scholarly journals Influence of Family Structure and Functionality on Immunization Status of Infants Attending GOPC of BMC Saki

2020 ◽  
Vol 8 (3) ◽  
pp. 163-174
Author(s):  
A.I. Bolaji ◽  
T.O. Ojebode ◽  
O.S. Adekanye ◽  
A.O. Bolaji
Keyword(s):  
Family Structure ◽  
Medical Center ◽  
Sampling Technique ◽  
Family Type ◽  
Systematic Sampling ◽  
P Value ◽  
Cross Sectional ◽  
Immunization Status ◽  
Study Population ◽  
Family Functionality

Introduction: Vaccine-preventable diseases are endemic in Nigeria, and contribute greatly to childhood morbidities and mortalities. Good family structure has been reported to improve children's wellbeing, health and eating habit, but the contribution of family structure together with family functionality on immunization status has not been documented. Overall, the goal of the research was to determine the level of immunization status in the study population, assess their knowledge of immunization and determine what influence family structure and functionality have on children's immunization status.Methods: A cross-sectional descriptive study was conducted in 2016 in the General outpatient clinic (GOPC) of Baptist Medical Centre (BMC), Saki, Oyo State. Family APGAR Scale and self-design questionnaire were used to collect data from 299 respondents using systematic sampling technique. A SPSS (version 21) was used for the analysis.Results: Our results showed that 82.9% of the respondents were fully immunized and 98% had knowledge about Immunization. Majority of the respondents came from functional families, accounting for 85.6% of cases. The following factors were found to be statistically significantly  associated with immunization status: family functionality (X2 = 101.694, P = 0.000), family type (p value =0.000), family size (p value = 0.000), ethnic group (p value = 0.000) and number of children (P value = 0.000)Conclusion: Our findings showed that there is an adequate knowledge of immunization in the study population, and that a child's immunization status is significantly influenced by the family structure and functionality. However, given the fact that this is a single, hospital-based study, several multi-center studies would have to be employed not just to validate this conclusion but also to inform policy making. Keywords: Immunization status, family structure, family functionality, vaccine, health facility, Nigeria   French Title: Influence de la structure familiale et de la fonctionnalité sur le statut de vaccination des nourrissons assistant au GOPC de BMC, Saki Les morts évitables par la vaccination restent endémiques et contribuent de manière significative à la morbidité infantile au Nigéria et il a été reconnu qu'une bonne structure familiale améliore le bien-être, la santé et les habitudes alimentaires des enfants, mais la contribution de la structure et de la fonctionnalité de la famille au statut vaccinal n'est pas encore établie. Le but de cette étude est de déterminer le niveau  d'immunisation des répondants, d'évaluer leurs connaissances en matière d'immunisation et de déterminer l'influence de la structure et de la fonctionnalité de la famille sur l'état de vaccination. Méthode de l'étude: Une étude descriptive transversale a été menée en 2016 dans la clinique externe générale (GOPC) du Baptist Medical Center (BMC), Saki, dans l'état d'Oyo. L'échelle familiale APGAR et le questionnaire d'auto-conception ont été employés pour recueillir des données auprès de 299 répondants à l'aide d'une technique d'échantillonnage systématique. Un SPSS (version 21) a été utilisé pour l'analyse. Résultats de l'étude: Les résultats ont révélé que la majorité (82,9%) des répondants était entièrement immunisée et que 98% avaient des connaissances sur la vaccination. La majorité des répondants (85,6%) étaient issus de familles fonctionnelles. La fonctionnalité de la famille était statistiquement significative sur le statut vaccinal (X2 = 101,694, P = 0,000) ainsi que sur certaines composantes de la structure familiale: type de famille (P = 0,000), taille de la famille (P = 0,000), groupe ethnique (P = 0,000), et nombre d'enfants (P = 0,000)Conclusion: Les répondants avaient une connaissance adéquate de la vaccination. De plus, la fonctionnalité familiale et la structure familiale influencent le statut vaccinal des nourrissons. Par conséquent, d'autres études devraient être menées sur l'influence de la fonctionnalité et de la structure de la famille sur le statut vaccinal en utilisant une approche multicentrique. Mots-clés: Immunisation, fonctionnalité familiale, structure familiale, vaccine

