Healthcare-associated infections (HCAI) are a major setback for any organization. The most important mechanism of spread of these HCAI is via the contaminated hands of the healthcare givers that is doctors, nurses, other staff or relatives/friends of the patients. Contaminated environmental surfaces are another important reservoir for the spread of these infections. However, they are often under recognized. HCA is one of the most important public health problems in most countries of the world. In any healthcare setup basic infection control, measures can reduce the rates of healthcare-associated infections, which help to reduce the length of stay, nosocomial infection and cost. It is important to implement the quality system which can be executed and monitored by using compliance measures in the routine process of the hospital in order to improve the standard of patient health care. The quality of hospital infection control program is a reflection of the overall standard care provided by the institution. The current study is aimed to help in assessing the pre-existing knowledge regarding infection control practices among doctors and nurses. In our study, both doctors and nurses had a fair knowledge about the spread of nosocomial infections, practised safe patient-care protocols, and had positive attitudes. Still, some gaps have been identified in their knowledge and practice of infection control. It is suggested that an effective training sessions should be organized at the time of hire and in-service periodically which might help to decrease the healthcare associated infections.

Early diagnosis of lung cancer plays a pivotal role in reducing death rate due to lung cancer. Bronchial washing, brushing and fine needle aspirations not only compliment tissue biopsies in diagnosis of lung cancer but also comparable. We aim to assess the diagnostic utility of bronchial wash and brush cytology and bronchial biopsy in diagnosing various pulmonary lesions and to compare the bronchial wash and brush cytology with bronchial biopsy in patients with lung cancer. All the patients who underwent fiberoptic bronchoscopy at Alluri Sitarama Raju Academy of Medical Sciences, Eluru during the period of August 2016 to June 2018 for suspected lung lesions on chest radiograph/ CT scan and came to cytology division of pathology department for bronchial wash & brush cytology were included in the study along with biopsy in available cases. Total 60 cases of bronchoscopically visible abnormal lesions underwent bronchial wash and/or brush cytology and/or bronchial biopsy. Of them, only 11.8% of cases of lung malignancy was detected by bronchial wash where as 28.9% of cases of lung malignancies were detected by bronchial brush and 58.8% of cases by bronchial biopsy. We conclude that endobronchial biopsies along with bronchial brush give better cellularity and yield when compared to bronchial wash. The probability of finding the histological subtypes is higher in Endobronchial biopsy when compared with brush and wash samples.

Nowadays the automotive industry in Indonesia is becoming increasingly competitive, causing an intense competition among the ATPM (Single Agent of Brand Holders), as well as competition between existing automotive manufacturers (sole agent) and newcomers. In the midst of the current business industry and its competitive environment, various strategies were implemented by the company in order to maintain its customers, and to win the competition by increasing its market share. Customer satisfaction has become one of important focus for many companies. This study aims to examine and analyze the effect of product quality and after-sales service on customer satisfaction at an authorized Mazda Serpong Dealer, Tangerang. The sample used in this study were 200 respondents from customers at Mazda Dealer Serpong, Tangerang. Sample size determination using Hair’s formula. Hypotheses of the study analized by using multiple linear regression performed with SPSS 2.4. The sampling technique uses purposive sampling. The results showed that the quality of the product significant and positive affect on customer satisfaction. And after-sales service is also significant and positive affect to customer satisfaction. Other results shows that the quality of products and after-sales service of significant and positive affects on customer satisfaction simultaneously

Fomite is an inanimate object or substance that could serve as a vehicle for transmission of infectious organisms amongst individuals. A large number of factors may affect the contamination rate of fomite such as moisture, consistent use and overall cleanliness. Fomites that are found in public places, restaurants, hotels, hospitals and restrooms may include among others handbags, mobile phones, money, door handles or knobs of showers, conveniences, faucets and toilet seats, chairs, lockers, sink and tables. Ladies handbags are multipurpose personal gadgets which may usually habour several kinds of microorganisms such as bacteria. The presence of viable pathogenic bacteria on inanimate entities had been reported by earlier investigators. In this study, a total of one hundred (100) handbags from female undergraduate Microbiology students of Gombe State University (GSU), were investigated for bacterial contaminants and their resistance or otherwise to some commercial antibiotics using standard Microbiology procedures. The results obtained revealed the presence of six (6) different bacterial species, namely Staphylococcus aureus, Escherichia coli, Proteus mirabilis, Pseudomonas aeruginosa, Klebsiella pneumoniae and Bacillus subtilis. The antibiotic sensitivity test showed that all the six (6) bacteria were sensitive to Pefloxacin while five isolates (S. aureus, E. coli, P. mirabilis, K. pneumoniae and Bacillus subtilis) , two isolates (B. subtilis and P. mirabilis) and another two isolates (K. pneumoniae and E. coli) were sensitive to chloramphenicol, amoxicillin and streptomycin, respectively. In conclusion, high level of bacterial contaminants were observed from the studied handbags and found some of the contaminants resistant to the tested antibiotics hence, appropriate use of effective disinfectants is highly encouraged to reduce the magnitude of bacterial contaminants and likelihood of transmitting drug recalcitrant organisms.

