Role of CT in Early Diagnosis of Small Bowel Lymphoma in a Patient with Presumptive Diagnosis of Adhesive Bowel Obstruction- A Case Report

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Small bowel obstruction is one of the commonly encountered disease state by surgeons all over the world and postoperative adhesions remain the most common cause of small bowel obstruction till date. Other rarer causes of small bowel obstruction include small bowel malignancies like lymphomas and adenocarcinoma, foreign bodies, intussusception, volvulus, hernias etc. Even though adhesions are the commonest cause behind bowel obstruction, these patients are also equally susceptible to be diagnosed with other rarer causes of small bowel obstruction. In such situations, a CT scan can aid in early diagnosis of these rarer causes and prevent unnecessary delays in surgical management. Here we report a case where a presumptive diagnosis of adhesive obstruction was made but a CT scan early in the course of treatment helped us diagnose small bowel malignancy immediately, to terminate conservative management and proceed with immediate laparotomy.

Antiinflammatory Activity of Polyherbal Gel Formulation

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The present study has been undertaken with the aim to formulate and evaluate the new polyherbal gel formulation containing 0.3 % hydroalcoholic  extract from Trigonellafoenum-graecum and Glycyrrhiza glabra for its topical anti inflammatory activity against carrageenan induced rat paw edema method .The studies were conducted on Wistar rats of either sex (150-180g).The polyherbal gel formulation was designed by using Carbopol 934, SodiumCMC, Trigonellafoenum-graecum, Glycyrrhizaglabra  extract, Ethanol, propylene glycol 400,  methyl paraben, propyl paraben, and required amount of distilled water. The skin ph (6.8-7) was maintained by drop wise addition of tri- ethanolamine. The prepared polyherbal gels were evaluated for physical appearance, pH, spreadability, skin irritation to observe side effect. It was inferred from the results that polyherbal gel formulations were good in appearance and homogeneity. The overall result of this research the prepared poly herbal gel formulation shows significant anti-inflammatory activity.

Effect of Nutrient Intake, Nutritional Status, Physical Activity and Sunlight Exposure on Bone Mineral Density in Women: A Systematic Review

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Osteoporosis is a condition or disease that can cause bones to become brittle and break easily. The risk of osteoporosis in women is greater than in men, which is four times greater. Bone mineral density (BMD) or bone density is the total mineral present in bone. Measurement of BMD is important to show the degree of bone mineralization associated with osteoporosis. There are factors associated with reduced bone density. Thus, this systematic review aimed to analyze several factors related to BMD in women including nutrient intake, nutritional status, physical activity, and sunlight exposure. Studies in this systematic review were gathered by the (PRISMA) guidelines and identified through PubMed, Google Scholar, and ScienceDirect databases from 2017 until 2022. A total of 17 articles passed the eligibility and were analyzed in this systematic review. Studies found the effect of nutrient intake, BMI, physical activity, and sunlight exposure on BMD in women from different age groups. So it is necessary to make eating habits with good nutritional intake and have a lifestyle that routinely carries out sufficient physical activity and gets sufficient sunlight to improve and maintain bone health until old age.

Utilization of Antenatal Care and Pregnancy Outcomes of Women in Advanced Maternal Age at a Tertiary care Hospital in Sri Lanka

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Introduction: Childbearing in latter part of reproductive age is challenging. Adverse pregnancy outcomes increase with advanced (>35 years) maternal age (AMA) and comprehensive antenatal care (ANC) usage by AMA women improves their pregnancy outcomes. However, no recent local data are available on the AMA and pregnancy outcomes.

Objectives: To describe utilization of ANC and pregnancy outcomes of AMA women delivering at North Colombo Teaching Hospital and assessed the association between utilization of ANC services and selected pregnancy outcomes.

Methods: A descriptive cross-sectional study was conducted among 216 women aged >35 years delivered at Colombo North Teaching Hospital selected using a non-probability consecutive sampling method. Women were interviewed within 7 days postpartum inward using an interviewer-administered questionnaire. Selected data were extracted from clinical records. Key elements of ANC (booking visit, type, frequency, services etc.) were scored and their association with pregnancy outcomes were assessed.

