1 - 10 of 12,959 items :

  • Clinical Medicine x
Clear All


Introduction. The prevalence of obesity is increasing worldwide in high, low, and middle-income countries such as Indonesia. Obesity rate is higher in females in Indonesia. Obesity has important contribution in the occurrence of insulin resistance (IR) and type 2 diabetes mellitus. Several anthropometric measurements such as waist circumference (WC), body mass index (BMI), body mass (BM), total body fat percentage (Fat%) and visceral fat (VF) are related to IR. This study aimed to investigate which of those measurements could be used as a better predictor of IR in non-menopausal Indonesian adult females.

Methods. Total of 80 non-menopausal Indonesian adult females ranging from 21-40 years were recruited in this study. Insulin resistance was measured by using Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) equation. Subjects with HOMA-IR index >75th percentile with cut-off 2.74 were defined as IR. Waist circumference, BMI and BM were measured, while TF and VF were measured by bioelectrical impedance analysis (BIA).

Results. HOMA-IR had significant correlation with WC (r = 0.563, p<0.001), BMI (r = 0.537, p<0.001), BM (r = 0.515, p<0.001), VF (r = 0.515, p<0.001), Fat% (r = 0.490, p<0.001). The area under curve of VF (0.809), BMI (0.807), WC (0.805), and BM (0.799) are slightly larger than and Fat% (0.766).

Conclusion. Insulin resistance had strong correlation with all anthropometric measurements, but the correlation was less significant with Fat%.


Sufficient caloric intake is important to maintain the balanced health status, especially during the period of aging, as aging and sickness share paths. Maintaining adequate nutritional balance is the best preventive measure to counteract the risk of malnutrition. There are several causes for malnutrition in elderly people, and some techniques such as anthropometric measurements, laboratory and clinical parameters could help to diagnose malnutrition in these patients. The use of a simple validated questionnaire called the ‘Mini Nutritional Assessment’ measures the nutritional status of elderly patients. In this review, we discuss about the malnutrition in elderly people with and without a known cause and we present some of nutritional intervention. There are promising strategies that help overcoming malnutrition.


Introduction. Studies regarding antibiotics administration during pregnancy and atopic dermatitis (AD) in children are only few. In this context, the objective of our study was to investigate the potential association between the timing of intrauterine exposure to antibiotics or prenatal antibiotic administration in general and AD occurrence in children.

Methods. This was a cross-sectional study in 1046 subjects. The exposure to antibiotics during pregnancy was initially evaluated using simple logistic regressions. Then, each period of antibiotics administration was adjusted with the other periods of antibiotics exposure (model 1) and with the other variables associated with AD in our database (model 2).

Results. In simple logistic regression analysis, the administration of antibiotics during pregnancy, as a whole period, presented a trend of association with AD (OR = 1.28, %CI: 0.99 – 1.65). When we analyzed antibiotic administration during each trimester of pregnancy, only antibiotherapy during the 3rd trimester was associated with AD (OR = 2.94, %CI: 1.21 – 7.12). After adjusting with all the other important risk factors associated with AD in the database, antibiotics administration during the 3rd trimester of pregnancy was still independently associated with AD (OR=2.64, %CI: 1.01 – 6.91).

Conclusion. Antibiotic administration during the 3rd trimester of pregnancy was independently associated with AD in children.


In recent years there has been an increase in the incidence of acute pancreatitis worldwide. In spite of efforts to improve the treatment and care of patients with acute pancreatitis, to develop imaging investigations and interventional diagnostic and treatment techniques and to facilitate patients’ access to them, acute pancreatitis continues to be associated with significant mortality and morbidity, and the treatment of patients suffering from this disease entails significant costs for healthcare systems.

Researchers are in a permanent quest to get to a global consensus for stratifying the severity of acute pancreatitis. We need this in order to offer the proper management for each patient diagnosed with this condition and to improve hospital and health system strategies.

Over the years, it has been attempted to develop algorithms to support a swift assessment of patients with acute pancreatitis with a prediction of disease severity as close to reality as possible for optimal management. This has led to the development of classifications of severity and severity scores. These require a permanent updating to keep up with the technical and technological developments involved in investigating and treating the patient and encompassing the most recent studies.

The goal of this paper is to go through these classifications and scores, emphasizing factors that should be taken into account, and reflecting upon their utility and upon the necessity of improving them.


The discovery of an adaptive immune system especially in archae and bacteria, CRISPR/Cas has revolutionized the field of agriculture and served as a potential gene editing tool, producing great excitement to the molecular scientists for the improved genetic manipulations. CRISPR/Cas9 is a RNA guided endonuclease which is popular among its predecessors ZFN and TALEN’s. The utilities of CRISPR from its predecessors is the use of short RNA fragments to locate target and breaking the double strands which avoids the need of protein engineering, thus allowing time efficiency measure for gene editing. It is a simple, flexible and highly efficient programmable DNA cleavage system that can be modified for widespread applications like knocking out the genes, controlling transcription, modifying epigenomes, controlling genome-wide screens, modifying genes for disease and stress tolerance and imaging chromosomes. However, gene cargo delivery system, off target cutting and issues on the safety of living organisms imposes major challenge to this system. Several attempts have been done to rectify these challenges; using sgRNA design software, cas9 nickases and other mutants. Thus, further addressing these challenges may open the avenue for CRISPR/cas9 for addressing the agriculture related problems.


