European Journal of Molecular & Clinical Medicine

Background: The increasing numbers of infected cases with Coronavirus disease (COVID-19) overwhelmed the population all over the world. The advice with regard to social distancing and staying at home were recommended in the community which have led to the spread of psychological distress.
Objective: To assess the psychological status of the general population in Egypt during the coronavirus disease (COVID-19).
Methods: The authors conducted a cross-sectional, observational survey before the peak of the pandemic in Egypt through an online questionnaire. It was shared through e-mails and different social media platforms. The COVID-19 Peritraumatic Distress Index (CPDI) questionnaire adapted by the Shanghai Mental Health Centre was used to inquire about the incidence of anxiety, depression, specific phobias, cognitive changes, avoidance, compulsive behaviors, physical warning signs, and loss of social interaction in the aforementioned period. Logistic regression was used to analyze factors affecting CPDI score to evaluate the relationship between CPDI category, socioeconomic, and demographic characteristics.
Findings: Overall, 523 eligible participants were enrolled (including 266 health care workers (HCW) and 257 non-HCW). It was found that 51.9% of HCWs experienced mild to moderate distress, while 15% experienced severe distress. Additionally, non-HCWs’ results showed that 39.7% of them experienced mild to moderate distress; 21.8% experienced severe distress (OR: 0.717; 95% CI: 0.493–1.043). Moreover, the percentage of females with severe distress (21.7%) was two times higher than that of males (10.7%) (OR: 0.412; 95%CI: 0.278–0.612).
Conclusion: Public health emergencies such as COVID-19 increase the psychological distress liability of the general Egyptian population. Promoting mental health well-being, as well as behaviorally public psychological engagement during outbreaks, is required to support people who are distressed and to ameliorate their mental health.

Aim:To compare the efficacy of conventional therapy over combination of Therapeutic Ultrasound & Conventional therapy in management of Myofascial pain patients.
Keywords: Myofascial Pain Dysfunction Syndrome (MPDS), Therapeutic Ultrasound, Temporomandibular disorders, Orofacial Pain, Combination Therapy
Materials and Methods:
The present randomized comparative study was conducted on 20 patients who came to the Out Patient Department of our institute with a complaint of Myofascial pain.All the patients were evaluated for pain over TMJ area and muscles of mastication on a visual analog scale (VAS), maximum inter incisal distance was measured by Vernier caliper. Patients were randomly assigned into two groups each comprising of 10 patients. Group I
patients received conventional therapy while Group II patients received combination of Conventional therapy and Therapeutic Ultrasound. Descriptive Analysis of the dataset was carried out to obtain data estimates and all the variables i.e. Mouth opening (MO), Pain recorded as per visual analogue scale on TMJ, Masseter (M) and lateral pterygoid (LP) muscles in nature except the gender of the patient for which frequencies were observed. The means of the differences between the values of the two groups were compared using Wilcoxon Rank Sum Test/ Mann Whitney U-test.
Results – A significant pain reduction was found in the patients who were given Ultrasound massage therapy (p – 0.003). There was a decrease in pain over TMJ area, tenderness over Masseter and lateral pterygoid and mouth opening was improved which was statistically significant. This therapy appears to be effective in pain reduction in Myofascial Pain Dysfunction Syndrome.
Conclusion–US massage therapy appears to be useful in relieving pain and improves subsequent mouth opening, and hence can be considered as a valuable aid in managing Myofascial pain. Thus, US massage therapy serves as a potent and independent therapeutic modality in Myofascial Pain Dysfunction Syndrome.

Aim: There have been tremendous modifications in the composition as well as in properties of composite resins in the recent past. This study was performed to assess the effects of usage of different rotary cutting burs in the shear bond strength of three different flowable composites on tooth surface used in various pedodontic procedures. Surface changes were also evaluated using Scanning Electron Microscopic (SEM). Materials & Methods: This study was attempted on sixty freshly extracted permanent mandibular molars. Initially teeth were sectioned at coronal one third and polished with abrasive paper made up of silicon carbide. The samples were separated into 2 groups of 30 teeth each. In group I, teeth were prepared using fissure carbide bur and in group II with coarse taper round end diamond bur. Teeth after preparation were again segregated into 3 groups. In Group A, prepared teeth were applied with Vertise Flow which is a self adhering type of flowable composite resin. In group B, all prepared teeth were applied with Dyad flow (Kerr) SAFC. In Group C samples, Tetric N Bond which is a self‑etch adhesive was applied on the dentin surface. Teeth were then subjected to universal testing machine for evaluation of shear bond strength. Surface texture characteristics and changes were further explored by Scanning Electron Microscopy. Results: Data thus obtained were compiled for statistical analysis by latest SPSS software package. Shear bond strength (SBS) in group C was 22.4 MPa, in group B was 15.1 MPA and in group A was 12.8 MPa in group I. However when checked in group II, group C had SBS of 18.2 MPa, group B had 12.6 MPa and group A had 11.2 MPa. Therefore, author noticed non- significant difference (P = 0.71) in SBS values of flowable composite resin (self-adhering)Group A) for surfaces prepared with carbide (Group I) and diamond (Group II) burs. Conclusion: The shear bond strength (SBS) of Tetric-N Flow was reported to be higher when compared to other tested materials. Dentinal surface those prepared with carbide bur showed higher shear bond strength for Tetric N Flow and Dyad-flow. Clinical Significance: In the present in vitro study, the overall breaking shear bond strength (SBS) was reported higher in samples those prepared with carbide burs. Also, Tetric N Flow expressed highest values among the studied composites. These findings are very crucial and have a clinical applicability in selection of type of burs for critical and prone pedodontic circumstances.

World Health Organisation (WHO) declared the ongoing COVID-19 as a global pandemic on March 11, 2020.For this advancement, countries all over the world has begun to implement lockdown as one of the strategies to tackle the spread of SARS-CoV-2 virus. Like other countries, the lockdown in India also poses serious problems to the health industry and to many other sectors. One of the severely affected and ignored programs, the Universal Immunization Programme (UIP)which approximately addresses 27 million new-borns seeking immunization per year, is also suspended. In this scenario, outbreaks of vaccine-preventable diseases could be catastrophic for communities and health systems which are battling the impacts of COVID-19. At present, there exists no definite medicine and vaccine for COVID-19. The immunity of an individual plays a crucial role in the prevention of disease as well as severity. The interruption of vaccination program can give rise to a resurgence of measles cases. This resurgence can lead to profound immunosuppressants which can cause an increased incidence of COVID-19 with a rise in the number of severe cases which eventually leads to increased mortality rate. Moreover, the suppression of immune function can lead to increased incidence of other infections which may have a huge burden to the healthcare system where services have already been compromised due to low resources. Lessons should be learned from Europe and Africa. Initiatives should be taken to restore the routine immunization program immediately with all precautionary measures as per WHO guidelines.

This paper deals with seven mathematical models within the current COVID-19
pandemic situations. We developed a number of mathematical models which are
compartment solutions of nonlinear differential equations. These models are useful for
research scholars, faculty members and academicians in the area of mathematical biology.
Also, we study these models and parameter estimation from real-world problem (data of
COVID-19 in World Health Organization (WHO)). The researchers discussed to analyze
the possible solutions of each model in the general discussion section. The researchers
recommended that at the end of the year 2020, there will be a reduction on the spread and
an increased recovery rate of COVID-19. These situations are fully changed and return to
the normal life very soon. In this paper to the researchers discuss the simple SIR model
compared to real-life data for COVID-19 pandemic in Tamilnadu by district wise. This
model helps to predict the future calculations of Susceptible, Infections, and Removed
people from the total population and reproduction number R0 . The researchers conclude
that the infection rate is increased for the next two months (September and October, 2020),
and death rate percentage is also possible to decrease from the number of total
populations. Also the researchers recommend the continuous lockdown for these two
months and for all people to follow the instruction given by the Tamilnadu Government.

Breast carcinoma is the most commonly diagnosed cancer and the leading cause of cancer death. Breast cancer also produces and is influenced by ectopic hormones. Beta Human Chorionic Gonadotropin (hCG) is one such hormone and is encoded by chorionic gonadotropin beta (CGB) genes. The aim of this study was to determine the CGB gene methylation in breast cancer tissues and compare them with normal tissues.
Materials and methods: After approval from Institutional Ethical Committee (IEC), consent from patients were obtained. Normal and tumour tissues from breast cancer patients were taken. DNA was isolated from normal and tumour tissues. Post bisulfate conversion samples were processed for qPCR using methylation specific primers for the set of selected CGB genes and SYBR green.
Results: 1-2M was found to be significantly higher among the normal tissues (50.22). 3-9M was found to be 65.93 in tumour tissues and 5.05 in normal tissues and this was significant.
Conclusion: 3-9 M is significantly higher in tumour tissues compared to normal tissues and 1-2 M is significantly higher in normal tissues. This suggests that there are 2 different types of beta hCG secreted by two different types of genes and this can be used for further analysis as a part of future projects. This may help in formulating a new treatment process and may also be used as a tumour marker in high risk patients

As power generation demand is being increased in renewable energy sector, power generation from wind energy plays important role in present growing scenario. The design of wind generator is a important parameter to extract the power from wind. In this paper a new approach is explained how maximum power is being obtained. The strong magnets Neodymium magnets N52 were used in this design of wind generator. The vertical type which is most common using now is used in this design. The voltage generated by each coil is presented in this paper. It proves that using two magnetic stator and one coil rotor improves power generation. The modified Savonius vertical axis wind turbine performance can be identified in this paper. The construction design and components details are discussed here.

The problem of collaborative computing in the cloud environment has been well studied. Several approaches available to handle the issue of collaborative computing and still suffer to achieve higher performance in different QoS parameters. The performance of various simulation models has been analyzed for different parameters in this paper. To improve performance an efficient multi-attribute performance analysis model has been presented. The method first presents a collaborative content sharing strategy (CCSS) which maintains a dual copy of any resource in the cloud which has been accessed by different users. The method enforces an attribute-based update restriction (ABUR) algorithm which uses different keys to restrict malicious updating from different users. The public auditing has been enforced with ABUR and CCSS algorithms. The multi-attribute performance analysis model estimates various QoS parameters like throughput, completion, and public auditing on various simulation models of the cloud environment. A testbed is generated to simulate the performance of different cloud computing tools in a collaborative environment. The performance of simulation models has been measured and compared with the results of other models in detail

This paper proposes a combination of Genetic Algorithm based Power Oscillation Damping (GAPOD) and DC Voltage Regulator (DCVR) controllers are proposed for Unified Power Flow Controller (UPFC) for the enhancement of dynamic stability of IEEE 30 bus system. The difference between mechanical power and electrical power is the input to the GAPOD, and the output of GAPOD is connected to UPFC one of the input and the input of GADCVR is deviations of capacitor voltage and this output connected to another input of UPFC. GA tunes the parameters of POD and DCVR by minimizing the error; this error is the difference between mechanical and electrical power. The proposed method is applied to IEEE 30 bus system in MATLAB/Simulink environment, and results compared with Genetic Algorithm based Multi Stage Fuzzy DC Voltage Regulator (GAMSFDCVR) and conventional controllers. The results demonstrated that the proposed controller is effectively damping the oscillations.

Wet and dry dressing is one of the factors that have a major influence in the
process of wound recovery. It is a way to protect from widespread infection in postoperative
of herniatomy. Purpose of this study was to identify the difference in the
provision of wet dressing in post-operative of herniatomy patients. This type of research is
cross sectional analytical design. Sampling method was accidental sampling. The samples
of this study were 30 people. Result of this study shown that using wet dressing 16 people
(53.3%) and those not using wet dressing 14 people (46.7%).Another side who were fast
wound recovery 16 people (53.3%) and the slow healing of the wound 14 people (46, 7%)
used dry dressing 18 people (60.0%) and who did not use dry dressing 12 people (40.0%),
there were fast wound healing 18 people (60.0%). The Odd Ratio results obtained = 0.067
means that respondents who do wet dressing are likely to have a risk of 0.06 times greater
risk of infection. It can be concluded that there are differences in the provision of wet and
dry dressing in postoperative patients with herniatomy. Based on the study, it can be
concluded that there were differences in the provision of wet and dry dressing in postoperative
herniatomy patients in Pirngadi Hospital Medan

Purpose: The objective of the present study was to evaluate the association between personality traits, dental anxiety and socioeconomic profile with the dental myths among adults in Chennai City, India.
Methods: A pilot study was conducted among 90 adults aged 18 years and above by multistage random sampling methodology across the socioeconomic groups. The final sample size was found to be 162. A validated and a reliable, bilingual, self-administered questionnaire consisting of four sections namely 1. The demographic details, 2. Personality traits, 3. Modified Dental Anxiety and 4. A 26-item dental myth questionnaire. The collected data was analysed using SPSS version 20.0 and Chi -square test, One way ANOVA and correlations were done and a p-value
Results: Dental myth scores was found to be more in the middle social class, followed by the lower and higher social class and this difference was not statistically significant (p=0.21). The personality traits and dental anxiety were found to be weakly correlated with dental myth scores.
Conclusion: The startling results of the study have shown no relationship between socioeconomic status, dental anxiety, personality traits with the occurrence of dental myths.

Background:- Alkaline phosphatase is the group of hydrolytic enzymes that are involved in the cellular metabolism. Alkaline phosphatase in saliva is used as an indicator of gingival inflammation, bone metabolism and other oral lesions like premalignancies and oral cancer.
Aim and objective: To estimate the levels of Salivary Alkaline Phosphatase (S-ALP) in smokers and tobacco chewers associated with diabetes and diabetics without any habits.
Materials and Methods: The study includes 30 cases and 10 control. 30 cases divided in group A, B and C and control group D: (1) Group A - 10 smokers who are diabetic. (2) Group B - 10 tobacco chewers who are diabetic. (3) Group C - 10 nonsmokers and non-tobacco chewers who are diabetic. (4) Group D - 10 nonsmokers, non-tobacco chewers and nondiabetic as control. Saliva was collected from the subjects of the above mentioned groups and the levels of S-ALP were estimated using a semi auto- analyzer and comparison was made.
Results: The result reveals increase in the alkaline phosphatase levels in saliva of smokers and tobacco chewers with diabetes group (Group A, B). Non-smokers and non-tobacco chewers with diabetes group (Group C) had higher level compared to the control group (Group D).
Conclusion: Salivary alkaline phosphatase is a clinical biomarker that is used to determine the oral diseases due to adverse habits and diabetes at its early stage.

In the context of increasing demand for energy and regarding the availability of conventional energy sources renewable plays a crucial role in nowadays, But we can’t assure continuous supply from these renewable as their performance totally depends on the weather conditions. So, in order to overcome these problems to some extent hybrid systems are used. This work addresses a new concept in a hybrid system i.e., the photovoltaic cells are placed on the wind blades. Thus, this model signifies the reduction in design, optimizes the cost, and to shows the new development in renewable. This paper explains darrieus model of vertical-axis wind turbines (VAWTs) accompanied by polycrystalline solar cells. This system is connected to 555 timer astable mode of operation of the boost converter and a protected model of charge controller for the battery. So, to exploit the energy efficiently by this hybrid model i.e. extract of solar energy from panels and wind energy from darrieus wind turbine at a time helps to meet the concept of uninterrupted supply on besides the discontinuity of nature. A small working model is also developed basing on this concept and it is performance curves of the wind and solar are obtained.

Aim of the stud; To verify the correlation between abdominal Aorta Length in the fetus and gestational in weeks between 34- 40 weeks
Type of study; Case Control
Methods; a healthy pregnant women were chosen who’s age between 15-40 years all are primigravida and conceived within 3 months of marriage. They were between 34- 40 weeks in gestation. Their last menstrual period was know and recorded in addition all were scheduled for ultrasound examination for measurement of the abdominal aorta length, femoral length and biparietal diameter.
Result; a highly significant correlation was found between abdominal aorta and biparietal diameter and femoral length . In addition a highly significant correlation was found between gestational age calculated by their LMP and abdominal aorta. In addition a highly significant correlation was found between gestational age and abdominal aorta length. A non linear exponential equation was constructed with lowest mean of sum of squares=1, and coefficient of correlation= 0.97 between abdominal aorta length and gestational age in weeks. From this equation a reference table built which contains value for the abdominal aorta between 34- 40 weeks for 1,2.5,5,10,90,95, and 99 centiles. After the building of this table further 35 women were taken for assessment of this table. Only 2 were miss calculated, the Kappa Cohen coefficient=0.93
Conclusion; a table by which the gestational age can be calculated between 34-40 weeks by measuring the abdominal aorta. However under no circumstances this table may be used apart from assessment applications. Further studies are required to verify its accuracy

Firefly Algorithm is a stochastic and meta heuristic approach inspired from nature having a wide range of applications in solving various optimization problems. Firefly Algorithm (FA) suffers from problem of slow convergence speed. This problem can be solved by using modified Firefly algorithm called as Enhanced Firefly Algorithm. By using this algorithm side lobe level of rectangular antenna array can be reduced considerably without appreciable effect on beam width. SLL is most important array pattern parameter because reduced SLL results in minimizing received noise and interference. Low SLL in the radiation pattern of the rectangular antenna array can be achieved by considering phases and amplitudes of the excitation currents of elements of array as variables to be controlled having fixed spacing between the elements. In this paper SLL of symmetric rectangular array antenna is optimized using Enhanced Firefly algorithm (EFA) and its results are compared to the results obtained with Genetic Algorithm.

Medical imaging organizations currently face a significant problem with stealing of medical data. Watermarking is a powerful tool that can be used to authorize the hidden information in cover image. The unique features associated with watermarking are authorization and copyright protection. Because of its unique characteristics, watermarking associated with medical data hiding gives more robustness in medical imaging. In spite of this adding security to watermarking in medical imaging, gives more protection for medical information. This paper explored two main fields that, the encryption of medical images using DNA Encoding and Spatiotemporal Chaos Algorithm and the embedding of medical images in cover image using hybrid transformation of NSCT, RDWT and SVD. The goal of this study was to develop a methodology to improve the robustness, imperceptibility and security for medical information without implementing a physical model, thus saving time, money and reducing the risks associated with hacking partners. For this paper, I used patient health document as one watermark and his medical image as another watermark. The theoretical model has demonstrated that it is possible to use this type of technique and apply it to a complex digital image transmission. The correlation observed before and after encryption and embedding procedures. Experimental results show how robustness and imperceptibility and security of medical images are improved.

We live in a time where many technological advancements are at our fingertips, our lives are made easier, which is fortunate considering the fast-paced lives most of us lead. In recent years, great strides have been made in making homes a bit more “tech savvy.” This technology, in short, allows the homeowner to run his or her home while away through remote, often on a Smartphone or iPad. In our project we presented a prototype implementation of home automation system that uses wifi technology as a network infrastructure connecting its parts. Previously Bluetooth module was used for this purpose which has reduced control since it covers small distance, high power consumption due to Bluetooth connectivity. We are using ESP8266 wifi module which is a self contained SOC with integrated TCP/IP protocol stack that can give any microcontroller access to your wifi network. For home security we are using PIR motion sensor which are basically made up of pyroelectric sensors which can detect the level of infra-red radiation. It almost always used to detect whether a human has moved in or out of the sensors range. These home automation systems provide increased comfort especially installed in private home. The conclusion of our project is to increase overall energy saving which is main issue today.

Introduction: One of the major complications of varicose veins is the non-healing ulcer of the leg. The traditional treatment for this is regular dressing, foot end elevation with appropriate antibiotics and local application of silver-based ointments. The gold standard treatment for these patients is surgery (Trendelenburg surgery with or without venous striping and subfascial perforator ligation and endovenous procedures). Surgeons usually reach a crux when a patient develops persistent ulcers which does not heal even after all these efforts.
Aim: Our objective in this study was to study the effects of Platelet Rich Plasma (PRP) in chronic non-healing post-surgical venous ulcers.
Methodology: This was a case control study with 40 patients conducted over 2019 and 2020, after institutional ethical clearance. All patients were treated with appropriate antibiotics prior to the study and obtained a culture negative status. PRP was separated and injected locally into the borders of the ulcer in cases, while controls were given regular dressings with silver-based ointments.
Results: We found that patients who were given PRP had a significantly faster healing rate and a lower infection rate.
Conclusion: Hence PRP can be safe, effective and reasonably cost effective in treating post-surgical venous ulcers.

Swami Vivekananda was one of the eminent personalities in the history of India. His work is always remembered as the big contribution to the history of India. He was an Indian Hindu monk who spent his whole life spreading the faiths and beliefs of Hinduism all around the world as well as in India. To be religious for him means leading life in such a way that we manifest our higher nature, truth, goodness and beauty, in our thoughts, words and deeds. All impulses, thoughts and actions which lead one towards this goal are naturally ennobling and harmonizing, and are ethical and moral in the truest sense. He says, we need technical education and all else which may develop industries, so that men, instead of seeking for service, may earn enough to provide for them-selves, and save something against a rainy day. He feels it necessary that India should take from the Western nations all that are good in their civilization. He says for the development of a balanced nation, we have to combine the dynamism and scientific attitude of the West with the spirituality of our country. The entire educational program should be so planned that it equips the youth to contribute to the material progress of the country as well as to maintaining the supreme worth of India’s spiritual heritage.

In evolving countries like India, there is a swift growth in load and energy demand due to heavy industrial development, urbanization and economy rise. Most of this demand is met through power generation from conventional sources which have adverse environmental impact. Renewable energy resources provide a good alternative but lack of continuous generation, high initial cost, complex control, conversion between AC and DC generation, grid integration etc. are some of the drawbacks associated with renewable energy sources. To overcome these disadvantages and to efficiently utilize the available energy resources, a hybrid power system combining the advantages of individual power sources, can be seen as a preferred option to generate and deliver power. In this paper, an attempt has been made to perform techno-economic analysis of a hybrid power system existing in an educational facility with conventional grid power supply, diesel generator and photovoltaic generation and the results are summarized. An augmentation for the existing system has been proposed with biogas and small hydropower generation systems as these resources are available within the accessible limits of the study area.

One of the unresolved problems in vascular surgery and neurosurgery is the
internal carotid artery ex tra and intracranial segments combined lesion, namely the
combination of the arterial aneurysm or vascular brain malformation with extracranial
brachiocephalic arteries lesions. Currently, there are no clear tactical approaches and
recommendations for the brachiocephalic arteries' comorbid pathology treatment. This
article show s the treatment experience of 55 patients with combined lesions of the internal
carotid artery intra and extracranial pool: a combination of the intracranial aneurysm or
vascular br ain malformation with brachiocephalic arteries stenotic lesions or
asymptomatic internal carotid artery pathological deformation at the cervical level.
Clinical cases were accumulated over 6 years (from 2013 to 2019). The incidence of
comorbid pathology wa s 3.5%. The bigger part of brain vascular malformations (53 of 55
patients or 96%) were asymptomatic. The majority of patients with comorbidity were
women 69% or 38 patients )). Surgical activity among the target group of patients was 40%,
22 o f 55 patients were operated on. Repeated ischemic stroke after asymptomatic internal
carotid artery stenting was beared by one patient (4.5%) in the early postoperative period.
Most aneurysms in the first group were localized in the anterior sections of the W illis circ le
(81% versus 11%, p <0.001), saccular aneurysms prevailed (41 patients or 95%). There is an
existing necessity of accumulation brachiocephalic vascular pool comorbid pathology
surgical treatment experience and major studies conduction that should help in the
development of therapeutic algorithms and optimization of surgical tactics for the
brachiocephalic pool combined vascular pathology.

Scarless tattoo extraction remains as a major problem in a cosmetology field nowadays. At the moment laser removing method is a basic procedure for tattoo removal. However, this technology is painful and leads to significant trauma of the skin cover. Thise article presents a new combination of laser and chemical technique for skin inclusions removal. The group of techniques belongs to the chemical industry and represents a lightning and neutralizing composition and a method for removing a dye introduced under the skin. The skin area with dye is exposed to a laser effect. After laser exposure an oxidizing composition of 2-3 mm thickness is applied. Oxidizing composition: carboxylic acids, fermented celandine oil extracts and propylene-glycol celandine extracts. The main novelty of the method is presented by several chain processes: in applying of the oxidizing composition on the skin surface after laser radiation, a significant role is played by physicochemical characteristics changes of the skin. Without the skin surface damaging, the percentage of chemical reactions dissociations aimed at removing the pigment is raising which shows better efficiency comparing with classical laser method of dye particles removing.

Investigating the causation and course of the herpesvirus hepatitis in groups of children and the results of treatment of different types. 173 children with herpesvirus hepatitis were examined. The causation of the disease was verified in all patients with the detection of CMV, EBV, HHV-6 DNA in blood, urine, saliva, and hepatocytes, and of CMV LA, EBNA-2 and EBV LMP1 in hepatocytes of the patients after needle biopsy of the liver. Clinical implications and laboratory findings in acute and chronic herpesvirus hepatitis in children showed no differences in virus hepatitis as a whole. 113 children receiving Viferon® for the treatment of the chronic herpes virus hepatitis were monitored. The Interferon dose of all children was 5 mln/m2 three times a week. In the course of the treatment, the primary biochemical remission was achieved in 15 (13.3%) children, the primary virological: in 8 (7.1%) children, the stable biochemical: in 7 (6.2%) children, the stable virological: in 5 (4.4%), the stable complete: in 3 (2.6%) children, the long-lasting biochemical: in 10 (8,8%) children, the long-lasting virological: in 4 (3.5%) children, the long-lasting complete remission: in 26 (23.1%) children with chronic herpes virus hepatitis. The disease recurrence was found in 7 (6.2%) patients; there were no remission in 28 (24.8%) children. 1/3 of the patients the decrease was recovered with complete recovery of the functional status of the liver within 1-3 months. The result of the symptomatic herpes virus hepatitis the disease of 64.9% of the patients had chronic progression

The article reflects the results of an experimental study of the specifics of coping behavior of university students. Considering coping behavior as a special purposeful socially-oriented behavior of a person that ensures his productivity, health and, both psychological and social, well-being, we believe that the formation of the experience of coping behavior is a prolonged process and is carried out throughout a person's life. We determined the study of the specifics of coping behavior among students of a higher educational institution as the target guidelines of our research. Relying on theoretical and methodological provisions in the field of personality psychology, psychology of coping behavior, as well as the theory of stress, we have designed a diagnostic program that included the method of scientific observation, as well as a system of test methods. Our pilot study showed that the complex application of the diagnostic program developed by us makes it possible not only to study the specifics of coping behavior of students within the framework of their educational activities, but also to determine the type of behavioral activity of respondents, the characteristics of their behavior in emotionally stressful situations, and also to determine the main reasons stimulating the onset of stress.

The need for electrical energy is increasing day by day and the required surplus electrical energy is supplied by renewable energy sources (RES). The usage of RES is a solution to save the fossil fuel reserves for the future generations to come and it also protects the environment. Solar energy as RES has number of advantages like freely available, pollution free, etc., Solar energy is converted to electrical energy using solar photovoltaic (PV) system, it has number of advantages and few challenges too. The generated voltage depends upon solar irradiation and operating temperature. Number of PV systems connected to the grid is ever increasing and this is leading to number of challenges like voltage quality, power quality, islanding etc., and these have to be increased. Solar PV system is used as distributed generator (DG). These DG’s help in supplying the additional electric power demand, improve the power quality, reduce the distribution losses, etc., This paper presents mathematical modeling of PV cell, DC/DC converter, inverter and maximum power point (MPP) controller. The discussed model is designed with Simulink block libraries and done in Matlab/Simulink software. Simulations are done and the results are deliberated and discussed.

Background:Professional governance is currently the biggest demand of the community. However, this is problematic because people still have to deal with limited numbers and unequal distribution of employees in one particular work unit. This is not to mention the designation of employees who are not compatible with the needs of each government organization. Workload analysis can be used to find out what positions employee shortages or employee overload have. Recruitment can be arranged to resolve the problem of employee shortages. However, if an organization has not been able to increase the number of its employees shortly, then a possible alternative is to rearrange job designation by implementing job enlargement and job enrichment. Purpose:This study aims to find out the effectiveness of policies in overcoming the limited number of employees. Methods:This was a descriptive study that aimed to see the effectiveness of the variables studied using descriptive analysis of the results of employee performance appraisal before and after job enlargement and job enrichment implemented. Results:Job enlargement and job enrichment are fairly effective to carry out as an alternative in overcoming the limited number of employees. Conclusion:This is concluded from the absence of a decrease in the results of employee performance appraisal. Some of them even increased despite the addition of responsibilities.

The objective of this research article is to analyze the existence of Indonesian Patent Law and policy on providing a compulsory license to use pharmaceutical patents without consent for patent holders to enhance public health in Indonesia. The focus of this research is to examine whether such law and policy adequate to support access to affordable medicines in Indonesia. The type of this research is normative legal research by using statute and conceptual approaches, while legal resources used in this research is primary and secondary legal resources. The statute approach was used in this research to examine all Indonesia legislation, regulations, and policies dealing with this compulsory license on pharmaceutical patents. This research found that normatively, Indonesian Patent Law and Policy dealing with compulsory license is adequate to secure people's access to affordable medicines. Unfortunately, this compulsory license has not been utilized by the Indonesian Government. The Ministry of Human Rights Regulation No. 39 of 2018 concerning Procedures for Granting of Compulsory License to implement the Patent Act of 2016 has issued to apply for such License. This research advises the Government should ensure that procedure and technical guideline to implement this compulsory license is transparent so that it can be understandable by the third party; thus, accessibility and affordability of medicines can be achieved

This article aims to review the ease of business licensing policy through the online system in health sector as a follow-up to the Online Single Submission (OSS) service policy intended to facilitate entrepreneurs’ legality. Licensing in the health sector is designedto protect for the public in obtaining safe, high quality, and affordable health services.Therefore,its existenceis an instrument to achieve health development and the third goal of the Sustainable Development Goals, namely health and well-being and the prevention of health services that could harm the community. Based on a literature review, licensing services through the OSS application is a policy that accelerates licensing services, which havebeen considered long and expensive.Yet,the implementation of online licensing services still raises legal issues,including not meeting the legal certainty, accuracy, and openness principles.Therefore, the potential of having permission for health services doesnot guarantee the availability of safe, high quality, and affordable health services. This article’s discussionwas written through a conceptual analysis of licensing and health servicesthat analyzethe laws and regulations in the field of health services licensing.

