOGRAPHY

Objective: The purpose of this study is to evaluate the location, configuration, and degree of differences in upper airway obstruction between the Mueller Maneuver (MM) and Drug-induced sleep endoscopy (DISE), thus acquiring a better diagnostic value for SDB patients. Methods: A cross-sectional and analytical descriptive study using retrospective secondary data to evaluate the location, configuration and degree of upper airway obstruction in SDB subjects using the Mueller Maneuver and DISE. Polysomnography (PSG) type 2 was used to determine the SDB degree. Results: Subjects with SDB non-Obstructive sleep apnea (OSA) and OSA show a multilevel obstruction with a different location and configuration due to the various risk factors, such as nasal congestion, laryngopharyngeal reflux, obesity and menopause. Conclusion: Statistical differences in upper airway obstruction configuration between MM and DISE were found in the level of the velum (p=0,036), oropharynx (p<0,001) and epiglottis (p=0,036) and were also found in the obstruction degree of the velum, oropharynx, tongue base and epiglottis with p=0,002; p<0,001; p<0,001 and p<0,001. No statistical difference was found on the lowest oxygen saturation between PSG and DISE (p=0,055)

Rino-orbital-cerebral Mucormicosys in A Patient Type 1 Diabetic: A Case Report

Mucormycosis is an opportunistic andfrequently fulminating fungal infection causedby members of the family Mucoraceae, orderMucorales and class Zygomycetes which highly invasive and high mortality. Mucormycosis occurs in diabetic patients with poor blood glucose control. We reported a case of rhinocerebral mucormycosis in 20-year-old female patient with type 1 diabetes. The patient was treated for diabetic ketoacidosis and swollen symptoms in the left eye and out secretions from the left nose containing blackish spots. The probable diagnosis of rhinocerebral mucormycosis is made based on the results of direct examination and culture of nasal and palate tissue biopcywhich result suitable for Mucor sp. She was given systemic antifungal therapy with amphotericin B and symptoms of swelling of the left eye and secretions of the left nose with patches of blackness improved

Pengaruh Lama Perendaman Terhadap Absorpsi Tetrasiklin Pada Adsorben Limbah Sisik Ikan Gurami (Osphronemus Gouramy)

Influence of Immersion Length on Tetracycline Absorption on Gourami (Osphronemus Gouramy) Scales as Adsorbent. Gourami (Osphronemus Gouramy) scales are one of the natural sources of collagen. This fish scale\u27s collagen has functional properties, such as bio-degradable (easily decomposed), bio-compatible (compatible with surrounding tissue), and potential as bio-adsorbent. The absorbent properties of collagen are currently used as a transport material in local drug delivery for periodontal disease treatment, which is known as tetracycline chip. However, this chip is made of synthetic collagen so it is not absorbable by the body\u27s system. The price is also expensive. This study\u27s aim is to prove the potency of Gourami scales as a source of collagen in medical treatment, especially as a transport material of tetracycline for periodontal disease treatment. The gourami scale was obtained from seafood restaurant in Jember, Jawa Timur. About 500 mg of gourami scales was immersed into 20 ml tetracycline solution in beaker glass. About 200 μl solution from the beaker glass was taken with micropipette after 1-hour, 2-hour, 4-hour, 12-hour and 24-hour after immersed. After that, the solution was collected into an eppendorf for each time. The absorbance was measured with spectrophotometer at 450 nm wave length. This procedure was repeated five times. The lowest absorbance occured at 1-hour time (160,6 μg/μl). The result from light and inverted microscope examination shows a bond between collagen from gourami scales with tetracycline. Gourami scale has the ability to absorb the highest rate of tetracycline at 1-hour immersed time by forming a bond between collagen and tetracycline

Treatment of the common cold with herbs used in Ayurveda and Jamu : monograph review and the science of ginger, liquorice, turmeric and peppermint

BACKGROUND : The common cold is typically managed with decongestants, antihistamines, antitussives and antipyretics. In addition to these established medications, herbal ingredients have been used over centuries to help treat common cold symptoms. The Ayurveda and Jamu systems of medicine, originating from India and Indonesia, respectively, have leveraged herbal therapies to treat many illnesses. METHOD : An expert roundtable discussion comprising specialists in Ayurveda, Jamu, pharmacology and surgery along with a literature review was conducted to evaluate the use of four herbs – ginger, liquorice, turmeric and peppermint – for common cold symptom management in Ayurvedic texts, Jamu publications and monographs from the World Health Organization, Health Canada and various European guidelines. DISCUSSION : Due to a lack of antivirals, common cold management revolves around maintaining personal hygiene and symptom management. Herbal medicines have been an integral part of many cultures worldwide. Despite its growing acceptance, there is a perception that healthcare providers lack interest and may prevent patients from discussing the use of herbal medicines. Limited education and training may also widen the communication gap between patients and healthcare providers, hindering effective management. CONCLUSION : Evaluation of scientific evidence and the standing in international monographs can offer perspectives on the use of herbal medicines for common cold management.Procter & Gamble Health.http://drugsincontext.comhj2023PharmacologySDG-03:Good heatlh and well-bein

European Position Paper on Rhinosinusitis and Nasal Polyps 2020

The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings. EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. All available evidence for the management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care pathways based on the evidence are proposed. Despite considerable increases in the amount of quality publications in recent years, a large number of practical clinical questions remain. It was agreed that the best way to address these was to conduct a Delphi exercise. The results have been integrated into the respective sections. Last but not least, advice for patients and pharmacists and a new list of research needs are included.Peer reviewe

Black Fungus Complicated with COVID-19 in a Man with Underlying Non-Hodgkin’s Lymphoma

COVID-19 is a disease reported to suppress cellular immunity. This may lead to the development of opportunistic infections, among others black fungus, or mucormycosis. On the other hand, pre-existing defect in immunity may render patients susceptible to both mucormycosis and COVID-19. Mucormycosis is a relatively rare fungal infection with rapid progression unless diagnosed promptly and treated adequately, and urgent surgical and medical intervention is lifesaving. The manifestation of mucormycosis largely depends on the presence of exposure to the pathogen and the existing risk factor of the host. As black fungus is locally invasive, the majority of cases will involve tissue damage with local destruction and contiguous spread to nearby structure. We here with present a case of black fungus complicated with COVID-19 in a man with underlying non-Hodgkin’s lymphoma