bluuebunny/crossref_metadata_2025 huggingface dataset:
Karakteristik anak yang mengalami child abuse dan neglect di RSUP Sanglah, Denpasar, Indonesia tahun 2015-2017
Authors: Ardinata Made , Soetjiningsih Soetjiningsih , Windiani I Gusti Ayu Trisna , Adnyana I Gusti Agung Ngurah Sugitha , Alit Ida Bagus Putu
Published: April 2020

Background: Child abuse and neglect is any form of physical, emotional, sexual abuse, or neglect of children. Child abuse causes various consequences that are harmful to the child and the future of the nation. The purpose of this study was to determine the characteristics of children who experience child abuse at Sanglah Hospital Denpasar.Methods: A cross sectional study design was conducted using secondary data taken from medical records of the Forensic Medicine Department, Sanglah General Hospital Denpasar from January 2015 to December 2017. Data related to age, gender, origin, types of abuse, and perpetratorâ€™s house were analyzed as percentage using SPSS version 17 software. Ethical clearance was carried out prior study conducted. Result: From 2015 to 2017, 173 subjects were recorded as child abuse. The age group of 13-15 years and 16-18 years is the highest age group that experiences child abuse which is 28.3% and 33.5%. Subjects of female sex were 56.0%. The highest distribution of subject origin comes from Denpasar area 20.8% and the highest education level of parents is 45.0% senior high school. Subjects who experienced physical violence and threats were 93.6%, sexual violence was 50.8%, and 1.7% experienced neglect. The perpetrators of child abuse are mostly people who are known to the victim. The perpetrator's or subject's house is the place where most physical, emotional, or sexual violence occurs, which is 72.2%, 69.7%, and 89.7% respectively.Conclutions: Most cases of Child abuse occur in the age group of 13-15 years and 16-18 years. Child abuse is more common in women; most of the perpetrators are people who are recognized. Home is the most common place of physical, emotional, or sexual violence.
Displasia ektodermal tipe hipohidrotik pada seorang anak bayi tiga tahun
Authors: Sasmita I Putu Arie , Rusyati Luh Made Mas
Published: April 2020

ABSTRACTIntroduction: Ectodermal dysplasia (ED) is a rare genetic disorder characterized by defect in two or more ectodermal structures such as teeth, hair, nails and sweat glands. Ectodermal dysplasia divided into 2 types, which is hidrotic and hypohidrotic. The hypohidrotic type was found in 80% of cases. There is no specific treatment for this disorder, which is more of a symptomatic measures depends on the structure involved.Case: A 1 year old male, Balinese, consulted from Department of Pediatrics to Department of Dermatovenereology with the chief complaint of dry skin, absence of sweat, teeth, scalp hair and eyebrow since birth. Recurrent fever present especially in hot climates. No growth abnormalities. No history of incest between parents. His grandfather also complained about the same symptoms, which are sparse hair and decreased sweating. General examination revealed frontal bossing, saddle nose, prominent chin and anodontia. Dermatologic examination revealed multiple hypopigmented macules, well defined margin, oval-round shaped, size Ã¸ 0,5-1 cm, distributed over entire skin and anhidrosis. Department of Dermatovenereology gives moisturizer every 12 hours topically. Department of Pediatrics gives zinc tablets, 20 mg every 24 hours orally.Conclusion:The diagnosis of ED was mainly clinical. Treatment is symptomatic and effective education is needed to increase patient's quality of life. Early fetal detection can be performed if there is a risk in the family. Currently, there is a team joined under SIDIC program in Sanglah Hospital whose main purpose is to detect and prevent congenital disorders early.
Kehamilan usia dini di wilayah kerja UPT Kesmas Tegalalang I Kabupaten Gianyar, Bali-Indonesia
Authors: Hardiani Raka Mery , Friarsa Daondy , Panji Aswin , Ani Luh Seri
Published: April 2020