Dental artisan is a common and preferred profession that has been widely known amongst the general public due to its low price. However, because the job was unsafe, the dental artisan was prohibited by Legislation No. 29 of 2004 on Medical Practice and the Ministry of Health Regulation No. 1871/MENKES/PER/IX/2011 on the Repeal of the Ministry of Health Regulation No. 339/MENKES/PER/V/1989. On the other hand, the Constitutional Court, through its decision No. 40/PUU-X/2012 has re-legalized the dental artisan profession. Amongst considerations made by the Constitutional Court, the re-legalization was caused because although the profession has a high risk of security, it can be settled through teaching, licensing, and supervision, instead of prohibition. This research is juridical research that studies the existent legislation provision on the legal protection regarded to dental artisan in Indonesia. Based on this research, it was noticed that: First, under Article 6 (1) of Ministry of Health Regulation No. 39 of 2014, a dental artisan is only allowed to, (a) create a partial or complete removable dentures that are made out of heat curing acrylic, that adheres to health standard requirements, (b) install a partial or complete removable dentures that are made out of heat curing acrylic without covering the patient‟s left-tooth root. In the event a dental artisan conducted practice outside of the two, the City or Regency Local Government will impose an administrative sanction upon them. Second, the form of teaching, licensing, and supervision intended by the government will be given directly to the City of Regency Local Government to decide appropriately.

Change is an essentialaspect for the organization to enable employees to learn new skills andexplore new opportunities, which ultimately benefit the organization. One crucialelement in change management is the readiness of the organization to change or the readiness to change.This study aims to determine the effect and the dimensions of change valence, which have the most substantialinfluence on readiness to change.This studywas conducted at one private hospital that planned to change the typeof its hospital into a teaching hospital. This studywas classified asan observational analytic with a cross-sectional research design. The study samples were chosen randomly utilizinga proportional random sampling technique. Retrieval of research related data employeda questionnaire that had been tested for its validity and reliability.The results indicatedthat change valence influencedthe readiness to change based on statistical tests using simple linear regression (R = 0.726 and R2 = 0.527). The strongest dimension that influencedthe readiness to change was Perceived Appropriateness (R = 0.529 and R2 = 0.280).The higher the change valence, the higher the level of organizational readiness to change. A critical dimension of change valence was the Perceived Appropriateness dimension. Therefore,if the organization plans to increase its readiness to change, the management should consider the perceivedappropriateness dimension more than any other aspects.

Changing the status of the hospital froma particular type such as Maternity Hospital to General Hospital has the consequence of adding several new services such as internal medicine, dental treatment, general surgery, etc. Internal medicine as a new service has the lowest visit in the past two years. Itmight happensince the public does not yet know its existence, so it needs to be promoted more. This study aims to analyze the market segmentation and buyer readiness stage of the community around the hospital.This studyemployed descriptive research through cross-sectionaldata collection. A total of 101 respondents were identifiedwith simple random samplingfrom a population living within a radius of 3 km from the hospital. Then this study used primary data obtained by utilizingquestionnaires consisting of several questions about the characteristics of respondents, psychographic, and buyer readiness stage. The results indicatedthat the market segment characteristics were people who arehighlyeducated, work as civil servants and entrepreneurs, and those with a middle economic level. Then the medical service center that was frequently visited was the clinic/primary health service. The purchase readiness was at the awareness level, meaning that the respondents are still in the early stage of being aware of the hospital existence.Promotion is needed to increase purchase readiness to the level of knowledge to generate conviction and purchase. Understanding market segments and purchase readiness level couldhelp hospitals to determine the suitable promotional methods for marketing campaigns.

A person whose life highly depends on his health will certainly have a higher demand for health status. Based on the medical records from one of the PublicHospitals in Madiun, it is identified that the score of class II inpatient Bed Occupancy Rate (BOR) in 2016 exceeded the standard score of 85.53%.On the contrary, the score of class I inpatient BOR in 2016 was far below the standard of 27.74%. This study is to examine the correlationbetween patients'ability and willingness to pay in the selection of inpatient class at a Public Hospital in Madiun. The study is an analyticobservational study with a cross-sectional study design conducted on 100 patients as respondents. From the results of the chi-square correlation test, there was a significant correlation between the respondents' Ability to Pay and the selection of inpatientclass in PublicHospitalin Madiun (p-valueis less than0.05).With the variables of work, income, and expendituresub-variables are significantly related to the selection of inpatient classes at patients from one of the Public Hospitals in Madiun.From the users'aspect, in this case, the subject that determined the value of the applied tariff, the current tariff is far below the Ability to Pay (ATP) and Willingness to Pay (WTP).Thus, there is flexibility in the calculation for the submission of new tariff values.

Congenital hearing loss in Indonesia is still not getting optimal treatment. The number of patients from year to year does not get a clear picture and the government program for this problem is still not clearly visible. Patients with hearing loss are a burden of the State response if handled early this problem can show good progress. To Proving that early hearing screening in newborns can reduce complications from congenital hearing loss. Systematic searches were carried out at PubMed, Sciencedirect, ProQuest, Ebsco, and Web of Science to identify peer-reviewed research. The paper used is an original peer-reviewed research article in English that discusses the rehabilitation of children with hearing loss. Papers that meet the criteria are analyzed using PICO. 80% of children with congenital hearing loss identified under the age of 2 years have improved behavior, communication, and knowledge compared to children identified above 2 years. The rehabilitation process for speech ability 83% of children with congenital hearing loss under 2 years have more vocabulary. Rehabilitation costs incurred in children with congenital hearing loss identified >2 years are higher. Early Hearing screening is important to be carried out early on with the aim of preventing speech delay, behavior disorders, and knowledge disturbances.

Handling of patients in the Emergency Department for emergency cases requiresprompt, timely, and clinically effectiveservice. The response time is one of the service indicatorsinpatient care at the Emergency Department. This research aims to determine the factors associated with response timeinthe emergency department of a regional publichospital. This research was conducted in the Emergency Room ofMojowarno Christian Hospital,Jombang from October to December 2018 by using cross-sectional study. The researcher collected the data using a closed questionnaire from 50 nurses and midwives, as well as the patient observation sheet of the emergency room, was randomly selected. The data were analyzed with the Pearson chi-square test with significance level ≤0.05. The results indicated that 92% of the response time was right, and 8% did not match with the response time, where the response time was ≤ 5 minutes. 90% of patients with emergency cases and 10% of patients with non-emergency cases. 86% related to the doctors' presence and 14% related to the doctors' absence. There is a significant correlationbetween response time and patient cases [0.05] and a significant correlationbetween response time and the presence or absence of the doctors.

Nurse performance evaluation is a formal system structure in evaluating nurses' performance in the past and present periods.However, its implementation in health service facilities still has many shortcomings. The problem of nurse performance appraisal is the existence of unstructured supervision, and the results remain subjective.This study aims to provide recommendations on the nurse performance appraisal system, which can be applied as a basis for career development, promotion, and reward.This study employed a descriptive quantitative approachby comparing secondary data and interview resultswith the head of the hospital room. The data included 160 documents that were selected using a simple random samplingfrom medical record data in the NganjukGeneral Hospital in East Java and analyzed based on the literature.Data from the general unit suggested that there were 25% of documents for nurse promotion in October 2017 and an increase of 40% in April 2018. There was no correlation between employee performance goalsand the proposed list of proposed credit scores. There weresome recommendations based on contextual problems, appraisal structure problems, appraisal process problems, and appraisal result problems. Nurse performance evaluation requires job descriptions, performance appraisal indicators, assessment according to the guidelines

Nowadays, the nurse's job performance is a global issueconsidering there areconsequences of the need for excellent and high-quality nursing services. The quality of work atmosphere or the Quality of Work Life in the work environment at the hospital is required.To analyze the Quality of Work Life on nurses in the hospital, the method employedin this study was descriptive-correlation performed among 75 nurses at urban hospital in Indonesia by utilizinga questionnaire with Work-Related Quality of Life scale. The results obtained and analyzed using the method of Prosentase analysis. The samplesweretaken by a simple random method. The Quality of Work Life measurements used the Work-Related Quality of Life scale. The size of Work-Related Quality ofLife usedsixfactors consisting of (1) General Well-Being, (2) Homework Interface, (3) Control at Work, (4) Working Condition, (5) Stress at Work, and (6) Job and Career Satisfaction. The results of the study revealedthat there were still nurses who were dissatisfied with the Homework Interface factor by19.01%, Control at Workby34.9%, Working Conditionby28.6%, and Stress at Workby87.3%.Furthermore, the quality of work liferemains low by 30.2%.In a nutshell,the quality of the work-life of nurses at an urban hospital in Indonesia is indicatedpoor. It is suggestedto identify the factors that influence and develop recommendations on improvement of Quality of Work Life on nurses

Background:In 2017, East Java Province was ranked second in Indonesia to discover tuberculosis (TB) patients. The Southern Regional Health Center of Kediri City was ranked fifth out of 27 cases.
Objectives of the study: This study aims to analyze the problem and prioritize health issues of TB in the Southern Regional Health Center of Kediri in 2019.
Methods: The observation was carried out using performance assessment for the Southern Regional Health Center data in 2018 with the ultrasound and fishbone methods.
Results: It was noticed that all TB cases were found and treated, including the discovery of suspected TB cases and the successful treatment of all TB cases (Success Rate/SR). The main problems in the Southern Regional Health Center in 2019 were that the suspected tuberculosis sputum pot was not returned, the people’s lack of knowledge, and less active TB cadres.
Conclusion: Some of the problems found are the lack of knowledge regarding TB, less active TB cadres, lack of coordination among TB cadres, limitation of people who are willing to become TB cadres, and the time limitation of TB cadres.

Background: The corporate image is the fundamental performance aim of public relations practitioners which is formed through experience services that are obtained through the perception of the visitors when visiting a particular place, such as a private hospital. Aims: This study aims to investigate the image of a private hospital in Surabaya, Indonesia, especially at the Medical Check-Up section, from the visitors’ perspectives. Methods: The image measurement was done based on five image measuring indicators, namely primary impression, familiarity, perception, preference, and position. This research was descriptive research that used a quantitative approach and survey methods. The data was collected by distributing questionnaires to a total sample of 100 respondents who were chosen by using the simple random sampling technique. The data was analyzed by employing the descriptive statistical analysis and cross-tabulation technique. Results: The image of the private hospital, particularly of the Medical Check-Up section, was positive according to the visitors’ perspective. The highest image indicator was the primary impression with an average score of 4.14, while the lowest one was the position with an average rating of 3.59. The acquisition of the other indicators’ average score was recorded as much as 4.12, 4.09, and 3.92 for familiarity, preference and perception indicators, respectively. Conclusion: This study concludes that a positive image with the highest percentage is given by medical visitors corporate. On the other hand, the negative image with the highest rate is provided by medical visitors’ insurance

Background: Human Resource Planning is the process of analyzing and drafting the concept of Human Resource Management in an organization. The identification between the necessities and the number of available personnel is required in Human Resource Planning. In the Health Office of Tulungagung District, the calculation results exhibit a significant gap between the necessities and the available personnel. From the calculation through the Renbutnakes application, there are 358 staff shortages for all types of health workers. Aims: This study aims to analyze the type and number of health and non-health workers calculated based on the number of services performed, population and distribution, work area characteristics and coverage, availability of other first-level health facilities in the work area, and working time division. Methods: This study employed a cross-sectional approach and secondary data in the form of the existing profile reports. Results: It was found that to meet this gap, job design was required to be made. The job design concept deemed suitable to be applied in the Health Office of Tulungagung District was job enrichment, in which the existing health workers were assigned an additional task vertically. This way, the activities at the community health center and the Health Office could run smoothly. In addition to job enrichment, interprofessional collaboration was also applied, namely collaboration among the health workers to improve service quality. The health workers recruitment was complicated since several things must be considered, including the position formation and the government policies. Conclusion: From the identification results, it is discovered that there is a significant gap between the necessities and the available workers in the job enrichment policy and interprofessional collaboration

Background:Diphtheria is a lethal disease caused by a type of microorganism from a group of bacteria called Corynebacterium diphtheria. In 2015, 1 case was found, and one died, in 2016, there were 8 cases, and one died, and in 2017, there were 36 cases, and 2 children died.
Aims:The purpose of this study is to analyze the extraordinary causes of diphtheria cases continue to increase despite good basic immunization coverage.
Methods:This study used the literature review that was obtained from various sources, namely Google Search, Google Scholar, Sciencedirect.com, E-book, and SAGA Journal, Scientific Work with the keywords of immunization and diphtheria from 2015-2019.
Results: From the results of observations on the physical environmental conditions of the house carried out by chi-square statistical tests, the significance of 0.008 or p-value was <0.05 (p <α) [6]. The results of statistical analysis using multiple linear regression showed a significance value of 0.01, indicating that there was an effect of population density (p <0.05) (2)
Conclusion: It can be concluded that the cause of diphtheria outbreaks in Sampang District is independent of basic immunization coverage, including (1) poor vaccine management, (2) inadequate physical environment of the house, and (3) population density.Therefore, further and more detailed research is to be carried out.

Indonesia is a country with high number of road traffic accidents. The number of accidents in January-March 2017 was 43.121 cases, and the number of motorcycle accidents approximately 31,247 cases. Coordination is an important factor needed to solve a particular program or problem involving two or more institutions. This study aims to analysis the coordination of the police, schools, and community health centers in the District of Krian on reducing motorcycle accidents. This research used descriptive method with cross-sectional approach. Data collectedthroughquestionnaires and distributed to 14 officers in the Krian police agency, , high school, andKrian communityhealth center. The respondents selectedby purposive sampling. The result showed the study shows that 64.3% of respondents claimed always need coordination, 42.9% of respondents always obeyed in carrying out the leadership's instructions, 50% of officers often carry out informal communication.The obstacles that occur in the implementation of coordination is the ignorance of other agencies, regarding the role of community health centers in traffic accident prevention efforts. It can be concluded that the implementation of coordination between the police, schools and health centers is good.

Hospitals have an obligation to provide education and training to staff who are potentially exposed and have direct contact with patients. This research was conducted because the number of hand washing non-compliance in 2017 still become the high standard set by the hospital at 0%. The study aims to analyze the elements of hand washing training on nurses based on the training effectiveness by Kirkpatrick's 2- Level theory. This research was descriptive, using a questionnaire to know the effectiveness of the training and the effectiveness of knowledge. The sample consisted of the nurses at DKT GubengPojok Hospital Surabaya. The sampling technique was total sampling with 14 nurses who participated in the training and also 20 nurses who did not attend, and there were 34 respondents. Fourteen nurses who participated in the training had an adequate reaction level about the training they get and supported by an average score of 78.29 had good knowledge and ability to remember the training material, compared with 20 nurses who did notattend the training. This research concludes that the identification of each element of training gets effective results. Moreover, the result showed the comparison of the knowledge level between the participating nursesand those who did not participate in practice as they received different grades.

Patient satisfaction is the benchmark for the level of health service quality. The patient satisfaction regarding the perceived treatment at the hospital determines whether he will use the same hospital in the future. Muji Rahayu Surabaya Hospital experienced a reduction in inpatient visits by 1.01% in 2018. The decrease in inpatient visits is likely due to patient complaints. The purpose of the study was to analyze patient satisfaction towards the perceived health care quality and the effect on patient loyalty. This study used a cross-sectional approach. The sampling technique was done by using proportionate stratified random sampling with 116 respondents who received inpatient services at Muji Rahayu Surabaya Hospital. The statistical test used was descriptive analysis and regression. The detailed discussion showed that 14.4% of patients felt very satisfied regarding the physical environment quality. There are 20.7% of the patients felt very satisfied regarding the interaction quality of doctors. Moreover, 21.3% of the patients are satisfied regarding the interaction quality provided by nurses, and 16.8% of patients felt very satisfied with the outcome quality. Meanwhile, overall patient loyalty was still low, which was as much as 13.2%. Regression analysis showed that patient satisfaction has a significant positive effect on patient loyalty (p=0.000). Patient satisfaction towards perceived health care quality has a strong effect on patient loyalty.

Background:The coverage of exclusive breastfeeding in Surabaya is still lower (65.10%) than the national target (80%). Aim:This study aims to examine the implementation of policies regarding exclusive breastfeeding in Surabaya. Method:This research employeda qualitative method. The data collection was conducted through in-depth interviews and observations. The research informants included midwives and nursing mothers in Surabaya. Result:The results indicated that the implementation of exclusive breastfeeding policy hadnot run properly due to the lack of knowledge and public awareness about the benefits of breastfeeding and inadequate infrastructure that supports the implementation of exclusive breastfeeding policy. Conclusion:The advice provided is that the implementation of exclusive breastfeeding policies should be carried out in accordance with Government Regulation by providing a lactation roomand supervising the distribution of formula milk for babies 0-6 months. Furthermore, it is also expected that all parties can support this implementation.

Background:The success of an organization in providing healthcare service depends on the staff competencies in completing thegiventask. Somepsychological factors thataffect the service include personality, psychological capital, and work engagement. Psychological capital is a kind of attitude and behavior capital that plays anessential role in determining individual success, while work engagement is a constituentthat underlies the staff attitude. Aim: This study aims to analyze the correlation between psychological capital and work engagement of health workers in the EmergencyUnit at South Madiun District General Hospital, East Java, Indonesia.Methods: This researchemployed adescriptive method and an observational approach.Furthermore,the research design applied was cross-sectional,involving 18 health workers in the Emergency Unit consisting of 13 nurses and 5 doctors who wereselected using a total sampling technique. The data were obtained through questionnaires distributed to the respondents in the Emergency Unit. Result:Results showed that thecorrelation between psychological capital and work engagement had a positive value of n=15, (93.8%). Conclusion: It can beconcluded that there was a positive correlation between psychological capital and work engagement of health workers in the Emergency Unit at South Madiun District General Hospital, East Java, Indonesia. It is recommended for the hospital management to evaluate every health worker performance trimonthly and to monitor the psychological factors to support the achievement of performance targeted by the hospital director.

Patient satisfaction is the core of patient-oriented marketing. Satisfying and quality service will form patient loyalty, so it will also bring in new customers. This study aimed to analyze the cause of complaints contributing to the occurring updates. The research design used was a quantitative descriptive. Analysis of training needs was carried out by looking at the organization based on the number of complaints and customer satisfaction surveys as a result of the Organizational Assessment, competency assessments as a result of the Task Analysis, attitudes and work methods of officers conducted by interviews as a result of the Individual Assessment. Based on data of complaints from public health center, the number of patients in 2018 was 14; 8 people were not satisfied with the attitude of the medical staff who provided services and 6 people were dissatisfied with the services provided. The customer satisfaction survey agreed that the descriptive executors were categorized as bad and the training was only carried out to improve competence in accordance with the fulfillment of competency requirements. The results of the research from the customer satisfaction survey conducted showed that the behavior of officers and service time was bad. Therefore, it is necessary to improve the services of the Public Health Center of Siwalankerto by reducing complaints, namely by increasing the ability of medical staff, one of which is through communication training.

Human resources are one of the most important aspects of an organization, including the existing health services at the Health Office. Therefore, planning for human resource needs is necessary to achieve organizational goals. This research was conducted at the Tulungagung District Health Office. This study aimed to determine the workload of human resources in the planning subdivision.This was descriptive qualitative research. Data collection techniques used were interviews with informants, documentation study, and observation. The population in this study was the Tulungagung District Health Office. The sample in this study were health administrators in the planning subdivision. The analysis was conducted based on workload. The workload is important in calculating employee formation and can be used to calculate the number of employees efficiently. The results showed that based on the number of ratios, a percentage of 2.908 was obtained, which means that the required number of employees should be 3 people. This indicated that the current workforce was less than the actual need because the workload was too large so it was advisable to undertake enrichment, enlargement, or recruitment in the planning subdivision of the District Health Office. This research concludes that there is an influence of workload with individual pressure and additional working hours, considering that the current state of human resources administrators is still lacking, known from the results of workload analysis calculations.

Hospital Information System (HIS) has an important role in clinical and administrative services to achieve quality services. However, monitoring and evaluation are necessary to find out how the benefits of HIS in the hospital work unit.This study aimed to evaluate the Hospital Information System using the HOT-Fit method in a hospital in Central Sulawesi Province.This type of research was descriptive quantitative. The sample in this study were all officers who used HIS in Undata Hospital, Central Sulawesi Province, amounting to 171 people. Sampling using a total sampling method. The data was collected using a questionnaire with a Guttman scale. The evaluation data obtained were analyzed statistically by showing the frequency distribution of each variable.The perceptions of HIS officers were as follows: respondents who had good perceptions based on human factors were 64.9%, respondents who had good perceptions based on organizational factors were 88.3%, and respondents who had good perceptions based on technological factors were 86.0%. The human, organizational, and technological factors in the SIRS of Undata Hospital, Central Sulawesi Province, were already good but there were still shortcomings for old users, and the SIRS application suddenly got errors.

The problem of adolescents should get serious attention and focus on directing adolescents to a more positive direction, which focuses on creating a system to deal with delinquency among adolescents. The type of research used in this research is the evaluation research (evaluation study). The adolescent reproductive health counseling program carried out is one of a series of Field Learning Practice Programs (PBL) conducted by the Department of Public Health, Universitas Negeri Malang. To evaluate the success of this activity, an evaluation was carried out containing the pretest,posttest, and rating questionnaire. The resultsof the evaluation showed that students who studiedhealth increased from an average value of 41.47 to 90 after counseling. Based on the evaluation of the Adolescent Reproductive Health or called ”Kesehatan Reproduksi Remaja“(KRR) counseling program through a questionnaire, an average score of 86.79 was obtained, which indicated that the Adolescent Reproductive Health Renewal Programwas given according to a top category. Thus, it can be concluded that supporting good health will increase knowledge about adolescent health

It has been reported that there are some obstacles in the implementation of the National Health Insurance, one of which is its referral system.The high number of referral in public health centers indicates that the implementation of the referral system has not gone well.This study aims to evaluate theimplementation of the outpatient referral system in a public health center in the national health insurance era. This study was qualitative research with a case study approach on eightinformants selected by purposive sampling method that was conducted in Singgani Community Health Center, Central Sulawesi, as one of the communityhealth centers in Indonesia. The data was obtainedthroughobservation, in-depth interviews, and document studies. The validity test was done with source triangulation and methodological triangulation and was analyzed by using Miles and Huberman analysis model.The results showed that the input in the form of human-related to doctors, machines-related to medical devices, and materials-related to the availability of drugs wasnot in line with the rules. The doctor's process of deciding to refer patients did not follow the rules of 155 diagnoses of diseases and the process of implementing referrals from the communityhealth center to the hospital was not listed in the waiting room. Besides, the output of the referral system was not optimal, seen from the suitability of the referral implementation at Singgani Community Health Center, which exceeded the ratio. Thus, it can be concluded thatthe application of the outpatient referral system on nationalhealth insurance participants is still not appropriate.

Pulmonary capacity is the maximum amount of air a person can expel from the pulmonary determined by the development of the respiratory system.. This study aims to describe the pulmonary capacity of the parking workers at PT FajarGraha Pena in Makassar. This descriptive study used an exploratory approach. Respondents were9 people obtained by a total sampling technique. Quantitative research method was applied in data collection. Data were acquired using questionnaires and spirometry. The results showed that three out of nine respondents experienced decreased pulmonary capacity. Pulmonary capacity was influenced by several variables including sex, sleeping pattern, smoking habit, exercise, and air pollution. Mostly, decreased pulmonary capacity was influenced by smoking habit and irregular sleeping pattern. In order to prevent decreased pulmonary capacity, parking workers is are suggested to change their living habits and the company management is recommended to revise the working hours policy.

Patient safety is one of the important efforts to guarantee and improve hospital quality.However, there are still patient safety incidents in several hospitals in Surabaya, both government and private hospitals.Based on patient safety incident reports, hospital X (private hospital) still has a high number of patient safety incidents in the last three years. It shows that the performance of patient safety in hospital X is still not optimal. The purpose of this study is to analyze the correlation between organizational communication climate and teamwork to patient safety incidents in hospital X. This research is an analytic study with a cross-sectional design conducted in a private hospital in Surabaya. There are 77 respondents from 21 work units as the sample of this study, where the population is 378 respondents from 21 work units. The results of this study indicate the influence of organizational communication climate and teamwork on the implementation of patient safety efforts. Well-organized organizational communication climate and teamwork in the hospitals can reduce the number of patient safety incidents and improve the patient safety culture.Therefore,this study concludes that there is a correlation between organizational communication climate and teamwork onpatient safety incidents.

Background:Professional governance is currently the biggest demand of the community. However, this is problematic because people still have to deal with limited numbers and unequal distribution of employees in one particular work unit. This is not to mention the designation of employees who are not compatible with the needs of each government organization. Workload analysis can be used to find out what positions employee shortages or employee overload have. Recruitment can be arranged to resolve the problem of employee shortages. However, if an organization has not been able to increase the number of its employees shortly, then a possible alternative is to rearrange job designation by implementing job enlargement and job enrichment. Purpose:This study aims to find out the effectiveness of policies in overcoming the limited number of employees. Methods:This was a descriptive study that aimed to see the effectiveness of the variables studied using descriptive analysis of the results of employee performance appraisal before and after job enlargement and job enrichment implemented. Results:Job enlargement and job enrichment are fairly effective to carry out as an alternative in overcoming the limited number of employees. Conclusion:This is concluded from the absence of a decrease in the results of employee performance appraisal. Some of them even increased despite the addition of responsibilities

The objective of this research article is to analyze the existence of Indonesian Patent Law and policy on providing a compulsory license to use pharmaceutical patents without consent for patent holders to enhance public health in Indonesia. The focus of this research is to examine whether such law and policy adequate to support access to affordable medicines in Indonesia. The type of this research is normative legal research by using statute and conceptual approaches, while legal resources used in this research is primary and secondary legal resources. The statute approach was used in this research to examine all Indonesia legislation, regulations, and policies dealing with this compulsory license on pharmaceutical patents. This research found that normatively, Indonesian Patent Law and Policy dealing with compulsory license is adequate to secure people's access to affordable medicines. Unfortunately, this compulsory license has not been utilized by the Indonesian Government. The Ministry of Human Rights Regulation No. 39 of 2018 concerning Procedures for Granting of Compulsory License to implement the Patent Act of 2016 has issued to apply for such License. This research advises the Government should ensure that procedure and technical guideline to implement this compulsory license is transparent so that it can be understandable by the third party; thus, accessibility and affordability of medicines can be achieved.

This article aims to review the ease of business licensing policy through the online system in health sector as a follow-up to the Online Single Submission (OSS) service policy intended to facilitate entrepreneurs’ legality. Licensing in the health sector is designedto protect for the public in obtaining safe, high quality, and affordable health services.Therefore,its existenceis an instrument to achieve health development and the third goal of the Sustainable Development Goals, namely health and well-being and the prevention of health services that could harm the community. Based on a literature review, licensing services through the OSS application is a policy that accelerates licensing services, which havebeen considered long and expensive.Yet,the implementation of online licensing services still raises legal issues,including not meeting the legal certainty, accuracy, and openness principles.Therefore, the potential of having permission for health services doesnot guarantee the availability of safe, high quality, and affordable health services. This article’s discussionwas written through a conceptual analysis of licensing and health servicesthat analyzethe laws and regulations in the field of health services licensing.

Dental artisan is a common and preferred profession that has been widely known amongst the general public due to its low price. However, because the job was unsafe, the dental artisan was prohibited by Legislation No. 29 of 2004 on Medical Practice and the Ministry of Health Regulation No. 1871/MENKES/PER/IX/2011 on the Repeal of the Ministry of Health Regulation No. 339/MENKES/PER/V/1989. On the other hand, the Constitutional Court, through its decision No. 40/PUU-X/2012 has re-legalized the dental artisan profession. Amongst considerations made by the Constitutional Court, the re-legalization was caused because although the profession has a high risk of security, it can be settled through teaching, licensing, and supervision, instead of prohibition. This research is juridical research that studies the existent legislation provision on the legal protection regarded to dental artisan in Indonesia. Based on this research, it was noticed that: First, under Article 6 (1) of Ministry of Health Regulation No. 39 of 2014, a dental artisan is only allowed to, (a) create a partial or complete removable dentures that are made out of heat curing acrylic, that adheres to health standard requirements, (b) install a partial or complete removable dentures that are made out of heat curing acrylic without covering the patient‟s left-tooth root. In the event a dental artisan conducted practice outside of the two, the City or Regency Local Government will impose an administrative sanction upon them. Second, the form of teaching, licensing, and supervision intended by the government will be given directly to the City of Regency Local Government to decide appropriately.

