Primary Jejunal Intussusception in Pregnancy: Clinical Challenges in Management

Intussusception is a common cause of abdominal pain in paediatric age group but infrequent in adults. We reported a 29-year-old lady, Gravida 2 para 1 with no known medical illness presented to the hospital at 35 weeks of gestations with complaint of abdominal pain and persistent nausea and vomiting. She had bilious vomiting more than 5 times a day which aggravated by food intake and epigastric pain. She also complained of had not passing flatus with no bowel opening 3 days prior to presentation. At presentation, she was dehydrated however not in shock and her vital signs were within normal range. Abdominal examination revealed mild tenderness over epigastric region without guarding. There was an evidence of electrolytes imbalance and kidney injury on her blood investigation. She was induced for labour due to lack of evidence of fetal signals. On day 2 post partum, she still complaining of persistent bilious vomiting, otherwise no abdominal pain. Radiologically, there is evidence to support a small bowel obstruction. An exploratory laparotomy was performed, intraoperatively noted presence of jejuno-jejunal intussusception closely related to duodenal-jejunal junction with 130cm of bowel involved in the intussusception were noted to be gangrene. Conclusion: Adult bowel intussusception is an uncommon and challenging condition for the surgeon. Intussusception in pregnancy is rare and difficult to diagnose. Preoperative diagnosis is usually missed or delayed. Abdominal CT is considered as the most sensitive imaging modality in the diagnosis of intussusception. However in pregnancy, the choice of imaging modality is ultrasonography

Analisis Risiko Manual Material Handling Metode SNI 9011 :2021 Pada Pekerjaan Pemuatan Kantong Pupuk

Pengangkatan beban secara manual (Manual Material Handling) adalah pekerjaan dengan risiko tinggi terhadap timbulnya keluhan Musculoskeletal disorders. Keluhan tersebut dirasakan oleh pekerja pemuatan kantong pupuk. Dari hasil survei GOTRAK berdasarkan SNI 9011:2021 diketahui bagian tubuh yang memiliki persentase keluhan paling tinggi yaitu pada bagian pinggul sebesar 60%. Berdasarkan uraian data tersebut terlihat bahwa keluhan MSDs pada pekerja cukup tinggi sehingga perlu dilakukan analisis manual material handling untuk mengetahui risiko pada pekerjaan pemuatan kantong pupuk. Untuk menindak lanjuti adanya keluhan pekerja melalui survei GOTRAK maka dilakukan analisis lanjutan menggunakan daftar periksa potensi bahaya ergonomi berdasarkan SNI 9011:2021 dan didapatkan hasil risiko berbahaya dengan nilai skor >7. Rekomendasi diusulkan berdasarkan hirarki pengendalian diantaranya dengan merubah postur dan posisi tubuh pekerja saat melakukan pengangkatan pupuk, pembuatan prosedur dan instruksi kerja, penggantian kantong pupuk, modifikasi conveyor existing, dan penggunaan APD yang tepat. Rekomendasi tersebut akan mengurangi potensi bahaya yang dialami oleh pekerja sehingga  tingkat risiko bahaya ergonomi pada pekerja pemuatan kantong pupuk juga akan menurun.   Kata Kunci: Ergonomi, GOTRAK, Low Back Pain, Manual Material Handlin

A knowledge-driven GIS modeling technique for groundwater potential mapping at the Upper Langat Basin, Malaysia.

The aim of this paper is to use a knowledge-driven expert-based geographical information system (GIS) model coupling with remote-sensing-derived parameters for groundwater potential mapping in an area of the Upper Langat Basin, Malaysia. In this study, nine groundwater storage controlling parameters that affect groundwater occurrences are derived from remotely sensed imagery, available maps, and associated databases. Those parameters are: lithology, slope, lineament, land use, soil, rainfall, drainage density, elevation, and geomorphology. Then the parameter layers were integrated and modeled using a knowledge-driven GIS of weighted linear combination. The weightage and score for each parameter and their classes are based on the Malaysian groundwater expert opinion survey. The predicted groundwater potential map was classified into four distinct zones based on the classification scheme designed by Department of Minerals and Geoscience Malaysia (JMG). The results showed that about 17% of the study area falls under low-potential zone, with 66% on moderate-potential zone, 15% with high-potential zone, and only 0.45% falls under very-high-potential zone. The results obtained in this study were validated with the groundwater borehole wells data compiled by the JMG and showed 76% of prediction accuracy. In addition statistical analysis indicated that hard rock dominant of the study area is controlled by secondary porosity such as distance from lineament and density of lineament. There are high correlations between area percentage of predicted groundwater potential zones and groundwater well yield. Results obtained from this study can be useful for future planning of groundwater exploration, planning and development by related agencies in Malaysia which provide a rapid method and reduce cost as well as less time consuming. The results may be also transferable to other areas of similar hydrological characteristics