Introduction: Early pregnancy events are predicted to increase globally by 2030. Early pregnancy is a global problem that occurs in countries with high, middle, and low economic status. Pregnant women aged 10-19 years are at high risk of eclampsia, puerperal endomtritis and systemic infections. This study aims to determine the description of early pregnancy at the UPT of the Primary Health Care Center Tegallalang I Gianyar-Bali.Methods: Descriptive research using cross-sectional design was carried out on 22 pregnant women in the Primary Health Care Center Tegallalang I Gianyar, Bali. The sample was selected using the total sampling method. Data collection was conducted in May 2018. Early pregnancy data along with respondent characteristics were collected by interview method. Early pregnancy is determined based on the age of adolescents when <20 years pregnant. Data were analyzed descriptively to obtain proportions and trends in the incidence of early pregnancy.Results: The prevalence of pregnancy at an early age was 13.6%. Early pregnancy is more prevalent in mothers who do not work (22.2%) and education levels are low (25%). All pregnant women early in the second trimester of pregnancy (100%), have performed ANC services and consume blood boosting tablets (Fe). In this study it was also found that one person had not received Tetanus Toksoid (TT) immunization, was in an abnormal BMI and blood pressure. There are no early pregnant women who have anemia.Conclusion: The prevalence of early pregnancy is relatively high, so primary and secondary prevention efforts need to be intensified to reduce the incidence of early pregnancy and its negative effects.
A-41 years old male with alcoholic cardiomyopathy at Tabanan General Hospital, Bali-Indonesia: a case report
Authors: Wikananda Gede , Ariawan Eka , Priadnyana Ary
Published: April 2020

Background: Alcoholic cardiomyopathy is a form of toxic cardiomyopathy which develops as a result of long-standing chronic ingestion of alcohol. Its clinical findings share similar features to other forms of dilated cardiomyopathy. Diagnosis can be made based on the history of long term alcohol abuse, clinical findings, and supporting diagnostic studies. This case report aims to overview alcoholic cardiomyopathy; from establishing the initial diagnosis to the treatment given for the condition.Case Description: A 41 years old male came to the emergency department unit with shortness of breath since last few days. Shortness of breath was said to be getting worse over time and progressed to breathlessness at rest. Other complaints were palpitations, fatigue, and long-standing cough. The patient was found to have a history of drinking alcohol in large quantities since 27 years ago. The blood pressure was 110/70â€…mmâ€…Hg, pulse rate 105â€…beats/min, and respiratory rate was 20 breaths/min. Slight edemas on both legs were also found.Â  From auscultation examination, bibasilar crepitation on both lungs was found. Cardiac examination showed systolic murmur of mitral regurgitation (MR) and tricuspid regurgitation (TR).Â  On supporting investigation, a chest x-ray showed cardiomegaly (cardiothoracic ratio; 57%). ECG examination showed sinus tachycardia and left atrial (LA) and left ventricular (LV) enlargement. Trans-thoracal echocardiographic (TTE) examination revealed; RWMA: global hypokinetic-akinetic, multi-chamber dilated and severe LV systolic dysfunction (EF 29%) and diastolic function (Grade IV (E/A Ratio>4)). Valve examination showed moderate-severe MR and moderate TR (TVG 40 mmHg).Conclusion: Alcohol cardiomyopathy is one of the most common causes of heart failure in young age and carries a poor prognosis if not treated properly. Treatment of alcoholic cardiomyopathy mainly includes total alcohol abstinence along with drugs used to treat systolic heart failure to reverse the condition and correct any nutritional deficiencies.
Gambaran sindrom metabolik pada pasien gangguan jiwa yang dirawat di rumah sakit jiwa provinsi Bali
Authors: Prabawa I Putu Arya Giri , Witari Putu Kristalina , Ariawan I Wayan Yuna
Published: April 2020

Introduction: Metabolic syndrome (MS) is a constellation of various disorders that can increase the risk of heart disease. MS is known to increase morbidity and mortality rates in psychiatric patients. However, MS in the population of mental disorders, especially in Bali, is still not well known.Methods: A cross-sectional analytic descriptive study was conducted in psychiatric patients treated at Bali Provincial Mental Hospital from January 2018 to February 2018. Inclusion criteria included inpatients who diagnosed with mental disorders based on DSM-IV criteria and those who had MS based on the National Cholesterol Education Program Adult Treatment Panel (NCE ATP III) criteria.Results: A total of 245 samples were included in this study with the prevalence of MS was 48.6%. According on sex, female had higher proportion among MS patients than male (42.8% vs 60.7%). In addition, the age group > 65 years had the highest frequency (75%) suffered from MS followed by age group of 45-65 years (54,9%). Based on the class of antipsychotic administered, MS patients with typical antipsychotic drug classes had the highest frequency, followed by the atypical group and combination of atypical and typical (49.4%, 49.3%, and 46.2%, respectively). Among MS patients, most of them had obesity (87.3%), followed by dyslipidemia, hypertension and impaired fasting glucose (76.4%, 65.5%, and 60.4%, respectively).Conclusion: There is a high prevalence of metabolic syndrome among patients with mental disorder admitted to the Mental Hospital of Bali Province. Comprehensive multidisciplinary co-operation is required in the treating those with metabolic syndrome as comorbid.
Three-Port Laparoscopic Sleeve Gastrectomy: Serial Cases Report
Authors: Antara Gede Eka Rusdi , Yustina Maria
Published: April 2020

