Proposed Business Strategy for PT Aneka Tambang TBK for Market Development in Order to Increase Export of Ferronickel

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PT Aneka Tambang (ANTAM) Tbk is part of the SOE’s Holding Mining Industry which vertically integrated, export-oriented, diversified mining and metals company. ANTAM has two big commodities which are gold sectors and nickel sectors. Nickel based products consist of Nickel Ore, Ferronickel, Bauxite, and Alumina. Ferronickel is a high-grade product of nickel downstream which contains 20% – 25% of nickel and mostly consumed by stainless steel companies. ANTAM is the only company in Indonesia that can produce Ferronickel. In the nickel market, many companies produce the substitute product of Ferronickel which is Nickel Pig Iron (NPI). Ferronickel and NPI are serving the same market while NPI itself contain lower of nickel and cheaper than Ferronickel. Government of Indonesia supported the development of downstream industries in Indonesia. The growth of battery industries is escalating resulted high demand for it. Technology is currently improving the process to transform Ferronickel and NPI into Nickel Mattes (Ni Mattes) which used to be an intermediate component to produce electric vehicles (EV). Based on the demand of global market, there are many demands for Ferronickel supplies in the worldwide. However, the capacity exports of Ferronickel in ANTAM are still far behind. This study analyzes business problems using several tools to identify the external environment and internal environment of ANTAM. SWOT analysis is used to capture the strength, weakness, opportunity, and threat that affects the business of the company. The Root Cause Analysis is used to define problems that happened in ANTAM and needed to be solved. Data and information were obtained from various sources such as interviews with the internal of ANTAM, observation, and study from the literature. The study found that ANTAM has lower export sales caused by the limited market scope, lack of promotion, and no product development. To overcome the problems that faced by ANTAM, the author proposes a business strategy for ANTAM for market development to increase export of Ferronickel by using the Strategy Diamond Framework and Ansoff Matrix as the strategy that will be implemented in ANTAM. The stages in this strategy were concerned more with the issues and provide solutions to increase the export of Ferronickel. Therefore, ANTAM should focus on market development to reach the widen market and fulfill the demand of Ferronickel in the global market.

The Effect of Fermentation Time on Product Quality of Cowpea (Vigna unguiculata L.Walp) Soft Cheese with Starter Culture of Lactobacillus plantarum B1765

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This research was conducted to determine the effect of fermentation time on lactic acid bacteria (LAB), pH, total titrated acid (TTA) and organoleptic (taste, flavor, color and texture) of cowpea soft cheese (Vigna unguiculata L.Walp) with starter culture Lactobacillus plantarum B1765. L.plantarum B1765 had been studied has a probiotic characteristics.   The fermentation time was 0, 6, 18 and 24 hours. The methods were total plate count (TPC) to measure the number of LAB, pH meter to measure pH, acid-base titration to measure TTA, and hedonic test for organoleptic. The results showed that the fermentation time affected the number of LAB, pH, TTA and organoleptic. The number of LAB increased by 3 log cycles from 8.7 x 106 CFU/mL to 5,3 x 109 CFU/mL. The pH value decreased from 6.53 to 3.69. The TTA value increased from 0.45% to 1.79%. The highest level of preference for taste, texture, color and flavor was at 18 hours of fermentation with a value of 3.17; 2.77; 2.70; 2.97 (likes). Cowpea soft cheese with starter L.plantarum B1765  could be improve potentially  as vegetable cheese and  probiotic agent.

 

Processes and Practices Improvement of Sample Receiving Counter at Government Clinical Laboratory in Sri Lanka

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Improving efficiency of a clinical laboratory service should be a first priority in healthcare development of any country. It plays a significant role as it facilitates diagnosing and treating diseases and finally to discharge the patients faster. Therefore, the reliability and the accuracy of a clinical laboratory should be guaranteed through a sound sample management. The aim of this study was to improve the process and practices of sample management at a sample receiving counter of a selected government clinical laboratory in Sri Lanka.

The study was an institution based interventional project. The research adopted mixed methods including a desk review, a checklist, focus group discussions and a staff satisfaction survey which was conducted among Medical Laboratory Technologists.  Proportions, percentages and means were calculated for quantitative data and narrative analysis was done for the analysis of qualitative data.

The results indicated that the incidences of missing samples and request forms and sample handling time have been significantly reduced at post intervention. Performance of the routine counter activities including proper documentation, updating the notice boards, monitoring temperatures of sample storing refrigerators and consideration of rejection criteria in accepting the samples were significantly improved after the intervention. Staff satisfaction on overall sample handling process and practices was significantly improved after the intervention except the current practice of sample data management and facility availability to carry out duties. The study recommends modifying the counter layout with adequate expansion. It also recognized the necessity of implementing a Laboratory Information Management System for whole laboratory operation.