This study aims to examine the influence of external and internal factors on the price of the company's coal mining subsector for the period 2015-2017. The independent variable used in this study consisted of exchange rate, coal prices, inflation, DER, and ROE. The research sample consisted of 18 coal mining subsector companies. The method of analysis uses panel regression analysis. The results showed that exchange rate and coal price partially had a significant effect on the coal stock price with a 95% confidence level, ROE partially had a significant effect on the coal stock price with a 90% confidence level, while inflation and DER has no significant effect. to the coal stock price. The exchange rate, coal prices, inflation, DER, and ROE simultantly influence the coal stock price, with a determination coefficient of 10.64%.

Fungal infections from the Candida have significant cause of blood stream infection. This is troublesome among those who have been hospitalized with serious underlying diseases or those who are immunocompromised. To know the prevalence and types of Candida species in blood stream infection and their antifungal susceptibility pattern. The study was carried out in the Department of Microbiology, PDU Medical College, Rajkot from September 2015 to August 2016. Total number of samples are 207. Blood culture specimens were collected and processed for, culture on SDA and HCDA, Slide culture, Gram stain, Germ tube. Antifungal susceptibility testing was performed by modified Kirby Bauer method as per the CLSI guidelines. 58 (28.01%) Candida spp. [C. tropicalis (18), C. glabrata(14), C. gullermondii(12), C. parapsilosis(10), C. albicans(4)] were isolated from 207 specimens. Out of these, 203 (98.06%) from NICU/PICU and 4 (1.93%) from Skin ward, predominantly Males (57.97%). The isolates sensitivite to Voriconazole (100%), Fluconazole (98.88%), followed by Ketoconazole (73.03%) and Clotrimazole (68.62%). Maximum resistance observed to Amphotericin B, Nystatin, Miconazole, Itraconazole. Candidemia is major cause of mortality due to lack of antifungal therapy. Blood stream infections by Candida species have shown highest rates of inappropriate therapy among all BSIs. Strategies are needed to rapidly identify cases of candidemia who are already suffering from serious underlying disease and develop rapid diagnostic technology that widely available and cost effective. By knowing Antifungal susceptibility pattern, patients who are at increased risk for developing nosocomial candidemia should be treated early with empiric therapy that reduced unnecessary patient mortality.

Aim and Objectives: The aim of this study was to determine the cephalometric skeletal and dental norm for orthognathic surgery for North Indian population using Burstone’s analysis and to test the hypothesis that there are racial and ethnic differences in cephalometric measurements between North Indian and Caucasians. Materials and Methods: A total of 120 young adults which consists of 66 males and 54 females, 18 26 years with well-balanced facial profile and minimum arch length discrepancies were chosen for the study. Lateral cephalograms with teeth in maximum intercuspation were recorded and analyzed with AutoCeph software. The mean values of cephalometric skeletal and dental variables of COGS (Cephalometrics for Orthognathic surgery analysis) analysis for North Indian males and females were compared with those Caucasians. P < 0.05 was considered to be statistically significant. Statistical Analysis: The statistical difference in the values of parameters between males and females of North Indian population was analyzed using unpair ‘t’ test whereas the difference between the study population and Caucasians was analyzed using one sample t test. Results: All the cephalometric parameters were found significantly less except convexity angle, maxillary and mandibular dental proclinations, occlusal plane angle. Maxilla and mandible was found prognathic and greater chin prominence in North Indian population compared to Caucasians. Conclusion: Significant difference in the cephalometric characteristics were found between Caucasians and North Indian population. Gender and racial/ethnic differences should be considered for diagnosis and treatment planning for orthognathic surgery for North Indian population.