HUBUNGAN INTELEGENSI DENGAN PERILAKU NERS TINGKAT II STIKES SANTA ELISABETH MEDAN

2016 ◽  
Vol 1 (1) ◽  
pp. 21-30
Author(s):  
Imelda Derang
Keyword(s):  
Student Nurses ◽  
Sampling Technique ◽  
P Value ◽  
Test Results ◽  
Cross Sectional ◽  
Intelligence Level ◽  
Level Ii ◽  
Study Population ◽  
Cross Sectional Design ◽  
The Relationship

Intelligence is the ability to apply the knowledge and experiences that have been gained into the effort tasks are challenging and flexible book. Behaviour is an action that involves aspects of affective, cognitive, and psychomotor. Goal: This study aims to determine the relationship between the behavior of student nurses intelligence level II STIKes Santa Elisabeth Medan. Method: This study uses correlation with cross sectional design. The study population was all students / i Ners Level II STIKes Santa Elisabeth Medan as 65. The samples used were 65 respondents, the sampling technique in this research is using purposive sampling. The instrument of this study using questionnaire and observation sheets by using product moment test person. Result: Intelligence students as many as 30 people (46.2%) classified as having an average level of intelligence. A total of 32 people (49.2%) classified as well-behaved students. Person product moment test results obtained p value = 0.172 where a significant level of p> 0.05 so that this value proves that the absence of a relationship between the behavior of student nurses intelligence level II STIKes Santa Elisabeth Medan. Conclusion: Recommended for institutions, motivating students in balancing the behavior and intelligence. 

scholarly journals Faktor – Faktor Yang Berhubungan Dengan Disiplin Kerja Karyawan Non Medis Di Rumah Sakit Pekanbaru Medical Center (PMC) Tahun 2020

2021 ◽  
Vol 1 (2) ◽  
pp. 170-181
Author(s):  
Nurhafiza Fiza(Fiza) ◽  
Aldiga Rienarti Abidin ◽  
Arief Wahyudi
Keyword(s):  
Health Workers ◽  
Medical Center ◽  
Univariate Analysis ◽  
Sampling Technique ◽  
Bivariate Analysis ◽  
P Value ◽  
Cross Sectional ◽  
Leadership Models ◽  
Center Hospital ◽  
Medical Center Hospital

ABSTRAK Keberhasilan suatu rumah sakit dipengaruhi oleh tenaga kesehatan atau sumber daya manusia yang disiplin, yang mencerminkan kesadaran dan kesediaan mentaati semua peraturan perusahaan dan norma-norma sosial yang berlaku. Faktor-faktor yang mempengaruhi disiplin  kerja diantaranya ketepatan waktu, pemanfaatan sarana, balas jasa, tanggung jawab dan ketaatan terhadap aturan. Tujuan penelitian untuk mengetahui faktor-faktor yang berhubungan dengan disiplin kerja karyawan non medis di Rumah Sakit Pekanbaru Medical Center. Jenis penelitian kuantitatif dengan desain analitik Cross Sectional study.Populasi dalam penelitian ini adalah seluruh tenaga non medis di Rumah Sakit Pekanbaru Medical Center (PMC) yang berjumlah 70 orang . Teknik sampling yang digunakan adalah teknik total sampling. Analisis Univariat dilakukan untuk mendeskripsikan karakter masing-masing variabel yang diteliti, sedangkan analisis Bivariat dilakukan untuk mengetahui hubungan kedua variabel independen dan dependen. teladan pemipin P value 0.016, balas jasa P value 0.000, keadilan P value 0.000, pengawasan melekat P value 0.011, sanksi hukuman P value 0.008 dengan disiplin kerja. Ada hubungan antara teladan pemipin, balas jasa, keadilan, sanksi hukuman. Di sarankan agar Rumah Sakit Pekanbaru Medical Center (PMC) dapat meningkatkan penerapan prinsip keadilan dalam lingkungan kerjanya untuk dapat meningkatkan disiplin kerja karyawan ABSTRACT The success of a hospital is influenced by health workers or human resources who are disciplined, which reflects the awareness and willingness to obey all company regulations and applicable social norms. Factors affecting work discipline include timeliness, utilization of facilities, remuneration, responsibility and adherence to rules. The purpose of this study was to determine the factors related to the work discipline of non-medical employees at Pekanbaru Medical Center Hospital. This type of quantitative research is analytic cross sectional study design. The population in this study is all non-medical staff at Pekanbaru Medical Center Hospital, amounting to 70 people. The sampling technique used was total sampling technique. Univariate analysis was carried out to describe the character of each variable under study, while Bivariate analysis was carried out to see the relationship between the two independent and dependent variables. leadership models P value 0.016, reward P value 0.000, fairness P value 0.000, supervision attached P value 0,11, sanctions P value 0.008. There is a relationship between leadership models, reward, fairness, supervision attached, sanctions. it is recommended that Pekanbaru Medical Center Hospital to increase the implementation of fairness principle in the work environment in order to improve employee’s discipline Pekanbaru Medical Center Hospital  