Histological Changes in the Lung Tissue in Association with COVID-19: Review Article

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Background: It has been shown that SARS-CoV-2 is a multi-systemic virus and can affect number of body systems including the respiratory tract, the gastro-intestinal tract, the liver, the kidney and the nervous system. Despite the high mortality rate, there is little literature on postmortem findings of this unique virus, perhaps due to its highly contagious nature, inadequate information on prevention, and a lack of robust infrastructure for appropriate management of infected cases at various centers throughout the world.

Aim of the study: The aim of the current study was to review and list the main histological changes seen in patients died because of COVID-19.

Methods: A systemic search was carried out including Google Scholar, PubMed, and MEDLINE and the Google search Engine in order to scan all available published articles dealing with histological changes affection the lung in patients with documented COVID-19. The following key words were used to accomplish the search mission: COVID-19, SARS-CoV-2, Lung Histology, Pulmonary Histology, Histopathology. The search was limited to articles written in English language. Any article published between the end of 2019 and the time of initiating the current work was reviewed. The information in the current review is totally based on reviewed articles that are mentioned in the section of references.

Results: The main sources of lung tissues were Whole lung biopsy, Postmortem study, Core needle biopsy and Ultrasound based samples from autopsy. The exudative changes include injury to pneumocytes, congestion of capillaries, giant cell formations, dilation of alveolar ducts, thickening of capillaries, edema of interstitium and formation of hyaline membrane. The proliferative changes include hyperplasia of Type-2 pneumocytes with some reactive atypia with proliferation of myofibroblastic cells leading to granulation tissue formation, thickening of alveolar wall accumulation of alveolar macrophages, interstitial thickening which harbors collections of proliferating fibroblasts together with foci of hemorrhage and lymphocytic infiltration.

Conclusion: The main histopathological changes in lung of patients with COVID-19 can be grouped into three main phases, exudative, proliferative and fibrotic phases in addition to changes involving vascular tissues, bronchi and bronchioles and the main changes are the diffuse alveolar damage seen in exudative and proliferative phases.

Assessment of Nurses’ Knowledge Regarding Management of Patient’s with Cholelithiasis Disease

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Cholelithiasis affects approximately 15% of the US population. Rising trends in obesity and metabolic syndrome have contributed to an increase in diagnosis of cholelithiasis. There are several risk factors for cholelithiasis, both modifiable and non modifiable. Women are more likely to experience cholelithiasis than are men. Pregnancy, increasing parity, and obesity during pregnancy further increase the risk that a woman will develop cholelithiasis. The classic presentation of persons experiencing cholelithiasis, specifically when gallstones obstruct the common bile duct, is right upper quadrant pain of the abdomen that is often elicited upon palpation during physical examination and documented as a positive Murphy’s sign Descriptive Cross-Sectional Design is adopted in the current study to achieve the early stated objectives. The study started from January   2nd, 2021 until May, 20th, 2021.  A Non-Probability (Convenience Sample) of (60) nurses were including in the present study. Sample collect from 1, 3,4) and emergency department The results of the present study indicated that the majority of the samples (93.33%) have deficit knowledge, which agree with the results of the study showed that the reasons for lack of nurses’ knowledge regarding from the researchers’ point of view “might be related to lack of continuing educational programs or sessions about Cholelithiasis, supervision, continuous evaluation of nurses’ practice, and cooperation between multidisciplinary health care team members (nurses-physicians). Conclusions according to the present study findings, the researcher can mention the following conclusions:Most of nurses in medical units had knowledge deficit concerning management of cholelithiasis nursing management. It is found that the most of nurses are middle age group within (35-39) years old. It is concludes that the most of nurses are institute and college graduated, most of the nurses years’ experience in medical wards(1-10 years). most of the sample have participating in the sessions training in medical wards  but no related to cholelithiasis nursing management. Encouraging nurses to update their information by participating in training sessions and conference inside and outside Iraq to improve their knowledge regarding cholelithiasis nursing management which working in medical wards.

Principal’s Leadership Style Based on Path-Goal Theory: A Literature Review

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The importance of the principal’s leadership style based on the Path-Goal Theory is interesting to study, and this paper examines the principal’s leadership style based on the Path-Goal Theory in achieving educational goals in schools. There are several articles on reviews of leadership styles based on Path-Goal Theory that can be found. This review aims to find out the principal’s leadership style based on path-goal theory in achieving educational goals in schools. Based on the literature review results, we found a significant relationship between the principal’s leadership style based on Path-Goal Theory in achieving educational goals in schools, which could be seen from the increase in teacher performance and teacher job satisfaction in school administration staff. The article review results showed a significant correlation between the principal’s leadership style based on the directive, supportive, participatory, and achievement-oriented leadership style on the level of performance and job satisfaction of teachers and administrative staff in schools. This is not underestimated from the influence of the principal’s leadership style based on PathGoal Theory in directing and motivating his followers in achieving educational goals at school.