Background: Laparoscopic sleeve gastrectomy is the procedure of choice for bariatric surgery. It is a minimally invasive procedure that giving good outcome and less complication compared to other procedures. The multiport sleeve gastrectomy technique is usually described by using 4 to 6 ports and an additional port for a liver retractor. Single-incision laparoscopic sleeve gastrectomy was reported, but not widely adopted. Â Objective: To describe a convenient and applicable modified technique of three ports laparoscopy for sleeve gastrectomy that may give better outcome and cosmetic.Cases: Four patients were diagnosed with obese class II and III. Upper GI study was performed before surgery. We performed three ports laparoscopic sleeve gastrectomy. The 15 mm port was placed in the umbilical, for the camera. The second 12 mm port was placed in the right side of the umbilical for the stapler, and the third port, 5 mm was placed in the right hypochondrium midclavicular line. During the surgery, we used endoscope as guidance during gastric stapling and also for evaluation the stapler line and the size of the stomach. The postoperative condition was uneventful, the patients have less scar and less length of stay.Conclusion: Three ports laparoscopic sleeve gastrectomy is easy to perform, convenient and applicable, consume less time and also give excellent results for the patient's recovery.Â
Hubungan kadar serum gamma-glutamyl transferase dengan profil lipid pada Diabetes Melitus-Tipe 2 (DM-2) terkontrol dan tidak terkontrol di Rumah Sakit Umum Pusat Haji, Adam Malik Medan, Indonesia
Authors: Furiyani Furiyani , Syafril Santi , Nst Burhanuddin
Published: April 2020

Background: Diabetes mellitus is a group of metabolic diseases with characteristics of hyperglycemia that occur due to impaired insulin secretion, insulin work, or both whereas also impaired lipid peroxidation caused by oxidative stress. Gamma-glutamyl transferase (GGT) is an enzyme on the surface of the cell membrane that is responsible for the catabolism of glutathione which acts as a marker of oxidative stress. This study aims to determine the relationship of serum GGT levels with lipid profiles in controlled and uncontrolled type 2 DM.Method: A cross-sectional study was conducted at H. Adam Malik General Hospital Medan from September - November 2018 among 60 patients with type 2 DM grouped according to HbA1c <7% controlled and HbA1C > 7% uncontrolled. GGT levels and lipid profiles examined using enzymatic calorimetry and HbA1c with Immunoturbidimetry method. The relationship of serum GGT levels with lipid profiles in controlled DM-2 was tested using the Pearson correlation test whereas controlled DM-2 correlation test using the Spearman's correlation test using SPSS version 21 for Windows.Results: Most of respondents were males with HbA1C levels <7% (53.3%) and HbA1C â‰¥ 7% (60.0%). There was no difference in the mean age and serum GGT levels between uncontrolled DM-2 or controlled DM-2 group (P = 0.260 and P = 0.520, respectively). There was no association between serum GGT levels and lipid profiles in the controlled type 2 DM group and uncontrolled type 2 DM. (r=P> 0.05).Conclusion: There is no significant relationship between serum GGT levels and lipid profiles in controlled and uncontrolled type 2 DM groups.
Gambaran kepuasan pasien rawat jalan terhadap pelayanan kesehatan di UPT Kesmas Payangan, Gianyar, Bali
Authors: Antari Ni Kadek Novi
Published: April 2020

Background: Health service is any efforts held by personal or together in an organization to maintain and increasing health as well as patientâ€™s satisfaction. This study aims to know the outpatient patientsâ€™ satisfaction representation toward health service in UPT Kesmas Payangan.Methods: A cross-sectional descriptive study was conducted among 85 outpatient at UPT Kesmas Payangan. Sample technique used in this study was convenience sampling method. Samples are outpatient patients who were visiting UPT Kesmas Payangan and assesses using valid and reliable questionnaire regarding patientâ€™s satisfaction based on 5 dimensions (tangible, reliability, responsiveness, assurance, empathy). Data were analyzed using SPSS version 20 for Windows.Results: Most of outpatient are satisfied at UPT Kesmas Payangan (88.2%). Based on satisfaction dimension, our study found that more patients are satisfied in reliability (82.3%), responsiveness (94.1%), assurance (92,9%), tangibles (84.7%), and empathy (88,2%). In addition, female patients are more satisfied (91,3%) than males (84,6%), following by lower level of education is more satisfied (95,2%) as well as in jobless group (100%) compared with others. According to the method of payment, group that using out of pocket method is more satisfied (90%) than using BPJS health insurance (88%).Conclusion: Most of outpatients at UPT Kesmas Payangan are satisfied with health services provided particularly in responsiveness dimension. Out of pocket as method of payment is also tend to given higher satisfaction than BPJS health insurance.
Pengaruh obesitas pada kualitas tidur mahasiswa Fakultas Kedokteran Universitas Udayana periode 2018
Authors: Kawi Yudha Anggoro , Wihandani Desak Made , Surudarma I Wayan
Published: April 2020