Change is an essentialaspect for the organization to enable employees to learn new skills andexplore new opportunities, which ultimately benefit the organization. One crucialelement in change management is the readiness of the organization to change or the readiness to change.This study aims to determine the effect and the dimensions of change valence, which have the most substantialinfluence on readiness to change.This studywas conducted at one private hospital that planned to change the typeof its hospital into a teaching hospital. This studywas classified asan observational analytic with a cross-sectional research design. The study samples were chosen randomly utilizinga proportional random sampling technique. Retrieval of research related data employeda questionnaire that had been tested for its validity and reliability.The results indicatedthat change valence influencedthe readiness to change based on statistical tests using simple linear regression (R = 0.726 and R2 = 0.527). The strongest dimension that influencedthe readiness to change was Perceived Appropriateness (R = 0.529 and R2 = 0.280).The higher the change valence, the higher the level of organizational readiness to change. A critical dimension of change valence was the Perceived Appropriateness dimension. Therefore,if the organization plans to increase its readiness to change, the management should consider the perceivedappropriateness dimension more than any other aspects.

Changing the status of the hospital froma particular type such as Maternity Hospital to General Hospital has the consequence of adding several new services such as internal medicine, dental treatment, general surgery, etc. Internal medicine as a new service has the lowest visit in the past two years. Itmight happensince the public does not yet know its existence, so it needs to be promoted more. This study aims to analyze the market segmentation and buyer readiness stage of the community around the hospital.This studyemployed descriptive research through cross-sectionaldata collection. A total of 101 respondents were identifiedwith simple random samplingfrom a population living within a radius of 3 km from the hospital. Then this study used primary data obtained by utilizingquestionnaires consisting of several questions about the characteristics of respondents, psychographic, and buyer readiness stage. The results indicatedthat the market segment characteristics were people who arehighlyeducated, work as civil servants and entrepreneurs, and those with a middle economic level. Then the medical service center that was frequently visited was the clinic/primary health service. The purchase readiness was at the awareness level, meaning that the respondents are still in the early stage of being aware of the hospital existence.Promotion is needed to increase purchase readiness to the level of knowledge to generate conviction and purchase. Understanding market segments and purchase readiness level couldhelp hospitals to determine the suitable promotional methods for marketing campaigns.

A person whose life highly depends on his health will certainly have a higher demand for health status. Based on the medical records from one of the PublicHospitals in Madiun, it is identified that the score of class II inpatient Bed Occupancy Rate (BOR) in 2016 exceeded the standard score of 85.53%.On the contrary, the score of class I inpatient BOR in 2016 was far below the standard of 27.74%. This study is to examine the correlationbetween patients'ability and willingness to pay in the selection of inpatient class at a Public Hospital in Madiun. The study is an analyticobservational study with a cross-sectional study design conducted on 100 patients as respondents. From the results of the chi-square correlation test, there was a significant correlation between the respondents' Ability to Pay and the selection of inpatientclass in PublicHospitalin Madiun (p-valueis less than0.05).With the variables of work, income, and expendituresub-variables are significantly related to the selection of inpatient classes at patients from one of the Public Hospitals in Madiun.From the users'aspect, in this case, the subject that determined the value of the applied tariff, the current tariff is far below the Ability to Pay (ATP) and Willingness to Pay (WTP).Thus, there is flexibility in the calculation for the submission of new tariff values.

Congenital hearing loss in Indonesia is still not getting optimal treatment. The number of patients from year to year does not get a clear picture and the government program for this problem is still not clearly visible. Patients with hearing loss are a burden of the State response if handled early this problem can show good progress. To Proving that early hearing screening in newborns can reduce complications from congenital hearing loss. Systematic searches were carried out at PubMed, Sciencedirect, ProQuest, Ebsco, and Web of Science to identify peer-reviewed research. The paper used is an original peer-reviewed research article in English that discusses the rehabilitation of children with hearing loss. Papers that meet the criteria are analyzed using PICO. 80% of children with congenital hearing loss identified under the age of 2 years have improved behavior, communication, and knowledge compared to children identified above 2 years. The rehabilitation process for speech ability 83% of children with congenital hearing loss under 2 years have more vocabulary. Rehabilitation costs incurred in children with congenital hearing loss identified >2 years are higher. Early Hearing screening is important to be carried out early on with the aim of preventing speech delay, behavior disorders, and knowledge disturbances

It has been reported that there are some obstacles in the implementation of the National Health Insurance, one of which is its referral system.The high number of referral in public health centers indicates that the implementation of the referral system has not gone well.This study aims to evaluate theimplementation of the outpatient referral system in a public health center in the national health insurance era. This study was qualitative research with a case study approach on eightinformants selected by purposive sampling method that was conducted in Singgani Community Health Center, Central Sulawesi, as one of the communityhealth centers in Indonesia. The data was obtainedthroughobservation, in-depth interviews, and document studies. The validity test was done with source triangulation and methodological triangulation and was analyzed by using Miles and Huberman analysis model.The results showed that the input in the form of human-related to doctors, machines-related to medical devices, and materials-related to the availability of drugs wasnot in line with the rules. The doctor's process of deciding to refer patients did not follow the rules of 155 diagnoses of diseases and the process of implementing referrals from the communityhealth center to the hospital was not listed in the waiting room. Besides, the output of the referral system was not optimal, seen from the suitability of the referral implementation at Singgani Community Health Center, which exceeded the ratio. Thus, it can be concluded thatthe application of the outpatient referral system on nationalhealth insurance participants is still not appropriate.

Pulmonary capacity is the maximum amount of air a person can expel from the pulmonary determined by the development of the respiratory system.. This study aims to describe the pulmonary capacity of the parking workers at PT FajarGraha Pena in Makassar. This descriptive study used an exploratory approach. Respondents were9 people obtained by a total sampling technique. Quantitative research method was applied in data collection. Data were acquired using questionnaires and spirometry. The results showed that three out of nine respondents experienced decreased pulmonary capacity. Pulmonary capacity was influenced by several variables including sex, sleeping pattern, smoking habit, exercise, and air pollution. Mostly, decreased pulmonary capacity was influenced by smoking habit and irregular sleeping pattern. In order to prevent decreased pulmonary capacity, parking workers is are suggested to change their living habits and the company management is recommended to revise the working hours policy.

Handling of patients in the Emergency Department for emergency cases requiresprompt, timely, and clinically effectiveservice. The response time is one of the service indicatorsinpatient care at the Emergency Department. This research aims to determine the factors associated with response timeinthe emergency department of a regional publichospital. This research was conducted in the Emergency Room ofMojowarno Christian Hospital,Jombang from October to December 2018 by using cross-sectional study. The researcher collected the data using a closed questionnaire from 50 nurses and midwives, as well as the patient observation sheet of the emergency room, was randomly selected. The data were analyzed with the Pearson chi-square test with significance level ≤0.05. The results indicated that 92% of the response time was right, and 8% did not match with the response time, where the response time was ≤ 5 minutes. 90% of patients with emergency cases and 10% of patients with non-emergency cases. 86% related to the doctors' presence and 14% related to the doctors' absence. There is a significant correlationbetween response time and patient cases [0.05] and a significant correlationbetween response time and the presence or absence of the doctors

Nurse performance evaluation is a formal system structure in evaluating nurses' performance in the past and present periods.However, its implementation in health service facilities still has many shortcomings. The problem of nurse performance appraisal is the existence of unstructured supervision, and the results remain subjective.This study aims to provide recommendations on the nurse performance appraisal system, which can be applied as a basis for career development, promotion, and reward.This study employed a descriptive quantitative approachby comparing secondary data and interview resultswith the head of the hospital room. The data included 160 documents that were selected using a simple random samplingfrom medical record data in the NganjukGeneral Hospital in East Java and analyzed based on the literature.Data from the general unit suggested that there were 25% of documents for nurse promotion in October 2017 and an increase of 40% in April 2018. There was no correlation between employee performance goalsand the proposed list of proposed credit scores. There weresome recommendations based on contextual problems, appraisal structure problems, appraisal process problems, and appraisal result problems. Nurse performance evaluation requires job descriptions, performance appraisal indicators, assessment according to the guidelines.

Nowadays, the nurse''s job performance is a global issueconsidering there areconsequences of the need for excellent and high-quality nursing services. The quality of work atmosphere or the Quality of Work Life in the work environment at the hospital is required.To analyze the Quality of Work Life on nurses in the hospital, the method employedin this study was descriptive-correlation performed among 75 nurses at urban hospital in Indonesia by utilizinga questionnaire with Work-Related Quality of Life scale. The results obtained and analyzed using the method of Prosentase analysis. The samplesweretaken by a simple random method. The Quality of Work Life measurements used the Work-Related Quality of Life scale. The size of Work-Related Quality ofLife usedsixfactors consisting of (1) General Well-Being, (2) Homework Interface, (3) Control at Work, (4) Working Condition, (5) Stress at Work, and (6) Job and Career Satisfaction. The results of the study revealedthat there were still nurses who were dissatisfied with the Homework Interface factor by19.01%, Control at Workby34.9%, Working Conditionby28.6%, and Stress at Workby87.3%.Furthermore, the quality of work liferemains low by 30.2%.In a nutshell,the quality of the work-life of nurses at an urban hospital in Indonesia is indicatedpoor. It is suggestedto identify the factors that influence and develop recommendations on improvement of Quality of Work Life on nurses

Background:In 2017, East Java Province was ranked second in Indonesia to discover tuberculosis (TB) patients. The Southern Regional Health Center of Kediri City was ranked fifth out of 27 cases.
Objectives of the study: This study aims to analyze the problem and prioritize health issues of TB in the Southern Regional Health Center of Kediri in 2019.
Methods: The observation was carried out using performance assessment for the Southern Regional Health Center data in 2018 with the ultrasound and fishbone methods.
Results: It was noticed that all TB cases were found and treated, including the discovery of suspected TB cases and the successful treatment of all TB cases (Success Rate/SR). The main problems in the Southern Regional Health Center in 2019 were that the suspected tuberculosis sputum pot was not returned, the people’s lack of knowledge, and less active TB cadres.
Conclusion: Some of the problems found are the lack of knowledge regarding TB, less active TB cadres, lack of coordination among TB cadres, limitation of people who are willing to become TB cadres, and the time limitation of TB cadres.

Background: The corporate image is the fundamental performance aim of public relations practitioners which is formed through experience services that are obtained through the perception of the visitors when visiting a particular place, such as a private hospital. Aims: This study aims to investigate the image of a private hospital in Surabaya, Indonesia, especially at the Medical Check-Up section, from the visitors’ perspectives. Methods: The image measurement was done based on five image measuring indicators, namely primary impression, familiarity, perception, preference, and position. This research was descriptive research that used a quantitative approach and survey methods. The data was collected by distributing questionnaires to a total sample of 100 respondents who were chosen by using the simple random sampling technique. The data was analyzed by employing the descriptive statistical analysis and cross-tabulation technique. Results: The image of the private hospital, particularly of the Medical Check-Up section, was positive according to the visitors’ perspective. The highest image indicator was the primary impression with an average score of 4.14, while the lowest one was the position with an average rating of 3.59. The acquisition of the other indicators’ average score was recorded as much as 4.12, 4.09, and 3.92 for familiarity, preference and perception indicators, respectively. Conclusion: This study concludes that a positive image with the highest percentage is given by medical visitors corporate. On the other hand, the negative image with the highest rate is provided by medical visitors’ insurance.

Background: Human Resource Planning is the process of analyzing and drafting the concept of Human Resource Management in an organization. The identification between the necessities and the number of available personnel is required in Human Resource Planning. In the Health Office of Tulungagung District, the calculation results exhibit a significant gap between the necessities and the available personnel. From the calculation through the Renbutnakes application, there are 358 staff shortages for all types of health workers. Aims: This study aims to analyze the type and number of health and non-health workers calculated based on the number of services performed, population and distribution, work area characteristics and coverage, availability of other first-level health facilities in the work area, and working time division. Methods: This study employed a cross-sectional approach and secondary data in the form of the existing profile reports. Results: It was found that to meet this gap, job design was required to be made. The job design concept deemed suitable to be applied in the Health Office of Tulungagung District was job enrichment, in which the existing health workers were assigned an additional task vertically. This way, the activities at the community health center and the Health Office could run smoothly. In addition to job enrichment, interprofessional collaboration was also applied, namely collaboration among the health workers to improve service quality. The health workers recruitment was complicated since several things must be considered, including the position formation and the government policies. Conclusion: From the identification results, it is discovered that there is a significant gap between the necessities and the available workers in the job enrichment policy and interprofessional collaboration

Background:Diphtheria is a lethal disease caused by a type of microorganism from a group of bacteria called Corynebacterium diphtheria. In 2015, 1 case was found, and one died, in 2016, there were 8 cases, and one died, and in 2017, there were 36 cases, and 2 children died. Aims:The purpose of this study is to analyze the extraordinary causes of diphtheria cases continue to increase despite good basic immunization coverage. Methods:This study used the literature review that was obtained from various sources, namely Google Search, Google Scholar, Sciencedirect.com, E-book, and SAGA Journal, Scientific Work with the keywords of immunization and diphtheria from 2015-2019. Results: From the results of observations on the physical environmental conditions of the house carried out by chi-square statistical tests, the significance of 0.008 or p-value was <0.05 (p <α) [6]. The results of statistical analysis using multiple linear regression showed a significance value of 0.01, indicating that there was an effect of population density (p <0.05) (2) Conclusion: It can be concluded that the cause of diphtheria outbreaks in Sampang District is independent of basic immunization coverage, including (1) poor vaccine management, (2) inadequate physical environment of the house, and (3) population density.Therefore, further and more detailed research is to be carried out.

Indonesia is a country with high number of road traffic accidents. The number of accidents in January-March 2017 was 43.121 cases, and the number of motorcycle accidents approximately 31,247 cases. Coordination is an important factor needed to solve a particular program or problem involving two or more institutions. This study aims to analysis the coordination of the police, schools, and community health centers in the District of Krian on reducing motorcycle accidents. This research used descriptive method with cross-sectional approach. Data collectedthroughquestionnaires and distributed to 14 officers in the Krian police agency, , high school, andKrian communityhealth center. The respondents selectedby purposive sampling. The result showed the study shows that 64.3% of respondents claimed always need coordination, 42.9% of respondents always obeyed in carrying out the leadership's instructions, 50% of officers often carry out informal communication.The obstacles that occur in the implementation of coordination is the ignorance of other agencies, regarding the role of community health centers in traffic accident prevention efforts. It can be concluded that the implementation of coordination between the police, schools and health centers is good.

Hospitals have an obligation to provide education and training to staff who are potentially exposed and have direct contact with patients. This research was conducted because the number of hand washing non-compliance in 2017 still become the high standard set by the hospital at 0%. The study aims to analyze the elements of hand washing training on nurses based on the training effectiveness by Kirkpatrick''s 2- Level theory. This research was descriptive, using a questionnaire to know the effectiveness of the training and the effectiveness of knowledge. The sample consisted of the nurses at DKT GubengPojok Hospital Surabaya. The sampling technique was total sampling with 14 nurses who participated in the training and also 20 nurses who did not attend, and there were 34 respondents. Fourteen nurses who participated in the training had an adequate reaction level about the training they get and supported by an average score of 78.29 had good knowledge and ability to remember the training material, compared with 20 nurses who did notattend the training. This research concludes that the identification of each element of training gets effective results. Moreover, the result showed the comparison of the knowledge level between the participating nursesand those who did not participate in practice as they received different grades.

Patient satisfaction is the benchmark for the level of health service quality. The patient satisfaction regarding the perceived treatment at the hospital determines whether he will use the same hospital in the future. Muji Rahayu Surabaya Hospital experienced a reduction in inpatient visits by 1.01% in 2018. The decrease in inpatient visits is likely due to patient complaints. The purpose of the study was to analyze patient satisfaction towards the perceived health care quality and the effect on patient loyalty. This study used a cross-sectional approach. The sampling technique was done by using proportionate stratified random sampling with 116 respondents who received inpatient services at Muji Rahayu Surabaya Hospital. The statistical test used was descriptive analysis and regression. The detailed discussion showed that 14.4% of patients felt very satisfied regarding the physical environment quality. There are 20.7% of the patients felt very satisfied regarding the interaction quality of doctors. Moreover, 21.3% of the patients are satisfied regarding the interaction quality provided by nurses, and 16.8% of patients felt very satisfied with the outcome quality. Meanwhile, overall patient loyalty was still low, which was as much as 13.2%. Regression analysis showed that patient satisfaction has a significant positive effect on patient loyalty (p=0.000). Patient satisfaction towards perceived health care quality has a strong effect on patient loyalty.

Background:The coverage of exclusive breastfeeding in Surabaya is still lower (65.10%) than the national target (80%). Aim:This study aims to examine the implementation of policies regarding exclusive breastfeeding in Surabaya. Method:This research employeda qualitative method. The data collection was conducted through in-depth interviews and observations. The research informants included midwives and nursing mothers in Surabaya. Result:The results indicated that the implementation of exclusive breastfeeding policy hadnot run properly due to the lack of knowledge and public awareness about the benefits of breastfeeding and inadequate infrastructure that supports the implementation of exclusive breastfeeding policy. Conclusion:The advice provided is that the implementation of exclusive breastfeeding policies should be carried out in accordance with Government Regulation by providing a lactation roomand supervising the distribution of formula milk for babies 0-6 months. Furthermore, it is also expected that all parties can support this implementation.

Background:The success of an organization in providing healthcare service depends on the staff competencies in completing thegiventask. Somepsychological factors thataffect the service include personality, psychological capital, and work engagement. Psychological capital is a kind of attitude and behavior capital that plays anessential role in determining individual success, while work engagement is a constituentthat underlies the staff attitude. Aim: This study aims to analyze the correlation between psychological capital and work engagement of health workers in the EmergencyUnit at South Madiun District General Hospital, East Java, Indonesia.Methods: This researchemployed adescriptive method and an observational approach.Furthermore,the research design applied was cross-sectional,involving 18 health workers in the Emergency Unit consisting of 13 nurses and 5 doctors who wereselected using a total sampling technique. The data were obtained through questionnaires distributed to the respondents in the Emergency Unit. Result:Results showed that thecorrelation between psychological capital and work engagement had a positive value of n=15, (93.8%). Conclusion: It can beconcluded that there was a positive correlation between psychological capital and work engagement of health workers in the Emergency Unit at South Madiun District General Hospital, East Java, Indonesia. It is recommended for the hospital management to evaluate every health worker performance trimonthly and to monitor the psychological factors to support the achievement of performance targeted by the hospital director.

Patient satisfaction is the core of patient-oriented marketing. Satisfying and quality service will form patient loyalty, so it will also bring in new customers. This study aimed to analyze the cause of complaints contributing to the occurring updates. The research design used was a quantitative descriptive. Analysis of training needs was carried out by looking at the organization based on the number of complaints and customer satisfaction surveys as a result of the Organizational Assessment, competency assessments as a result of the Task Analysis, attitudes and work methods of officers conducted by interviews as a result of the Individual Assessment. Based on data of complaints from public health center, the number of patients in 2018 was 14; 8 people were not satisfied with the attitude of the medical staff who provided services and 6 people were dissatisfied with the services provided. The customer satisfaction survey agreed that the descriptive executors were categorized as bad and the training was only carried out to improve competence in accordance with the fulfillment of competency requirements. The results of the research from the customer satisfaction survey conducted showed that the behavior of officers and service time was bad. Therefore, it is necessary to improve the services of the Public Health Center of Siwalankerto by reducing complaints, namely by increasing the ability of medical staff, one of which is through communication training.

Human resources are one of the most important aspects of an organization, including the existing health services at the Health Office. Therefore, planning for human resource needs is necessary to achieve organizational goals. This research was conducted at the Tulungagung District Health Office. This study aimed to determine the workload of human resources in the planning subdivision.This was descriptive qualitative research. Data collection techniques used were interviews with informants, documentation study, and observation. The population in this study was the Tulungagung District Health Office. The sample in this study were health administrators in the planning subdivision. The analysis was conducted based on workload. The workload is important in calculating employee formation and can be used to calculate the number of employees efficiently. The results showed that based on the number of ratios, a percentage of 2.908 was obtained, which means that the required number of employees should be 3 people. This indicated that the current workforce was less than the actual need because the workload was too large so it was advisable to undertake enrichment, enlargement, or recruitment in the planning subdivision of the District Health Office. This research concludes that there is an influence of workload with individual pressure and additional working hours, considering that the current state of human resources administrators is still lacking, known from the results of workload analysis calculations.

Hospital Information System (HIS) has an important role in clinical and administrative services to achieve quality services. However, monitoring and evaluation are necessary to find out how the benefits of HIS in the hospital work unit.This study aimed to evaluate the Hospital Information System using the HOT-Fit method in a hospital in Central Sulawesi Province.This type of research was descriptive quantitative. The sample in this study were all officers who used HIS in Undata Hospital, Central Sulawesi Province, amounting to 171 people. Sampling using a total sampling method. The data was collected using a questionnaire with a Guttman scale. The evaluation data obtained were analyzed statistically by showing the frequency distribution of each variable.The perceptions of HIS officers were as follows: respondents who had good perceptions based on human factors were 64.9%, respondents who had good perceptions based on organizational factors were 88.3%, and respondents who had good perceptions based on technological factors were 86.0%. The human, organizational, and technological factors in the SIRS of Undata Hospital, Central Sulawesi Province, were already good but there were still shortcomings for old users, and the SIRS application suddenly got errors

The problem of adolescents should get serious attention and focus on directing adolescents to a more positive direction, which focuses on creating a system to deal with delinquency among adolescents. The type of research used in this research is the evaluation research (evaluation study). The adolescent reproductive health counseling program carried out is one of a series of Field Learning Practice Programs (PBL) conducted by the Department of Public Health, Universitas Negeri Malang. To evaluate the success of this activity, an evaluation was carried out containing the pretest,posttest, and rating questionnaire. The resultsof the evaluation showed that students who studiedhealth increased from an average value of 41.47 to 90 after counseling. Based on the evaluation of the Adolescent Reproductive Health or called ”Kesehatan Reproduksi Remaja“(KRR) counseling program through a questionnaire, an average score of 86.79 was obtained, which indicated that the Adolescent Reproductive Health Renewal Programwas given according to a top category. Thus, it can be concluded that supporting good health will increase knowledge about adolescent health.

Patient safety is one of the important efforts to guarantee and improve hospital quality.However, there are still patient safety incidents in several hospitals in Surabaya, both government and private hospitals.Based on patient safety incident reports, hospital X (private hospital) still has a high number of patient safety incidents in the last three years. It shows that the performance of patient safety in hospital X is still not optimal. The purpose of this study is to analyze the correlation between organizational communication climate and teamwork to patient safety incidents in hospital X. This research is an analytic study with a cross-sectional design conducted in a private hospital in Surabaya. There are 77 respondents from 21 work units as the sample of this study, where the population is 378 respondents from 21 work units. The results of this study indicate the influence of organizational communication climate and teamwork on the implementation of patient safety efforts. Well-organized organizational communication climate and teamwork in the hospitals can reduce the number of patient safety incidents and improve the patient safety culture.Therefore,this study concludes that there is a correlation between organizational communication climate and teamwork onpatient safety incidents.

Background: The advancement of endodontic tools and materials that can improve the success of root canal treatment currently supports tooth conservation efforts.Purpose: This study aims to determine the description of endodontic practice performed by general dentists. Methods: This type of descriptive study was a population of general dentists at Dental and Oral HospitalUniversitas Airlangga. The variable used was the practice of endodontic treatment for general dentists at Dental and Oral Hospital Universitas Airlangga. The responses were received as many as 34 forms then analysed and presented descriptively. Results: The study subjects were 34 people, of which 62% performed endodontic treatment on double rooted teeth. The frequency of endodontic treatment within 1 week of 0-5 teeth was performed by 76% of respondents.The majority of root canal preparation techniques used were crown down as many as 56% of respondents. The root canal irrigation agent sodium hypochlorite was used by 85% of the respondents. The single cone root filling technique was used by 59% of the respondents. As many as 85% of respondents prescribe antibiotics to patients with inflammation. Conclusion: Endodontic practice of general dentists at Dental and Oral Hospital Universitas Airlanggastill does not use the latest technology and does not adequately meet the guidelines for endodontic treatment that are valid internationally

Background. The oral cavity is an inseparable part of the human body. The oral cavity is composed of a structure that is a unitary function known as mastication, such as the teeth, tongue, while mucosa known as the stomatognathic system. One part of the oral cavity, namely the tongue, is an organ that has a central function for taste and taste of various types of food flavours and other substances that will enter the body through the oral cavity. However, sometimes the tongue is coated with a thin white layer containing bacteria, desquamated epithelial cells, leukocytes, blood metabolites, and various other components. Purpose: of this study was to determine the relationship between the level of knowledge and the habit of brushing the tongue in coated tongue patients who come to the Dental and Oral Hospital of Universitas Airlangga, Method. This study was descriptive analytic with the type of study was cross sectional. Results: were 28 patients with a good level of knowledge, 11 patients with a moderate level of knowledge, and 2 patients with a bad level of knowledge, and the results were 12 patients with a good level of habits, and 29 patients with a bad habit level. Conclusion. Good level of knowledge about tongue hygiene does not make a good habit also in keeping the tongue clean.

Background: Dental practice has risks to occupational health for the body in terms of ergonomics. Broadly speaking, ergonomics is the study of humans to create work systems that are healthier, safer, and more comfortable. Musculoskeletal disorders (MSDs) are disorders of the muscles, tendons, joints, vertebrae, peripheral nerves, and vascular system that can be caused by various factors, including occupational factors such as posture distortion, too long a static posture, and repetitive movements. Pupose: The purpose of this study was to determine the relationship between the level of awareness about ergonomics to Musculoskeletal Disorders (MSDs) in the dental profession students of Universitas Airlangga. Methods: Data were collected through online questionnaires and analyzed using the Pearson Chi-Square technique. Results: Out of 55 students, 100% (55) dentistry profession students were aware of the importance of ergonomics. Then 84.9% (45) students experienced symptoms of musculoskeletal abnormalities and another 15.1% (8) students did not experience musculoskeletal symptoms. Statistically, there is no significant relationship between the level of awareness about ergonomics towards Musculoskeletal Disorders (MSDs) in the dental profession students of Universitas Airlangga. Conclusion: The level of awareness about ergonomics is not significantly related to Musculoskeletal Disorders (MSDs) in the dental profession students of Universitas Airlangga.

Background: The main physical appearance that can be seen from the face is inseparable from the appearance of the teeth and mouth. The teenagers realize that the first impression is greatly influenced by appearance. Purpose: Determine the relationship between the perception of young adults using fixed orthodontic appliance and interest towards of malocclusion treatment inclass of 2019 undergraduate students of Faculty of Dental Medicine Universitas Airlangga Surabaya. Methods: This research was an analytic cross-sectional study design and the sampling technique used purposive sampling. The amount of sample which met the inclusion and exclusion criteria was 87 students. Data collected by giving questionnaires to 87 students. Cross-tabulation between perception and interests showed that the most interests of the respondent were seen in the moderate category in the perception of both functional and aesthetic aspects. The data were analyzed using the chi-square test with α = 0,05. Results: The relationship between the perception of late adolescence using fixed orthodontic appliance and interest towards of malocclusion treatment did not show a significant result with p = 0,351. Conclusions: There is no relationship between the perception of young adults using fixed orthodontic appliance and interest towards ofmalocclusion treatment in class of 2019 undergraduate students of Faculty of Dental Medicine Universitas Airlangga Surabaya

Background: Employees need to be managed properly to provide a positive contribution to the progress of the organization. Purpose: To determine the relationship between Organizational Commitment, Emotional Intelligence, Job Satisfaction and with Turnover Intention on employees at Amanah Mother and Child Hospital Probolinggo, East Java. Method: Cross-sectional study with 120 respondents medical and nursing personnel. The study was conducted using a questionnaire consisting of 15 questions. Result : Characteristics of respondents with high turnover rate were female (42%), age <= 34 years (44.2%), length of work <= 5 years (38.2%), executive position (41.8%), income < = 7,000,000 (38.3%), Satisfied at work (37.2%), high emotional intelligence (36.9%) and low organizational commitment (15.1%). There is a significant relationship between organizational commitment and turnover intention (p <0.05). Conclusion: To improve staff loyalties, the hospital should prioritize female staff, positions, and organizational commitment so that organizational treatments can be more efficient and effective.

Background:Dental and oral health problems can have an impact on the ability to chew, bite, swallow or talk, one's appearance, smile and self-esteem, social factors such as eating or talking in front of others, pain or discomfort, which will affect the quality of life of individuals. Purpose:of this study was to determine whether there is a relationship between the age of patients with oral health problems with the quality of life.Method:This research is a descriptive type of research with 118 respondents. The questionnaire completed by the respondent which contained primary data including name, gender, age, disease history, OHIP-14 scale, and five-point scale. Result:Most of the study subjects were respondents who were in the young adult age group (25-44 years), with a higher quality of life score (12.04%). The average results of OHIP scores of subjects with the highest scores stated that subjects in both ages ranges felt disturbed especially in terms of mastication, ingestion, and speech functions by 11.9%. The lowest score is at the point of feeling hard to do any activity at 4.89% and feels easily offended or upset at 5.67%.Conclusion: The result shows a significant difference from the statistical analysis test of OHIP-14 scores according to age. Thus it can be concluded that there is a relationship between the age range in patients with oral health problems with the quality of life.