Current Aspects of Xenotransplantation in Human

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Xenotransplantation is an approach which will be able to support the increasing demand of organ donation since the organ does not need to come from humans. Up till now, xenotransplantation is still barely performed since its risk and chance of success are still not proven to be safe. One of the biggest obstacles is rejection which may lead to xenograft failure and can occur in certain types and from certain causes. However, the risk of rejection can be minimized by the process of genetic engineering and applying anti-rejection drugs in which scientists and researchers are developing so that the procedure becomes safer in the future. Although the patient who was considered as the first successful xenotransplantation in human case had died a few months after the surgery and the cause of death still remains unsolved, the field of xenotransplantation still keeps developing by researchers, medical universities, and biotechnology companies since they all agree that xenotransplantation will produce lots of advantages and will be a big step of the medical treatment field. Despite the fact that xenotransplantation is a procedure that is risky and raises public concerns and ethical issues, the procedure is still believed to give more benefits towards the patient and medical development since serious problems like organ shortage and high number of deaths on the waiting list will be solved.

Role of Aminotransferase in Patients of Type 2 Diabetes Mellitus

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Introduction: Diabetes mellitus is a heterogeneous group of disorders characterized by persistent hyperglycemia with carbohydrate, lipid, and protein metabolism resulting from defects in insulin secretion and/or insulin action.

Objectives: The main objective of the study is to find the role of aminotransferase in patients of type 2 diabetes mellitus. Methodology of the study: This cross sectional study was conducted in BVH, Bahawalpur during 2021. The data was collected from 100 patients of both genders. Patients whose fasting plasma glucose (FPG) ≥126 mg/dl on 2 occasion were included in the study. Patients with any concomitant diseases which can alter liver function and patient with hepatitis, alcoholic and taking any medicine were excluded from the study.

Results: The data was collected from 100 patients with a mean age of 53.72 ± 9.82 years old and mean duration of disease of 7.41 ± 6.01 years were included in the final analysis. There were no significant difference in the levels of Fas, AST, Cl, K, Ca, BUN, creatinine and uric acid in type II diabetics compared to the non-diabetic healthy control group.

Conclusion: Serum alanine aminotransferases are frequently high in patients of type 2 diabetes mellitus. However, there was no association with gender, body mass index, or duration of diabetes.

Surgical Treatment of Gallstones in Patients Undergoing Gastric Bypass Surgery as a Treatment of Obesity

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Introduction: Sustained weight loss after gastric bypass is achieved by a combination of gastric restriction and a variable degree of malabsortion and has therefore a greater risk for gallstone development than purely restrictive procedures like adjustable gastric banding.

Objectives: The main objective of the study is to analyse the surgical treatment of gallstones in patients undergoing gastric bypass surgery as a treatment of obesity.

Material and methods: This randomized control trial was conducted in Jinnah Hospital, Lahore during 2021 to 2022. Patients who underwent bariatric surgery for obesity were included in the study. Those who had cholecystectomy before bariatric surgery, those who underwent concomitant cholecystectomy (CC) during bariatric surgery, those with concomittant gall stoness and those who did not attend their follow-up regularly were excluded from the study.

Results: The data was collected from 100 patients and we reviewed records from all patients treated for acute biliary pancreatitis. The average age was 36.43±9.52 years and, the ratio of women/men was 151 (81.6%)/34 (18.4%). Mean BMI was determined as 44.16±5.09. When comorbidities were evaluated, 116 (62.7%) patients had comorbidity, while 69 (37.3%) patients did not. Conclusion: It is concluded that prophylactic and selective management can be safely performed and the only significant difference with patients not submitted to concomitant cholecystectomy is mostly observed in operative times that are higher in those who do undergo cholecystectomy.

Analysis of Role of Turmeric in Management of Alveolar Osteitis

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Background and objective: Alveolar osteitis created disruption in healing process after clot foration but before wound organization. The main objective of the study is to analyse the role of turmeric in management of alveolar osteitis.

Material and methods: This descriptive cross sectional study was conducted in DHQ Sargodha during Nov 2019 to Jan 2020. This study was done with the permission of ethical committee of hospital. There were 180 participants in this study. Data was collected from two study groups, one was treated with turmeric and group B was treated with Zinc oxide eugenol (Alveogel).

Results: The data was collected from 180 patients, 90 patients in each group. Group A shows symtopms of pain, swelling and halitosis from second day while Group B shows all these symptoms around day 5th. According to t-test there was a significant difference between two treatments. The significant value of p < 0.05. There was no side effect of turmeric observed in our study, so it can be used as an alternative for the management of dry socket.

Conclusion: It is concluded that there are no side-effects of turmeric. Excess use of euginol, can lead to necrosis of bone. The turmeric can be used as a medicament for the management of dry socket. Excess use of eugenol can lead to necrosis of bone.