Introduction: Increased obesity rates in adolescents can lead to the emergence of new risk populations for the occurrence of sleep disorders. The emergence of sleep disorders will have a direct impact on decreasing the quality of sleep. This study aims to determine the effect of obesity on the sleep quality of students of the Faculty of Medicine, Udayana University.Method: The study design was cross sectional analytic with a total sample of 74 students of the Medical Faculty of Udayana University (37 samples of the Body Mass Index (BMI) obesity and 37 samples of the normal BMI). Sample selection is done randomly. Measuring sleep quality was done through filling in the Pittsburgh Sleep Quality Index (PSQI) questionnaire and measuring obesity was done by calculating BMI. The answers to the questionnaire were scoring and based on the global score, sleep quality was categorized into poor and good sleep quality. The PSQI questionnaire also included questions about health problems experienced by students in the past month. Data analysis is presented in the form of tables and narratives.Result: The results showed that in the obese student group there were 22 samples with poor sleep quality (53.7%) and 15 samples with good sleep quality (45.5%). In the normal IMT student group there were 19 samples with poor sleep quality (46.3%) and 18 samples with good sleep quality (54.5%). In 20 students with health problems, there were 15 samples with poor sleep quality and 5 samples with good sleep quality. In 54 students without health problems, 26 samples with poor sleep quality and 28 samples with good sleep quality. Analysis using chi-square showed obesity did not have a significant effect on sleep quality (p = 0.483). There was a significant effect of health problems on sleep quality (p = 0.039).Conclusion: Conclusions of the study were obesity did not have a significant effect on the quality of sleep of students of the Faculty of Medicine, Udayana University.
Korelasi jenis dan lama waktu pemberian obat antituberkulosis paru terhadap kadar glukosa darah di RSUP Sanglah periode 2015-2016
Authors: Arimbawa Gde Dicky , Mulyantari Ni Kadek
Published: April 2020

Background: Tuberculosis (TB) is a chronic infectious disease caused by an infection of the Mycobacterium tuberculosis complex. Antituberculosis (OAT) drugs used in TB treatment include Isoniazid (H), Rifampicin (R), Pyrazinamide (Z), Ethambutol (E), and Streptomycin (S). The effects of OAT use are many that are hepatotoxic. This hepatotoxic disrupts liver function as a very important glucose buffer system. The purpose of this study was to determine the correlation of the type and duration of administration of OAT to blood glucose levels at Sanglah Hospital.Method: This study is an analytical study with a cross sectional study design. The population in this study were tuberculosis patients who were treated at Sanglah General Hospital, Denpasar in March 2015 - October 2016. The selection of samples used consecutive sampling with a total sample of 38.Results: The correlation test results between the duration of OAT administration and blood glucose levels in tuberculosis patients at Sanglah General Hospital using the spearman test obtained a correlation coefficient (r) value of 0.536 so that according to statistics it can be concluded that there is a positive correlation between the length of time OAT is to blood glucose concentrations. The correlation test between the type of OAT on blood glucose levels in tuberculosis patients in Sanglah General Hospital used the chi-square test obtained P value is 0.133 so according to statistics it can be concluded that there was no significant relationship between the type of OAT to blood glucose concentrations in tuberculosis patients at Sanglah Hospital.Conclusion: There is a significant positive correlation between the duration of OAT treatment of blood sugar levels, but there is no relationship between the type of OAT to blood sugar levels in patients with pulmonary tuberculosis.
Faktor resiko gangguan pertumbuhan pada anak usia balita (1-5 tahun) di Rumah Sakit Ibu dan Anak (RSIA) Pucuk Permata Hati, Bali-Indonesia
Authors: Bestari Made Diah Ari , Weta I Wayan , Aryani Putu
Published: April 2020