scholarly journals Menurunkan Kejadian Demam Berdarah Dengue dengan Pengetahuan dan Pelaksanaan Pencegahan

2017 ◽  
Vol 10 (2) ◽  
pp. 67
Author(s):  
Rita Sari ◽  
Anifatmawati Anifatmawati
Keyword(s):  
Quantitative Research ◽  
Sampling Technique ◽  
Systematic Sampling ◽  
Bivariate Analysis ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Quantitative Research Methods ◽  
Chi Square Test ◽  
Relationship Of

<em>Background: DHF is still an endemic problem for people. Prevention and eradication of DHF until now has not been able to free the community from DHF. Objective: This study aims to determine the relationship of knowledge and implementation of DHF prevention with the incidence of DHF in South Pringsewu in the working area of Pringsewu Public Health Center in 2015. Methods: The subjects of this study are the South Pringsewu community of 80 respondents. This research type is analytic survey, using quantitative research methods with cross sectional approach. The sampling technique in this research uses systematic sampling technique. Bivariate analysis using chi-square test with a confidence level of 95%. Results: The results of the study showed that there was a relationship between the level of knowledge and the incidence of DHF with p value 0.012 (p value &lt;0.05) and there was a correlation between the implementation of prevention with DHF incidence with p value 0.002 (p value &lt;0.05). Conclusion: The incidence of DHF is related to the factor of lack of knowledge and the implementation of prevention of DHF endemic emergence</em>

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN ACNE VULGARIS (JERAWAT) PADA REMAJA DI SMK TARUNA PEKANBARU TAHUN 2014

2018 ◽  
Vol 4 (1) ◽  
Author(s):  
HASTUTI MARLINA ◽  
HETTY ISMAINAR
Keyword(s):  
Acne Vulgaris ◽  
Sampling Technique ◽  
Skin Condition ◽  
Cross Sectional Study ◽  
Chronic Inflammatory Disease ◽  
Systematic Sampling ◽  
Measuring Instruments ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional

Acne vulgaris is a chronic inflammatory disease of the follicles pilosebaseous, characterized by comedones, papules, pustules, and nodules.The main causes of acne as yet known with certainty, but there is strong suspicion is a multifactorial disease, including heredity, hormonal balance, diet, skin condition and hygiene. Acne is a skin disease that is often found in adolescents by (85%).. Based on the results of the survey in 5 SMK Pekanbaru on class X , obtained the highest number of cases of acne that is in SMK Taruna Pekanbaru many as 113people. This study aims to determine the factors associated with the incidence of acne vulgaris in adolescents in SMK Taruna Pekanbaru 2014. The research is quantitative cross-sectional study research design that was held on 5-9 May 2014, in SMK Taruna Pekanbaru. The population this is the entire student SMK Taruna Pekanbaru class X at 302 people, and obtained a large sample of 117people, with rendom systematic sampling technique using a questionnaire measuring instruments. Data analiysis of univariate and bivariate using chi square test.The results showed that there is a relationship of knowledge obtainable, (p value = 0,006 dan POR = 3,06, 95%CI : 1,43-6,75), foods that can emergence the onset of acne obtainable (p value = 0,009 and POR = 2,88, 95%CI : 1,35-6,14, the frequency of facial wash (cleaning) obtainable (p value = 0,009 and POR = 2,88, 95%CI : 1,35-6,14) and the condition of facial skin obtainable (p value = 0,005, POR = 3,12 , 95%CI : 1,46-6,68) with incidence of acne vulgaris. It is recommended for adolescents to avoid foods that can emergence the onset of acne, skin treatment to reduce excess oil production by applying frequency facial wash (cleaning) on a regular basis.