Background: Endometrial carcinomas accounts for 4-8% of all gynaecological malignancies. Over the past 30 years, many genes which cause cancer have been identified in endometrial carcinoma and hyperplasias. Recently, many studies have shown that the most frequently variable expression gene in endometrial carcinoma is PTEN (Phosphatase and TENsilon homologue) tumor suppressor gene which is mutated in about 30 - 50% of endometrial carcinomas. Identification of inactivated PTEN gene is a very important step in the early diagnosis of endometrial carcinomas and hyperplasias. This study was carried out to evaluate the expression of PTEN in the precursor lesions of endometrial carcinoma in peri-menopausal women with abnormal uterine bleeding. Methods: In this cross sectional study, 3634 samples of endometrial tissue were received in the department during the period of 5 years (Jan 2008 to Dec 2012). Of these formalin fixed and paraffin embedded 100 cases of endometrial hyperplasia from perimenopausal women with abnormal bleeding were retrieved and reviewed. PTEN immunohistochemical staining was done and analyzed. Results: Simple hyperplasia without atypia was the most common precursor lesion in perimenopausal women. PTEN expression was significantly higher in immunoreactivity and intensity in simple hyperplasia without atypia. Complex hyperplasia with atypia showed significantly lower immunoreactivity and intensity of PTEN expression. Conclusion: Our study recommends PTEN expression by immunohistochemistry, in all endometrial hyperplasias in the biopsy specimens which is a simple and cost effective technique when compared to other molecular studies.

The strategy is a plan, implementation, and control in achieving long-term goals. Strategic management is an effort to achieve certain goals through the activities of others so that coordination is needed for the activities of planning, staffing, directing, and controlling in the long run. This study aims to develop a strategy for implementing the operational department procedures at the company PT "X" which has been standardized in the standard operating procedures integrated with computer programs. The research method used in this study is a qualitative analysis method trough interview, observation and documents. The result of analysis are operating procedures Standard of PT”X” are prepared in accordance with ISO 9001 requirements including: Control of Documents and Data (article 5), Process Control (article 9), Inspection and Testing (article 15), Identification and Product Traceability (article 18). The operating procedure standard of PT “X” is using: a. Job and activity, b. Format, c. Quality control. Standard of Operating Procedure for Marketing Division at PT. "X" consists of: Standard of Operating Procedures for Selling Consumer Shipping Services as follow: 1) Standard of Operating Procedures for Selling Consumer Services. 2) Standard of Operating Procedure for Making Shipping Services Cooperation Contracts. 3) Standard of Operating Procedure for Contract Cancellation. 4) Standard of Operating Procedure for Delay Fines. 5) Operational Standards Report Making Procedures and Performance Reporting Marketing Division. The Operating Procedure Standard of Document Management Divisipn as follow: 1) Standard Operational Procedure for Arranging the Decent Approval/Permit Document (SPB or letter of approval for shipping). 2) Standard of Operating Procedure for Document Management in the Transportation Department. 3) Standard of Operating Procedure for Port Document Management. 4) Standard of Operating Procedure for report making and performance document management division

Fermented milk products such as yoghurts can be produced without the addition of any stabilizers. However, some sedimentation of the milk solids would occur in the products (especially drink-type products) and has to be accepted, especially if the shelf-life of the product is more than one week. Sedimentation can, however, be avoided by the addition of stabilizer(s). Pectin has been established as a stabilizing agent in cultured milk products. However, the pectin used is majorly extracted from apple pomace and citrus peels. With the increase in production of processed fruit products, the amount of fruit wastes generated is increasing enormously. Large amount of these wastes poses the problem of disposal without causing environmental pollution. These wastes can be effectively disposed by manufacturing useful by-products from them and one such product is pectin. The peel of passion fruit, for example, constitutes about half of the fruit mass. Given the background of numerous studies which have been carried out on the extraction and characterization of pectin from tropical fruit sources, it is, therefore, necessary to formulate yoghurt stabilized with pectin from these sources and to evaluate its performance in yoghurt. The study was carried out to evaluate pectin extracts from jackfruit and passion fruit peels and their performance in yoghurt production.

This study aims to examine the direct influence of organizational culture (X1), leadership style (X2) and job satisfaction (X3) on the performance of principals (X4). The correlative descriptive quantitative research methods will explore information about organizational culture with leadership styles in achieving job satisfaction for high school teachers and staff on the performance of principals in Riau Islands Province. Variable data were obtained through the instruments of 35 variable items with Likert scales score in rank 1–5. Management of Islamic Education Institutions implements Organizational Culture with effective and efficient leadership styles. Supervision continues to be carried out by implementers of education, government, and end users, as an effort to improve the quality of national education and the quality of the quality of Indonesian society carried out in a sustainable manner. It utilized not only the science, the technology in advances but paid the attention to global challenges as well. The Islamic education management system is a coordinative, systematic and integrative process. The process starts with organizing planning, mobilizing, and monitoring. Based on the results of the variable calculation together affecting the performance of the principal (X4) obtained a value of 91% so that H0 is rejected and Ha is accepted. It can be concluded that organizational culture, leadership style, and job satisfaction have a significant influence on the performance of the principal