Background: Impaired growth is still a problem that is encountered in children, so the search for factors related to growth disorders is important to evaluate in order to make an early anticipation.Method: This study used a case-control design conducted at Pucuk Permata Hati Child and Mother Hospital during the period February to April 2019. Sample search was done through consecutive methods. The search was carried out on the variables of child birth weight, maternal age at pregnancy, gestational age, hypertension conditions during pregnancy, history of abortion, maternal hemoglobin during pregnancy, placental disease (placental abruption or placenta previa), and breastfeeding. Data analysis using the help of SPSS version 25.0 software, chi-square test, logistic regression, and odds ratio calculation.Results: This study found that there was a significant relationship between maternal age â‰¤ 20 years, preterm pregnancy, hypertension during pregnancy, and placental disease during pregnancy as a risk factor that contributed to the occurrence of growth disorders in children (OR> 1; p <0.05). Then placental disease during pregnancy was the most important risk factor for growth disorders in children (aOR: 7.79; 95% CI: 1.79-75.97; p = 0.037).Conclusion: Age of preterm pregnancy, history of hypertension during pregnancy, and placental disorders are factors that play a role in the occurrence of growth disorders in children.
Ketepatan ultrasonografi dan mammografi dalam mendiagnosis wanita dengan kanker payudara di RSUP Sanglah Denpasar
Authors: Baruna Cokorda Agung Abi , Manuaba I. B Tjakra Wibawa
Published: April 2020

Introduction: The high incidence of breast cancer in women, accompanied by delays in making contact with medical personnel and the absence of good early detection contribute to the very high mortality caused by breast cancer. Early detection using ultrasound and mammographic modalities plays an important role in the early diagnosis of breast cancer which will have an impact on the survival of patients. This study aims to compare the diagnostic values of ultrasonography and mammography compared with histopathological features in patients with breast cancer.Methods: This study used a diagnostic test design with a retrospective approach that compared sensitivity values, specificity, positive predictive value (PPV), negative predictive value (NPV), likelihood ratio from mammography and ultrasonography to histopathological morphology in patients with breast cancer at Sanglah General Hospital Denpasar .Results: It can be seen that in the total sample, ultrasonography in the toal condition of the sample has a diagnostic value that is very similar to mammography in establishing a diagnosis of breast cancer. Whereas at the age of> 40 years mammography has a diagnostic test value that is far better than ultrasonography (sensitivity: 85.71; specificity: 83.33; PPV: 92.30; NPV: 76.92; LLR (+): 5, 14; LLR (-): 0.17).Conclusion: ultrasonography and mammography have almost the same precision in the whole sample, but mammography has a better diagnostic value compared to ultrasonography in people aged> 40 years.
Skin flap pattern in skin cancer at Sanglah General Hospital Denpasar, Bali-Indonesia
Authors: Wardhana Made , Darmaputra IGN , Wirawan I Gde Nengah Adhilaksman Sunyamurti , Pramita Nyoman Yoga Maya , Maharis Rikcy Fernando , Puspawati Ni Made Dwi , Karmila IGAA Dwi , Praharsini IGAA
Published: April 2020

Background: The prevalence of skin cancer is consistently increasing recently, an hence a more comprehensive management is necessary for patientsâ€™ satisfaction. Generally, skin cancer is categorized into several histological types, including melanoma, basalioma, squamous cell carcinoma (SCC), and several other less common types such as keratoacanthoma, pyogenic granuloma, and Bechet disease. In dermatology, the intervention is limited which only consists of infiltrative anesthesia, no involvement of other organs, and no attachment to the underlying tissue. Therefore, random skin flap frequently becomes the preferred option that involves advancement, rotation, transposition, and interpolation flap. This study aims to investigate the profile of skin cancer and flap pattern among patients undergoing skin flaps procedure at Dermatology and Venereology Department of Sanglah General Hospital, Denpasar.Â Method: This study included all skin cancer patients who underwent skin flap surgery. Samples collection was performed retrospectively using patientsâ€™ medical records from January 2015 - December 2018.Â Results: Over the study period, there were a total of 41 skin cancer patients who underwent skin flap surgery of whom 10 (54.6%) patients were diagnosed with melanoma, 16 patients with basalioma, 9 patients with SCC and the remaining included 3 cases of acanthoma and 1 Bechet disease. Regarding the flap types, simple advancement and its variances were performed in 6 melanoma, 11 basaliomas, 5 SCC and 4 keratoacanthoma cases. Transposition flap was performed in 2 melanoma, 3 basalioma, and 3 SCC cases; whereas rotation flap was performed in 2 melanoma and 2 basaliomas and SCC cases.Conclusion: From 41 skin cancer patients discovered, basalioma was the most frequent cases and advancement techniques were the most frequently performed flap surgery. Only 1 post-surgical infection was found after rotational flap procedure.Â Â Â
Markeringar av lärararbetets gränser
Authors: Ackesjö Helena
Published: April 2020