scholarly journals Faktor Yang Mempengaruhi Pekerja Dalam Pemakaian Alat Pelindung Diri Pada PT. X

2020 ◽  
Vol 5 (1) ◽  
pp. 1
Author(s):  
Melda Yenni ◽  
Ede Surya Darmawan
Keyword(s):  
Personal Protective Equipment ◽  
Sampling Technique ◽  
P Value ◽  
Protective Equipment ◽  
Questionnaire Data ◽  
Inclusion Criteria ◽  
Chi Square ◽  
Cross Sectional ◽  
Purposive Sampling ◽  
Study Population

<p><em>Awareness of the benefits of using personal protective equipment (PPE) needs to be instilled in every workforce, because feeling uncomfortable (uncomfortable, hot, heavy, disturbed) is one reason why a worker does not use personal protective equipment (PPE). This study aims to look at the factors that influence workers in the use of Personal Protective Equipment (PPE) at PT. X This research is an analytic study with cross sectional approach. The study population was all workers at PT X while the study sample was workers at PT X as many as 77 workers. The sampling technique using purposive sampling technique based on inclusion criteria. The study was conducted in August to September 2017. The research instrument was a questionnaire. Data collection techniques with interviews. Data were analyzed using a statistical test that is chi square. The results showed that workers who are not compliant in usage are categorized as bad, that is 61.0%. Bivariate results indicate variables that influence workers in the use of PPE are supervision (p-value = 0.001). Variables that did not affect the behavior of PPE use were coworkers (p-value = 0.522) and punistment (p-value = 0.281). From the results above it can be concluded that the compliance of PPE usage in PT. X is influenced by supervision.</em></p><p> </p><p><em>Kesadaran akan manfaat penggunaan alat pelindung diri (APD) perlu ditanamkan pada setiap tenaga kerja, karena perasaan tidak nyaman (risih, panas, berat, terganggu) merupakan salah satu alasan mengapa seorang pekerja tidak menggunakan alat pelindung diri (APD). Penelitian ini bertujuan untuk melihat faktor yang mempengaruhi pekerja dalam pemakaian Alat Pelindung Diri (APD) pada PT. X .</em></p><p><em>Penelitian ini merupakan penelitian analitik dengan pendekatan potong lintang (cross sectional). Populasi penelitian adalah seluruh pekerja di PT X sedangkan sampel penelitian adalah pekerja di PT X sebanyak 77 pekerja. Teknik pengambilan sampel dengan mengunakan teknik purposive sampling berdasarakan kriteria inklusi. Penelitian dilakukan pada bulan Agustus sampai dengan September 2017. Instrumen penelitian adalah kuesioner. Teknik pengumpulan data dengan wawancar. Data dianalisis mengunakn uji statistik yaitu chi square.</em><em> </em><em>Hasil penelitian diperoleh bahwa pekerja yang tidak patuh dalam pemakain dikategorikan buruk  yaitu sebesar 61,0%. Hasil bivariat menunjukkan variabel yang mempengaruhi pekerja dalam pemakaian APD yaitu pengawasan (p-value=0,001). Variabel yang tidak mempengaruhi perilaku pemakaian APD adalah rekan kerja (p-value=0,522) dan punistment (p-value=0,281).</em><em> </em><em>Dari hasil diatas dapat disimpulkan bahwa kepatuhan pemakian APD di PT. X dipengaruhi oleh pengawasan.</em></p>

scholarly journals PENGETAHUAN IBU HAMIL DAN DUKUNGAN KELUARGA PADA KEJADIAN KEHAMILAN USIA MUDA REMAJA

2018 ◽  
Vol 11 (1) ◽  
pp. 093-101
Author(s):  
Kiki Andriana
Keyword(s):  
Health Promotion ◽  
Family Support ◽  
Health Workers ◽  
Sampling Technique ◽  
Young Age ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Study Population ◽  
Analytical Research