Background: During an unpredictable situation (uncertain environment), high purchase intentions for better and quality services results providers need an extraordinary level of expertise in the healthcare market. Purpose: To determine the effect of customer-based brand equity on purchase intention. Method: observational study with cross-sectional design. The population was all elderly in the East Lombok Regency, samples that fulfilled the criteria; not experience chronic diseases such as stroke, cataracts, chronic kidney disease (CKD), severe diabetes mellitus, and coronary heart disease. Measurement of independence used the ADL Bartle Index instrument. The cognitive level used the MMSE instrument and respondents were willing to fill in the questionnaire. Results: the characteristics of respondents and customer-based brand equity on purchase intention used the chi-square test and fisher's exact test. Risk estimates and 95% confidence intervals of customer-based brand equity, namely brand awareness 1,243 (1,000 to 1,546), brand association 1,245 (1,014 to 1,527), perceived quality 1,229 (1,014 to 1,488), and brand loyalty 1,240 (1,039 to 1,479), the test results showed a significant relationship and had a prevalence ratio (PR)> 1 to the purchase intentionof outpatient health centers. Conclusion: the majority of respondents who have an elderly purchase intention for outpatient services at the public health center

SICANTIK is an electronic information system created to prevent maternal and child deaths. In 2017, 30 out of 36,313 women died of maternal causesin Sidoarjo Regency. The overall mortality rate was83 deaths per 100,000 live births. This study aims to analyze the effectivenessof SICANTIK utilization by the community health centerofficers asan effort to improve maternal and child health. SICANTIK information system was evaluated using Human, Organization, andTechnology-FitFramework(HOT-Fit Framework) concerninghuman factors. The evaluation wasdoneintwo weeks at four community health centers. The evaluation of SICANTIK health information systemutilization demonstrated thatthe users were midwife coordinatorson the age range of 30-40 years and have worked for more thanthree years. The user satisfaction variableindicated that the midwiveshave maximized the utilizationof SICANTIK application. However, most of the health workerswere not ready to use SICANTIK health information system in the community health centers.

Leprosy is an infectious disease that requires health behaviour modification to combat the disease and at the same time to prevent thetransmission. This study aimsto determine the relationship between personal, physical environmental, and socio-economic factors andthe preventive behaviour of leprosy transmission. This study was a correlational descriptive analytic study with a cross sectional approach.As many as 60 out of 77 lepers in Surabaya were chosenthrougha purposive sampling technique. The dependent variable was the preventive behaviour of leprosy transmission, while the independent variables were personal, physical environmental, and socio-economic factors. Data was collected using questionnairesand then was analyzedby using Spearman’s Rho and Chi-Square test with α= 0.05. The study revealed that preventive behaviour of leprosy transmission was significantly related with age (p=0.033), gender or sex (p=0.002), education (p=0.016), occupation (p=0.043), knowledge (p=0,000), physical environment (p=0,012), family support (p=0,000), income (p=0,000) and stigma (p=0,043). Age and stigma performed a negative relationship with the preventive behaviour of leprosy transmission. Otherwise, education, knowledge, and physical environment showed a positive relationship. Further researchis expectedto provide intervention to promotethe preventive behaviour of leprosy transmission

Introduction: Adolescence is the second most critical period of physical growth in the life cycle after the first year. The increased prevalence of unhealthy lifestyles among adolescent girls has become a public concern, as they should maintain their health status for the health of their future children.
Aims: This study aims to analyze the determinants of healthy lifestyle among adolescent girls based on Pender’s Health Promotion Model.
Method: This was a descriptive-analytic study with cross-sectional approach. The population was adolescent girls (15-18 years old) at Senior High School, Gresik City, East Java. Samples were 210 respondents, taken by using simple random sampling technique. The independent variables were intrinsic motivation, perceived benefits, perceived barriers, self-efficacy, and peers support. The dependent variable was healthy lifestyle behavior. Data were collected by using questionnaire, then analyzed using chi-square (x2) (α <0.05).
Result: Result showed significant correlation between intrinsic motivation (p=0.001; C=0.253), perceived benefits (p=0.001; C=0.246), perceived barriers (p=0.002; C=0.233), self-efficacy (p=0,000; C=0.436), and peers support (p=0,000; C=0.348) with adolescent girls’ healthy lifestyle.
Conclusion: Positive cognition on benefits, no barrier perceived, strong self-efficacy, and strong peer supports would increase adolescent girls’ healthy life.

Introduction: The coverage of family planning in Indonesia has yet been evenly distributed. The government, the private sector, and the community, including health cadres, have an important role to succeed the family planning program. Through cadres, family planning promotion can reach a wider community.
Aims: This study aims to explain the relationship between cadre perceptions and their behavior in promoting family planning based on the Health Promotion Model (HPM).
Method: The research design used was correlational with a cross-sectional approach. Participants were 200 cadres from the community health centers obtained by cluster sampling techniques. Participants filled the perception questionnaires and the data was analyzed using Spearman's rho test (α=0.05).
Results: The analysis showed that there were correlations between perceived benefits (r = 0.490), perceived barriers (r = 0.148), perceived self-efficacy (r = 0.420), activity-related effects (r = 0.165), and situational influence (r = 0.481) with cadres’ behavior in promoting family planning at the community health centers (p<α<0.05).
Conclusions: Positive perceived benefits of action, perceived barriers to action, perceived self-efficacy, activity-related effects, and high situational influence will increase the cadres’ good behavior in promoting family planning to the community. Cadres should enhance their knowledge and ability as well as foster their intention and enthusiasm to support family planning to the community.

Background:Telemedicine is widely introduced to maximize ICT utilization in improving patient health outcomes by increasing the access to health and medical information. The interaction between health professionals and ICT implementation in telemedicine leads to massive changes in the health systems.
Aims:This study aims to investigate the future health professionals’ opinions about the feasibility of telemedicine implementation in Indonesia.
Methods:Expository essays on telemedicine were analyzed using qualitative content analysis. These essays were written up as part of the quality management in healthcare courses in the public health bachelor’s degree of Universitas Airlangga. 34 essays were included in the analysis.
Results:Students’ perspectives were portrayed through four overall feasibility themes: 1) technical feasibility was the most concerning issues in the implementation; 2) economic feasibility should be calculated by considering investment and operational costs; 3) operational feasibility remained low when the health professional competence in ICTs was lacking and unmotivated; 4) legal policy was urgently required. Conclusion: Based on the results, it can be concluded that the future health professionals agree that telemedicine is crucial for Indonesia.

Noises in hospitals cause noise-induced hearing loss in the employees. The standard diagnostic is audiometry to determine the hearing level. Distortion product otoacoustic emission (DPOAE)is a potential screening tool for cochlear problems. Noise exposure can be found not only in industrial areas but also in hospitals.This study aims to hear conservations to control the risk factors by doing noise measurement using the sound level meter. The design of this study was an analytic observational study with the cross-sectional design where measurements were made ofintensity and noise dose in 3 installations, namely medical facilities maintenance (MFM), sanitation, and nutrition. Fifty-sixsubjects underwent tympanometry to exclude conductive hearing loss, resulting in a total of 48 subjects who fit the inclusion criteria. The correlation between examination results and age, work station, and working duration were analyzed by usingthe Spearman correlation test (p<0.05). The correlation between noise dose, intensity, and hearing status, however, were analyzed by using Fischer test (p<0.05). The result showed theaverage noise intensity at MFM was 95.83dBA, at the nutrition installation was 99.07dBA, and at the sanitation installation was 105.5dBA. Meanwhile, the average noise dose at MFM was 674.25%, at nutrition was 1632.5%, and at sanitation was 8 977.75%.Abnormal audiometry was 50% and DPOAE refer 77.083%. Thus, it can be argued that there was a significant correlation between the work station and DPOAE (p=0.0184). There wasalso a correlation between noise intensity and hearing loss, whileno significant differenceswere discovered between DPOAE and audiometry.

An error due to the mistake in identifying the patient can happen at almost all stages of diagnosis and treatment. The possible result is the incident in patient safety which can cause damage to the patient along with the hospital. This research was focused on the implementation of correct identification to the patient at the regional public hospital of North Lombok regency using Donabedian model for the analysis with qualitative type research. The research subjects were six officers. Additionally, the data collection was through an in-depth interview, direct observation, and document analysis. The finding showed that some patients were not given (using) the patient ID wristbands (wristlet) and the Standard Operating Procedure (SOP) for identifying the patients had not been distributed to the officer yet. The infrastructures and the facilities were not sufficient in terms of both quality and quantity. In addition, the executing officer did not perform the identification maximally and correctly. Thus, the implementation of identifying the patient based on the Donabedian model (structure/input, process, and outcome) has not been performed at the maximum extent.

The incidence of multidrug-resistant organisms (MDROs) is found increasing in hospitals, in which this case causesan increaseinhealthcare-associated infections. Healthcare-associated infections (HAIs) or nosocomial infection is an infection obtained in a hospital after more than 72 hours of being admitted to the hospital. This infection transmission by multidrug-resistant organisms is caused by the health workers’ hand hygiene. One of the most effective prevention is to do proper hand hygiene, which results in breaking the chain of the multidrug-resistant organism incidence.Therefore, hand hygiene compliance may reduce healthcare-associated infection.This study aims to discoverthe relationship between hand hygiene andthe multidrug-resistant organism incidence. This study was a descriptive research conducted by utilizing surveillancedata of multidrug-resistant organisms in the intensive care unit (ICU) and the hospital ward in 2018, and the audit of WHO’s protocols for hand hygiene was collected by the infection prevention and control committee from January to December 2018. The result showed that the rate of hand hygiene compliance in 2018 at the ICU was 66% while at the hospital ward,on average,was about52%. There was a decrease in the multidrug-resistant organism incidencein 2018 compared to 2017; in the ICU, the highest percentage reduction was multidrug-resistant Acinetobacter baumannii (54.5 %), and the lowest was extended-spectrum beta-lactamase (5.5 %). Meanwhile, in the hospital ward, the highest percentage reduction was multidrug-resistant Acinetobacter baumanniiincidence (50%),and the lowest was extended-spectrum beta-lactamase (4%).Therefore, the trend patterns show aninverse correlation between hand hygiene compliance and multidrug-resistant organism incidence in the ICU and the hospital ward.

Background: Dental caries is a major problem in children’s oral cavity. Beside caries, the prevalence of gingival bleeding in children was also by plaque buildup due to poor oral hygiene. Toddlers are one of the groups most vulnerable to dental and oral diseases because they generally still have behaviors or habits that are less supportive of dental health. Primary teeth are indicators of dental health in preschool children needed to assess the dental health of children. Mother’s education, socio economic, and knowledge is one of the factors that affect health status.Objective: This study aims to determine the relationship of mother’s education and knowledge of the status of caries and periodontal in children aged 3-6 years.Methods: This study used observational analytic with cross-sectional and total sampling conducted in Paud Temoran Village, Sampang with respondents of 50 mothers and their children. WHO and dmft examination sheet to measured child periodontal and caries status. Questionnaire sheet to measured mother’s knowledge. Data analysis used spearman correlation test. Results: Statistical results between the level of education and caries status got a significant correlation, besides the results of statistics on education, knowledge and socioeconomic levels with periodontal status show insignificant correlation.Conclusion: There was a significant correlation between the level of education and caries status while the level of education, knowledge and socioeconomic with periodontal status there is no significant correlation.

Background: The prevalence of malocclusion in Indonesia is very high, which is around 80% of the total population. Orthodontic treatment in the mixed dentition stage is the right time to minimize the occurrence of malocclusion, and it requires space analysis in advance. To predict the space required in space analysis, prediction methods can be applied, such as Moyers method, Tanaka- Johnston method, and Sitepu method. These three methods are obtained from studies with different races.
Objective: This research was conducted to determine the differences in the results of space analysis with the three methods.
Methods: Seventy-three (73) dental casts were obtained from children aged 8-12 years at SD Negeri Gubeng 1. The space available and space required was measured by these three methods. The discrepancy of these methods was calculated based on the space available and the space required. The results were statistically analyzed using Kruskal-Wallis.
Results: By Kruskall-Wallis test, the space analysis measurement method in maxillary arch showed no significant differences (p> 0.05), while in mandibular arch showed significant differences (p< 0.05).Mann-Whitney Utest on the maxillary arch showed no significant differences (p> 0.05), while in mandibular arch was (p< 0.05). This means that there was a significant difference between the Moyers method in mandibular arch and the Sitepu method in mandibular arch, and also between the Tanaka-Johnston method in mandibular arch and the Sitepu method in mandibular arch.
Conclusion: By using these three methods, the results of space analysis on mandibular arch showed a significant difference, while on maxillary arch showed no significant differences.

Background: The tooth extraction process will always cause tissue damage, both hard tissue and soft tissue such as bleeding, pain, edema, and hard tissue such as loss of alveolar ridge volume after extraction. Substitutes for biological components have developed in increasing alveolar bone volume by using bone grafts. Chitosan can be used as an option. Addition of collagen membrane to post-extraction wounds can increase and protect the formation of initial blood clots to the root surface. Collagen membrane is a type of resorb able membrane that is often used. The function of this collagen membrane is increasing and maintaining blood clots and acting as scaffold for cell adhesion and growth. Purpose: To determine whether the use of collagen membranes does not slow down the chitosan adsorption speed of 150-355 μm in group O blood or not. Methods:There were chitosan samples measuring 150-355 μm were divided into two groups, namely control group, 7 samples for chitosan with gauze and 7 samples of the treatment group for chitosan with collagen membrane. Dip it in 75 ml of blood. Measurements of group O blood adsorption velocity in each group were seen for 10 minutes. Result: The result was analyzed statistically by using Mann-Whitney test with level of significance lower than 0.05 (Sig<0.05). There was significant difference between the control group and the treated group. Conclusion: There is a slowing of adsorption rate of blood type O on chitosan with membrane collagen.

Introduction:Human resource planning is the primary function the organization shall carry out to provide workers to occupy appropriate positions and jobs. In health development, public health workers are a part ofa crucial human resource role to increase awareness of promotive and preventive health services. Aims:In general, this study aims to analyze the public health workers planning at the Health Office of Tulungagung District, Indonesia. Methods:Descriptive methods and literature studieswere used. Results: The results indicated that the appointment of civil servants or moratorium had not been held, including Public health workers from 2014 to 2017. Accordingly, there was a gap between the needs and the availability of Public health workers at the Health Office of Tulungagung District. Job enlargement occurred to overcome these problems; namely, additional tasks were given to other Public health workers leading to the workload that was increasingly high and incompatible with the main tasks and functions and educational background. It affected the performance of the Health Office of Tulungagung District, namely the coverage of households with Hygienic and Healthy Behavior.Conclusion:Therefore, an alternative provision of Public health workers through the process of recruitment, selection, and orientation, which will later become contract workers with honoraria sourced from the Health Operational Assistance (BOK) fund, was required. Public health workers planning at the Health Office of Tulungagung District was carried out annually based on Workload Analysis (ABK). The number of Public health workers needed by the Health Office of Tulungagung District is 16 people.

Measles is one of the five diseases which becomesa leading cause of child mortality in the world. Measles in East Java from 2014 to 2017 has increased from 762, 2367, 3913, to 4936 cases. The problem is that measles remains endemic in Indonesia and Indonesiahas poor quality of a Case-Based Measles Surveillance(CBMS) system implementation which leads to the lack of epidemiological information.Aim: This study purposes toevaluateCase-Based Measles Surveillance system in East Java Province in 2018 based on the attributes of simplicity, flexibility, data quality, acceptability, timeliness, representativeness, and stability.Method:This studywas a descriptive study which utilized a qualitative approach in analyzing the data.Result:The evaluation results of CBMS system implementedin East Java based on the following attributes were: simplicity (officer hadnever received any training and there wasonly one officer, thus the quality of the officerwas belowstandard),flexibility (no change), data quality (completeness only reached 16%), acceptability (regarding the implementation of CBMS by the district government, only 29% met the targets, 79% did not meet the targets, 5% did not implement CBMS, and no data from the hospitals or the private sectors), timeliness (on-time 5.7% ), representativeness (lack of accurate information), and stability (less reliable).Conclusion:The CMBS system implementedis complicated, less acceptable, less representative, less timeliness, and not stable.

The differencein nursescompleting nursing care documentation will harm nurses, patients, and other parties. One of the factors that influences the completeness of the civil care documentation is motivation. This study attemptsto analyze the relationship between nurses’ motivation and the completeness of the electronic nursing caredocumentationat the inpatient installation of apulmonary hospital. This study was a correlational analysis study which employeda cross-sectional design. The respondents in this study were 48 nurses at inpatient unit of a pulmonaryhospital selected by the purposive sampling technique. The Spearman correlation rank statistical test results had a p-value of 0.000, which means that there was a significant relationship between nurses’ motivation and the completeness of electronic nursing care documentation. Meanwhile, the Spearman correlation coefficient value was 0.665. The relationship between nurses’ motivation and completeness of electronic nursing caredocumentationwas indicated with a strong relationship, in which the positive results exhibiteda direct relationship.The resultsdemonstratedthe good result of nurses’motivation and the completeness of electronic nursing care documentation. This study concluded that nurses with good motivation couldincrease the percentage and completeness of electronic nursing care documentation. It is recommended by the hospital to maintain the nurses’ motivation better.

Public health center is a facility in public health sectorpresented by the regional government. Public health center provides nonprofit services, prioritizing the best health service for the community. As a public organization, public health center is also demanded to be responsible forits entire performance to the regional government and the community. Balanced Scorecard is a proper choice to measure the public health center performance in financial and non-financial aspects. The objective of this research was to improve the service performance of a public health center using BSC. This performance measurement utilizedquantitative method,which started from describing every indicator of achievementdataof each perspective that has been collected and recapitulated. Then,the measurement continued with comparing the indicatorsof achievement result withevery performance target of the perspective before determining the weight of every perspective.After giving score and criteria for each indicator of the perspectives, the performance was assessed. In-depth interview was carried out involving the head of administration, survey team, Financial Manager of Special Allocation Funds (DAK), Financial Manager of Health Insurance (JKN), person in charge of National Health Insurance, and the head of management and planning. Thus,there were six (n=6) samplesin this research. The performance measurement of public health center using BSC identified that the highest performance assessment was the Internal Business Process perspective with 39.93%.The financial perspective was still low with 20.67% andon the third place was the learning and development perspective with 16.96%.Meanwhile, the lowest performance was the customers'perspective amounting to13.94%. The following step is an interpretation of the performancemeasurements results using Balanced Scorecard inthe radar charts. The publichealth center, as a nonprofit organization, needs to pay more attention to the learning and development perspective by utilizing the funding by JKN and DAK to improve the staff competencies.Besides, it is also necessary to increase the customer perspective as the lowest performance by optimizing the Complaint Center function.

The result of Indonesia Basic Health Research in 2018 showed an increase in the percentage of people with diabetes mellitus. This study aimed to analyze economic losses due to diabetes mellitus in National Health Insurance (NHI) participants with insurance fee waiver (IFW) and non-insurance fee waiver (IFW). This research was a quantitative study with a cross-sectional design. The sample of this study was 17 patients with IFW and 15 patients with non-IFW. The instrument used in this study was a questionnaire consisting of questions about the variable characteristics of the respondents and the direct and indirect costs that should be paid for treatment. Economic losses due to diabetes mellitus were analyzed through direct and indirect total costs.The economic loss for patients with IFW was IDR 5,572,366. Meanwhile, the economic loss for patients with non-IFW was IDR 2,989,984. So, the biggest economic loss due to diabetes mellitus was found in patients with IFW. This was very high when compared to their average income of around IDR 634,375. This can happen because the NHI participants have not taken full advantage of the use of NHI.

The total real hospital costs for Social Health Insurance (BPJS) Kesehatanpatients undergoing cesarean section are much higher than the collectible costs using the Indonesia Case-Based Groups (INA-CBGs) package as the basis of their payment policy. The purpose of this study was to determine the effect of using clinical pathways as a means of controlling the total real hospital costs of BPJS Kesehatan patients undergoing cesarean section.This research used action research. The clinical pathway was applied to BPJS Kesehatan patients undergoing cesarean section from January 1 to March 31, 2014, and compared the real hospital costs between that period and BPJS Kesehatan patients undergoing cesarean section from October 1 to December31, 2013. From the 126 study groups, 65 clinical pathway forms (51, 58%) were complete. The average real hospital cost was significantly higher after the implementation of CP with p = 0.019. The average length of stay, service costs, and hospital costs were significantly lower in the complete CP form group with p = 0.012, p = 0.013, and p = 0.012 respectively.This study demonstrated that implementing the clinical pathway can reduce the actual length of stay and hospital costs in C-section patients, and demonstrated that using the clinical pathway can make services more efficient.

Lean management is a concept that is applied to increase efficiency and prevent waste in the production process. Sidoarjo Government Hospital has implemented lean management through Kaizen activities since 2016. Kaizen Festivals were held in 2016 and 2018. However, for four years, there has been no evaluation of the sustainability of kaizen activities.This study aimed to evaluate the sustainability of kaizen activities and identify the influencing factors. Quantitative contingency coefficient analysis was carried out on survey responses. The research was conducted at Sidoarjo Government Hospital involving 20 respondents from 22 total population of the kaizen unit team. Data collection was carried out through a questionnaire filled out by representatives of the kaizen unit team who participated in the Kaizen Festival from 2016 to 2018.The results showed that all 20 respondents participated in the Kaizen Festival in 2016 and 2018, but only 13 (65%) had kaizen activities in 2017. The three-year sustainability of kaizen activities was 85%, the two-year sustainability of kaizen activities was 40%, and the one-year sustainability of kaizen activities was 75%. The factors affecting the sustainability of kaizen activities were the other stakeholder support (r 0.707, p <0.05), the benefits (r 0.622, p <0.05), and the regulatory changes (r 0.519, p <0.05). Meanwhile, the role of the unit leader (p 0.531-0.715), staff support (p 0.335-0.666), and the supervision of top hospital management (p 0.188-0.718) did not have a statistical correlation with the sustainability of kaizen activities. Thus, the most important factor affecting the sustainability of kaizen activities was the other stakeholder support. All units implemented kaizen activities because of the encouragement of the kaizen festival.

The preliminary survey showed the number of incidents at occupational accidents to nurses at Dr. MidiyatoSuratani Naval Hospital, Indonesia, was high at 82%, and nurses in the Emergency Unit experienced more incidents at 72.2%. This study analyzed the relationship between health behavior (knowledge, attitude, action) and incidents at work in the Emergency Unit of Dr. MidiyatoSuratani Naval Hospital. The method used was a descriptive-quantitative study with a cross-sectional design. The samples were nurses in the Emergency Unit of Dr. MidiyatoSurataniNaval Hospital. This study used a univariate analysis and bivariate analysis using the Chi-Square test. The results showed that incidents at work in the Emergency Unit of Dr. MidiyatoSurataniNaval Hospital were 72.8%. The nurses lacked knowledge (61.1%) and performed false action (66%) but hada good attitude (72.2%). The chi-square test found that there was a significant relationship between knowledge and occupational accidents, so is action and occupational accidentsin the Emergency Unit of Dr. MidiyatoSurataniNaval Hospital. There is no significant relationship between attitude and occupational accidentsin the Emergency Unit of Dr. MidiyatoSurataniNaval Hospital. To decrease risks of occupational accidentsoccurring to nurses, the hospital should design a policy for planning and implementing an occupational safety and health program.

Risk Management has an important role in identifying risks to reduce patient safety incidents. However, patient safety incidents are still very high. In 2016, there were 36 cases found at one of the hospitals in Surabaya. It means that it has not met zero-incident as the Hospital targets. The purpose of this study was to analyze the implementation of risk management at one of the hospitals in Surabaya. This study was a quantitative research with a cross-sectional research design which collected data at one time. The sampling technique was done withtotal sampling. The study results showed that 18 working units (81.8%) at the Hospital had implemented the risk identification process very well. Afterward, as many as 17 working units (77.3%) carried out an excellent risk analysis at the Hospital. They have classified types of risks found, and 15 working units (68.2%) at the Hospital have notably performed it. In addition, the risk control process as a follow-up of risk priority among 19 working units (86.4%) has been well-executed. However,risk management should be supported by awareness of all human resources at the Hospital. Thus, a strategy that can be carried out is strengthening collaboration among health workers, so they are integrated to adopt patient safety in accordance with their profession. The implementation of risk management was carried out very well in most of the hospital's working units. Still, the hospital needs more effort to raise awareness of the importance of patient safety.

Background: Anxiety is a condition characterized by strong fear, followed by somatic symptoms that indicate a hyperactive autonomic nervous system. This is a type of emotional disorder that is associated with unexpected and considereddangerous situations. The anxiety of pediatric patients will reduce the treatment success rate. Reducing the anxiety of pediatric patients is very important to increase thetreatment success rate. Purpose: The purpose of this study was to analyze the effect of sandalwood aromatherapy and bossa nova music on the anxiety levels of pediatric patients undergoing dental treatment. Methods: This research was conducted in four groups with four different treatments: the control group, the sandalwood aromatherapy group, the bossa nova music group, and the combination group. Each group consisted of 26 subjects. All 104 patients were treated with topical fluoride treatment for the first time. Blood pressure and pulse measurements asindicators of anxiety were performed twice on each sample, before treatment and after treatment. Blood pressure and pulse were measured with a digital sphygmomanometer. Results: There was a significant enhancement in the difference in blood pressure and pulse in the control group and a significant reduction in the difference in blood pressure and pulse in the other group (p <0.05).Conclusion: Sandalwood aromatherapy and bossa nova music can reduce anxiety levelsin pediatric patients undergoing dental treatment, with the largest reduction in anxiety levels in the group treated with a combination of sandalwood aromatherapy and bossa nova music.

Background: Third molars of mandibula are the last teeth that have erupted and often impacted. Impacted teeth can cause pathological abnormalities such as caries, infections, periodontal problems, pericoronitis, neoplastic lesions, cysts, androot resorption. The impact of third molars of mandibular and their accompanying pathological abnormalities can be observed by using radiographywith panoramic. Objective: To find out the prevalence of impaction of mesioangular third molars causing distal caries of second molars ofmandibular according to Pell and Gregory classification through panoramic radiographic observations at Dental and Oral Hospital of Universitas Airlangga. Material & Methods: Data of study based on secondary data form 49 panoramic digital radiographs observed by the impact of mandibular mesioangular third molars and classified according to Pell and Gregory to determine the class and position that most often causes distal caries in the second molars. To analyze and processed the data of this study using Friedman test. Results: Class and impact position of mandibular mesioangular third molars were found to be 55% at position IIA, 23% at position IIB, 18% at position IA and 5% at position IB. Distal caries in the second molar teeth 69% occurred in the impacted mesioangular third molar teeth, position IIA, followed by the IA position as much as 19%, then the IIB position as much as 10% and the IB position as much as 2%. Conclusion: Abnormalities ofpathological in the form of distal caries of the second molar through panoramic radiography were found most at position IIA, second at position IA, then position IIB, and only slightly at IB position.

Background: Dental caries and periodontal disease are global problems and can occur at any age, including children. Dental and oral hygiene and children’s diet are the main risk factors for periodontal and caries disease. In preschoolers, parents, especially mothers, dominate diet choices and oral hygiene behavior. The level of education, knowledge, and socioeconomic status will affect the mother’s attitude towards the child’s dental and oral health. Purpose: This study aims to determine the relationship between education and knowledge of mothers to caries and periodontal status of children aged 3-6 years. Methods: This study was an observational cross-sectional analytic study with simple random sampling conducted at Balai RW 3 Sidotopo, Semampir district, Surabaya in July to August 2018. There were 110 mothers and children as respondents. The level of education and knowledge of mothers were measured through questionnaires, while the caries and periodontal status of children were measured using the DMF-T and WHO examination. The obtained data were then analyzed by Spearman correlation test. Results: Statistical results showed that there was a significant relationship between income and caries status of children, but there was no relationship between education and mother’s knowledge of child caries. Education, knowledge, and income are also not related to the child’s periodontal status. Conclusion: There is no relationship between education and mother’s knowledge on child caries, but there is a significant relationship between income and caries status of children. While, there is no relationship between education, knowledge, and income on the child’s periodontal status.

Background: Street children often carry out activities on the streets, which causes them to be exposed to lead at a much higher rate than the average person. Apart from being found in exhaust gases and motor vehicle batteries, lead can also be present in cigarette smoke. The high frequency of street children being exposed to different sources of lead will make them more at risk of developingthe gingival lead lines.Aim: To analyze the effect of pollution exposure on street children in SDN Kota Lama 5 Malang with the occurrence of gingival lead line. Method: This research is observational analytic research with a cross-sectional approach. The research samples are street children from SDN Kota Lama 5 Malang, with a total of 30 children. The data obtained were the results of direct measurements of the upper anterior gingiva (canines, central incisors, right and left lateral incisors).Results: A 2nd-degree description of gingival lead line is found to be the most prevalent, with a percentage of 53.3% of 30 street children having it.Furthermore, every street child who lives in the street for 7–12 months was found to have either a 2nd-degree or a 3rd-degree description of the gingival lead line. The longer the child is in the street, the higher the number of children affected by a 2nd-degree or a 3rd-degree description of the gingival lead line, followed by another risk factor such as their smoking habits.Conclusion: The pollution exposure on street children affects the incidence of gingival lead lines, such as the amount of time the children are in the street, the intensity of their eating habits while in the street, their smoking activities and their use of protective masks for themselves.

Basic Immunization coverage is still one of problems in Tulungagung district. For the last 3 years, the basic immunization coverage did not cover all the target infants. In 2018, from the target of 15,147 infants, there were 1,116 infants who did not receive immunization of Hepatitis B, 689 infants were not immunized with Bacillus Calmette Guérin (BCG) and 849 infants were not immunized for Oral Polio Vaccine (OPV 1). Aim of the study : To analyze the problems of basic immunization program. Method: This study is a descriptive observational study, conducted at Tulungagung District Health Office from January to February 2019. Identification of problems was done by conducting interviews, analyzing secondary data on basic immunization coverage of the Tulungagung health profile from 2016 to 2017 and section report Surveillance and Immunization in 2018. Prioritisation of Basic Immunization problems was done using Urgency, Seriousness, Growth (USG) criteria. Analysis of the problem cause was done by Fishbone methods.Results: Of the problems identified, the first priority problem in Tulungagung District 2018 is Hepatitis B immunization coverage does not reach the target. The root causes were poor immunization, under qualified workers in data collection and validation of targets, poor integration of Basic Immunization and Maternal and Child Health (MCH), lack of promotion and media campaign.Conclusion: Low Hepatitis B immunization coverage is a priority problem for basic immunization programs. Optimization of the integration of child and maternal health immunization program (MCH) is needed, periodic validation of program coverage and health promotion on immunization using creative promotional media.