Politiska initiativ har tagits under senare år för att minska trycket mot lärarna, ”så att lärare kan vara lärare” och ”fokusera på sitt kärnuppdrag” – exempelvis genom att införa lärarassistenter. I artikeln studeras hur lärarprofessionens territorium (om-) förhandlas när avlastande tjänster införs. Resultaten visar att gränserna runt lärarprofessionens territorium förflyttas då lärarassistenterna tar över delar av territoriet och blir resurser till lärarprofessionen då de kompletterar på andra platser än i klassrummet. Lärarna positionerar sig på nytt inom sitt professionella territorium men resultaten visar även att gränsdispyter mellan lärarassistenter och lärarprofessionen kan förekomma. Resultaten visar att lärarassistenters arbete kan innebära att lärarprofessionens territorium kan renodlas och förtätats samtidigt som skolans territorium riskerar att utökas då nya arbetsområden tillförs skolan via lärarassistenterna.
Tecnologias leves e educação em saúde no enfrentamento à pandemia da COVID-19
Authors: Flores ceccon Roger , Jayce Ceola Schneider Ione
Published: April 2020

Este ensaio de cunho reflexivo tem o objetivo de discutir a importância das tecnologias leves e da educação em saúde no enfrentamento à pandemia da COVID-19. O texto aborda o contexto epidemiológico e as medidas de prevenção ao Coronavírus, especialmente a quarentena e o isolamento social. Além do mais, propõe um conjunto de estratégias micropolíticas que contribuem para o enfrentamento à pandemia, especialmente as tecnologias leves e a educação em saúde. Defendemos que, em tempos de pandemia, é fundamental a humanização do cuidado, o diálogo e as relações de confiança entre profissionais e usuários. As reflexões suscitadas constituem-se como práxis transversais ao trabalho e caracterizam-se como compromissos éticos, estéticos e políticos no enfrentamento à pandemia, necessárias para a produção de sentido e sensibilização das ações impostas por autoridades sanitárias.
DNA metabarcoding protocol for siphonophore gut contents v1
Authors: Damian Serrano Alejandro
Published: April 2020

Protocol for the SiphWeb DNA metabarcoding of siphonophore gut content. Starting with DNA extractions from pooled frozen gastrozooids, this protocol takes the user through the steps of PCR amplification, PCR cleanup and pooling of amplicons from six complementary 18S barcodes that can be submitted into an Illumina MiSeq Lane.
Dialysis using D-Tubes v1
Authors: Junior Neilier , de Almeida Barros Rafael , Elber Vital Camilo , Lessa Barbosa Samuel , Vitor Aguilar de Oliveira João , Corrêa Rocha Gabriele , Victor Marques Gonçalves Assis João , Neves Oliveira Cauê , Goreti de Almeida Oliveira Maria
Published: April 2020

Sample preparation is crucial for successful biomolecule analysis. For this, the method must be individually chosen, based on the characteristics of the sample and the analyte. How some strategies can compromise the integrity of the molecule of interest. The dialysis D-tubes allow the concentration of samples with no precipitation by organic solvents or salts.
Primary Cardiovascular Disease Prevention: Risk Factors Control vs. Imaging Subclinical Atherosclerosis
Authors: Vancheri Federico , Faggiano Pompilio , Henein Michael Y
Published: April 2020

The burden of cardiovascular disease in developed countries has shown dramatic improvements over the last 50 years, largely due the identification and control of major risk factors including, smoking hypertension and high cholesterol.   However, due to the significant increase in obesity and diabetes CVD incidence rates will not reduce as far over over the next years. Risk prediction in asymptomatic individuals remains a major challenge. Primary preventive treatment is currently based on the assessment of individual’s global risk mainly through screening of conventional risk factors and their treatment with lifestyle intervention and pharmacotherapy, often based on multivariate risk equations, and yet  a large proportion of CVD still occurs in individuals who are classified as carrying low- or intermediate-risk according to the risk scores. Atherosclerosis is the most common pathophysiologic process underlying CVD, often after a prolonged asymptomatic phase during which it may be possible to modify the course of the disease. Unlike conventional probabilistic risk scores, non-invasive imaging techniques such as carotid intima-media thickness (CIMT) along with plaque assessment (Figure 2), measured by B-mode ultrasound, and coronary calcium scoring (CAC) detected by CT scan have the advantage of direct visualization of the consequences of atherosclerosis on the arterial system. We consider the proposal that imaging of subclinical atherosclerosis is superior to risk equations as it directly identifies the disease and can effectively predict the risk of future CV events in low- and intermediate-risk individuals. In addition, imaging can improve the adherence to guidelines based treatment in patients and their physicians.
A prospective study on clinico-epidemiological profile and outcome in management of poisonous snake bite
Authors: Chaudhary Mukesh Kumar , Gupta Laxmi K. , Chand Lokendra B. , Chaudhary Ramesh , Ranpal Sabin
Published: April 2020