Unwanted teenage pregnancies are very embarrassing and can damage theirfuture, therefore some teenagers have an abortion to abort their pregnancy. This researchis an analytical research using Cross Sectional approach. The study population was allpregnant women from July to September as many as 370 pregnant women. The sample inthis study were 82 respondents. The sampling technique was carried out by means ofquata sampling. Data collection was carried out by filling out the questionnaire carriedout on October 23 to November 2, 2017. Data analysis was used chi-square with p-value0.005. The results showed that most respondents did not experience pregnancy at a youngage, lacked knowledge and had negative family support. Based on the results of theanalysis there is a significant relationship between knowledge and family support with theincidence of pregnancy at a young age with p-value, namely p = 0.033 and p = 0.030.Respondents' knowledge can be improved by conducting counseling, disseminatingfanplet, health promotion, and activeness of respondents seeking information aboutpregnancy at a young age, attending formal or non-formal health education namelyconsulting with health workers and respondents can seek information through print andelectronic media.

scholarly journals Determinan Stunting pada Balita Usia 12-59 Bulan di Puskesmas Bojongsari Kota Depok

2021 ◽  
Vol 1 (2) ◽  
pp. 77-86
Author(s):  
Ayu Wulansari ◽  
Astrid Novita ◽  
Herjanti
Keyword(s):  
Birth Weight ◽  
Health Center ◽  
Exclusive Breastfeeding ◽  
Sampling Technique ◽  
Primary Data ◽  
Bivariate Analysis ◽  
P Value ◽  
Child Feeding ◽  
Cross Sectional ◽  
Immunization Status

Introduction: Specifically for the 12-24 month age group, the report on the results of weighing children under five at the sub-district level in Depok City shows that the Depok sub-district is the sub-district that has the highest prevalence of stunting (22.3%). Objectives: This study aims to determine whether there is a relationship between birth weight, exclusive breastfeeding, immunization status, and infant and child feeding on the incidence of stunting in toddlers at the Bojongsari Health Center in 2021. Method: Respondents in this study were mothers who had stunted toddlers aged 12-59 months who were located in the Bojongsari Health Center area. This research is quantitative research with the analytic method with a cross-sectional approach. The population taken by toddlers who experienced stunting amounted to 130 respondents and the number of samples was 97 respondents. The sampling technique used was the Lemeshow formula with purposive sampling. The types of data used are secondary and primary data with univariate and bivariate analysis. The data were processed using SPSS 25. Result: The results of the Chi-square statistical test for birth weight variables (p-value = 0.027), exclusive breastfeeding (p-value = 0.038), immunization status (p-value = 0.036) and infant feeding and child (p-value=0.000). Conclusion: There is a relationship between birth weight, exclusive breastfeeding, immunization status, and infant and child feeding on the incidence of stunting in toddlers aged 12-59 months at the Bojongsari Health Center, Depok City in 2021.

scholarly journals Analisis Ketepatan Kode Diagnosis Utama Kasus Persalinan Sebelum dan Sesudah Verifikasi pada Pasien BPJS di Rsup Dr. Soeradji Tirtonegoro Klaten

2019 ◽  
Vol 4 (1) ◽  
pp. 1
Author(s):  
Nandani Kusuma Ningtyas ◽  
Sri Sugiarsi ◽  
Astri Sri Wariyanti
Keyword(s):  
Medical Record ◽  
Sampling Technique ◽  
Systematic Sampling ◽  
P Value ◽  
Fisher Exact Test ◽  
Main Diagnosis ◽  
Diagnosis Code ◽  
Cross Sectional ◽  
Diagnosis Codes ◽  
Before And After