Diphtheria in Bangkalan Regency is the third highest in East Java. The highest diphtheria cases in the last 5 years occurred in 2018. Until the end of January 2019, there had been 4 cases of diphtheria outbreaks, in which 2 cases of the toxigenic laboratory were confirmed positive. The purpose of this study was to determine the priority and root causes of immunization and to be used in planning and implementing a diphtheria control program appropriately.This was an observational descriptive study conducted at the Bangkalan District Health Office in January 2019. Problem identification was carried out using the Nominal Group Technique method. The determination of priority problems was done by using the Capability, Accessibility, Readiness, and Leverage (CARL) method. The root cause of the problem was done using a fishbone diagram. The priority problems detected were coverage of basic complete immunization and Diphtheria Pertussis Tetanus (DPT) Booster immunization for the last 3 years had not met the target and was not evenly distributed.The priority of the root of the problem is that the village immunization coordinator is not good at collecting data on the number of targets and does not conduct education before immunization. Immunization coordinator training at the village or private level is still limited. Strengthening the role of village immunization coordinators involving other sectors and the formation of community empowerment programs is also limited.

Kediri is one of the cities in Indonesia which has a high poverty rate. This study aims to design an integrated program in poverty reduction in Kediri City, the percentage of poor people in Kediri City in 2018 was 7.68 percent, a decrease of 0.81 percent compared to conditions in 2017, namely 8.49 percent, This percentage is still better because it is below the achievements of the Province of East Java and the national level. There have been many poverty reduction programs implemented by the Kediri municipal government. However, the program is still ineffective because: 1) there is no coordination between agencies in running the program, and 2) the program does not reflect the needs of the poor to live properly in urban areas. The research used qualitative methods and was carried out in agencies related to poverty alleviation programs in Kediri City, namely the Research and Development Planning Agency (Barenlitbang), Bapemas and KB, the Cooperative and UMKM Office, Disperindag, Health Office, Manpower Office, Office Social, Education Officer, and Transportation Service. The data collection technique was carried out in 3 ways, namely observation, interviews, and documentation. The results of this study indicate that there are eight priority needs of the poor, namely (1) education, (2) social welfare, (3) health, (4) infrastructure and infrastructure, (5) food security, and (6) the environment. Of the eight priority needs of the poor, it is found that an integrated poverty reduction program design requires good coordination among related agencies

Garbage can cause several diseases, garbage piles can cause the emergence of several vectors such as mice and flies. Scavengers can be directly affected by garbage. Based on observations made from 10 scavengers, there are 7 who have skin diseases and there are still many scavengers who do not have good hygiene behavior and the lack of sanitation facilities can trigger several diseases, one of which is skin disease. Th purpose of this study was to analyze the effect of personal hygiene and sanitation facilities on the incidence of skin disease among scavengers at TPA Klotok, Kediri. The research design used was observational analysis, the research observing the subject with cross sectional approach with quantitative research methods. Implemented in TPA KlotokKediri City with 44 respondents and used Simple Random Sampling. Based on the statistical test results Of logistic regression, personal hygiene was obtained for the incidence of skin disease sig = 0.032 and sanitation facilities for the incidence of skin disease sig = 0.998. It can be concluded that the results of both have the significance value> 0.05 furthermore there is an effect of personal hygiene on the incidence of skin disease, meanwhile there is no effect of sanitation facilities on the incidence of skin disease in scavengers at TPA Klotok, Kediri City.One of the causes of skin disorders is poor work and personal hygiene. To maintain clean skin, healthy habits must be considered such as maintaining clean clothes, bathing regularly, bathing using clean water and soap. So it is concluded that it is very important for scavengers to maintain and care for the cleanliness ofthe skin, especially from exposure in the work environment.

Diabetes Mellitus (DM) is a chronic disease that has become a major health problem in Indonesia. The Chronic Disease Management Program (Prolanis) developed by BPJS Kesehatan in collaboration with First Level Health Facilities (FKTP) seeks to promote and prevent DM disease control. Efforts made include controlling the glycemic index to prevent microvascular and macrovascular complications that may occur with activities including medical consultation, counseling, home visits, club activities, and monitoring of health status. Aim : The purpose of this study was to analyze the effect of DM patient adherence in participating in Prolanis activities on the patient's HBA1C profile. Method:This study is an analytical study using a retrospective cohort design. The research data is secondary data obtained from the Medical Records of DM patients from January-April 2019. The research subjects were 42 DM patients who were registered as active Prolanis participants who had HBA1C data at the April 2019 examination. Result: The results of this study showed that the mean HBA1C value in 22 patients who routinely followed prolanis activities (7.2 ± 1.48)% was more controlled than the mean HBA1C in 20 patients who did not routinely participate in prolanic activities (9.27 ± 2.06)% . Conclusion: From this study it can be concluded that there is a significant difference between DM patients who adhere to the schedule of prolanis activities and patients who do not comply with the schedule of prolanist activities at the UPTD Puskesmas Nursing Ngletih Kediri City with a value of p = 0.001 (p <0.05; CI = 95% )

Background: WHO has designated Covid-19 as a pandemic, this has an effect on mental health when people are stuck at home and it is unknown when the social distancing rule ends. This affects the quality of student learning faced with stressors in dealing with lecture material and exposure to Covid-19 information from social media. This study aims to predict the effect of social media exposure on depression and anxiety disorders in health students in the face of the Covid-19 pandemic. Methode: This research is a cross sectional study with a sample of students majoring in health in Indonesia in May 2020. Data were collected using a questionnaire through an online survey. Data were analyzed using multivariate logistic regression with Stata 13. Result: Results from the study found that there was a significant effect of social media exposure on depression (OR=1.64; CI 95%=1.05 hingga 2.57; p=0.031) and anxiety disorders (OR=1.64; CI 95%=1.18 to 3.40; p=0.008) in dealing with the Covid-19 pandemic. Conclusion: Exposure to social media during this pandemic can increase the risk of depression and anxiety disorders in college students. So, it is expected that students also need to know the steps to protect themselves from excessive stress and panic in the midst of the Covid-19 outbreak.

Background:An amputee is a person with a disability who needs special attention because of the condition of the amputation they are experiencing so that it disrupts their quality of life. Amputee uses prosthesis for daily activities. Quality of life is influenced by many factors, by knowing factors affected to prosthetic users quality of life. Purpose:This study aims to conduct an Analysis of factors affected to prosthetic users quality of life in Indonesia. Methods:This is Quantitative research, using observational analytic. It is a cross-sectional design. Transfemoral Prosthetic user in Kuspito Clinic is the population. The sampling technique used is a simple random sampling. There were 110 samples. Structural Equation Modeling with AMOS software is used for analysis. The instrument of this research is the questioner. Result: The Questioners are valid and Reliable. The Model purposed is fit. The SEM result shows that motivation, optimism, religiosity, self-efficacy, social supporthave direct and indirect effect in quality of life. Subjective well-being is the mediator of factors affecting quality of life of prosthetic users.Conclusion:The study showed that motivation, optimism, religiosity, self-efficacy, social support, are the factors affected to prosthetic users quality of life. It is mediated by subjective well-being.

Shingles disease roomates is because of infection of the virus of varicella zoster groaning husk and mucosa, this infection represent the reactivation of the virus that happened after the primary infection. Herpes Zoster assumed by circumstance as depicting reaction of the varicella virus (cow pox of water roomates latent, and mirror the immunity degradation). This research is targeted Know the relation of personal hygiene of high school student with the disease herpes In high school north coast of Subdistrict of Middle Biboki Anle'U Regency East North of Province of Nusa of East South-East.This research use the approach of cross sectional. accurate by population is a student of class X and XI of SMA to 105 people by using the method of random sampling Obtained by sample 51 responder. Independent variable is accurate by personal hygiene and accurate by the dependent variable is disease of herpes zoster. Its result is analysed by using test of contingentcoefficient. This reseach on May, 2015.Result of research indicate that most good personal hygiene owning 23 responders (45.1%) enough categorize the which 20 (39.2%) less roomates category 8 (15.7%) and spring from positive responders of herpes zoster as much 28 responder (54.9 %) Which are negative 23 (45.1%). From result analyze got by value p-value 0.000 <α (0.05). Hence H0 refused and H1 accepted meaning there is relation of among personal hygiene of high school student with the disease of herpes zoster in high school.Result of research indicate that most responder dry keep the caused Because of x'self Also haves and understand for the importance of personal hygiene to be student of high school do not experience of the disease of shingles hence student of high school ownself always keep dry.

The process of treating pulmonary tuberculosis patients must be done regularly so that the disease can be completely cured. Treatment of pulmonary tuberculosis that is incomplete will have an impact on the resistance of Mycobacterium tuberculosa so that it will be more difficult in the healing process. This research design is correlation analytic. The population in this study were all patients with pulmonary TB in the Wajak Public Health Center in Malang Regency, there were 33 respondents, a large sample of 30 respondents with accidental sampling technique. The independent variable is the nurse of nursing agency while the dependent variable is compliance. The test used is rho spearment. The results showed that 22 (73.3%) respondents thought that the nursing agency of nurses was sufficient, most respondents of family nursing agencies were quite good as many as 16 respondents (53.3%) and the majority of respondents complied with taking medication as many as 21 respondents (70%) . Based on the results of the analysis using the rho spearment test. The results obtained p = 0.020 there is a relationship between nursing agency nurses with medication adherence in TB patients and the research results obtained that p = 0.033, which means that there is a relationship between family nursing agency and medication adherence in TB patients in Puskesmas Wajak. The existence of a family and nurse nursing agency is a psychosocial support that is able to provide emotional strength, family affection and the attention of health workers increases the patient's enthusiasm to spend drugs with the aim of being cured

Chronic renal failure is a clinical condition characterized by irreversible decline in renal function and is always associated with a progressive decrease in GFR (Glomerulo Filtration Rate). The condition of patients with chronic diseases is often found to have psychological disorders. Psychological disorders that are not handled properly in patients with chronic diseases will aggravate the pain and reduce the quality of life. The purpose of the study was to analyze the effect of length illness and stadium on stress levels with the impact on quality of life in chronic renal failure patients. The research method used was cross-sectional analytic with respondents totaling 92 patients with chronic renal failure and were taken using accidental sampling method. Data collection tools for length of illness and stadium using a questionnaire, stress levels using the DASS scale and the WHOQOL-BREF quality of life scale. Analysis using path regression analysis. The results showed that there was an effect of length of illness and stadium on the stress level of patients with chronic renal failure with their respective significance values, namely length of illness (0.002) and stadium (0.000). The length of illness, stadium and stress level affect the quality of life of patients with chronic renal failure with their respective significance values, namely length of illness (0.002), stadium (0.000), and stress level (0.000). The length of illness through stress levels has an influence on the quality of life of patients with chronic renal failure with a direct effect (-0.272) and an indirect effect (-0.188). Stadium through stress levels has an influence on the quality of life of patients with chronic renal failure with a direct effect (-0.318) and an indirect effect (-0.095). The conclusion is that the longer a patient experiences chronic renal failure with a higher stadium, the heavier the stress level and the lower the quality of life. Therefore, in addition to focusing on physical therapy, it is also important to teach relaxation techniques so that sufferers can cope with the stress that comes from their illness.

Aspects of children's development during preschool are important aspects that need to be optimized, especially social personal. More than 25% of children experience developmental delays such as lack of independence of children, unable to communicate smoothly so that children tend to be passive and unable to develop their abilities. Many factors influence children's development, one of which was fundamental was parenting. Parenting patterns greatly determine the social activities of children when children begin to grow and develop.
This study aims to determine the relationship of parenting parents with social personal development in preschool children. This type of research uses observational with cross sectional approach using 67 respondents. The study was conducted from January 22 to February 24, 2020 using a questionnaire. Data analyswas used the Coefficient Contingency Test with α = 0.05. Statwastical test results obtained sig. 0.013 which can be concluded H0 was rejected, which means there was an influence between Parenting Parents Against Social Personal Development in Preschoolers in TK Dharma Wanita Tosaren II Kediri City and the value of Counseling Contingency = 0.338.
Parenting style can have a big influence on children's development, especially social personal development. Parents are the environment when children first interact to develop children's abilities according to their developmental age. Stimulation must be given routinely and continuously with affection, so that the child's development will run optimally.

Consumers have relationship and sensorial experience with products / services that tend to use the product / service repeatedly. relationship and sensorial experience that consumers have for products / services can prevent switching intention. The research objective was to determine the effect of relationship and sensorial experience on switching intention on inpatient services at RSIA Puri. This study used a cross sectional quantitative method. The population in this study were all inpatient service consumers who were being treated at RSIA Puri. The total sample size of 78 respondents was determined using purposive sampling technique with inclusion and exclusion criteria. The independent variable is relationship and sensorial experience, the dependent variable is the switching intention behavior of inpatient service consumers at RSIA Puri. Data were analyzed by multiple linear regression. The results of the study simultaneously relationship and sensorial experience have a significant effect on switching intention with (p <0.005), which means that the greater the application of relationship and sensorial experience, the switching intention of inpatient consumers will change. Conclusion This study shows that the relationship and sensorial experience carried out by RSIA Puri affects the switching intention of inpatient consumers at RSIA Puri.

Liposomes are vesicle-shaped particles whose walls are composed of lipid molecules ( the main constituent is a double layer phospholipid which wraps the liquid compartment inside. Liposomes can be made from natural ingredients in the form of natural phospholipid derivatives mixed with fat chains (eg phosphatidylcholine) by dispersing. Liposomes from papaya leaf extract (Carica Papaya Linn) are made with the aim of increasing the effectiveness of the drug and biocompatible work, as well as protecting healthy tissue from the toxic effects of the drug. The process of making liposom papaya leaf extract using the sonication method by mixing soybean lecithin with papaya leaf extract. Then do the heating and sonication. This method is done to reduce particle size. The aim of this study was to produce an extract of liposomes from papaya leaf phospholipid formulations using a combination of heating and sonication.The method to produce liposomes with a size of <150 nm using a combination of heating 40○C for 40 minutes and stirring using ultraturrax at a speed of 15,000 rpm for 30 minutes, then stirring with a sonicator for 30 minutes.The results showed the liposome nano papaya leaf extract formulation from soybean lecithin by the PSA (Particle Size Analyzertype 1090 / Cilas) method. The liposome product was in the form of liquid, light green and milk white and odorless. Particle size distribution is obtained in the range of 0.04 μm - 500.00 μm / 100 Classes and an average pH of 5.45.

Background: Preeclampsia is related to the inability to adapt to the physiological changes of pregnancy that result in decreased maternal organ perfusion. This complex clinical syndrome in preeclampsia can affect all organ systems such as the hemodynamic system, kidney, retina, and blood chemistry, which is manifested by increased blood pressure and protein urine.
Purpose: This study aimed to determine the correlation of the factors causing preeclampsia with blood pressure and protein urine.
Methods: This correlational study using the 127 respondents, sampling purposive sampling techniques, the independent variable factor in preeclampsia (age, genetics, history of diabetes mellitus, history of hypertension), and the independent variable blood pressure and protein urine. The measuring instrument used is a sheet checklist and analyzed by Spearman rank.
Results: The results showed the risk of preeclampsia in the age factor of 40.9% occurred in the 28-35-year-old respondents; 100% of patients had no history/genetic preeclampsia, 100% of respondents did not have a history of diabetes mellitus, and 88.9% did not have a history of hypertension.Systole blood pressure increased moderately and high by 26.0% and 22.0%, while diastolic blood pressure increased moderately and high by 26.0% and 11.0%. Respondents had positive proteinuria of 52%. The results of the analysis are not found a significant correlation between the factors of age, genetics, history of diabetes, and history of hypertension with blood pressure and preeclampsia protein urine on respondents.
Conclusion: History of hypertension associated with blood pressure and proteinuria in preeclampsia. History of hypertension is related to the condition of the blood vessels that manifest hypertension and decreased renal function (protein urine). Therefore, it is recommended in women with a history of hypertension to control blood pressure and perform routine prenatal care during pregnancy to prevent further complications.

Background:Anemia is a health problem throughout the world, especially in developing countries, where an estimated 30% of the world's population suffers from anemia. The incidence of anemia in Central Java in 2013 reached 57.1%. Moringa leaves are rich in nutrients and are a source of beta carotene, vitamin C, iron, and potassium. The mango seed flour without going through the sulfurization stage contains 20.00% carbohydrates, 14.83% fat, and 4.84% protein. The manufacture of biscuits made of the main ingredients, namely Moringa leaf flour and mango seed flour, can be useful for preventing anemia.
Purpose:This study aims to produce alternative products and biscuit food innovations to prevent anemia, by knowing the results of the organoleptic test, hedonic test, and nutritional content.
Methods:This is descriptive research. The stages of making biscuits include mixing mango seed flour and Moringa leaves. Processed biscuits are then tested for organoleptic, hedonic test, and nutritional content. There are 30 respondents on the hedonic test in this study.
Result: Organoleptic test results found F1 = round shape, strong green color of moringa leaves, savory and bitter taste (typical of moringa), and distinctive aroma of moringa; F2 = round shape, green color of Moringa leaves, savory and distinctive taste of Moringa, and distinctive aroma of biscuits; F3 = round shape, light green color of moringa leaves, savory taste and distinctive aroma of biscuits.The hedonic test results, namely 30 responses, showed F1 as many as 27 respondents (90%) did not like, formula 2 as many as 23 respondents (76.7%) liked, and formula 3 as many as 22 respondents (73.3%) liked.The nutritional content test of the biscuits was selected at F2 with the result that the water content was 4.1%; ash content 1.38% (b / b); protein content 18.1%; fat content 30.2%, and iron content 37.2 mg
Conclusion:The formula that meets the requirements for the organoleptic test, hedonic test, and nutritional content with proximate analysis is formula 2.

Background :Inadequacy of breast milk after delivery can be caused by the ineffectiveness of milk production and ejection. One way that can be done is oxytocin massage and breast care. Purpose :The purpose of this study was to determine the effectiveness of oxytocin massage and breast care for the adequacy of breast milk in Post Partum mothers. Method :This research uses a comparative design. The study was conducted on April 7 - May 7, 2020. The study population was post partum mothers with a purposive sampling technique obtained a sample of 24 respondents. The independent variable is oxytocin massage and breast care while the dependent variable is the adequacy of breast milk. Data collection uses observation sheets. Data analysis using Wilcoxon and Mann-Whitney test with α = 0.05. Results :The results of this study indicate that the adequacy of breast milk before and after being given oxytocin massage using the Wilcoxon test obtained p value = 0.025 ≤ α = 0.05, the adequacy of breast milk before and after being given breast care using the Wilcoxon test obtained p value = 0.005 α α = 0 , 05, the effectiveness of oxytocin massage and breast care using the mann-whitney test obtained p value = 0.020 α α = 0.05 so that Ha is accepted. Conclusion :There is a difference in the effectiveness of oxytocin massage and breast care on the adequacy of breast milk in post partum mothers. So that breast care is more recommended to increase the adequacy of breast milk in post partum mothers.

Stunting is a state of the body that is short and so short that it exceeds the SD-2 deficit below the median length or height. Stunting is a public health problem because it is associated with an increased risk of morbidity and death, delayed motor development and stunted mental growth. The general objective of the study was to find out the most dominant determinant factors related to stunting in infants aged 6-24 months at UPT Puskesmas Garum, Blitar Regency. This research is quantitative using a cross sectional research design with a total sample of 151 toddlers. This research was conducted by processing secondary data from the Weigh Month Results of the Garum Health Center UPT and Blitar District Health Office in February 2019. The interview respondents were conducted in November 2019. Variables used include stunting toddlers, nutritional status of pregnant women and exclusive breastfeeding. Data processing and analysis using chi square test (bivariate) and multiple logistic regression (multivariate). The results of the analysis showed that based on the TB / U index, stunting toddlers were 73.9%. Chi square test results show that there is a relationship between stunting toddlers aged 6-24 months based on the history of the nutritional status of pregnant women, the history of the baby's birth weight and the history of exclusive breastfeeding. The results of multivariate analysis showed that the most dominant independent variables related to stunting under five were birth weight after being controlled by the nutritional status variable of pregnant women and exclusive breastfeeding.

Background: Pregnant women need adequate nutrition during their pregnancy, especially in the 1st trimester. Undernutrition status will result in chronic energy deficiency and the risk of stunting babies. Emesis gravidarum is a nausea symptom, commonly experienced by pregnant women in the first trimester. Give IEC and hypnotherapy as complementary therapies to reduce complaints of emesis in pregnant women. Objective: The main goal of this study was to examine interventions between IEC interventions and hypnotherapy interventions in first-trimester pregnant women with emesis gravidarum on maternal weight gain. Method: The research design used was a quasi-experiment design with a time-series. The study population was all first-trimester pregnant women at Muhammadiyah Gresik Hospital with emesis gravidarum,200 respondents taken with a quota sampling technique. There are two research variables, mother weight as the dependent variable along the independent variable is IEC and hypnotherapy. Data analysis using Kolmogorov Smirnov as the normality test, Anova test with the alternative solution, Post Hoc analysis with the Mann Whitney test. Results: The results of data processing, there was a tight effect between the IEC intervention and hypnotherapy with maternal weight gain in the first week (p-value <0.001), the second week (p-value = 0.029), but there was no significant interaction between the IEC intervention and hypnotherapy with the increase in maternal weight in the third week (p-value = 0.105). Conclusion: There is an effect between educational information communication intervention and hypnotherapy intervention in first-trimester pregnant women with emesis gravidarum on weight gain. IEC intervention increases the weight gain of pregnant women in the first trimester compared to hypnotherapy.

Anemia in general is a condition where hemoglobin and erythrocyte levels are lower than normal Anemia that is occurred by many adolescents due to Fe deficiency and can be called Fe deficiency anemia (Tarwoto, 2014). The purpose of this study was to determine the effect of consumption ofred beans (Phaseolus Vulgaris L) boiled on hemoglobin levels in adolescent in institute of health science STRADA Kediri.The research design used was pre-experiment with one group pre-post test design. The population in this study were all third semester students in Institute of health Science STRADA who experienced anemia with a sample of 18 respondents. The sampling technique used was Purposive sampling.The results showed that all (100%) had mild anemia before treatment, after the treatment, the results of all respondents (100%) experienced a change to non-anemia. Based on the results statistically using test, Wilcoxon the obtained p value 0.005 <α 0.05 thenH0 is rejected and H1 accepted, which means there is the effect of red beans(PhaseolusvulgarisL) boil on hemoglobin levels in adolescent in institute of health science STRADA Kediri.It can be concluded that boiled red beans (Phaseolus Vulgaris L) contain iron which is useful for increasing hemoglobin levels in the blood. It is recommended for respondents to use boiled red beans as food to prevent anemia.

Introduction of the research Self-Help Groups is a new method of participation, now the growth of India. Non-Governmental organisations and community development agencies have been working out the possibility for years together in Tamil Nadu. It has found support from the people and the governmental agencies. Objectives of the study to analyse socio-economic information, benefits, employment and income generation of self-help group in Krishnagiri district. The concepts understand through review literature of review five literatures was taken for the study. The study is based on the primary data collected from the self-help group members in Krishnagiri district, Tamil Nadu. The research work was carried out during period of October to November 2019. The most important of this research paper is to analyse the demographic information, benefits, employment and sources of income. The research respondents are selected based on convenience sampling due to availability, and the study was carried on a sample of 184 respondents out of 200 questionnaires were used for data collection. Descriptive analysis and factor analysis is used for data analysis. Finally conclusion of the research there may be enough purpose to be satisfied with the overall status of SHG in rural regions in regards to their family reputation, upbringing of their kids, their schooling, handling household affairs, their finance and different activities. The ladies now have turn out to be more vocal in selecting the SHG is the path of freedom

In despite of the geographical location, internet connection is provided always and everywhere with the implications of designing of Mobile ad hoc network (MANET). Different types of applications of MANETs are included environment monitoring, military and disaster recovery. The resource-constrained environment of MANET is not allowed to perform the communication processes easily. For the network nodes, the limited batteries are utilized as an equipment. Throughout this process, the major challenging issue is replacing and recharging of these batteries. Within the MANET, the nodes are added without considering the circumstances. To process the communication among nodes, the trustworthy and reliable techniques should be inculcated. The definition of trustworthiness is about the opinion of a node on the other node with the numerical representation. The trust is computed based on the previous communication among current nodes. To address the limitations, a technique of modified multipath routing is needed. By using the network layer, efficiency is achieved in terms of energy utilization as the MANET is an infrastructure-less network and a peer-to-peer network. The routing path is chosen according to the network nodes’ current residual condition with the improved modified multipath routing protocol. The proposed technique is performed efficiently in terms of network stability and network’s lifetime than the existing methods like MRPC and E-AODV. To determine the proposed method’s effectiveness, NS2 software is utilized to assess the simulation results.

Automatic plant leaf curl detection is an important step towards the development of Computer-aided crop damage analysis systems. It helps in analyzing the health condition of the plants through leaf images. Image processing techniques are recently being used to analyze the condition of the leaf and identify the disease that inflicted the crop. Leaf curl disease can be identified by analyzing the edges of the leaf. This paper presents a procedure to identify the curl disease occurring in plant leaves using active contour, Fourier feature descriptor, and deep learning. Active contour is used to identify the shape of the leaf. The edge contour of the leaf is then given to the Fourier feature descriptor. The feature extracted using the Fourier descriptor is invariant to the angle and size of the leaf. The same feature vector is produced in any given angle and size of the leaf in the image. The features are trained using 1D CNN. The model can then be used to classify new images and automatically identify the leaf have curl disease or not. The experimental results prove that the proposed algorithm produces good results in identifying the leaf curl disease.

Background: In Pediatric Dentistry, Fear and anxiety associated with dental treatment are a well recognized factor which has a negative impact on the child’s willingness towards dental treatment. The role of a dentist in managing a child is to treat the problem with which the child report with anxiety and to modify and shape the behavior of a child towards a positive dental response.
Aim: This review article aims to discuss the development of dental anxiety, various coping strategies and whether the newer psychological approach of McGurk Effect in Attention Focused Coping Strategy can be acceptable at the reduction of dental anxiety in children in near future.
Methods: An electronic search was performed using databases such as Google Scholar, PubMed, PubMed Central, Science Direct, and Scopus by using keywords such as (“McGurk Effect”) AND(“Coping Strategy” OR “Coping Style” OR “Distraction”) AND (“Fear” OR “Anxiety”) AND (“Behavior” OR “Behavior management”) AND/OR (“Pediatric Dentistry” OR “dentistry”). The last search was performed in March 2020. Exclusion criteria included studies published in a language other than English and abstracts from congress.
Results: The McGurk Effect based Attention focused coping style with incongruent audiovisual stimuli can be an innovative behavioral technique in pediatric dentistry in reducing the child’s anxiety regarding dental drill.
Conclusion: It seems that the highly structured McGurk Effect based Attention focused coping style can be effective in managing the internal perceptions and emotions (e.g., anxiety, fear) that are aroused during the dental restorative procedure and can guide favorably the child’s behavior in the dental setting However, more evidence is required regarding the clinical outcome of applying this new coping strategy in behavioral pedodontics in near future

Background: Direct 3D printing of aligner trays involve printable materials; the study aims to investigate the in-vitro cytotoxicity of the direct-printed aligner using photopolymer resins and SmartTrackInvisalign tray for varying time intervals on 3T3 mice fibroblast cells using MTT assay.
Materials and Methods: Directed printed aligner trays using two 3D printing materials with SmartTrackInvisalign tray were compared in this study. Samples were placed in Dulbecco’s Modified Eagle’s Medium (DMEM; 0.1 mg/mL) for 1,3,5& 7 days interval. Cell viability percentage was calculated, and data were analyzed using a one-way analysis of variance and post hoc tests (α = 0.05).
Results: All materials exhibited slight cytotoxicity on MFCs with a visible trend of a significant increase in cell viability from day 1 to 7. Among the groups, the higher cytotoxicity was by E-Guard clear, and Dental LT, and the least cytotoxicity by Smartrack material. The highest level of cell viability and no cytotoxicity was exhibited by Invisalign (94.07% ± 3.00 of cell viability) at day 7. No statistically significant difference in viability percentage was seen between Dental LT and E-Guard material.
Conclusions: SmartTrackInvisalign material (polyurethane) was found to be more biocompatible, followed by directly printed aligner materials (polymethylmethacrylate). Cytotoxicity was found to be more on the first day for all materials and gradually decreases as day’s progress. The results indicate the increased leaching of material during the initial period of use though the level of cytotoxicity is slight.