Background: Snake bite is a major health problem in Nepal. According to WHO, annual morbidity due to snake bite is 162 out of 100,000 people in Nepal. Aim of the study is to observe epidemiology, clinical features, and analysis of possible relationship between time delay in administration of anti-snake venom (ASV) and mortality. Methods: This prospective observational study analyses the data of 81 patients admitted to the Lumbini zonal hospital, Butwal, Rupandehi, Nepal with history of snake bite between April to September, 2017.Results: In this study 56% patients were female. Patients of age group (15-30) years were maximum (38.27%). The study showed that 50.61% of snake bites were occurred outside home. Most of patients (84%) were from the Terai region. Average no. of vials used per case was (28±10) vials. Most of victims of snake bite were from rural areas. In most of cases we found that prothrombin time was prolonged. It was found that most of patients 57% reach hospital before 4 hours of snake bite. The mean days of hospital stay was 6±2.86. Most of case of snake bite was unknown (62%). The mortality rate in this study was 6.17%.Conclusions: There is a great need to improve in existing health care conditions for effective management of snake bite; it requires training of the personnel engaged in the emergency health care management, development of national guidelines based on the clinical trials, improving the distribution and easy availability of antivenom.
Prospective, randomized, and comparative study of efficacy of ivermectin, benzyl benzoate 25%, permethrin 5% and gamma benzene hexachloride 1% in the treatment of uncomplicated scabies
Authors: Chitra K. , Ratnam R. Swathi , Sudha J. , Suryanarayana G.
Published: April 2020

Background: Scabies is an infectious and contagious human skin disease. The aim of the study was to study the efficacy and safety of four different treatment modalities in clinically diagnosed cases of scabies of single dose of oral ivermectin and commonly used topical scabicidal agent’s benzyl benzoate 25% (BB), permethrin 5% and gamma benzene hexachloride 1% (GBHC).Methods: This study was carried out in the Department of Dermatology, Andhra Medical College, Visakhapatnam. 200 patients diagnosed of scabies were included in the study during the period from August 2013 to July 2014. The percentage of improvement was compared between four groups. Intergroup comparison between two groups was done Chi square test.Results: In the present study a greater number of patients were students (54.5%). Subsidence of lesion and itching with oral ivermectin given as a single dose (200 μg/kg body weight) was 45 (90%) and 44 (88%), with topical permethrin 5% lotion single application 48 (96%), 47 (94%), with topical GBHC 1% lotion 40 (80%) patients, 38 (76%). Topical application of BB lotion 25% was 38 (76%), and 36 (72%) at fourth week.Conclusions: In the present study permethrin 5% cream was found to be more effective among topical agents. Both BB and GBHC 1% lotion are being inexpensive and they can be used as an alternative treatment in developing country like India.
The effectiveness of ultrasonogram guided intervention in chronic shoulder pain cases attending pain clinic of a government hospital of East zone, India: a prospective observational study
Authors: Biswas Pabitra , Roy Uttam K. , Mandal Purnendu
Published: April 2020

Background: Ultrasonogram guided intervention in chronic shoulder pain is well known for relief of pain and improvement of range of movement (ROM) of affected shoulder joint. Ultrasonogram gives accuracy helps in localized corticosteroid delivery. Corticosteroids relieve the pain by its anti-inflammatory effect. There is conflicting evidence available regarding the effectiveness of the intervention in chronic shoulder pain, questioned in many studies. We planned this study to evaluate the efficacy of ultrasonogram guided intervention in chronic shoulder pain in a tertiary teaching hospital of rural Bengal.Methods: The prospective observational study was carried out in 100 patients with chronic shoulder pain attending pain clinic who fulfilled predetermined inclusion criteria. Patients were injected with 40 mg of depomethyl prednisolone and 10 ml of 1% preservative free lignocaine via standard posterior approach. Then half an hour of standard shoulder range of motion (ROM) exercise regimen was performed under supervision. Pre injection and post injection pain level were scored by visual analogue score (VAS) shoulder exercises were taught and home-based physiotherapy was carried out by patients themselves. Patient were followed at 4, 8, and 12 weeks.Results: The mean age of patients was 53.23±5.680 years with 63 % male study subjects, After the intervention, excellent result in VAS score and improvement of ROM observed in patients. There was statistically significant difference from baseline in both pain relief and shoulder movement.Conclusions: USG guided intervention is effective in pain relief and in improvement in ROM in chronic shoulder pain in long term.
Evaluation of knowledge, attitude and practice of pharmacovigilance among interns and nursing students in a tertiary care teaching hospital
Authors: Pawar Sudhir R. , Gawari Nitin C. , Lokhande Jaisen M.
Published: April 2020