LCsingle bondHRMS-based metabolomics on Acalypha indica with different altitude and antioxidant activity

Achalypha indica is a weed that has medicinal properties. This study aims to determine the metabolite profile and evaluate the antioxidant activity of A. indica from areas with different altitudes, Tuban (20 to 50 masl; TBN), Banyuwangi (60 to 90 masl; BB), Magetan (300 to 600 masl; MGT), and Malang (500 to 800 masl; MLG). The ethanol extract of A. indica was analyzed for total phenolics and antioxidant activity. Separation and identification of samples were carried out using liquid chromatography-high-resolution mass spectrometry (LCsingle bondHRMS), then classified by Principal Component Analysis (PCA). The total phenol value ranged from 6.83 to 10.67 mg GAE /g of dry powder, with an antioxidant IC50 of 86.09 to 118.96 µg/mL. LCsingle bondHRMS successfully identified 83 metabolites. PCA analysis was able to clearly distinguish each sample based on the altitude of the growing location with a total variance value reaching 82 % (PC-1: 57 %, and PC-2: 25 %). Heat map analysis that observes variations in metabolite composition in each sample shows an increase in the content of flavonoid compounds in the lowlands under certain geographical conditions. Therefore, the height of the growing location has a significant influence on the metabolite profile and antioxidant activity. These findings are very important for assessing the quality, safety, and efficacy of medicinal plant raw materials

Toxocariasis: a silent threat with a progressive public health impact

Background: Toxocariasis is a neglected parasitic zoonosis that afflicts millions of the pediatric and adolescent populations worldwide, especially in impoverished communities. This disease is caused by infection with the larvae of Toxocara canis and T. cati, the most ubiquitous intestinal nematode parasite in dogs and cats, respectively. In this article, recent advances in the epidemiology, clinical presentation, diagnosis and pharmacotherapies that have been used in the treatment of toxocariasis are reviewed. Main text: Over the past two decades, we have come far in our understanding of the biology and epidemiology of toxocariasis. However, lack of laboratory infrastructure in some countries, lack of uniform case definitions and limited surveillance infrastructure are some of the challenges that hindered the estimation of global disease burden. Toxocariasis encompasses four clinical forms: visceral, ocular, covert and neural. Incorrect or misdiagnosis of any of these disabling conditions can result in severe health consequences and considerable medical care spending. Fortunately, multiple diagnostic modalities are available, which if effectively used together with the administration of appropriate pharmacologic therapies, can minimize any unnecessary patient morbidity. Conclusions: Although progress has been made in the management of toxocariasis patients, there remains much work to be done. Implementation of new technologies and better understanding of the pathogenesis of toxocariasis can identify new diagnostic biomarkers, which may help in increasing diagnostic accuracy. Also, further clinical research breakthroughs are needed to develop better ways to effectively control and prevent this serious disease

Financial risk management strategy for broiler farmers in facing fluctuations in prices of feed and products

This study investigates financial risk management strategies for broiler chicken farmers, focusing on price fluctuations of feed and livestock products. We examined a 46,000-animal farming operation, analyzing aspects from cage preparation and chick reception to feed provision, environmental maintenance, and waste management. Marketing processes and results were also scrutinized. Primary data, including production costs (cage and feed preparation), livestock performance (efficiency indicators), management data, and potential waste income, were collected through observation and in-depth interviews. Marketing data, such as selling prices, trade chains, and profit/loss, were also gathered. We used quantitative descriptive analysis to identify cost patterns, production efficiency, and marketing outcomes. Using sensitivity analysis, the study reveals that fluctuations in feed costs and selling prices have a substantial impact on farm profitability, with feed price increases being the most critical determinant of financial outcomes. This underscores the importance of adaptive risk management strategies within broiler partnership models. Recommended risk management strategies include diversifying feed sources and improving feed efficiency. This study offers insights into effective strategies for broiler farmers to manage financial risks from price volatility, ultimately enhancing farm resilience

Search for Dark Matter and Supersymmetry with a Compressed Mass Spectrum in the Vector Boson Fusion Topology in Proton-Proton Collisions at root s=8 TeV

Peer reviewe