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Abstract : Companies carried out the Termination of Employment (PHK) on the grounds of Force Majeure during the Covid-19 pandemic supported by Law No. 13 of 2003 concerning Employment because the company's financial condition was unstable, resulting in termination of employment on a large scale so that it would have an impact on people who are experiencing enormous mental pressure so that it disrupts the psychological health of both employees who have stopped working. The purpose of this study was to determine the effect of the Force Majeure impact of termination of employment during the Covid-19 pandemic on workers' psychological and physiological health. The method used is quantitative descriptive analysis with a cross-sectional research design with a research instrument design using the main questionnaire, namely the Perceived Stress Scale by Sheldon Cohen with a sample of 50 workers, and analyzed using the Pearson regression and correlation test. The research on the level of psychological stress by workers showed that 60% experienced moderate psychological stress, and 52% experienced moderate physiological stress. The test results showed a significant relationship between the impact of termination of employment and the psychological health of workers (p = 0.002). There was a significant relationship to the physiological health of workers (p = 0.049). It can conclude that the higher the force majeure cases with layoffs during the Covid-19 pandemic, the higher the psychological and physiological disturbances of workers who experienced sudden termination of employment.

Abstract : Radiotherapy on patients with nasopharyngeal carcinoma (NPC) can induce oropharyngeal dysphagia (OPD). Giving a diet to OPD patients may increase penetration-aspiration risk, resulting in pneumonia and death. One of the methods to reduce penetration-aspiration risk in OPD patients is adjusting the bolus delivery. This study aims to determine the relationship between bolus delivery methods and the incidence of penetration-aspiration in NPC patients after radiotherapy. The type of research is pre-experimental with nine sequential observations. Sampling was carried out for three months consecutively until the sample size was met (n=23). Samples were instructed to swallow three boluses (puree, thick, and thin liquid) using three types of delivery (spoon, straw, and cup). The incidence of penetration-aspiration using spoons, straws, and cups for each kind of bolus was recorded. The statistical data analysis was performed using the Cochran comparison test and the McNemar comparison test. The incidence of penetration-aspiration occurred in as many as 64 out of 207 swallow attempts (30,91%). Puree bolus viscosity resulted in a p-value = 0.054, thick liquid bolus resulted in a p-value = 0.080, and thin liquid bolus resulted in a p-value = 1,000. There is no relationship between the bolus delivery methods and penetration-aspiration incidence in patients with NPC after radiotherapy.

Abstract : Testicular torsion is a condition that manifests with acute pain in childhood and adolescence which can lead to infertility despite urgent surgical intervention. The aim of this study is to investigate and compare the protective and preventive effects of sufentanil, remifentanil and fentanyl, a potent analgesic agent on testicular ischemia-reperfusion injury (tIR). 28 adult male Wistar rat were divided into four groups (n=7). Torsion was performed on all left testicles rat 720' clockwise. 1 hour ischemia. 30 minutes before detortion, control group (Nacl 0.9%), fentanyl group (2 mcg/kg), Remifentanil group (1 mcg/kg), Sufentanil group (0.6 mcg/kg) were injected intraperitoneally. During 1 hour of ischemia, the left testes was detorted to restore physiology. 24 hours after reperfusion, rats in euthanasia were taken blood to see Malondialdehyde levels and ipsilateral testes to find germ cell damage. Leydig cells count and percentage tubular necrosis. Administration of Sufentanil before detortion significantly reduced malondialdehyde levels (6.01+0.24SD,P<0.05), damage to germ cells (5.93,P<0.05), Leydig cells count (20.2+4.5SD,P<0.05) and tubular necrosis (3.95+0.62SD,P<0.05) which were subjected to torsion compared to the fentanyl and remifentanil groups. However, lipid peroxidation content of malondialdehyde was significantly decline in remifentanil group (3.58+0.23SD,P<0.05). Sufentanil in ischemia preconditioning has the most protective effect compare to remifentanil by preventing testicular ischemia reperfusion injury leading to infertility in the future.

Abstract : Osteoarthritis (OA) is a shared progressive disorder in old-aged adults that is marked by joint pains and dysfunctions. Hyaluronic acid (HA) is an integral constituent of synovial fluids that play as joints lubricants throughout shear-stress and shocks absorption Intraarticular injecting by exogenous HA is proposed to substitute this OA-persuaded deficit and for production stimulation of endogenous HA, which can alleviate signs of knee OA by means of various path-ways. Determine the impact of intra-articular HA injections on knee Osteoarthritis cases. A clinical trial to assess the impact of intraarticular HA on gait functions and clinical outcomes detected in radiographic imaging moderate-severe knee OA cases. A sample of 100 patients from 40 to 80-yrs old, provided knowledgeable agreement at the pretreatment visits 1-wk previous to the 1st injection, and all contributors have detected knee OA built on the criteria set forth via the American College of Rheumatology. A highly significant change was found among different periods regarding WOMAC score. We concluded that the findings of this work showed that a regime of intraarticular injections of hyaluronic acid has a significantly high influence on functional outcomes and a decrease in osteoarthritic knee pains for at least six months.

Abstract : Despite the advent of various antimicrobials, nowadays, the community acquired and health care associated infections are relatively frequent with Proteus species. Its resistance to various groups of antibiotic has been increasing, which needs a continuous survey for better therapeutic response. From total 5055 samples, 591 (11.7%) Proteus mirabilis isolates were obtained. 186 (5.4%) from urine samples, 120 (18.5%) from wound 105 (30.7%) from blood, 172 (28.5%) from pus were isolated. Out 591 samples of Proteus mirabilis 185 (31.3%) were ESBL positive. Maximum samples were obtained from wound (37.5%), followed by pus (36.0%), urine (31.7%), and blood (16%). Statistical analysis was done using chi – square test and p value was found to be significant. The frequency of ESBL producing strains in our study was 31.3 %. In the present study, presence of ESBLs was determined with CLSI phenotypic confirmatory test (PCT), double disc diffusion test (DDST) and E-test. PCT detected 185 (31.3%) isolates, DDST detected 169 (28.5%) isolates and E - test detected 185 (31.3%) isolates. Thus a higher rate of ESBL detection was found with CLSI phenotypic confirmatory test. All the positive isolates detected in PCT were confirmed by MIC using E-test. The clinical laboratory standards institute (CLSI) also recommends the use of the combination disc method for the phenotypic confirmation of ESBL production among Enterobacteriaceae. The raising resistance to various groups of antibiotics is a common problem and its management is a subject of concern. Identification, surveillance and study of the epidemiology of antimicrobial resistance will assist in the therapeutic management of patients by reducing the prescription of large spectrum antibiotics control of infections. This study is therefore a step towards the generation of national data on the prevalence of antimicrobial resistance pathogens.