In the present situation COVID-19 is the critical problem facing in all over the world. Therefore for detecting and diagnosing this virus effectively, quickly and with a low cost on a lot of tests, several countries are facing the problem of lacking the medical resources. In general, COVID-19 causing the pulmonary opalescence in frosted glass and bilateral pulmonary parenchyma, sometimes with a rounded morphology and peripheral pulmonary distribution. Therefore, main aim of this paper is rapidly extracting the small regions from the chest which can characterize the features of COVID-19 through the X-Ray images. For diagnosing these X-ray images to detect the virus the segmentation method of marine predator’s algorithm is mostly used. Hence to get a best solution within a few iterations, a strategy of Ranking based Diversity Reduction (RDR) is proposed in this paper which improves the performance of the marine predators algorithm. Moreover, to this ongoing outbreak of corona virus disease (COVID-19), it is important to provide valuable situational information for the public and authorities to know in which manner it is being spreading over society. Hence, to it is required to provide appropriate information. So, the appropriate information publishing strategy of Weibo data is used to classify information related to the COVID-19 epidemic into seven types of situational information are proposed in this paper.

Heart disease (HD) is one of the most common diseases, and early diagnosis of this disease is a vital activity for many health care providers to avoid and save lives for their patients. Heart disease accounts to be the leading cause of death across the globe. Health sector contains hidden information which helps in making early decisions by predicting existing disease such as coronary heart disease using machine learning methods. The proposed Hybrid Linear Regression Model (HLRM) implemented in two phases. Initially, data preprocessing is done; missing values are imputed with KNN and simple mean imputation and next Principal Component Analysis is used to extract the most contributing attributes for the cause of disease. Second, Stochastic Gradient Descent is the linear regression used to record the probability values of dependent variables, in order to determine the relationship between the dependent and independent variables. The overall prediction accuracy of the proposed model is observed as 89.13%. The outcome of this study will help as a reference for medical practitioners and also as a research platform for the academia

Redundant Binary Partial Product Generators are used to minimize, without any increase in the delayed partial product development block by one row, the maximum height of the partial product array generated by radix- 16 Modified Booth Encoded multiplier. The optimization for binary radix-16 (modified booth coded multipliers is defined in this project to decrease the maximum volume of the partial product columns to [n/4], with n = 64-bit non-signed operand. This compares [(n + 1)/4] with the normal maximum height. Thus the overall height of a single device is limited. This multiplier improves ALU and processors' efficiency. In contrast to the traditional booth multiplier, we test the suggested solution. In terms of field, delay and control, the logical synthesis showed its effectiveness. Using Verilog, the project will be built. The Simulation and Synthesis Xilinx ISE method is used.

There need to be another effort to reduce disaster risk through disaster mitigation measures in Early Childhood Education (ECE) institutions. Through disaster mitigation education, the school stimulates students to be able to prevent disasters and respond to emergency wherever and whenever. This research aims to design a model of disaster mitigation education in early childhood educational institutions. This research type is research and development (R&D). The main data obtained from this research comes from educators and parents in ECE institutions in the 2020-2021 school year. The result of material experts’ assessment on the products developed is that 80% of module and media developed are feasible used as a guide for early childhood disaster mitigation education. Limited teste conducted on teachers and children in small groups show that the module and media developed includes in 81.6% assessment category and it is highly feasible to be used in early childhood disaster mitigation education. The results of this research can be used as material to solve problems and donation of information relating to the Development of Disaster Mitigation Program for Early Childhood Education in the Institute of ECE.

A healthy society is being formed by the equal efforts of men and women. Contributions of both are important to create a real society. In country like India, women in parallel with man faced difficulties in the old days. But now it is seen to be the opposite. Now a days both men and women are bringing pride to the country by achieving a high level of success. In this way in the context of the North-East India, women’s of Assam have significant contributions to Assamese literature along with the various aspects of knowledge, Cultures, Science etc. This study attempts to discuss contributions of women’s to the Assamese Novel of the 20th century.

Currently the case of children pornography addiction has entered a high percentage. According to Indonesian Children Protection Commission, about 65.34 percent of children aged 9 to 19 years in Indonesia access Pornography Via Gadget. The percentage makes Indonesia change its status to a sexual violence emergency. The purpose of this research is to analyze the communication model conducted by parents towards children addicted to pornography. In this research, the researcher uses qualitative approach. Data collection is conducted with in-depth interviews and participant observations. The number of informants in this research consist of three people. The data analysis in this research use the interaction model proposed by Miles and Huberman through the stages after the data was obtained and then in reduced, displayed, and verified. Meanwhile, checking the validity of data is done by triangulation of sources and method. The result of this research is the model used in this research is Permissive Communication Pattern and Militaristic Communication Pattern. Besides by communicating with children, a religious approach is also taken by parents in order to children do not more fall down and addicted to access pornography through internet media.

Oral potentially malignant disorders (OPMDs), the group of conditions with the risk of malignancy being present in a lesion or condition either at the time of early diagnosis or future date. Oral carcinoma is a major global, health care issue with high morbidity and mortality rates to date. Leukoplakia, Erythroplakia, Palatal lesion associated with reverse smoking, Oral Lichen Planus, Oral Sub Mucous Fibrosis, Actinic Keratosis, Discoid Lupus Erythematosus are other OPMDs. The aetiology varies from exogenous factors such as tobacco and various autoimmune disorders or inherited genetic aberrations. Early detection of the lesion is essential to prevent malignant transformation, and also to improve the chances of the patient’s survival. Though tissue biopsy and histological assessment is the gold standard diagnosis for OPMDs, in recent years, demand for non – invasive adjunctive diagnostic techniques are increasing for early detection. With this in view, the early diagnostic methods were divided into 3 main categories such as vital Staining, light-based detection systems, and optical diagnostic technologies. Among the recent developments in optical imaging systems, the tissue autofluorescence, optical coherence tomography have been proved to be considerably efficient. These techniques have proven valuable for screening and monitoring OPMDs. Awareness should be created in public in employing screening methods that are non-invasive, robust and economic thereby it would enhance early detection of oral cancer which gives a positive impact on patient’s survival. This review explains the sensitivity, specificity and limitations as well as their advantages, disadvantages and clinical applications of these techniques and to identify which one is better advisable and adaptable for all population groups

Background: The major factor for endodontic failure is the inability to control and prevent persistent microbial infections. Irrigants and untracanla medicaments are used to reduce microorganisms. A good combination has to be studied Aim: To compare the antibacterial efficacy of 3 irrigants- 3% Sodium Hypochlorite, 3% Calcium Hypochlorite and 2% Chlorhexidine against E.faecalis biofilm and then to assess if any further reduction in microbial load after the placement of 2 intracanal medicaments - Calcium hydroxide and 1% Metronidazole + 0.25% Chlorhexidine. Materials and Methods: Sixty- three mandibular incisors were used to form a 6-week E. faecalis dentinal biofilm. Canals were instrumented up to Protaper F2. The tooth samples were divided into 4 groups as per irrigation regimen as Group A- Sodium Hypochlorite (n=20), Group B- Calcium Hypochlorite (n=20), Group C- Chlorhexidine (n= 20) and Group Control (n =3). The Groups A, B and C were further divided into 2 subgroups each for the placement of intracanal medicament. After 7 days, the specimens were analysed for presence of colonies of E.faecalis. Results: When compared to control group, significant difference was observed between all test groups. But statistically no significant difference was found between the three irrigants. Both Calcium hydroxide and Metronidazole +Chlorhexidine have effectively destroyed the remaining E.faecalis culture, hence exhibiting their bacteriocidal nature without any significant difference between them. Conclusion: Irrigation alone did not eliminate E.faecalis, combining Irrigant with medicament eliminated all E.faecalis and different combinations of irrigants and medicaments were equally effective.

The morphologic aberrations of root canals include bifurcation and trifurcation of canals which makes it difficult to diagnose and manage. The difficulty in identifying and treating such aberrations make it more prone to re-infection and persistence of infection in the root canal. Therefore the clinician should know the various morphologic aberrations occurring in the tooth before starting the treatment. The present case report is made to provide a clinical insight of one such variation. The case presents with mandibular left canine with 2 root canals and one root in a vertucci type II canal morphology. The tooth was treated endodontically and successfully managed.

In recent years, as there is increased usage of rotary system, separated rotary nickel - titanium (NiTi) files in root canals is the most frequently reported mishap, causing lot of stress and anxiety among clinicians and patients. The prognosis of endodontic treatment is dependent on condition of the pulp, presence or absence of periapical lesion, operator knowledge and skill and many other factors. This review was attempted to help the general dentists and non -endodontists decide which strategy is best when faced with a broken file in root canal.

The main aim of root canal treatment is to disinfect the entire root canal system. The main agenda is to eliminate the necrotic pulp. This goal can be achieved using chemical irrigation and mechanical instrumentation combined with medication of the root canal between treatment sessions. The major causes of pulpal and periapical pathosis are the microorganisms and their by-products. Various irrigation solutions have been suggested in order to eliminate or reduce bacteria and pulpal tissue remnants. The irrigants used in endodontics are Sodium hypochlorite, chlorhexidine digluconate, chitosan, EDTA and a few herbal derivatives. The most commonly used irrigant is sodium hypochlorite because of its excellent antimicrobial properties.

Root perforations occur most frequently during endodontic treatment procedures, in cases of calcified canals and curved canals which compromise the prognosis of the affected tooth. The prognosis of the perforated tooth depends on the time, location and the size of the exposure. The success of the procedures to repair perforation totally depends on proper diagnosis and sealing of the perforated site. The present article highlights the causes, diagnosis, and management of root perforations.

Currently, dental patients are expectingthat restorative material should fulfill both aesthetic and functional excellence. Composite resin can meet these requirements but with the major limitation of shrinkage during polymerization. This shrinkage will be manifested as marginal leakage,marginal staining, subsequent secondary caries,cuspal deflection, tooth or restoration fracture, postoperative sensitivity which ultimately ends by a failed restoration.Polymerization shrinkage of composite resin generates high degree of stress at the tooth/restoration interface owing to the failure of resin-based composites. The magnitude of these stressesdepends on the composition of resin composites, its ability to flow before solidification,cavity configuration and curing characteristics of the composites.Since, polymerization shrinkage cannot be completely eliminated, various techniques has been suggested in the manipulation for resin based composites to minimize the shrinkage and associated stresses. The purpose of this article is to review on theorigin of polymerization shrinkage, various factors involved in the process of polymerization shrinkage,the clinical factors affecting polymerization stress and the various material science advances and techniques that are currently available to deal with polymerization shrinkage in a clinical practice.

The use of magnification devices in endodontics is mainly meant for visual enhancement and improved ergonomics. This is important especially when long hours are spent in a narrow operating space to treat minuscule anatomy. The utilization of magnification gives off an impression of being of expanding interest. With the ongoing advances of magnification devices with increased magnification and illumination, there is improved specialized accuracy and performance. A significant aspect of the modern endodontic armamentarium have focused light on high degree of magnification, the endoscope, dental loupes, and operating microscope. These advancements enables the operator to visualize even the tiny details for proper diagnosis and treatment of dental pathology. Despite the high cost, the use of dental operating microscope into the endodontic practice has improved the quality of treatment and ergonomics. To have a better understanding of the functioning of the magnifying devices, it is necessary to review some of the fundamental aspects of optics

Oral cavity is subjected to various types of diseases worldwide. Materials used to cure such diseases has to be bioactive, inert and in neutral zone, without harming the tooth structure. At present, numerous materials are available with much more capabilities of regeneration, strength and biocompatibility. Such newly emerging materials has the ability not only to restore lost tooth structure, but actively respond to stimuli of oral environment. Such as stress, temperature, moisture and ph. Such materials are called “smart materials”. They are known for their smart behavior such as shape memory, thermochromic, photochromic, magneto rheological,sensitive and biofilm formation. This review article throws light on benefits and application of smart materials in various fields of dentistry.

Cone Beam Computed Tomography (CBCT) has progressed over 15-20 years from being a technique with great potential to one that has become primary diagnostic investigation. 3D imaging has made complex root canal anatomies more accessible and helps in accurate treatment planning for many endodontic problems. A modification of original cone beam algorithm was developed by Feldkamp et al in 1984[1]. Since then there were significant progress in imaging technique starting from linear to hypocycloidal tomographic movements wherein the centre of rotation remains the same and movement of the equipment becomes more complicated for better resolution. The goal of this article is to summarize theapplications and limitations of CBCT in various clinical scenarios in day to day endodontic practice.

Inferior alveolar nerve block (IANB) is most commonly used technique performed to anesthetize mandibular tooth. Sometimes it fails even though it’s been performed by well experienced clinicians.The reasons for failure:difficulty in identifying anatomical landmarks, patient compliance, anaesthetic solution,variation in the anatomical landmarks and inflammation.This paper is a review of various studies conducted on failure of inferior alveolar nerve block and Will be discussing in detail about the reasons for failure and how to overcome that. Selecting the best technique by the dentist or surgeon depends on complications related to the alternative techniques.

Dens invaginatus is a kind of malformation with varying anatomical features, posing challenges to treatment. Early and accurate diagnosis plays a significant role in selecting the acceptable treatment. This review discusses regarding the classification, clinical and radiographic features,diagnostic methods and treatment options for teeth with dens invaginatusKey words: Dens invaginatus, radiographic features, management

In today’s era, numerous improvements in materials and procedures have been made for the aesthetics demands of the patients. The self-etching primer system consists of an etchant and primer distributed in a single unit which reduces the number of steps and chance of introduction of error, resulting in saving time for the clinician. It also causes a lesser amount of enamel calcification. The purpose of this article is to review the current knowledge on various dentin bonding agents, which emphasises on self etching primers. This article aims to bring the feasibility for the usage of self-etching primers in a clinical scenario.

The role of endodontic treatment is to provide proper cleaning, shaping and obturation of the root canal system, all three processes are interlinked and dependent on one another. Endodontic sealers are materials which provide a three dimensional fluid- proof seal in the root canal system of a tooth, which provides a favourable environment for periapical healing as well as to prevent chances of re-infection. An ideal endodontic sealer has to possess certain characteristic properties essential for attaining the desired sealing of the root canal system such as high radiopacity, flowability, sealing, biocompatibility, low solubility, reliable working time and adhesion to canal walls. Currently sealers available in the market are zinc-oxide eugenol, calcium hydroxide containing, resin-based, glass-ionomer based, silicone-based, and bioceramic-based sealers.

The hyoid bone is a horseshoe-shaped bone situated in the anterior midline of the neck between the chin and the thyroid cartilage. At rest, it lies at the level of the base of the mandible in the front and the third cervical vertebra (C3) behind. The hyoid bone is a unique structure in the human body for many reasons. The hyoid bone is the only bone in humans that does not articulate with any other bone, but only has muscular, ligamentous, and cartilaginous attachments. Together with its attached muscles, the hyoid bone has number of physiological functions, including breathing, swallowing and speech and other two important functions: it holds up the tongue, which sits above it, and it holds up the larynx, which hangs below it by bracing these structures alongside each other in order to produce variation. Typically, a broken hyoid result from forced strangulation (i.e. choking). The position of the hyoid bone one of the important considerations for obstructive sleep apnoea because it anchors the musculature of the tongue in keeping the airway patent. A few other clinical considerations such as Hyoid bone insertion tendinitis, hyoid bone syndrome, Eagle’s syndromes are discussed in this article.

The alteration of the chin through either osseous manipulation or implant augmentation, is an integral component of aesthetic surgery of the face. The chin (mentum) is vital to the human facial morphology as it contributes to the facial aesthetics and harmony both on frontal and lateral views.Genioplasty is an extremely versatile instrument of change of human chin morphology - it offers the surgeon the ability to mould the native chin into the desired and near ideal form with commensurate ease, irrespective of the pre-operative deformity, with excellent and sustained long-term results.When performed with proper preoperative assessment and technical execution, the results can harmonize and restore balance between skeletal, soft tissue, and dental components of the lower face. This study presents pertinent points on preoperative assessment, a description of the surgical technique, postoperative and discusses advanced procedures and optimizes outcome

Trigeminal neuralgia (TN) otherwise called tic douloureux. It is a form of neuropathic pain. The trigeminal nerve carries sensation from face to brain. It is a long-term disorder that affects the trigeminal nerve. 1 in 8000 people per year suffers from trigeminal neuralgia. it is more common in women aged over 50. It is caused by the compression of the trigeminal nerve root. maxillary divisions are more commonly involved. TN of unknown etiology is considered as idiopathic. Diagnosis is more commonly based on the signs and symptoms. Symptoms range from mild to severe pain, often triggered by chewing, speaking or brushing of teeth. Pain areas are in the mouth and face. uncomfortable tingling and burning sensation. Treatment includes medication and surgery. The anticonvulsants are usually the initial treatment and are effective in about 90% of the patients. Side effects are frequently experienced that necessitate drug withdrawal in as many as 23% of patients.

The definition of death lost its significance in favor of brain death. Brain death is a permanent cessation of all functions of the brain in which though individual organs may function but lack of integrating function of the brain, lack of respiratory drive, consciousness, and cognition confirms to the definition that death is an irreversible cessation of functioning of the organism as a whole. In spite of medical and legal acceptance globally, the concept of brain death and brain-stem death is still unclear to many. Brain death is not promptly declared due to lack of awareness and doubts about the legal procedure of certification. Many brain-dead patients are kept on life supporting systems needlessly. An attempt has been made to highlight the history and concept of brain death and brain-stem death; the anatomical and physiological basis of brain-stem death, and criteria to diagnose brain-stem death in India.

Dystonia is a chronic disorder characterised by an aberration in the control of movement. Sustained co- contraction of opposing agonist and antagonist muscles can cause repetitive and twisting movements, or abnormal postures. Cervical dystonia (CD), often referred to as spasmodic torticollis, is a type of focal dystonia involving the muscles of the neck and sometimes the shoulders. It is a relatively rare neurologic disorder. This condition frequently results in cervical pain and disability as well as impairments affecting postural control. This article reviews the etiology and pathophysiology of the disease as well as medical and physical therapist management for people with cervical dystonia.

Deformities are often considered together with dystrophies, but the two are slightly different;deformities are generally considered to be gross changes in nail shape, whereas dystrophies are changes in nail texture or composition (eg, onychomycosis).About 50% of nail dystrophies result from fungal infection. The remainder result from various causes, including trauma, congenital abnormalities, psoriasis, lichen planus, benign tumors,and occasionally cancer.

Temporomandibular joint (TMJ) is a complex, sensitive, and highly mobile joint. Temporomandibular disorders (TMD) are a class of degenerative musculoskeletal conditions associated with morphologic and functional deformities. The most frequent structural cause of TMD are Internal derangement , which involves progressive slipping or displacement of a component of temporomandibular joint called articular disc. It is a piece of cartilage located between the condyle and fossa of the joint. The disc can degenerate or even tear. Because of the displacement and high mechanical need of TMJ, the internal derangement disorder often progressively worsen over time. In the mechanically demanding and biochemically active environment of the TMJ, therapeutic conservative and surgical approaches can restore joint functionality and has become a necessity.

Killian-Jamieson diverticulum is an outpouching from the lateral wall of the proximal cervical esophagus. These diverticula are rare and are distinct from the more commonly known Zenker’s diverticulum. Literature regarding Killian-Jamieson diverticula and its suggested management is scarce. The present article report describes the clinical findings, diagnosis and management of kilian jamieson diverticulum.

In the temporal bone, between the posterior wall of the external acoustic meatus and the posterior root of the zygomatic process is the area called the suprameatal triangle, suprameatal pit, mastoid fossa, foveolasuprameatica, or Mac Ewen's triangle, through which an instrument may be pushed into the mastoid antrum..In the adult, the antrum lies approximately 1.5 to 2 cm deep to the suprameatal triangle. This is an important landmark when performing a cortical mastoidectomy. The triangle lies deep to the cymba conchae.The sex determination of unknown human skulls can be evaluated by using the measurement of the area formed by the xerographic projection of 3craniometric points related to the mastoid process: the porion, asterion, and mastoidale points.

Pleomorphic adenoma of the parotid is the most common tumor of salivary gland origin, accounting for 60 to 70 percent of all benign salivary gland tumors. This lesion usually presents as a slow-growing painless mass inferior to the pinna of the ear.The diagnosis is based on clinical presentation, magnetic resonance imaging or computed tomography, and fine-needle aspiration biopsy.The treatment is wide excision in which the entire capsule is removed but the facial nerve is spared. Proper diagnosis and treatment are necessary to prevent the complications of tumor recurrence and malignant transformation. Carcinoma ex pleomorphic adenoma arises in longstanding tumors and has a five-year recurrence rate of 75 percent.

Background: Oral potentially malignant disorders (OPMD) of the oral mucosa are one of the increased risks of oral cancer transformation. This is primarily caused by habitual risk factors such as tobacco (smoking and smokeless), betel quid chewing and alcohol consumption, which are the most important etiologic factors. Multiple studies have assessed the correlation of increased oral cancer and oral potentially malignant disorder with polymorphism in DNA repair genes. Highlight: This review explores the genetic perspectives of the OPMD with special emphasis on DNA repair genes polymorphism associated with the risk exposures. The base Excision Repair (BER) pathway plays an important role in repairing damaged base pairs caused by oxidative stress due to tobacco carcinogens. Adenosine diphosphate ribosyl transferase (ADPRT), x-ray repair cross-complementing 1 (XRCC1), and apurinic/apyimidinic endonuclease (APE1), MGMT and other repair gene polymorphisms are involved with OPMD associated with habitual risk factors. Conclusion: Genetic differences between various ethnicities and differences in the carcinogenesis of OPMD development in various countries could partially explain the discrepant of these gene-environmental lifestyle habits. An understanding of DNA repair genetic variants associated with habitual risk factors contribute to more accurate identification and establishing tailor-made prevention measures.

The present study reviews salivary antimicrobial peptides and their single nucleotide polymorphisms in periodontitis. Periodontitis is an important inflammatory condition of the oral cavity where there is destruction of periodontal ligament and adjacent supporting alveolar bone resulting in tooth loss. MEDLINE, PubMed and Google Scholar were searched for relevant literature using the combination of following search terms: “Periodontitis”, “Single Nucleotide Polymorphism”, “Salivary Antimicrobial Peptides”, “Defensin”, “Lactoferrin”, “Cathelicidin”. Periodontal disease is initiated by bacterial invasion and colonization and this is not sufficient for the predisposition and progression of the disease. Besides this, several genetic factors influence disease susceptibility and severity. Many studies have reported the role of genetic polymorphisms for the difference in the host inflammatory responses against periodontal pathogens. Our review focuses on the salivary antimicrobial peptides which are important constituents of the innate immune system secreted mainly by epithelial cells and neutrophils and form the first line of defense against the pathogenic microorganisms in the oral cavity. Investigation of genetic polymorphisms in salivary antimicrobial peptides will aid in identifying an individual's genetic susceptibility and might be valuable for developing prognostic markers in periodontitis

Squamous cell carcinoma is commonly occurring cancer of the oral cavity and it is the major cause of morbidity and mortality. Apart from risk factors like tobacco habit, alcohol consumption and betel quid chewing, certain microorganisms are also implicated in the etiology of oral cancer. The oral microbiota contributes significantly in the human oral disease, systemic diseases and in health. The imbalances between microbes and their hosts mostly caused by bacteria leads to cancer. This review presents the literature on oral microbiota involved in causing oral squamous cell carcinoma. Articles were searched in databases such as PubMed, Google Scholar, Scopus, EBSCO, E-Journals and Science Direct until 2018 with the following search terms: “Association of oral microbiota with oral cancer Squamous cell carcinoma”. Initially, 40 full text articles were identified and after taking into consideration of inclusion/exclusion criteria, 17 were excluded and finally, 23 articles were included in the review. The reports of 23 articles revealed that microbiota involving Fusobacterium nucleatum, Porphyromonas gingivalis were most commonly involved in oral cancers. As oral bacteria are found to be associated with OSCC, they can be certain biomarkers in the early diagnosis of carcinoma.

Objective: Alterations in microbiome have been linked to Oral squamous cell carcinoma (OSCC) by few earlier studies. We aimed to assess such changes in OSCC patients. Methods: 16S rRNA metagenomic analysis of saliva samples from OSCC patients and health were performed by the latest next generation sequencing (MinION nanopore platform) using pan-eubacterial primers that amplify the entire 16S rRNA gene. The sequences were analysed with MG-RAST. Results: Capnophilic Capnocytophaga species, (Capnocytophaga gingivalis Capnocytophaga ochracea, Capnocytophaga sputigena, Capnocytophaga cynodegmi and Capnocytophaga canimorsus) were found to be in low abundance among OSCC patients compared to the healthy subjects. Conclusion: These findings suggest the association of Capnocytophaga species to health.

Oral submucous fibrosis (OSF) is an insidious, chronic, progressive, debilitating disease. It is mostly prevalent in the South-east Asian countries. Areca nut chewing usually causes the condition. The hallmark of the disease being sub mucosal fibrosis that affects most parts of the oral cavity, pharynx and upper third of the oesophagus and its clinical presentation depends on the stage of the disease at detection. As the disease has a spectrum of presentation, the management differs with the various stages of the disease. This article reviews the various medical management techniques of oral submucous fibrosis

Xeroradiography is a highly accurate electrostatic imaging technique. In this technique a conventional single‐phase dental x‐ray unit is used as an x‐ray source, but instead of a silver‐halide film image, a uniformly charged selenium alloy plate housed in a light‐proof cassette is used. It is used for detecting carious lesions, calculus deposits, periodontal disease and interpreting periapical structures.

Cone Beam Computed Tomography (CBCT) is a three-dimensional imaging technology, which has been specifically developed for imaging of the teeth and jaws. An view of the underlying principles will allow the users of this technology to tailor the imaging protocol to the patient‘s individual needs to achieve appropriate imaging at the lowest radiation dose. The new technology is more precise and easier for the clinician and the patient. This article discusses about what is CBCT, its evolution, the principals of CBCT, its imaging techniques and safety protocol, its applications, advantages and disadvantages of CBCT, and conclusion

Serum alkaline phosphatase (ALP) is an individual from a group of zinc metalloprotein enzymes that works to separate a terminal phosphate group from aorganic phosphate ester. Numerous things may cause increments of ALP activity in serum, themost common being obstructive liver disease and metabolic bone disease. An increase of the liver or especially the bone isoform (bone specific ALP) in serum can give important diagnostic data. Bone specific alkaline phosphatase isoenzyme is raised because of increased osteoblastic activity. The most elevated absolute ALP values have been credited to an expanded bone isoenzymelevel because of Paget disease or rickets/osteomalacia. The compound action, which is restricted in the plasma membrane of osteoblasts prior to extracellular delivery, associates with the degree of the infection on skeletal studies and with boundaries of bone resorption. This isoenzymes is regularly raised in developing youngsters and grown-ups over the age of fifty. Reasons for high bone ALP includes bone development, healing fracture, acromegaly, osteogenic sarcoma, or bone metastases, leukemia, myelofibrosis, and once in a while myeloma; soALP is utilized as a tumor marker.Hyperthyroidism, by its impact upon bone, may likewise raise ALP. This article reviews the characteristics, diagnostics and clinical significance of ALP.

A large group of non-neoplastic disorders can affect the salivary glands, although the more common are: mumps, acute suppurative sialadenitis, Sjögren's syndrome and drug-induced xerostomia. Salivary dysfunction is not a normal consequence of old age, and can be due to systemic diseases, medications or head and neck radiotherapy. Diagnosis of salivary disorders begins with a careful medical history, followed by examination. While complaints of xerostomia may be indicative of a salivary gland disorder, salivary diseases can present without symptoms. Therefore, routine examination of salivary function must be part of any head, neck, and oral examination. Health- care professionals can play a vital role in identifying patients at risk for developing salivary dysfunction, and should provide appropriate preventive measures and treatment.

Calcifying odontogenic cyst (COC) is also known as “Gorlin cyst,” first described by Gorlin in 1962 which is a rare developmental odontogenic lesion. The calcifying odontogenic cyst (COC) is a heterogeneous lesion existing either as cystic or solid variant. This lesion has different terminologies and is classified into various subtypes. The World Health Organization classified (2005) COC as a neoplasm and used the term calcifying cystic odontogenic tumor for benign cystic type, the dentinogenic ghost cell tumor for the benign solid type lesions and the malignant type as ghost cell odontogenic carcinoma. The dentinogenic ghost-cell tumor (DGCT), a solid variant of the COC, is an uncommon odontogenic neoplasm. This article discusses the various terminologies, clinical features, classification, histopathology, and treatment of COC.

Cementoblastoma is a rare benign lesion that represents less than 1% of all odontogenic tumours. It’s characterized by proliferation of cementum-like tissue and in almost all cases tends to be associated with an erupted permanent tooth, most often the first molar. Cementoblastoma is a rare odontogenic tumor, it should be considered in the differential diagnosis of periapical radio-opacities. The diagnosis is established by its attachment to the root of tooth and radiographic halo surrounding the radio-opaque mass. The treatment of choice is complete removal of the lesion with the extraction of the associated tooth. Complete excision of the tumor mass reduces the chances of recurrence.

Clear cell lesions are heterogeneous groups of odontogenic and salivary gland having its origin derived from epithelial, mesenchymal, hematopoietic and melanocytic components. Clear cells are found in different tumors and these clear cells are usually identified by the histopathological sections .Benign and malignant clear cell tumors are rare in oral cavity (2%).Pathologically H and E staining method is a gold standard method for histological examination for various human diseases. Identifying the clear cell is one of the clue or proof of accurate diagnosis. There are also some other structures observed in histopathological sections like grooves,Islands,granules,inclusions,globules,halo or clearing which enables the pathologist to find out the proper and accurate diagnosis .Clear cell changes are seen in various benign , malignant and non neoplastic conditions . Clear cell tumors are affect other body parts also including CNS, skin, female urogenital tract ,head and neck areas rarely bone and soft tissue region. For an approach to clear cell tumors the pathologist must identify if the change is from artifactual or mimic like the clear cell tumors, or originally clear cell tumors from appropriate origin. This Article gives idea of the clear cell tumors and various differential diagnosis of the clear cell tumors that affect the oral cavity

The most common form of orofacial injury experienced during participation in sports is dental injuries. Oral injuries can cause the victim to become disfigured after recovery, which can affect the athlete's quality of life. The health consequences of a traumatic mouth injury or the potential for severe head and orofacial injuries while playing are not known to many athletes. The dentist may play an important role in sharing the importance of preventing dental and facial injuries in sports with athletes. This article aims to increase professional understanding and interest in training in sports dentistry.

