Objectives:To assess knowledge and practice levels in asymptomatic hyperuricemia (AH) and investigate predictors of urate-lowering therapy (ULT) misprescribing among primary health care (PHC) physicians.Methods:A cross-sectional study was conducted among 201 PHC physicians from December 2017 to May 2018. A based clinical guidelines for hyperuricemia management from American Professional Organizations, a semi-structured questionnaire was administered to collect demographic and professional data; knowledge and practice levels in management of AH; and barriers to the management of hyperuricemia and gout, with focus of the misprescribing of ULT in AH. A 2-stage stratified sampling technique was used to select 4 PHC centers were from each of the 5 advisory sectors in Jeddah, Kingdom of Saudi Arabia; and to recruit a minimum of 10 eligible participants per primary health care center (PHCC). Binary logistic regression was used to analyze predictors of ULT misuse in AH.Results:Only 32.8% participating physicians had adequate knowledge about AH. Regarding practice, while majority (88.1%) correctly recommended a low-purine diet and lifestyle changes to patients, almost half misprescribed ULT and 10.9% misprescribed non-steroid anti-inflammatory drugs. Lack of knowledge and awareness about guidelines were the most frequently self-reported barriers to adequate practice. Predictors of ULT misuse included the percentage of patients having gout (1-10%: OR=5.40, p=0.047) or receiving ULT (>10-20%: OR=20.02, p=0.001)among patients seen in clinic, attendance of rheumatology conferences (OR=2.55, p=0.017), and having a close relative with hyperuricemia or gout (OR=2.45, p=0.026).Conclusion:There are inadequate levels of knowledge regarding AH among Saudi PHC physicians increasing risk of malpractice including misprescription of ULT and anti-inflammatory medications.

Agricultural service providers (Agric. SPs) play an essential role in the adoption of promising agricultural technologies by small and medium-sized farms. Similarly, agricultural service provision also generates substantial income for them. The study highlights the role of Agric. SPs in promotion of moisture conservation; soil health and fertility improving technologies at specific sites in Pakistan for three years i.e. from 2015 to 2017. It is based on primary data collected in the year 2018-19 from eighty sampled farmers, which were purposively selected to cover a range of selected technologies. It is found that Agric. SPs-induced adoption of these technologies has increased over time. They achieved considerable success in the promotion of the use of gypsum for moisture conservation and fertilizer placement drill in Pothwar-Punjab, ridge planting of crops in irrigated province Punjab, laser land leveling in irrigated areas of Sindh province, and use of biozote for improving soil fertility in both irrigated and rain-fed areas of Punjab province. These technologies have good income generation potential for Agric. SPs. The article also highlights factors hindering the large-scale adoption of the technologies in the country. Technical and entrepreneurship capacity building of the Agric. SPs in the provision of services to farmers in multiple technologies, and technical feasibility assessment of few technologies to use these for more than one crop are suggested for large-scale adoption of these technologies.

The most common malignancy of testis is seminoma with prognosis that is not always

Background: Bladder cancer, particularly urothelial carcinoma, is prevalent in male and ≥55 years old population. Grade of the bladder tumor affects clinical characteristics, management, and prognosis of the patient. This study aimed to analyze the association between age and histopathological grade of bladder urothelial carcinoma. Methods: This cross-sectional analytical study was approved by the Ethical Clearance Committee of Dr. Hasan Sadikin General Hospital, involving 241 medical records of bladder urothelial carcinoma patients in the Department of Anatomical Pathology at Dr. Hasan Sadikin General Hospital during 2009-2013. Chisquare test was applied to 45 patients with complete record of histopathological grade. Results: Most of the subjects were 65 years old. Male patients were the most frequent. The proportion of low-grade carcinoma in <65 years old age group was only 39.1%, while in ≥65 years old age group was 72.7%. The proportion of high-grade carcinoma in <65 years old age group reached 60.9%, which was 27.3% higher than in ≥65 years old age group. Chi-square test result showed a statistically significant difference between histopathological grade of urothelial carcinoma in <65 years and ≥65 years age groups (p=0.023). Conclusions: Proportion of high-grade and low-grade urothelial carcinoma between <65 years and ≥65 years age groups are statistically different; therefore, an association between age and histopathological grade of bladder urothelial carcinoma is shown.