Background: Based on the preliminary survey at RSUP dr. Soeradji Tirtonegoro Klaten found the main diagnosis code differences in 5 out of 10 BPJS patient medical record for labor cases before and after verification.Objective: To determine the accuracy of the main diagnosis codes of labor cases before and after verification in BPJS patients at dr. Soeradji Tirtonegoro KlatenGeneral Hospital.Methods: Type of research is comparative analytic with cross sectional approach. The population is medical record of JKN BPJS inpatients in the first quarter of 2017. The samples are 50 documents use systematic sampling technique. The instrument is checklist and list of questions. Collecting data use observation and unstructured interviews. Data processing use collecting, editing, coding, entering, processing, cleaning and presenting data. Data analysis used Fisher exact test.Results: The accuracy of the main diagnosis codes of labor cases before verification is 25 (50%) correct and 25 (50%) incorrect. The accuracy of the main diagnosis code for labor cases after verification is 29 (58%) correct and 21 (42%) incorrect. The results of Fisher exact test were obtained p value (0.274)> 0.05.Conclusion : There is no difference in the accuracy of the main diagnosis codes of labor cases before and after verification in BPJS patients. It is recommended in determining the main diagnosis code based on the coding rules in ICD-10 and the internal verifier still check the diagnosis code.

scholarly journals Assessment of immunization status among under five children in rural Mangaluru: a cross sectional study

2019 ◽  
Vol 6 (9) ◽  
pp. 3866
Author(s):  
Chandana Gopal Manglik ◽  
Shrivathsa Dala N.
Keyword(s):  
Sampling Technique ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Immunization Status ◽  
Validated Questionnaire ◽  
Study Population ◽  
N 93 ◽  
Vitamin A2

Background: Immunization is the process whereby a person is made immune resistant to an infectious disease, typically by the administration of vaccine. If exposure to a disease occurs in a community there is a little to no risk of an epidemic if people have been immunized. This study was to assess the immunization status among children up to 5 years in rural Mangaluru.Methods: A community based cross sectional study was conducted among children of 0-5 years of age group (n=93) in rural Mangaluru using convenient sampling technique. After obtaining oral consent from parents, immunization status of children was assessed using validated questionnaire and details of child found to be partially immunized or not at all, reasons for not giving the vaccine were also collected.Results: 52.7% of the study population was partially immunized and 46.2% were fully immunized; only 83.9% possessed an immunization card. Majority of them have not taken measles/MR (55.9%) and also IPV 1 (46.2%) and Vitamin A2 (61.3%) because of unaware need for further immunization (58%).Conclusions: According to the survey, conducted in rural fields, we found that half of the population was partially immunized. Reasons being lack of awareness, negligence of parents, unaware of 2nd and 3rd dose of vaccines.

scholarly journals Prevalence and severity of Depressive illness among youth coming to Psychiatry Out-patient department of District Headquarter Hospital (DHQ), Sargodha

2020 ◽  
Vol 24 (4) ◽  
pp. 322-327
Author(s):  
Rida Dawood ◽  
Aftab Nazir ◽  
Muhammad Shahid Javed ◽  
Kashif Rauf ◽  
Zunera Tanveer ◽  
...  
Keyword(s):  
Sampling Technique ◽  
Cross Sectional Study ◽  
Depressive Illness ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Diagnostic And Statistical Manual ◽  
Study Population ◽  
Study Participants ◽  
Patient Department

Introduction: Prevalence and severity of depressive illness among the youth are on the rise. Objective: To examine the prevalence and severity of depressive illness among youth coming to the psychiatry outpatient department of District Headquarters Hospital, Sargodha. Material and Methods: This is a descriptive cross-sectional study. The study population includes young people (15-24 years) coming to the Out-patient Department of Psychiatry in District Headquarters Hospital, Sargodha. The duration of the study was from 1st February 2018 to 20th May 2018. 50 patients were selected through the convenience sampling technique. Beck’s depression inventory-II semi-structured questionnaire was used for data collection from people aged 15-24 years coming to psychiatry OPD. The diagnosis was made as per the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V). Informed consent was obtained from all participants. Chi-square applied. P-value of 0.05 taken as cut off value. Results: Depression was present in 64% of the study participants. Among female participants, 77.42% of females while among male participants, 42.11% of males were suffering from depression (P-value=0.012) which shows that there is a significant association between gender and depression. Overall, 50% of the participants were mildly depressed, 34.37% were moderately depressed and only 15.63% were severely depressed (P-value = 0.618). Among depressed, 75% were 20-24 years old and 25% were 15-19 years old. Conclusion: Prevalence of depression is found to be more among women and in the young age group 20-24 years. Therefore, regular psychiatric screening, treatment, and follow-up are recommended in an educational institute for early diagnosis and treatment.

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