Regarding oral mucosa, oral ulcers are common complaints of patients. Ulcers refers to damage of epithelium and connective tissue or both. Most common cases are due to physical trauma, infective diseases immune related and neoplastic. A detailed history of patient is mandatory in assessing oral ulcerative lesions. Clinical presentation varies depending upon drugs involved, trauma. Diagnosis of oral ulcerative lesions are challenging. Additional diagnosis is required in patients not responding to treatment. Histopathological examination is required in case of definite clinical verification purpose. The aim of this article is to briefly explain about nonneoplastic oral ulcers.

Forensic odontology is a branch of forensic science that is capable of human identification through dental tissues or more precisely teeth in cases where there is the destruction of body tissues in criminal investigations and mass disasters. Forensic odontology mainly involves dentists collaborating in legal and criminal issues. Parameters like age and gender identification are crucial in identifying the victim or victims. Through the past two decades, the molecular aspect of forensic sciences has expanded considerably, Molecular advancements in science like DNA analysis have expanded the reach of forensic dentistry, since teeth possess the ability to resist extreme environmental condition be it temperature, pressure or any chemical aggressions. Teeth are found to be the abundant supply for DNA, and hence it is an excellent source of genomic DNA. The present review focuses on molecular advancements in the field of forensic odontology as DNA analysis advances as molecular signature in forensic odontology.

Fibrosarcoma has been characterized as a malignant tumor of the fibroblasts that shows no other proof of cell separation and is equipped for repeat and metastasis. Fibrosarcomas are uncommon however may happen anyplace in the body, most ordinarily in the retroperitoneum, thigh, knee and distal limits. Fibrosarcoma is exceptional in the head and neck area and comprises about 1% of the relative multitude of malignancies influencing humankind. Of all the fibrosarcomas happening in people, just 0.05% happens in the head and neck region. Of this, practically 23% is found in the oral cavity. Fibosarcomas by and large have a helpless forecast and the general endurance rate is 20-35% over a time of 5 years

The embryonic head development, including the formation of dental structures, which is a complex and delicate process guided by specific genetic programs. The development of the face involves a coordinated complex series of embryonic events. Recognizable features of the human face develop around the 4th week of gestation and are closely related to cranial neural crest cells. Genetic changes and environmental factors can disturb the execution of these programs and result in abnormalities in the facial and dental structures. Orofacial clefts and hypodontia/ oligodontia are examples of such abnormalities frequently seen in dental clinics. This review article focuses on the mechanisms and genes involved in the formation of dental structures. The development dental pathological conditions depends very much on a detailed knowledge of the molecular and cellular processes that are involved in orofacial formation.

Ghost cell have always been a topic behind the shadow and a controversy for years. Many research have made an attempt to explain the nature of ghost cells by using special histochemical methods, transmission electron microscopy, and scanning electron microscopy. Ghost cell is a enlarged epithelial cell with eosnophilic cytoplasm, but without a nucleus. In routine H and E staining these cells give a shadowy appearance. Hence these cells are also called as shadow cells or translucent cells. The appearance of these cells varies from lesion to lesion involving odontogenic and nonodontogenic lesions. The purpose of this article is to unravel some of the facts regarding ghost cells with emphasis on their histogenesis, a comprehensive review of available literature on ghost cells and ghost cell containing odontogenic lesions.

Giant cell granuloma lesions are benign, non-odontogenic, moderately rare tumors of the oral cavity. They develop peripherally (within gingiva) or centrally (in bone)1 .The peripheral and central giant cell lesions (PGCL and CGCL) are a group of pathological entities with similar histopathological features and whose origin has not been fully elucidated. The former is reactive and the latter exhibits a nonneoplastic proliferative behavior.

Gingival bleeding is a common, mild form of gum disease. It is a primary sign of gingival disease such as gingival inflammation or Gingivitis is caused by accumulation of plaque at the gum line. Gingiva becomes swollen, reddish and irritable to the patient due to plaque accumulation. Plaque which is not removed will harden into tartar. This will lead to severe advanced gum disease and its progresses to periodontitis and finally tooth loss. Bleeding gums or Gingival Bleeding can cause discomfort to the patient both physically and mentally. Every dentist must know the underlying causes of gingival bleeding based on both local and systemic factors. This article aims to discuss the systemic causes of GINGIVAL BLEEDING.

Halitosis is an unpleasant offensive odor .Which leading to causes anxiety and psychosocial embarrassmentof the people. It is the most common social problem among one in four people and is reported as third most common reason thatpeople seeks dental care. The causes can be intra-oral or extra-oral.which is caused by the microbial degradation of organic substrates in the food debris. Volatile sulphur containing compounds is the major constituent for oral malodour.

Syphilis is an infectious disease which is associated with specific oral lesions. Oral manifestations of syphilis are most likely to be observed in secondary disease but all stages of the disease can also give rise to oral lesions. The congenital disease gives rise to dental anomalies as well as bone, skin, and neurological anomalies of the face.

Pain is the most common symptom reported to the physicians. Orofacial pain is one of the commonest complaint that affects millions of people around the world on a daily basis. It constitutes any symptom that occurs from a large number of disorders and diseases that result in a sensation of discomfort or pain felt in the region of face, mouth, nose, ears, eyes, neck, and head. Orofacial region often sparks an immediate attention response consisting of a significant level of concern and worry. Use of a wide range of treatments though available but clinician should not get confused by that an early diagnosis, reassurance to patients and patient family and often following some simple physiotherapy especially those with coping strategies turns out to be effective

One of the newest and evolving fields of dentistry is Sports Dentistry. It is involved in oral and facial disease prevention, maintenance and treatment, as well as the compilation and distribution of dental trauma information, beyond study stimulus. Preventing these orofacial accidents in sports dentistry is the primary concern. The value of different preventive measures, such as the availability and use of different types of preventive aids, is briefly defined in their significance and maintenance for a person in sports dentistry. Overall, in different areas of the sports community, a dentist plays a significant role in the diagnosis, treatment planning, assessment, prevention and management of these orofacial dental injuries. This article includes a summary of preventive aids that can be used while playing

Dental caries is the second most common disease. In 1950s it reached its peak in children and young adults. Cariology science, has solved many mysteries but dental caries still remains a misunderstood phenomenon by the clinicians. This article describes about the etiological factor, pathogenesis ,microbes causing dental caries and recent advances in prevention. Some of these, such as vaccines and antimicrobial varnishes, are still in the research stages, while others, such as sucrose substitutes, low-calorie sweeteners, and sugar alternates. Keywords: D

It is difficult to distinguish certain lesions radiographically because of the similarity of radiographical appearance. Since some specific radiographical findings are present for some specific diseases, radiographs are important in the clinical practice for investigating most important lesions. This review article describes various radiographic patterns of lesions present intraorally and extra orally.

Human saliva plays a crucial role infood digestion and maintaining oral hygiene. Components of saliva constituting the electrolytes, mucus, glycoproteins, enzymes, various antibacterial compounds, and gingival crevicular fluid provides the optimum condition both of oral cavity and general health. Fortunately collection of this amazing fluid is very easy and non invasive. These particular advantages only make saliva a potential diagnostic fluid. Through detailed analysis, an array of salivary proteins and peptides found which may be beneficial as biomarkers in oral and systemic diseases. So by this review, we discuss the importance of human salivary proteomes and tabulate the recent salivary biomarkers found in subjects with acute myocardial infarction and other systemic disease. Since acute myocardial infarction contributes to large cases of mortality worldwide,especially in a clinical setting, an early detection using these biomarkers can provide an effective solution to decrease the global heart attack incidence particularly among the high-risk group of type-2 diabetes mellitus patients. Currentchallenges in saliva collection are also mentioned which need to be improved, resulting in better quality of saliva samples and produce biomarkers for future use in clinical applications.

Usually physicians are familiar with the cutaneous signs in cardiac patients. They include Central and PeripheralCyanosis, Erythremia, and erythema, Digital clubbing. Some cardiac conditions usually have diagnostic cutaneous clues.Among the association of coronary heart disease, hyperlipidemia and xanthomas is important. Leopard syndrome is the rarest syndromes which have often have characteristic skin signs.Hence with this knowledge a physician can be able to diagnose and hence treatment for these diseases can be planned accordingly.

Lupus is associated with multisystemic inflammation resulting from abnormal lupus erythematosus. Systemic Lupus erythematosus(SLE)is an autoimmune disease in immunlological function. The four main types of lupus are Systemic Lupus erythematosus(SLE), Discoid Lupus Erythematosus(DLE), drug induced lupus, neonatal and paediatric induced where the immune system attacks its own tissues, causing inflammation in widespread and tissue damage in the affected organs. It can affect the joints, skin, brain, oral cavity, lungs, kidneys, and blood vessels. Discoid lupus erythematosus (DLE) is a chronic, scarring, atrophy producing, photosensitive dermatosis. This article reviews about its pathophysiology, oral manifestations and its clinical management.

Severe infections of the head and neck region may lead to life threatening complications. The infections of the odontogenic and upper airway origin may spread to facial planes and led to space infection. The morbidities and fatalities from these infections have reduced to a large extent with the advent of modern antibiotics. However early diagnosis plays an important role in preventing the lethal complications. The aim of this review article is to discuss the etiology, manifestations and management of space infections.

Gingival enlargement is a common disease of gingiva and also a common clinical problem associated with specific conditions. The etiological factors and treatment may vary for various types of gingival enlargement. This review article gives the systemic cause of gingival enlargement along with their clinical features, histology, and treatment.

Taste sensation is a very important factor for maintenance of the health of an individual. It is very essential sensation that serves to assess the nutritious content of food, and also supportsthe oral intake, and preventsfrom the ingestion of potentially toxic substances. Patients become distressed because of the taste disorders. This will causethe serious threat to the health of an older and more vulnerable patientsthey can have high chances to become malnourished through the loss of taste sensation or changes in taste perception.The dentist is the first person who hear complaints about alteration in taste from the patients.Taste changes which may lead the patients to seek inappropriate dental treatments. The proper diagnosis of the etiology is the most important step in the treatment of taste disorders. Thus, it is much needed that dental clinicians to be familiar with the various causes and proper management of taste changes.

Oral squamous cell carcinoma (OSCC) is the most important malignant tumour in the oral cavity. 90-95 % of cases were encountered as OSCC in dental practice. Diagnosing the OSCC is a challenging task for oral pathologists because the histopathological features of certain lesions might be confusing with the histopathological features and clinical features of OSCC. Thorough clinical examination, history taking and knowledge about the histopathological features of OSCC and other tumours mimicking OSCC helps an oral pathologist to derive a proper diagnosis and thus treatment can be planned accordingly. This review article discusses about the lesions which are resembling OSCC.

Over the past few years there has been a large change in the outlook and treatment modalities used in dentistry. Implants are considered to be the major breakthrough in the replacement of a lost tooth as, it has lots of pros and less of cons as explained earlier. After the loss of the maxillary molar tooth, the alveolar bone shows rapid resorption, and the size of the maxillary sinus also increases.

An oroantral fistula is an abnormal pathological communication between maxillary sinus and oral cavity, which arise as a result of infections in the tooth, radiation therapy ,osteomyelitis and iatrogenic exposure. It is mainly present in the region of maxillary bicuspids and molars. Oroantral communication is a common one faced by oral surgeons. This poses a risk between sinus and oral cavity, causing regurgitation of sinus contents into oral cavity. This article describes about the different methods and materials used for of closure of oroantral fistula.

Replacing the lost teeth with the help of implants has become familiar and popular among clinicians, which is due to high success rate and technical accuracy. Peri implantitis is an inflammatory disease affecting the implant , thereby reducing the survival in oral cavity, leading to failure. This literature discusses about the various methods to treat peri-implantitis.

Introduction: This article aims to weigh in on the concept of prophylactic antibiotic therapy in the extraction of third molars. Materials: There are four indications for antibiotic prophylaxis: 1. Antibiotic is administered to prevent bacterial contamination of the operating field. 2. Procedures have a high infection rate 3. Antibiotic Prophylaxis should be considered for surgical procedures where the incidence of infection is low although there may be high mortality rate following infection 4. When a foreign body is inserted into the tissues Use of antibiotics is reported to reduce the infection rate, but inappropriate antibiotic administration can lead to development of side effects. The infection rate of surgically removed impacted teeth is found to be quite low however it is higher for immunocompromised patients. Conclusion: The decision about whether or not to administer prophylactic antibiotic regiment must be made based on the individual’s requirement. In case of high risk patients, it may be undertaken, but if the patient

Fractures of the mid face pose a medical complication for the their socio - economic impact, complexity ,frequency. Inter disciplinary approaches and up-todate diagnostic and surgical techniques provide favourable results in the majority of cases though. Traffic accidents are lead to trauma mostly in male patients Treatment algorithms for nasal bone fractures, maxillary and zygoma fractures are widely agreed lead to trauma in frontal sinus and orbital .As for the fractures of the frontal sinus a strong tendency towards minimized approaches can be seen. Obliteration and cranialization seem to decrease in numbers. Some critical remarks in terms of high dose methyl prednisolone therapy for traumatic optic nerve injury seem to be appropriate.

The oroantral fistula (OAF) is a communication between the maxillary sinus and oral cavity . the pathological communication created by the dental extraction of maxillary molar and premolar teeth. OAF mayleads to sinusitis. Adequate management should be performed include closing the OAF and elimination of sinusinfection to provide good healing and prevent recurrences. Antrostomy, FESS or Caldwel-Luc areprocedures to eliminate maxillary pathology

Buccal fat pad is an extremely good graft which is used in oral and maxillofacial surgeries. It was recognized in the early seventeenth century, but its use was popularized after the eighteenth century . This article is a brief review on the applications of buccal pad of fat in oral and maxillofacial surgery such as reconstructive procedures , oroantral fistula, oral sub-mucous fibrosis, resections, reconstructions cases.

obstructive sleep apnoea hypopnea syndrome is an important medical condition brought to limelight in the last five decades. It is a major cause of morbidity and significant cause of mortality worldwide, including developed and developing nations. OSA is a sleep disorder that involve cessation or significant decrease in airflow in the presence of breathing effort. It is most common type of sleep disordered and is characterized by recurrent episodes of upper airways collapse during sleep, usually at the level of soft palate. The golden standard diagnosis is by polysomnography. Treatment includes positive continuous airway pressure,oral appliance and several surgical procedure Conservative procedures includes alcohol& tobacco cessation,weight loss

Surgical removal of the impacted lower third molar tooth is one of the most performed procedures in oral and maxillofacial surgery. Literature search was conducted to identify the pre-operative and post-operative complications associated with lower third molar surgery and the different modalities available for its management. The various complications associated with impacted lower third molar surgery and its management are discussed in this review article. The most common complications associated with third molar surgery are pain, swelling and trismus. It is concluded that complications after lower third molar surgery remains an important factor in quality of life in post-operative periods. As an Oral and maxillofacial surgeon should be aware of the complications, preventive measures and management to reduce pre-operative and post-operative complications.

Cone Beam Computed Tomography (CBCT) is a most valuable imaging technique used in oral and maxillofacial surgery. The introduction of CBCT for imaging the oral and maxillofacial region, holds a major change from two dimensional to three-dimensional approach. CBCT provides a complete 3D view of the oral and maxillofacial structures with high resolution which helps for accurate diagnosis, treatment planning and postoperative outcomes compared to conventional 2D images. Radiation exposure to the patient is very low in CBCT. The main clinical applications of CBCT arein oral and maxillofacial surgery, orthodontics, periodontics and in endodontics. The aim of this article is to review on the advantages, disadvantages and clinical applications of CBCT in the oral and maxillofacial surgery.

Chronic renal failure has become a very important health care modality in recent times and the incidence is already increasing mainly in the industrialized areas where physical, social, environmental, dietary factors play a major role. Renal failure as a disease shows different oral manifestations at different stages of the disease. This article is a review of the several factors in management of a dental patient with chronic renal failure (CRF), End Stage Renal Disease (ESRD)

Distraction osteogenesis is a biological process of Formation of the bone between the two bone spaces by the Gradual incremental traction. The simultaneous expansion of the soft tissues, including nerves, blood vessels, muscles, ligaments, fat and skin produces excellent aesthetic and functional results and minimizes the skeletal relapse.

As oral and maxillofacial surgeons we do come across various intra oral lesions, laceration and often we induce such, through incisions and dissections. Thus, we are faced with the challenge to select the proper material to approximate such tissue injury in order to enable it to heal. There are various materials commercially available, yet not all can be used intra orally. We shall delve deeper into the efficacy of non-absorbable suture materials which are commonly used intraorally.

Dental implants are generally considered as a long-term successful treatment modality in a dental clinic. Though many cases have been reported in relation to the failure of implants. Successful implants are those which stay healthy in the oral cavity and also doesn’t cause damage to its surrounding tissues. Recognizing any diseases or abnormalities in the oral cavity prior to the placement of the implant increases the chances of successful implant placement. Other factors such as age, sex, smoking, dietary habits, alcohol consumption and location of the abutment placement also play a major role in the success of implant placement. The follow up procedure after the implant placement is very important considering the longevity and stability of the implant.

cyst is a Pathological cavity containing solid ,liquid,gases substance but not by the pus which does not always with epithelial lining. its is a pathological lesion ,even it is a bengin it required a attention ,large cyst may cause the destruction and displacement of the anatomical structure.killey and kay gave a definition of the cyst in 1966 that was modified by Kramer in 1974 due to the modification found in epithelial lining by Kramer in1974. The treatment planning of the cyst in oral cavity is various according to the location,size and the involvement of the structure that occurs.

Smart meters are automated devices that can exploit to monitor the real-time electricity consumers’ power consumption. The smart grid with key technological enablers are considered as the collected information consumption that would useful for enabling the real-time schemes of new sophisticated billing. A wide-variety of value-added services could rise and the power distribution system’s efficient operations could facilitate. As the meters can collect the consumers’ sensitive data, the information of energy consumption is provided. For data collection, a prime challenge and a major concern is considered as privacy. In this paper, the metering data with different applications in the smart grid and the reviewing of relevant privacy legislation are made. The research implications, suggestions, structured overview, and defects of security solutions have been demonstrated for effective management and data delivery of privacy-preserving meter data. To collect the meter-data for three application areas such as 1) value-added services; 2) operations; and 3) billing including demand response, recent works on privacy-preserving technologies for collecting meter data have been investigated in this paper.

Self efficacy can influence a person's choice of action. Likewise, individual students of primary school age are able to brush their teeth with the correct procedure. This study aims to examine the effect of self-efficacy on students' actions to brush their teeth properly (with the right tool, on time and in the right way).
The research method was a quasi-experimental research design with a randomized control group pretest-posttest design. In this research design, the subjects were divided into two groups, namely the treatment group and the control group, all of which would be carried out pretest and posttest. The population of this study were all Grade 5 Elementary School students in the working area of Puskesmas Pegandan Kota Semarang. The intervention carried out was assisting in teeth brushing use a control card when brushing teeth at home for 10 days, after being given education using booklets to both groups.
Data analysis was performed using the Wilcoxon Signed Ranks Test to determine differences in self-efficacy and student actions before and after the intervention in the intervention group and t test in the control group. Meanwhile, the correlation test between self-efficacy and action used the nonparametric correlation test.
The results showed that there were differences in self-efficacy and respondent actions between before and after the intervention (p <0.0001). There is a relationship between self-efficacy and respondent's actions in the intervention group (p <0.005). In the control group, there was no relationship between self-efficacy and respondent actions (p = 0.089).

C- reactive protein (CRP) is an acute phase protein observed in increased quantities in plasma during the infections and presence of any inflammation, which could be a further possible risk factor in systemic inflammatory diseases such as arthritis, diabetes mellitus, and obesity. CRP molecules help as a biological marker for the determination of the inflammatory process when obtained from the gingival crevicular fluid and there is association between periodontitis and CRP levels. These levels are found to be reduced after the non-surgical and surgical periodontal treatment. Therefore, the levels of CRP would play a major role in determination of the inflammatory process.

The research aims to investigate the effect of taking doses of the food supplement creatine
on the development of pulse and achievement indices for swimmers of 100m afternoon.
The research was conducted on a sample of the national team, whose number was (6). The
exploratory experiment was conducted on three swimmers from outside the main research
sample, and after providing all the necessary supplies and needs to carry out the research,
the two researchers, in cooperation with the team coach, proceeded to conduct the pre-test,
which includes measuring the pulse index before the effort in the 100m swim back and
after the effort and after 2 minutes after the end of the test That is, the two researchers
administered doses of creatine to the research sample and after the completion of the
dosing, the post-test was performed, the data were collected and treated statistically. The
necessity of giving a nutritional supplement creatine, because of its importance in
developing pulse indicators, which leads to improved achievement

The rehabilitation process for the handicapped or those with special needs has become an
important aspect of physical education and one of the goals of physical education, where
both the medical staff and the sports coach work side by side with the purpose of meeting
the requirements of the process of rehabilitation of the handicapped and those with
injuries that hinder their physical or movement capabilities, and from these injuries It is
partial paralysis due to an injury to the spinal cord and the spine and limits movement to
parts of the body (lower extremities), as the injured were exposed to various accidents in
the vertebrae of the spine and the spinal cord injury led to this injury, and as a result of the
injured losing their normal movement status and the inability to walk Correctly, which
forced them to use wheelchairs permanently, and these injured persons are wheelchair
basketball practitioners, so the researcher decided to prepare a set of exercises in the form
of an integrated rehabilitation program to help the injured to develop their motor
performance and also to overcome the movement difficulties they face due to Physical
weakness as a result of injury. The researcher used the water medium and physical
exercises inside and outside the water in the program Eligible to get the maximum benefit
from motor performance and activate the largest possible muscle group while performing
more exercises and movements in the aqueous medium

Aim: Diabetes mellitus is considered as a lifelong degenerative illness that deteriorates insulin use and production which leads to numerous organ dysfunctions. The relationship between diabetes mellitus and hearing impairment is argued in many literatures. In this study we intended to investigate the relationship between hearing loss and diabetes mellitus to expand and develop the knowledge in this significant field as well as to prevent early hearing impairment.
Materials and methods: We analyzed medical histories and pure tone audiometric charts collected from 32 adult patients participate in this study of both genders, the age was between 20-75 years who diagnosed with diabetes mellitus, seen in outpatient of otolaryngology department in Baquba Teaching Hospital . These results compared to 32 non diabetic individuals (control group)
Results: When comparing the two groups, we observed statistically significant hearing impairment among participants with diabetes mellitus compare to non-diabetic individuals.
Conclusion: The present study shows significant correlation between hearing impairment and diabetes mellitus. These findings may explain the essential neuropathic effects of diabetes mellitus on hearing organs.

Recent years have witnessed a great development in the field of education and the educational process has become the focus of attention of researchers and specialists, in order to keep pace with progress and reach the best education that the educated can reach.
Basketball is a fast-paced game that is taught in colleges within a pre-prepared curriculum, whose skills should be performed quickly in line with the game's specificity.
The research problem lies in the fact that the performance of the students is slow in movement, and this indicates the lack and lack of focus on speed exercises within the lessons.
The research aims to prepare physical exercises for speed for the third stage students and to know their effect on speed development, in addition to knowledge of speed development in some offensive skills with basketball.
The researcher used the experimental method using the method of one experimental group, and it was conducted on a randomly selected sample of (4) four divisions and a number of (16) sixteen students, at a rate of 15.53%.
Pre and post tests were conducted for the research variables, and the search continued from (11/18/2019 to 25/12/2019), as well as statistical means.
The researcher concluded that the exercises led to the development of speed in its transitional and kinetic forms for the students, as well as the emergence of an improvement in some complex offensive skills. Basketball skills.

The individual's efficiency in performance such as problem solving or the time it takes to perform a task depends on his mental abilities, and what needs arise according to its size, and the accuracy of its complexity, to include simple and complex mental activities, including visual selective attention. In addition to the extent of its precise contribution to volleyball defensive skills, the students of the College of Physical Education and Sports Sciences, the third stage, numbered (78) applications from the third stage. They were randomly selected by a percentage of (39.59%) of the total number (197).
That the highest correlation of the first order with the skill of reception, and then the skill of the wall of block ranked second, and in the end, the skill of defending the court ranked third in terms of the value of the correlation coefficient, and that all the correlations were significant, because the error rates are less than the significance level (0.05) and the degree of freedom (76) with a percentage of confidence of (55.8%) for visual selective attention (reaction) to technical skills in defense in volleyball. Therefore, the researchers recommend conducting a similar study for different levels that include aspects of the current study. Standards and standard levels for the studied research variables

Background: Tonsillectomy is one of the most common surgical procedures in the world, various other techniques have been attempted over the previous decades to lower morbidity of this operation, and one of these new techniques is the bipolar radiofrequency dissection to remove the tonsils.
Objectives: This study is to compare the radiofrequency tonsillectomy with traditional cold steel dissection tonsillectomy prospectively regarding intraoperative time and blood loss, and postoperative pain and complications in children.
Methods: 194 children suffering from recurrent tonsillitis are included in this study, their age range from 3-16 years, they are divided randomly into two equal groups, each group 97 children, and one group sustained bipolar radiofrequency tonsillectomy while the second group sustained traditional cold dissection tonsillectomy. In all operations we record blood loss amount and operative time and they are followed for 10 days after operation during which we record degree of pain and incidence of postoperative complications.
Results: The radiofrequency tonsillectomy patients got less intraoperative blood loss (mean 10ml) and shorter operation time (mean 9 minutes), when compared with cold steel dissection tonsillectomy ( mean blood loss 80ml,mean time 16 minutes). The postoperative pain was significantly less in the radiofrequency patients than in the cold steel dissection tonsillectomy patients. In addition, no postoperative hemorrhage occurred after radiofrequency tonsillectomy in our study but it happened in 2 of cold steel dissection tonsillectomy group of patients.
Conclusions: Radiofrequency tonsillectomy is better than cold dissection tonsillectomy in terms of lower blood loss and operation time, with less postoperative pain and complications, so we recommend it as an ideal technique for tonsillectomy.

The article formulates a generalized model of an elastic-viscous fluid, in particular, from this model one can obtain Newtonian, generalized Newtonian, Maxwellka and other models. Basically, the generalized model of a viscoelastic fluid is built on the basis of the topological hypothesis of Astarit and Marrucci and the axiomatic principles of Truesdell and Knoll. The developed generalized model of a viscoelastic fluid is convenient for solving engineering problems and thus is easily implemented for studying the flow of non-Newtonian fluids in a flat channel and in a circular cylindrical tube.

Based on questionnaires and level of 25(OH)D in 466 children under 1 year factors for rickets was
identified. Reliable factors were iron deficiency anemia during pregnancy, toxemia of pregnancy of the mother and the lack of vitamin D during first year of life of a child, lack of outdoor stay (less then 20 minutes per day), frequent colds, not effective traditional prevention of rickets vitamin D.

. In traditional unstructured text clustering techniques mostly they use vector space model usually considers all the text documents as bags of words where the word sequence are not considered for efficient clustering.  For Cluster quality the order of terms in the document collection plays a main role in which vector space model do not support. Hence recent days for the text clustering usually done through frequent item based. This paper analysis the different techniques like Frequent word sequence(FWS),Frequent item based on maximum document occurrence(FIMDO) and weighted frequent utility pattern agglomerative clustering(WFUPAC) and evaluates the input datasets like newsgroup and Reuters dataset with varying size. The result proves that the weighted frequent utility pattern agglomerative clustering(WFUPAC) outperforms when compared to Frequent word sequence (FWS) and Frequent item based on maximum document occurrence(FIMDO).Thus enhances the accuracy of text clustering in big data environment.

Tuberculosis is one of the perilous infectious diseases that can be categorized by the evolution of tubercles in the tissues. This disease mainly affects the lungs and also the other parts of our body. Five stages are being used to detect tuberculosis disease. They are pre-processing an image, segmenting the lungs and Extracting the feature, Feature Selection and Classification. The optimal features are selected by Modified Random forest. Finally, Support Vector Machine classifier method is used for image classification. The proposed system accuracy results are better than the existing method inclassification.
Index Terms—Tuberculosis, Segmentation,K Means clustering, Feature extraction, GLCM approach, Modified Random Forest, SVM classifier.

One of the important roles of Driver Assistance System (DAS)is to assiststhe driver by alertingthe road anomalies. Detection of the speed bumps/breakers, potholes, and maintenance holes will fall under the road anomalies category.In India, generally there are two type of speed bump i) marking type speed bump ii) unmarking or non-marking speed bump. Among the two, using image processing technique identification of speed bump in earlier is comparatively easily than the later. Still, it is very challenging to detect the unmarked speed bump sincethere is a noyellow or white stripe to indicatetheir presence. During driving, the human visual system recognises the marking type speed bump in long-distance, but it is very tough in the case unmarked speed bump. So, a new method is proposed to identify the Real-time speed bump.The detection of such type of speed bump is essential for the driver to avoid accidents/inconvenience in driving. In the proposed method, after converting the RGB image into a grayscale image,a Gaussian filter is used to remove the noisy environment in the road image. Followed by canny edge detection to identify the edges of the image. This helps to locate the edges of speed bump though the colour of road and speed bump remains the same;there is a minute transition between them. Commonly the speed bump is constructed horizontally in the form of the linethat can be identified easy using Hough transform. On average, the accuracy ratio of corrected detected speed bump is 95.5%. In addition to driver assistance, the system can also be implemented in self-driving cars.