A field experiment was carried out in sub-tropical climate of Bhimdattanagar, Kanchanpur to assess the effect of site specific nutrient management approach in productivity of spring rice. The experiment was carried in single factor randomized completely block design with four replication, in four different farmer’s field, each farmers’ field as single replication. The seedlings were grown in the mat nursery bed and transplanted in the experimental plots with different nutrient management practices. Nutrient management practices were Site Specific Nutrient Management with Nutrient Expert dose (SSNMNE)(109:28:38 kg NPK/ha), Government recommendation dose (100:30:30kg NPK/ha +6 ton FYM), Farmer’s field practice (FFP)(different among farmers) with three omission plots viz. omission of Nitrogen (0:28:38 kg NPK/ha), Omission of Phosphorus (109:0:38 kg NPK/ha) and Omission of Potassium (109:28:0 kg NPK/ha). SSNM-NE dose was obtained by household survey in the respective area and using nutrient expert model. The growth parameters, yield, yield attributing traits and total cost of production were recorded. Data were analyzed using Duncan’s Multiple Range Test (DMRT) in Genstat. Result indicates that the highest grain yield (5.81 t/ha) was obtained from SSNM-NE which was statistically at par with government recommendation (5.54 t/ha). Similarly, thousand grains weight, straw yield in the experiment 23.20g, 6.90t/ha were significantly higher in SSNM-NE respectively. Straw yield, grain yield and thousand grain weight of SSNM-NE were found to be statistically at par with government recommendation. The economic analysis revealed that higher B: C ratio (1.91), net return and gross return were higher in SSNM-NE.


The aim of the present study was to investigate the relation of technology, organizational culture and emotional intelligence with knowledge management using the mediators of organizational structure and empowerment. The methodology of the research was descriptive-correlational and the population of the study consisted of all the physical education instructors of Zanjan universities with three-year teaching record (61 people). The population size using the census sample criterion. Research tool included Stankosky and Baldanza’s technology, organizational culture and structure, Bar-On’s emotional intelligence inventory, Spreitzer and Mishra’s empowerment, Kordnaij et al. and Newman and Conrad’s knowledge management framework questionnaires. The structural equation modelling was used via Smart PLS 2 software for analyzing the data. The results showed that there is a negative and significant relation between technology and knowledge management. Also, there is significant relation between organizational culture and knowledge management, emotional intelligence and knowledge management, technology and organizational structure, organizational culture and organizational structure, technology and empowerment, organizational culture and empowerment, organizational structure and empowerment and empowerment and knowledge management; while the significance of relations between organizational structure and knowledge management and emotional intelligence and empowerment were not confirmed. The results of the present study can help the people in charge of education and research in the universities in order to produce, keep and use the needed knowledge related to proper time and place by making decisions and educating people.


Background.Early intervention for septic shock is crucial to reduce mortality and improve outcome. There is still a great debate over the exact time of therapeutic plasma exchange (TPE) administration in septic shock patients. This study aims to investigate the effect of early initiation (within 4 hours) of TPE in severe septic shock on hemodynamics & outcome.

Methods. We conducted a prospective, before-after case series study on 16 septic shock patients requiring high doses of vasopressors admitted in two ICUs from Cairo, Egypt. All of our patients received TPE within 4 hours of ICU admission. The fresh frozen plasma exchange volume = 1.5 × plasma volume.

Results. In the 16 patients included in the study, mean arterial pressure was significantly improved after the initial TPE (p < 0.002) and norepinephrine dose which significantly reduced post TPE (p < 0.001). In addition, norepinephrine dose to mean arterial pressure significantly improved (p < 0.001). There was reduction of a net 6 hours fluid balances following the first TPE were observed in all the patients (p < 0.03) by a mean of 757 ml. Systemic vascular resistance index was markedly improved post-TPE along with statistically improved cardiac index (p < 0.01). Stroke volume variance was also significantly decreased after the TPE sessions (p < 0.01). C-reactive protein significantly improved after TPE (P < 0.01).

Conclusion. Early initiation of TPE in severe septic shock patients might improve hemodynamic measures.


Physical activity can contribute to societal health and prevent antisocial behaviors. This study explored the driving forces facilitating these goals in Iran’s socio-cultural context. Through a literature review, investigation of available political documents, interviews with experts and consensus of the research team, seventy-three driving forces were explored from different domains and then categorised via the STEEPV framework. This framework considers drivers from Social, Technological, Environmental, Economic, Political, and Value/Cultural dimensions. The “sport/sport sciences” domain was also considered as an additional domain. In the next step, a questionnaire with an answer scale of 1 to 7 was distributed among experts. The fuzzy Delphi method was used to analyse the collected data. Results showed eighteen drivers from five domains (social, environmental, economic, technological and sport/sports sciences) dramatically influenced leisure time physical activity (LTPA) in Iran. “Physical activity opportunities for vulnerable groups” was identified as the most important driver for participation in LTPA. Results suggest the need for a multidimensional and thorough consideration by organisations, leisure managers and policymakers to discover methods to promote health-related physical activities in the future.