Blood is a lifesaving resource; it can be infused to a needy patient from a healthy donor after proper screening and cross matching. Infected blood is also a source of transfusion transmissible infections particularly Hepatitis B & C, Human Immunodeficiency Virus, Malaria and syphilis. Stringent screening of each blood unit donated reduces the prevalence rate up to some extent. The objective of this study is to know the seroprevalence of HBsAg among the blood donors in a tertiary care hospital. It is a prospective study done for 3 years between January 2016 and December 2018 with a sample size of 55,376 donors. The overall prevalence among the blood donors in this study was 3.58 % and is more among the replacement donors within the age group 18-40 years. To reduce the prevalence of HBsAg blood transfusion services should be stringent in selecting a donor; proper pre and post donation counseling should be given to the donor. Implementation of more sensitive tests such as NAT for HBV that detects HBV infection earlier during the window period will further decrease the risk of transfusion transmitted HBV and improve the blood safety.

Background: Endometriosis affects approximately 6%–10% of women of reproductive-aged. Pain is the common symptoms associated with endometriosis and manifests as dysmenorrhea, chronic pelvic pain, dyspareunia, and/or dyschezia, can be debilitating. Aims and Objectives: To find out the association between type and degree of pelvic pain with the Revised American Society for Reproductive Medicine classification system. Materials and Methods: Thirty women with endometriosis were studied in Department of Obstetrics and Gynaecology. Pain intensity was assessed by visual analogue scale (VAS) and a score of 1-3, 4-6 and ≥7 is classified as mild, moderate and severe pelvic pain. Disease was staged as per the American Society for Reproductive Medicine (ASRM) classification system in grade I to Grade IV and pain severity was compared. Results: Mean age of study cohort was 30 ±5.75 years. Majority of the women with endometriosis were in stage III (36.66%), stage IV (30%) and stage II (23.33%). Distribution of type of pain across the ASRM stages was insignificant (p >0.05). Distribution of visual analogue scale for pain with ASRM Staging was statistically significant (p=0.001). Conclusion: We did not find any association between type of pain and ASRM stages however severity of pain has a significant association with ASRM stages.

Context: Non-communicable diseases (NCDs) are also known as chronic diseases, because they tend to be of long duration. Detection, screening, treatment and palliative care, are the key components of the response to NCDs. Aim: To know the prevalence of risk factors of non-communicable diseases in rural and urban districts of Etawah. Setting and design: It is a community based cross sectional study among person aged between 25-64 years residing in the rural and urban areas of district Etawah. Methods and material: WHO STEPS approach was used. Statistical analysis: The collected data was analysed using SPSS Inc. version 23.0, Chicago. Results: In the study almost half of the subjects were males. Prevalence of current tobacco users, alcohol users, insufficient use of fruits and vegetables and physical inactivity were found 42.4%, 22.0%, 92.8%, 51.1% in rural areas and 25.4%, 19.8%, 84.8% and 54.9% in urban areas respectively. Prevalence of included overweight, obesity, increased waist circumference, raised systolic and diastolic blood pressure were found 32.2%, 11%, 26.1%, 14.8% and 19.7% in rural areas and 42%, 21.2%, 49.2%, 14.4%, 18.9% in urban areas respectively. Prevalence of self-reported diabetes and hypertension in rural areas were 2.27%, 9.47% and in urban areas 4.92% and 10.98% respectively. Conclusion: Healthy lifestyle changes should be encouraged in order to reduce modifiable risk factors.

This study aims to analyze the implementation of the Financial Services Authority's circular letter number 14 / SEOJK.03 / 2017 concerning the health level of regional government-owned banks through a comparative analysis between Bank DKI Jakarta (“Bank DKI”) and Regional Development Bank Jawa Tengah (“BPD Jawa Tengah”) in 2017, the soundness level of PT BPD Jawa Tengah before implementation (2016) and after implementation (2017) and the soundness level of Bank DKI before implementation (2016) and after implementation (2017). The method used in this study is RGEC (Risk Profile, Good Corporate Governance, Earning, Capital), while the long-term goal is modeling the financial performance strategy of the Regional Development Bank. The results of this study shows that the comparison of the performance of Bank DKI and PT BPD Jawa Tengah in 2017 are not significant difference; the comparison of the performance of PT BPD Jawa Tengah are not significant difference for 2016 and 2017, but the comparison the performance of Bank DKI for 2016 and 2017 are significant difference. The implementation of Circular Letter Number 14 / SEOJK.03 / 2017 regional development banks period 2016 (before) and 2017 (after), shows that the assessment of financial performance of PT BPD Jawa Tengah are not significant difference, however the assessment of financial performance of Bank DKI are significant difference. In 2017 after the implementation of Circular Letter Number 14 / SEOJK.03 / 2017 the results shows that the comparison of the performance of PT BPD Jawa Tengah and Bank DKI are not significant difference.