This paper manages the nature of water utilized for making concrete cement by Ready-Mix Concrete (RMC) makers in Chennai. Water tests gathered from three diverse RMC plants situated in Chennai and the water tests are evaluated for compound properties as per significant Indian guidelines and the broke down technique for their Growth are gathered. The constraints of compound properties according to Indian principles are introduced and results are examined for the appropriateness of water tests for the creation of Ready-Mix Concrete for the development business. The usage of contaminated water for strong mixing is seen unreasonably incredible for quality headway at early ages and abatement in long stretch quality.All the parameter values were within the permissible range, hence the ground water from the said areas is suitable for construction.

Tour is going to be the foremost uttered word in weekends and summer breaks. So as to formulate tourism scenarios, the previous researches have provided an analysis report supported processing the downloaded images which seems to be partially accurate and time latency. The goal of our project is to verify the attractiveness of places supported location provided along-side the dataset taken such foreign tourists and tourists on-site to market the tourist places(feedback) and also to segregate the people into ages and suggesting them tourist spots. We are getting to build an internet application for our project. This concept benefits the tourists in various aspects like suggesting better places that also includes less popular but exorbitant sites.

Video Shot Segmentation is the basic technique inPost Video Processing Application Software. Video Shot Segmentation divides a video into meaningful temporal segments called shots. A shot is composed of series of interrelated images continuously recorded without any interrupt by a single recording device. A video frame is the unique image in the shot.There are two shotboundarychange Abrupt and Gradual.The abrupt shot transition is called Cut and gradual shot transition includes dissolve, Fade,Wipe.Identifying the video frame at which shot changeoccurs is called Shot Boundary Identification. In this paper, a detailed study on Shot Boundary Segmentationmethods using conventional Machine learning Techniques and deep learning Techniques are studied.

The formation of cardinalmortalities as aexplorationpitch has revealed that the practice of systems as utensils, then also the habitof arrangements and practicessince computer discipline, can subsidize hugely to exploration ended in the humankinds. Subsequentlyquantum supercomputers are probable to convertnormallyaccessible in the succeedingscarcecenturies; it is auspicious to routine the doles of this new expertise for lecturing prevailing as well as entirely new inquiries in the humankinds. The practice of quantum computers compromisesaexcessive contract of budding: (i) they are considerablequicker than conventional computers in crackingconvinced intricatecomplications, (ii) solutions may be much more accurate, (iii) they permit the resolution of unrulymodules that canisterscarcelystayedcracked on standard computers, and (iv) custom possibilities to be ampleinexpensive than other CPUs. Probable are previously used in diverse domains but are also certainhopeful for numericalmortalitiesstudy. Our papersummaries the hallucination of such quantum humankinds and describing about the entanglement and superposition nature of Quantum Computing.

 In this paper, Fuzzy KM-ideal on K algebras and bipolar valued fuzzy set are discussed and bipolar valued fuzzy KM-ideal on K-Algebras  introduced and related topics are discussed

Steel fiber fortified self-compacting concrete (SFRSCC) is a generally ongoing material that joins the advantages of a self-combined material with those got from adding filaments to a bond based material, coming about a composite material that can be utilized in a few auxiliary applications with specialized and monetary preferences, when contrasted with customary fortification arrangements. The present paper condenses the fundamental accomplishments got in research programs did at the Department of Civil Engineering of Minho University, inside the ambit of SFRSCC innovation. The secured themes are: blend plan; fiberpullout; age effect on the pressure and flexural conduct; displaying the monotonic and cyclic pressure conduct; flexural and punching opposition of models and full scale boards; material nonlinear investigation under the system of FEM. The Self Compacting Concrete doesn't require vibration for compaction. It can stream with its own weight, totally rounding formwork and doing full compaction, even within the sight of blocked support. The solidified cement is thick, homogeneous and has the equivalent designing homes and strength as ordinary vibrated concrete. It diminished framework costs as no vibration is required, abbreviated generation time, early quality gain. By including steel filaments, it enhances the elastic parameters. The steel strands (straight) can be successful on miniaturized scale and full scale breaks. In the present paper, the impact of steel filaments with a length of 30mm and distance across of 0.5 mm were utilized in oneself compacting concrete. It decreases the functionality of the solid. Increment the usefulness by including super plasticizer. The solid is trying at a time of 28 days. At 28 days 60% of solidarity will accomplish. In SCC the steel fiber sum is 0.3 %, 0.6 %, 0.9 %, 1.2 % has taken. By expanding the level of steel fiber, the compressive quality and flexure quality will pick up.

Background: Sphygmomanometer, blood pressure instrument, measure blood pressure of one side of arm at one time, consists of an inflatable cuff to collapse and then release the artery under cuff in a controlled manner. 0 to 30 mmHg points or more variation of blood pressure and pulse rate occurs in human beings in inter-arm. Blood pressure of normal adult is approximately 120/80mmHg and pulse rate is 70-80/minute. Blood pressure and pulse rate variation may lead to misdiagnosis of hypertension and hypotension.  
Method: Apparatus used are digital sphygmomanometers. Blood pressure and pulse rate is measured of both arms turn by turn and simultaneously by using two digital sphygmomanometer, thrice, the concordant readings are considered and noted for this purpose of blood pressure and pulse rate,  in different age groups persons and average real variability method is also used to estimate blood pressure and pulse variation. Data is collected from different rural areas by gathering people, on some fixed places, or by visiting in different rural areas.
Result: Total Persons of different age groups investigated = 1765, Males = 834(47.25%), Females = 931 (52.75%). SBPV persons in 0-10 mmHg= 76.99%, 11-20mmHg= 21.42%, 21-30mmHg = 1.59%. DBPV in persons with variation from 0-10mmHg = 92.18%, 11-20mmHg= 7.14%, 21-30mmHg = 0.68%, PV in persons from 0-10mmHg= 95.86%, 11-20mmHg = 3.68%, 21-30mmHg= 0.45%. Diseased persons = 22.38% (Hypertension, diabetic mellitus type I and type II, hypotension, kidney diseases, chronic and obstructive pulmonary diseases), Normal Persons= 77.62%.  
Conclusion: Variation in inter-arms in systolic blood pressure and diastolic blood pressure and pulse is observed when detected with sphygmomanometer, thrice in each arm turn by turn or by using two instruments simultaneously in both the arms, concordant readings are considered and average real variability method is also used to estimate blood pressure and pulse variation. Variation in blood pressure and pulse rate in inter-arms observed in different age groups, ranged from 0-10mmHg to 21-30mmHg. Maximum persons have variation in 0-10mmHg in systolic blood pressure, diastolic blood pressure and pulse which is not showing significant diseases and persons in 11-20 and 21-30mmHg variations show cardiovascular diseases or have probabilities.

The IoThealth-care supporting for disabled peoples is an important milestone in technological advancement. In this paper, it is developed a mobile Health-care app, called M-Health, on the system using iPhone with smart Apple watch to help seniors to manage their health life. The proposed M-Health measures the heart rate and notifies to emergency contacts, when it is abnormal. The notification can be a call, SMS, email, or a combination of them. The M-Health suggests the users to take optimum dosage of medicine. This reminds the users to move out for a walk and suggests to perform optimum exercise.Also, it records, heart rate of a patient and sends to the physician periodically. Simulation results shows that, it is beneficial with better performance in avoiding end-to-end delay, resulting excellent throughput of achieving the goal of serving the health-care to the blind, disabled and elderly peoples in time. The results also shows that it is less prone to failure addressing probability of fog computing in IoTenvironment.

Due to increase in population growth and the reduction of available land in India, more and more construction of the buildings and the infrastructure works have to be carried out on weak or soft soils. In India, the one of the soft soil is the Clay Soil, which covers an area of approximately 20% of the available land area. It is considered as unsuitable soil for construction purpose due to its swell and shrinkage properties upon wetting and drying. Such soils shows immense swelling while it comes in touch with water; however, it shrinks with decrease of Water content material and develops cracks on drying. Soil stabilization is the process to alter the properties of a present soil to improve the required engineering properties.
This paper presents the results of the soil stabilization of Clay Soil using e-waste and Fly Ashwith varying dosages of e-waste i.e. 3%, 5% and 9% and with 20% of Fly Ash. The performance the Stabilized soil was evaluated the use of the familiar soil tests namely; Atterberg’s limit, specific gravity, compaction test, unconfined compressive test, California bearing ratio (CBR).After performing Take a look at there was an improvement in angle of friction (Ф). While the proportion of e waste multiplied it became also located that there may be a growth in the Bearing capacity of the clay soil as bearing capacity is depending on C and Ф.

: Huge quantity of noticed dirt is being generated international because of the speedy urban- ization. The disposal of saw dust in open regions or landfills isn't a surroundings friendly Answer. Us- age of saw dust as ash in geotechnical packages is in all likelihood presents a Better answer. Maintain- ing this in view, an intensive experimental examine turned into accomplished .To illustrate the soil de- velopment prospective of noticed dirt ash soil data access(SDA) with the aid of carry outing California bearing ratio (CBR) and unconfined compression power assessments. The Experimental take a look at has discovered that the addition of soil data access (SDA) effects a huge growth incbr and unconfined compressive energy. Furthermore the values of CBR received are within the limits advocated by wooden ash (WA)of the asphalt institute for motor wooden ash(WA) sub-base and sub-grade. For this reason from the existing examine it's miles concluded that soil data access(SDA), an industrial Wooden ash(WA), is a cheap pleasant stabilizing operator for sub-base and base course in clayey Fills; in spite of the fact that its presentation can be progressed by methods for consolidating it with other holding Materials, for example, lime, andturns into an options use of commercial wooden ash(WA) to reduce The construction value of avenue especially within the rural regions of the U. S . A.

Utilization of business and rural Waste items inside the undertaking has been the Awareness of research for money related, Environmental, and specialized reasons. Sugar-stick bagasse is a sinewy waste Made from the sugar refining industry, Along with ethanol fume. This waste Product is now causing genuine Environmental contamination which requires Urgent strategies for taking care of the waste. It Reasons the persistent lung situation Pulmonary fibrosis all the more explicitly Known as bagasse’s. On this paper, Bagasse debris can be used to balance out the Expansive soil. The reason for this exploration was to make financially savvy and to hold Environmental steadiness, and avoid bother of debris removal. This dirt become arranged as according to Indian general sort Gadget (iscs). Various doses of impact Furnace slag i.e. 2%, 4%, 6%, eight%, and 10% had been utilized to settle the extensive Soil. The general execution of bagasse debris Stabilized soil transformed into assessed the utilization of substantial and force execu- tion tests explicitly; Plasticity Index, Unique Gravity, Compaction and California bearing proportion (CBR) and unconfined compressive. These tests have been conducted in order to survey the improvement in quality Characteristics of the subgrade soil. Thusly Use of such unrivalled materials in road Construc- tion can show productive in Growing the power of soil and in flip Reduce the task cost. From the out- comes, it became seen that the basic tests completed demonstrated sizable after the expansion of Bagasse debris.

In the present focused world, an individual need to act astutely and find a way to create his abode in the challenge. The proportion of the adolescents to that of the senior individuals is nearly more and furthermore they subsidize concerning the advancement of the general public. This paper shows the strategy to remove feeling from the content at constant and add the articulation to the printed substance during discourse amalgamation by utilizing Corpus, feeling acknowledgment section and so on. Alongside the feelings acknowledgment from the human literary information the framework will investigate the different human body signals, for example, circulatory strain, EEG signals, vocal prosody to foresee the degree of gloom with the goal that reasonable treatment can be proposed utilizing Prediction calculation. In content examination, every single passionate catchphrase and feeling adjustment words are physically characterized. To comprehend the presence of test was done on set of printed sentences and primer standards composed for 34 unique feelings. These principles are utilized in a computerized technique that allocates passionate state esteems to words. These qualities are then utilized by discourse synthesizer to add feelings to discourse and info sentence. Pitch location calculation has been executed for pitch acknowledgment

Black cotton soil that's one of the most important soil deposits in India becomes especially problematic due to its property of higher degree of swelling and shrinkage. These soils are used in subgrade of pavement and also in construction of structures. Hence so as to improve the houses of such soils many strategies are to be had like soil stabilization, soil replacement, moisture control, prewetting etc. In recent years, soil stabilization by the use of numerous minerals like quarry dust, saw dirt, copper dust and fly ash were most generally used. These strong wastes are every day increasing in India, which isn't environmental pleasant hence they ought to be recycled. Thus, a review is presented to make use of the ones wastes in soil stabilization. In this paper, the observe mainly focusses on stabilization of soil using strong waste. To recognize the performance of stabilized soil, its residences like Atterberg limits, compaction characteristics, swelling, shear strength, CBR value and other Index & Engineering properties have been discussed.

This paper deals with installation stability Analysis and management by intelligence system. The cautious running of power channeling systems needs the attention of sustainable line communications. The validity and rapid grading of any disturbances thus prevents to handle replaced system which can be created later. Thus this paper considers the issues of selecting the stabilizing structures of installation and provides some rule solutions by analyzing the reference papers associated with stability analysis and management in installation. Here grid assessment throughout restoration time done by the Wide house activity System. If the stableness performed throughout the restoration time, then stability has to be controlled using computing.

Population growthprediction shows the future rate of fertility, mortality and migration of people of a country. It is very important for the population and health system. Nowadays, Machine learning concepts are most growing and popular for predicting future values. In order to predict population growth, the machine learning concept applied to build the map between year and population growth. The paper investigates the population growth of Indian government population data using time series forecasting machine learning techniques and analyzed byLinear regression, Support Vector Regression, Multilayer perceptron and Decision tree classifier. The optimum prediction method is based on the technique which gives very less error rate. The increment or degradation of instances in datasets do not affect the performance of the techniques is also analysed. The obtained result shows that the linear regression gives less error than the other classifier to predict population growth of India.

Vehicle retrieval is a demanding application in interdisciplinary research areas such Vision-Based Intelligent Transportation System (ITS), finding traffic density, recognising licence plate, analysing traffic flow etc., Vehicle retrieval becomes possible by detecting and tracking the vehicles.  An efficient framework for vehicle detection and tracking system to retrieve vehicle is a great demand in the field of ITS system. In this paper vehicle retrieval based on vehicle detection and tracking is developed based on selecting high level feature set like size and shape for an efficient vehicle retrieval system which is in turn helps to reduce the traffic flow on highways thereby reducing accidents happen on road, autonomous vehicle guidance, vehicle safety, helps in finding the parking slot and identifying suspicious vehicles etc. Mostly vehicle retrieval systems are query based, attribute based such as colour, shape, size etc., and licence plate based retrieval. In this paper vehicles are retrieved from various features like increasing number of vehicle on the road day-by-day, increasing number of cameras etc., Multidirectional Grey-Level Texture and Shape Model for Feature Based Vehicle Retrieval System (MDGLTS -VRS) for vehicle retrieval has been developed. This approach identifies an optimal subset of features, useful to discriminate between local and global features.

 
Water quality prediction play an essential role in aqua environment management.  The demand for accurate water quality prediction techniques for efficient water resources management. Currently, the Indian pollution control board has set up various monitoring stations to measure water quality frequently. However, the forecast for water quality is currently not being carried out. In this work, machine learning models have been implemented to predict the indices of water quality. The efficiency of logistic Linear regression and AdaBoostRegressor in the prediction of seven major water quality parameters were evaluated. The Tamil Nadu water quality dataset is used in this analysis. The parameters such as pH value, the quantity of oxygen dissolved, total coli form, B.D.O, electric conductivity, the quantity of phosphorus, and nitrate are considered. The assessed error-index value of the applied models showed that the AdaboostRegressor obtains a lesser error-index and it can consider being a more accurate model than the Linear regression model. The entire methodology proposed here is in the context of water quality is based on numerical analysis. While investigating the outcomes of the implemented machine learning models, it is demonstrated that they have nearly over-estimation properties. The proposed models are assessed using the metrics Mean Square Error and R² score the results reflect that AdaboostRegressor predicts the (Water Quality Indices) WQI rate with a Mean Square Error value of 0.8, and R² score rate is 0.41, whereas AdaBoostRegressor with a obtains Mean Square Error (MSE) rate as 0.74 and R² score rate as 0.44.

Gaining knowledge of Vision and language is becoming a happening topic with in-depth research in Artificial Intelligence (AI). This AI, NLP, and computer vision have recently hit by issues like Graphical Question Answering (GQA). Here, we present the mission of the Multimedia Machine Modal Comprehension Question Answering Algorithm (MMCQA), focusing on addressing multimodal queries concerning words, figures, and pictures. Dataset addresses the questions and has around twelve thousand and odd lessons and more than thirty-six thousand multi-modal questions obtained from the science curriculum. Our study demonstrates that a significant part of queries need resolving of texts, figures, and cognitive analysis, denoting that the info in our report is way more complicated than the earlier studies and obvious question answering datasets. Lastly, we put forth a method based on dual-LSTM  having spatial as well as temporal focus and prove that it is useful compared to other standard GQA methodologies via experiential studies.

Transition metal complexes have been used widely by many bioinorganic chemists for developing active transition metal anticancer complexes with better efficiency. The interaction of transition metal complexes with DNA has been a subject of passionate research in the field of bioinorganic chemistry. To synthesize a new Schiff base ligand (1-Methyl-4-nitro-benzene(2-imino-1,2-dihydro-indol-3-ylidene)-(4-nitro-phenyl)-amine) by the condensation reaction between isatin and p-nitroaniline and  Its Co(II), Ni(II), Cu(II) and Mn(II) complexes were prepared by the interaction of the Schiff base ligand with metal(II) chloride. They were characterized by elemental analysis, IR, ¹H NMR, EPR, UV–Vis, magnetic susceptibility measurements and conductivity measurements.  DNA cleavage activity by the complexes was performed by gel electrophoresis method. The Schiff base and its complexes have been screened for their antibacterial (Staphylococcus aureus, Escherichia coli, Bacillus subtilis and Klebsila Pneumonia.). All the synthesized complexes have distorted octahedral geometry and the coordination of ligand to metal complexes confirmed by IR spectral studies .In all the biological studies, metal complexes show better activity than the ligands.
 

Credit card frauds have become significant owing to the rise of latest technologies and the global superhighway of communication. Credit card fraud identification models are necessary for any bank or financial institution to reduce the loss. Several methods are developed for the identification of credit card frauds. To solve this problem, the proposed system designed a Time-Varying Inertia Weight based Dragonfly Algorithm (TVIWDA) with Weighted Feature based Support Vector Machines (WFSVM) for classifying the normal/fraud behavior features. In this proposed work, initially, credit card dataset is taken as an input and feature selection is performed based on Time-Varying Inertia Weight based Dragonfly Algorithm (TVIWDA). According to the selected features, Weighted Feature based Support Vector Machines (WFSVM) approach is utilized for credit card fraud detection. A brief set of experiments were performed to highlight the betterment of the proposed model and the obtained simulation values ensured the better outcome of the proposed model over the compared methods.

: Brain tumor (BT) segmentation is a significant process in clinical imaging. Earlier identification of BT acts as a crucial process to improve the treatment prospects and enhances the endurance rate of the patients. Manual segmentation of the BTs for cancer detection from enormous quantity of MRI images produced in a daily medical schedule is a troublesome and tedious process. Therefore, an automated BT segmentation tool is required. In this view, this paper presents a novel Likelihood based Probability Density Function with Relevance Vector Machine (LPDF-RVM) and Growing Convolution Neural Network (GCNN) for automatic BT segmentation. Initially, MR brain images are taken as input. In addition, the image normalization process and wiener filter based noise removal process takes place along with the skull stripping process.  After that, Gray-Level Co-Occurrence Matrix (GLCM) and Histogram of Oriented Gradients (HOG) features extraction is performed. Based on the features, LPDF-RVM is applied as a segmentation technique followed by GCNN. A detailed simulation analysis was carried out to highlight the better performance of the presented model.

The gonadal cycle constitutes a significant biological parameter to be investigated in the
fields of Anabas testudineusreproductive biology and ecology and fisheries science.
Maturity data may also be used to carry out temporary analysis of fish stocks' life-history
characteristics. Maturity data was often used to characterise the species' gondola cycle and
to track long-term transition in the reproductive cycle. That's why, according to the
reproductive plan of the genus, the maturity stage should be calculated. In the current
research, the gonadal cycle is observed by Anabas testudineus to maturity. The ripeness
scales should ideally be based on quantitative and universal gonadal properties, which are
measured macroscopically since they are less costly and labour intensive than microscope
maturity stadiums.. The rate of ripeness should be standardised.

Background: Dysfunction and anatomic abnormalities of the thyroid are among the most
common diseases of the endocrine glands. Almost one-third of the world’s population lives
in areas of iodine deficiency and present study determines the association ofglycated
haemoglobin level in non-diabetic overt hypothyroid patient.
Materials & Methods:130 subjects of both genders were divided into 2 groups. Group I
comprised of 70 patients with overt hypothyroidism and group II were 60 subjects (control
group) with no thyroid dysfunction. HbA1c was measured by immunoturbidimetry method
by clinical chemistry analyzer and serum TSH and FT4 were measured by radio immune
assay.
Results: Common clinical features were hoarseness of voice in 65%, fatigue in 53%,
weight gain in 70%, depression in 42%, puffy face in 35%, non- pitting edema in 39%, cold
intolerance in 31% and constipation in 22%. The mean TSH level in group I was 18.2
mIU/l and in group II was 3.4 mIU/l, FT4 level was 5.0 pmol/l in group I and 12.4 pmol/l
in group II, HbA1c level was 5.9% in group I and 5.2% in group II and FBS level was 5.2
mmol/l in group I and 4.7 mmol/l in group II. The difference was significant (P< 0.05).
There was correlation between TSH and HbA1c levels (r- 0.412, p< 0.05).
Conclusion: Hypothyroid patients had high level of glycatedhemoglobin level as compared
to control subjects

A novel gastroretentive drug delivery system based on a polysaccharide substance from linseeds (Linum usitatissimum L.) has been developed as floating matrix tablets for Gatifloxacin. To achieve a desirable prolonged release profile of gatifloxacin, a number of formulations were created using a combination of linseed hydrogel (LSH) and various excipients. The drug release test was carried out mostly at pH 1.2. However, due to specific factors, the tablet may pass through the stomach and into the intestine, where it provided sustained drug release at intestinal pH 7.4. The results showed that sustained gatifloxacin release was related to LSH concentration and that drug release followed a non-Fickian diffusion pattern. The porous character of LSH with elongated channels was revealed by SEM of the tablets, which contributed to the swelling of the tablet and later promoted the release of gatifloxacin from the core of the tablet. An in vivo X-ray investigation was conducted to examine tablet disintegration and real-time floating, which proved the tablet's presence in the stomach for 6 hours. These findings suggest that LSH could be exploited to create novel gastroretentive sustained release drug delivery systems that have the added benefit of delivering drugs at all GIT pH levels.

Helicobacter pylori infection is regarded as the causal factor of most of the diseases of the gastrointestinal tract in adults and children. Isolation of H. pylori by culture is highly specific and is considered as the gold standard technique. But often H. pylori are difficult to isolate in proper culture media. Helicobacter pylori infect about half of the world population causing chronic gastritis, peptic ulcer or 175 gastric cancers. This study investigated the prevalence of H. pylori and determined the antimicrobial susceptibility patterns of isolates; the molecular basis of the resistance pattern of isolates.
 
Keywords: H.pylori, Culture, Endoscopy, Rapid urease test.

Today, e-commerce services became more popular on the Internet and the web. Network
security is extremely essential for e-commerce services, and it is always the key to the
success of e-commerce (e-commerce). In this article, we address various security problems
concerning both the conventional and the new generation e-commerce model, such as P2P
authentication, authorization, non-repudiation, and integrity. By examining the key
characteristics of P2P e-commerce, we summaries several trust model design concepts in ecommerce.
We provide a comprehensive overview of network security problems relating to
e-commerce and e-commerce applications, and offer a related e-commerce security
research framework. In contrast with other security approaches, we think that as long as
security concerns are properly handled, P2P e-commerce will achieve tremendous success
on future e-commerce marketplaces.

The human coronaviruses was first identified in mid 1960s. Coronavirus are subgrouped in alpha, beta, gamma & delta. Severe Acute Respiratory SyndromeCoronavirus (SARS-CoV and SARS-CoV-2) & Middle East Respiratory Syndrome Coronavirus(MERS-CoV) are included in Beta coronaviruses (Sharifi-Mood 2015; Ksiazek etal., 2003, Cho et al., 2016., Kim et al., 2015). Coronaviruses are viruses thatbelong to the subfamily of Coronavirinae in the family of Coronaviridae, causesthe common cold and severe acute respiratory syndrome; they are well known tocause disease in humans and animals including himalayan palm civets, raccoon,monkeys, dogs, cats, dogs, and rodents. MERS-CoV is genetically distinct fromthe SARS-CoV and SARS-CoV-2, which has emerged as a pandemic in the last decade and appearsto behave differently (Baseler et al., 2015; Yang et al., 2015). Incidence of Humancoronaviruses infection among infants is highest during the winter and earlyspring seasons.Middle East Respiratory Syndrome (MERS) is a syndrome affecting upperrespiratory system and is caused by Middle East Respiratory SyndromeCoronavirus (MERS-CoV). MERS cases high fever, chills, chest pain, bodyaches, cough, breathing problem, sore throat, diarrhoea, renal failure, pneumonia,nausea/vomiting and running nose. First case of MERS to human was reported inyear 2012 in Saudi Arabia. After 2012 MERS-CoV infection has been reportedfrom 27 countries only within 4 years (WHO report: 2016). Till present threeMERS outbreaks have taken place in Saudi Arabia (2013, 2014) and in SouthKorea (2015) (Assiri et al., 2013; Oboho et al., 2015; Park et al., 2015). Outbreakreported in South Korea was reported to have fatality rate as high as 40%, and italso involved spreading of MERS while hospital-to-hospital transit of patients.High attack rate and easy spreading means has put MERS disease at risk of anepidemic (Kim et al., 2015; Ki., 2015; WHO Emergencies preparedness,response, 2015). Till date no specific vaccine is available against MERS. There isan urgent need for specific and safe MERS vaccine 
keeping in mind the steepincrease of MERS cases and it’s high mortality rate. As far now the pathogenesisof MERS-CoV is largely unknown. Hence, an immunoinformatics approach tothoroughly study and screen potential immunogenic proteins from availableproteome sequence data of MERS-CoV is very essential for vaccine development.SARS started off in the Guangdong Province in southern China in themonth of November 2002. Eventually it reached Hong Kong, from where itrapidly spread around the world, infecting people in 37 countries (Hsieh et al.,2015., Kong et al., 2015). Severe acute respiratory syndrome coronavirus (SARSCoV)causes a severe form of upper respiratory track disorder called the Severeacute respiratory syndrome (SARS). The SARS infection is highly contagious andis prominently characterized by breathing difficulties, high fever, dry cough, andpneumonia. SARS is endemic in southern China. In the year 2003, the SARSoutbreak in south China caused 8098 people sick and 774 dead. Eventually, SARShas now reported to spread around the world, infecting people in 37 countries(Zhong et al, 2003; Booth et al., 2003; Leung et al., 2003; CDC report; 2018).Even though there is an urgent need to develop a specific SARS vaccine, till datethere is no specific and safe vaccine against SARS. Pathogenesis mechanism ofSARS-CoV and SARS-CoV-2 being still largely unknown the immunoinformatics approach todesign and develop an epitope-based specific vaccine against SARS would be anessential step forward.

Hepatitis infection burdens have been increasing and alarming around the globe in recent
years. The mainstream therapeutics of hepatitis infections are non-specific with numerous
side effects. To combat viral hepatitis, a novel therapeutic platform is needed. In the present
study, we explored a novel biogenic approach of nanotechnology as an alternative therapeutic
platform for treating hepatitis. Biogenic silver nanoparticles (PTNPs) synthesised from
Pterocarpus santalinus bark extract were used in the treatment against induced hepatitis. DGalactosamine
was given to male Wistar strain rats to induce hepatitis similar to viral
hepatitis inflammations. The hepatic serum markers, Alanine aminotransferase and Aspartate
aminotransferase were examined during the hepatitis conditions. The results obtained
indicated that the Alanine aminotransferase and Aspartate aminotransferase enzyme levels
were significantly reduced after the treatment with PTNPs. The hepatoprotective activity
demonstrated from PTNPs would find application in alternate therapeutics in the treatment of
hepatitis

Dabigatran is an oral anticoagulant drug requiring rapid onset of action to exert desired pharmacological effect. It is a lipophilic (BCS Class-II) with little/no aqueous solubility, its absorption is dissolution rate limited. Increase in solubility of the drug is required to get rapid action. It has the half life of 14 hours and bioavailability in the body is 65% due to first pass metabolism. The purpose of this investigation is to develop fast dissolvimg tablet of Dabigatran to improve oral bioavailability for its immediate action for the treatment of stroke prevention in atrial fibrillation, the fast dissolving tablet was formulated by wet granulation technique using hydrophilic carrier like PEG-400 as solubilizer and POLYPLASDONE XL-10 and PRIMELLOSE used as super-disintegrant. The pre and post compression parameters were evaluated. From the dissolution profile it was concluded the tablet prepared by wet granulation technique, the formulationF6 containing 4% of PEG 4000 and 7.5% PRIMELLOSE showed 85.46% drug release due to its increase in porosity and wettability. From the DSC and FTIR study it was concluded that there was no possible drug and polymer interactions.