Results: A total of 216 AMA postpartum women (age range 35–45 years, mean 37.8 (SD=2.4)) were recruited (response rate 100%). Majority (91.7%, n=198) were multiparous. The current pregnancy was planned in 77.8% (n=168) and 52.7% (n=114) experienced antenatal morbidities. Adverse maternal (8.3%, n=18) and newborn (37%, n=80) outcomes were noted. Majority (75.9%, n=164) optimally utilized ANC. Sinhalese (OR=2.98, 95%CI 1.29–6.87, p=0.008), Buddhist (OR=2.53, 95%CI 1.33–4.80, p=0.004) women with intended pregnancies (OR=5.67, 95%CI 2.81–11.43, p<0.001) well utilized ANC. Women educated <10 years of formal education (OR=0.4, 95%CI 1.33–4.80, p=0.027), had contraceptive issues (OR=0.27, 95%CI 0.10–0.74, p=0.007) and had adverse newborn outcomes (OR=0.32, 95%CI 0.16–0.61, p=0.001) reported low tendency to utilize ANC.

Conclusions: Many AMA women are multiparous and with planned pregnancies. Presence of adverse maternal & newborn outcomes is substantial. Majority well utilized ANC and it reduced adverse pregnancy outcomes. Effective strategies should be formulated to promote well-planned pregnancies in early reproductive ages of women.

Acinetobacter Baumannii: An Emerging Threat to Public Health – A Review of Literature

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Background: Acinetobacter baumannii is a microbe that is fast becoming a danger or threat to public health. Studies have described a rapidly changing epidemiology of the opportunistic pathogen and credited it with increasing importance in the community and healthcare-associated infections. The threat of A. baumannii is considered to be of public health significance due to its recent association with increased length of hospital admission, increased mortality, and morbidity, particularly among patients in the intensive care units. The objective of this review is to highlight the characteristics of this emergent pathogen to better understand and curtail it.

Methodology: This review comprises a literature search of chapters in books and journals which gives an insight into the peculiarities of A. baumannii. It centers on evolving pathogenesis, epidemiology, antimicrobial susceptibility, laboratory investigations, the molecular basis of resistance, and management of infections caused by the pathogen.

Conclusion: Due to the public health significance of the pathogen, there is an urgent call for increased vigilance and improved knowledge/research-driven approaches to the diagnosis and management of A. baumannii infections.

Feasibility Study for Tugboat Expansion Project Using Capital Budgeting And Sensitivity Analysis (Case Study: PT. ABC)

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The Covid-19 pandemic and the unstable geopolitical environment has highly disrupted the global economy. The turn of events affected businesses sectors differently, due the disruption of the supply chain many industries have to suffer. However, there are sectors that performed well in a very uncertain economic condition. One of the business sectors that flourish during this turbulent time is in the mining sector. The soar in demand for natural resources such as coal, nickel, and construction stones have increased the sector’s operational activity drastically. Being a part of the mining industry supply chain, PT. ABC is a marine transport company that provide delivery services for the minerals by utilizing tugboats and barges. The surge of activity in the mining sector has positively impacted the company. A mining companies has queued up to acquire marine transport services, however it is quite difficult to meet the rapidly demand due to the limited number of tugboats and barges available in the market. To keep up with the market demand, PT. ABC is planning to add and additional set of tugboat and barge to its fleet.

The management’s decision to acquire a new set of tugboat and barge is a sizeable investment for the company. Financial calculations such as the capital budgeting method is needed to support the management’s decision for to invest in the expansion project. Therefore, the objective of this research is to utilize the crucial financial calculations to analyze whether if the expansion plan is worth pursuing.

The research results shows that the expansion project is feasible, by examining the base assumptions by the company’s management. The assumptions consist of the initial investment of Rp 40.500.000.000, an annual growth rate of 8,18%, the assumption of 30 working days for the charter duration, and 10 years useful life of the asset. The project will begin in the year 2023. Furthermore, the sensitivity analysis suggests that the most influential factor for the project’s NPV is the charter rate. Based on the analysis, the minimum charter rate that should be charge to the customer is Rp 834.480.000 per month.