AbstrakKeganasan terbanyak ketiga di dunia pada organ kolorektal adalah karsinoma yang berasal dari lapisan epitel mukosa. Modalitas yang digunakan untuk terapi karsinoma kolorektal stadium lanjut selain operasi adalah kemoterapi dan saat ini dikembangkan terapi target sebagai alternatif terapi, yaitu metabolit aktif vitamin D, calcitriol. Calcitriol bekerja sinergis dengan agen kemoterapi yang aktivitasnya dimediasi oleh vitamin D reseptor (VDR). Penelitian ini bertujuan mengetahui korelasi imunoekspresi VDR dengan stadium dan derajat diferensiasi Colorectal carcinoma (CRC) is a malignancy from mucosal epithelium of the colon/rectum. The treatment modalities used for advance stage colorectal carcinoma therapy is chemotherapy, in addition to surgery. Targeted therapy is currently being developed as an alternative therapy. One of the agents used in this therapy is calcitriol. Calcitriol is an active metabolite of vitamin D. Calcitriol works synergistically with chemotherapeutic agents and its activity is mediated by the vitamin D receptor (VDR). VDR plays a role in the inhibition of tumor progression via induction of cellular differentiation and proliferation inhibition. In this study, imunoexpression of vitamin D receptor was examined in conjunction with the staging and degree of differentiation (grading) of colorectal adenocarcinoma. The study objects include 35 colorectal adenocarcinoma paraffin blocks created from colectomy which were collected at the Department of Patology Anatomic of Dr. Hasan Sadikin General Hospital Bandung from January 2009-June 2014. The blocks were divided into three groups of staging (I, II, and III) and three groups of grading: well, moderately, and poorly differentiated. Immunostaining was used to evaluate the VDR immunoexspression by histo-score. The data were tested using rank spearman test. There was a weak negative correlation between VDR imunoexpression and staging(p=0.045, R=-0.341), and a moderate positive correlation between VDR imunoexpression and grading (p=0.000, R=0.558). It is concluded that a significant correlation of VDR imunoexpression with staging and grading of colorectal adenocarcinoma is found and this finding can be used as a reference for further studies in the development of targeted therapies. [MKB. 2016;48(2):123-8]

Sepsis causes damage for cells, behavioral phenotype regression, and will end in most patients' death. The ethanol extract of cogongrass (Imperata cylindrica L.)  acts as an antioxidant. This study aimed to observe the effect of giving ECGR to body weight (BW) and the sepsis score of the sepsis mice model by lipopolysaccharide (LPS) induction. This study was an in vivo study with a randomized post-test controlled group design at the animal laboratory of Universitas Padjadjaran, 2018. We used 4 (four) groups of male mice (Mus musculus) DDY strains. Group 1 as a control, group 2: LPS 10 μL/kgBW, group 3, and 4: LPS+ECGR (90 mg/kgBW, and a dose of 115 mg/kgBW, respectively). This treatment was performed for two weeks. Every three days, we measured their body weight. After two weeks, group 2, group 3, and 4 were injected with LPS for 8 hours to induce sepsis. Next, we measured body weight and sepsis score using murine sepsis score (MSS). Then statistical analysis was performed using ANOVA and the Kruskal-Wallis test. The results showed no differences in body weight were found in the treatment groups (3 and 4) compared with control, suggesting no effect of ECGR in decreasing mice body weight. The sepsis score was more than 21 in groups treated with LPS (2, 3, and 4), suggesting LPS can induce sepsis. There was a slight decrease in scores in-group 3 and 4 compared with group 2. This study concludes that the treatment of ECGR caused no harm to body weight and slightly decreased sepsis score in the sepsis mice model. EKSTRAK ETANOL ALANG-ALANG (IMPERATA CYLINDRICA L.) TERHADAP BERAT BADAN DAN SKOR SEPSIS MENCIT MODEL SEPSISSepsis menyebabkan kerusakan sel, regresi fenotipe perilaku, dan akan berakhir kematian pada sebagian besar pasien. Ekstrak etanol akar alang-alang (Imperata cylindrica L.) (ECGR) berperan sebagai antioksidan. Penelitian ini bertujuan mengetahui pengaruh pemberian ECGR terhadap berat badan (BB) dan skor sepsis pada mencit model sepsis yang diinduksi lipopolisakarida (LPS). Penelitian ini adalah penelitian in vivo dengan desain randomized post-test controlled group di laboratoium hewan Universitas Padjadjaran tahun 2018. Kami menggunakan 4 (empat) kelompok mencit jantan (Mus musculus) strain DDY. Kelompok 1 sebagai kontrol, kelompok 2 diinduksi LPS 10 μL/kgBB, kelompok 3 dan 4 diinduksi LPS + ECGR (dosis 90 mg/kgBB dan 115 mg/kgBB masing-masing). Perlakuan ini dilakukan selama 2 minggu. Setiap tiga hari dilakukan pengukuran berat badan mencit. Setelah dua minggu, kelompok 2, kelompok 3, dan kelompok 4 diinjeksi LPS selama 8 jam untuk menginduksi sepsis. Selanjutnya, diukur berat badan dan skor sepsis menggunakan murine sepsis score (MSS). Analisis statistik menggunakan ANOVA dan Uji Kruskal-Wallis. Hasil penelitian menunjukkan tidak terdapat perbedaan berat badan pada kelompok perlakuan (3 dan 4) dibanding dengan kelompok kontrol yang menunjukkan ECGR tidak berpengaruh dalam menurunkan berat badan mencit. Skor sepsis lebih dari 21 pada kelompok yang diinduksi LPS (2, 3, dan 4) menunjukkan LPS dapat menyebabkan sepsis. Terdapat sedikit penurunan skor pada kelompok 3 dan 4 dibanding dengan kelompok 2. Simpulan penelitian ini, pengobatan ECGR tidak membahayakan berat badan dan mengakibatkan sedikit penurunan skor sepsis pada mencit model sepsis.