Assessment of PT. XYZ’s Change Management Initiatives towards Employee Readiness in Organization Restructuring

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Digital content and influencer marketing leader PT. XYZ Located at the crossroads of content, platforms, and brands, aims to revolutionize content creation, distribution, and consumption in Asia. Singapore, Kuala Lumpur, Seoul, Tokyo, Manila, Shenzhen, Hong Kong, and Jakarta are the 8 Asia Pacific offices (including Philippine after the merger with Indonesia). Organizational reorganization is essential, according to PT. XYZ. After Q1–Q3 2021 revenue declines, this campaign was launched. Employee readiness to adopt the new organizational structure must be assessed. This study assesses staff readiness for the new organizational structure and then determines the best approach to address current and future results. For the Managing Director and HR Manager, the writers use the Kotter 8-Steps model, followed by the ADKAR model for Leader Functions and their personnel. This study found that employees are aware of company changes, although their views on the need for change vary. Some employees reject the idea despite knowing it will boost business success. This is largely due to a lack of accurate information and change-specific training. Because leaders want to help, employees are ready for change. Unfortunately, there is no assessment system with clear success criteria, making it difficult to determine which appraisals were beneficial. Especially without prizes or recognition to motivate improvement. Thus, improvements are needed, such as forming appropriate guiding coalition teams with the same goals, one-on-one meetings with employees, providing training to support new hires, launching short-term wins, publishing change progress reports, and HR system alignment in compensation, promotion, and succession planning.

Feasibility Study of Student Financing Startup Company for BRI Ventures Investments Study Case of: “Company A”

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The problem faced by BRI Venture is to determine the feasibility of investing in Company A, a start-up in the student financing market in Indonesia. The valuation of start-ups in Indonesia is difficult, making it challenging for BRI Venture to assess the viability of the investment. This study aims to provide a comprehensive analysis of the factors affecting Company A’s business, both internally and externally, in order to make an informed investment decision.

The study focuses on three key research objectives: (1) to examine the macroeconomic and industry impact on Company A’s business by using Porter’s Five Forces model, PESTLE model, and market sizing; (2) to examine the internal aspects impacting Company A’s business by using the VRIO model; and (3) to determine the valuation of Company A by using the DCF and relative valuation methods.

The findings of the study reveal that the Indonesian student financing market presents both opportunities and challenges. The PESTEL analysis highlights the increasing demand for student loans in Indonesia, creating growth opportunities for the industry. However, the Five Porter framework analysis highlights the intense competition, strong buyer bargaining power, and weak supplier bargaining power, which may make it difficult for new entrants to succeed.

The VRIO Framework analysis suggests that Company A has a number of sources of sustained competitive advantage, including adaptable repayment terms, technological capabilities, and market position, indicating that Company A’s internal situation is strong. The Absolute Valuation and Relative Valuation results indicate that Company A valuation is between $59 million and $73 million.

In conclusion, while the Indonesian student financing market presents a growth opportunity, BRI Venture must carefully consider the challenges and competition in the market before making an investment in Company A. The internal analysis of Company A suggests that it has a strong position in the market, with a range of assets and competencies that can offer a sustainable competitive advantage. The valuation results provide a range of potential equity stake that BRI Venture could ask for if an investment in Company A is made.

Ectopic Fibres of Articularis Genu

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Articularis genu is a vestigial muscle considered as the 5th part of the quadriceps. This is represented as the detached fibre bundles from the vastus intermedius. Morphologically the muscle is flat, thin, wispy. It shows highly variable attachments taking origin from the lower 1/4th of anterior surface area of the femoral shaft. Articularis genu may be considered as 5th head of quadriceps femoris. The variant morphology of the muscle may prevent incidental removal during total knee replacement, investigating osteoarthritis and so more.

BUMDes Partnership Model with Microfinance Institutions in the Context of Developing the Tourism Industry and Creative Economy in Madura

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Independent Village as a dream of the ideals of National Development, so far it has faced many obstacles. The Social and Economic Sector is one of the many factors faced in the village. In the economic sector, there are still many people who are below the poverty line. Data from BPS (Central Statistics Agency) in 2017 there were 26.58 million people or 10.12% of Indonesia’s population below the poverty line. Meanwhile, in the social sector, the nature of mutual cooperation has begun to fade among rural communities. One of the efforts that can alleviate poverty and increase economic growth in rural areas is the existence of BUMDes in the Labang Bangkalan District, Madura, which is spread over 3 villages. There are 3 active BUMDes in the Labang sub-district, namely in Labang, Sukolilo Barat and Bunaji villages.

To improve the village economy, there are two approaches that can be taken: a) Community needs in making changes. b) Political will and the ability of the village government together with the community in implementing the plans that have been prepared (Rutiadi, 2001 in Bachrein, 2010)

This study aims to see the appropriate partnership model between BUMDes and Microfinance Institutions in improving the tourism and creative economy sectors in Labang sub-district.