Based on data Riset Kesehatan Dasar (Riskesdas) in 2007, the people who had no or low physical activity reached 48.2 %. This condition contributes to increase number of metabolic disease cases such as: hypertension, heart disease, stroke and diabetes mellitus. Optimizing training approach especially aerobic type helps to counter metabolic diseases. Unfortunately, benefits of resistance training (RT) is less understood. RT improves muscle strength, induce muscle hypertrophy, improvement of local muscular performance, and also help to strenghtening body balance and coordination. There is interplay between training and hormone in muscle adaptation during resistance training. Hormone plays an important role in the regeneration of muscle after resistance training. The changes of hormone level cause hypertrophy. Regeneration and muscle hypertrophy are mediated by activation, proliferation and differentiation of satellite cells. It is regulated by mitotic and myogenic activity, namely insulin-like growth factor-1 (IGF-1), which serves as a paracrine or autocrine. Better understanding of homeostasis hormone during training in skeletal muscle and its ultimate purpose to counter metabolic disease will lead us to better treatment approach for the patient.

Abstract. Nurse work stress is a human resource management issue in hospitals that is caused by a combination of stress at work, individual characteristics, and stressors outside the organization. Organizational factors and role conflicts have a major effect on work stress for nurses in the Emergency Room (ER). The objective of this study was to investigate at the link between job stress and the characteristics of nurses working in the emergency room (ER). This study employs an observational analytic method with a cross-sectional design. This study was conducted in the Emergency Room between January and July of 2022, using a large sample of 50 participants drawn utilizing non-probability sampling and purposive sampling. The results showed that the nurses in the Emergency Department had the highest stress level, with 23 persons (46%). The majority of nurses were female, with a total of 36 people (72%), the most age was in the 26-30 years group with a total of 15 people (30%), and the most education level was DIII nursing with a total of 26 people (52%), the majority of marriages were married with a total of 35 people (70%), and most had a working period of 4-6 years with a total of 23 respondents (46%). There is no significant relationship between job stress and nurse characteristics (p> 0.05). Work stress on nurses working in the hospital emergency room Health standards are relatively high, but several factors, including age, gender, education level, marital status, and duration of employment, cause significant levels of stress. Abstrak. Stress kerja perawat adalah salah satu masalah manajemen sumber daya manusia di Rumah Sakit yang merupakan kombinasi dari stress saat kerja, karakteristik individu, dan penyebab stres di luar organisasi. Stres kerja perawat di Instalasi Gawat Darurat (IGD) sangat dipengaruhi oleh kondisi organisasi dan konflik peran. Tujuan penelitian ini adalah untuk menganalisis hubungan antara stres kerja dengan karakteristik perawat di Instalasi Gawat Darurat (IGD). Penelitian ini adalah observational analitik dengan pendekatan Cross-Sectional design. Penelitian ini dilakukan pada bulan Januari – Juli 2022 di bagian IGD besar sampel penelitian menggunakan rumus Slovin yaitu sebanyak 50 orang yang diambil mengunakan non probability sampling dengan purposive sampling. Hasil penelitian menunjukkan bahwa tingkat stres perawat di bagian Instalasi Gawat Darurat paling tinggi mengalami stres berat yaitu 23 orang (46%). Karakteristik perawat menunjukkan mayoritas perawat berjenis kelamin perempuan sebanyak 36 orang (72%), usia terbanyak pada kelompok 26-30 tahun dengan jumlah 15 orang (30%), tingkat pendidikan paling banyak adalah DIII keperawatan dengan jumlah 26 orang (52%), status pernikahan terbanyak adalah menikah dengan jumlah 35 orang (70%), dan sebagian besar mempunyai masa kerja 4-6 tahun dengan jumlah 23 responden (46%). Tidak terdapat hubungan yang signifikan antara tingkat stress kerja dengan karakteristik perawat (p > 0.05). Stres kerja pada perawat yang bekerja di IGD RS. Harapan Sehat Slawi cukup tinggi, namun banyak faktor yang menyebabkan tingginya tingkat stress, tidak hanya faktor usia, jenis kelamin, tingkat pendidikan, status pernikahan, dan lama bekerja.