Background: Even though the role of spontaneous reporting of adverse drug reactions (ADRs) is well established in pharmacovigilance, it is not followed in the practice and a large number of ADRs goes unreported. In our institute, almost all of the ADR reported to the department of pharmacology are through either the faculty members or the residents and very few by the nurses and interns.Methods: The current survey was thus conducted to assess the knowledge, attitude and practice (KAP) of nursing students and interns. It is expected that the results should help us to designs specific activities to improve ADR reporting. The study was a questionnaire based survey to assess the knowledge, attitude and practices (KAP) of the interns (n=74) and nursing students (n=108) regarding ADR reporting and pharmacovigilance in this tertiary care centre.Results: More interns gave correct responses to knowledge based and attitude based questions of pharmacovigilance compared to the nursing students. On the other hand, more nursing students came across ADRs in the patients compared to interns. Even though 93.24% interns responded to have got training on “how to report ADRs”, only 6.76% ever reported ADR to pharmacovigilance centre.Conclusions: Proper training on pharmacovigilance, with easy way for reporting ADRs would be a useful step in improving pharmacovigilance status in nursing students and interns.
Assessment of parents induced self-medication in paediatric population in rural and urban areas of Ahmedabad, Gujarat
Authors: Patel Sanskruti J. , Dumra Gurusharan H.
Published: April 2020

Background: Self-medication is termed as administration of medications by care-givers without medical consultation. It includes several forms through which the individual themselves or the ones responsible for them decide, without medical evaluation, which drug they will use and in which way for the symptomatic relief and cure of a condition. Objectives of the study was to estimate the overall prevalence of parents induced self-medication, to identify the most commonly used drugs and the reasons of self-medications in rural and urban areas of Ahmedabad, Gujarat.Methods: This is community based observational cross sectional study was conducted over a period of four months in urban and rural areas of district Ahmedabad under the field practice area of AMC MET Medical College and Sheth LG General Hospital, district Ahmedabad, Gujarat. The study population included children from 5-15 years. The data was collected from the care giver/parents of the children through a pre-validated questionnaire.Results: Prevalence of self-medication was 86.14%. Most common illness for which self- medication was done was fever in 84 children (22.16%) followed by acidity in 72 children (18.99%). Commonly used drugs were antipyretics, antibiotics and oral rehydration therapy. Previous prescription was used by most of them to procure the drugs and previous experience on efficacy was the most common reason cited.Conclusions: In this study, the prevalence of parents induced self-medication is quite high. There is a need to strengthen public education regarding self- medication, by mass media and local government authorities.
A comparative assessment of safety and tolerability of metoprolol versus carvedilol in patients of chronic stable angina
Authors: Bansal Megha , Gari Manju , Varshney Manisha
Published: April 2020

Background: Angina pectoris is a clinical manifestation characterized by chest pain typically in substerum radiating to left arm, jaw, back lasting for 1-5 minutes and is relieved by rest. Beta blockers are one of the drugs indicated in angina. The aim of the study is to compare safety and tolerability of metoprolol and carvedilol in patients of chronic stable angina.Methods: The study done is randomized, open label, parallel type where tablet carvedilol and tab metoprolol is given in a group of 50 patients each. The patients were followed thereafter on 8th, 16th, 24th week to study safety in terms of haematological parameters like complete blood count, liver function tests, renal function tests, serum sodium, serum potassium, fasting blood glucose, 2 hours post prandial blood glucose, HbA1C, and Lipid profile and tolerability in terms of side effects. The study was conducted for one year and the data was assessed by relevant statistical analysis where p value <0.05 was considered significant.Results: It was seen that the disease was most common in the age group of 51-60 years with male preponderance, and carvedilol was found to cause non-significant decrease in Serum Triglyceride with no change in total cholesterol, HDL-C, LDL-C was found. No significant changes were observed in metoprolol group. There was no significant difference observed when blood sugar profile and other haematological parameters were considered. Both drugs were considered to be equally tolerable.Conclusions: Compared with carvedilol and metoprolol in patients of chronic stable angina, carvedilol resulted in better lipid profile whereas metoprolol showed no changes in lipid parameters.
Amoxicillin induced erythematous maculopapular rashes: a case report
Authors: Krishna Kumar Dhakchinamoorthi , Rajganesh Ravichandran , Jaya Shree Dilli Batcha , Cherian Sam Nikhil , Mohamed Thayub
Published: April 2020

Cutaneous adverse reactions (CAR) can occur with any class of drugs, however more widely caused by various antibiotics. Amoxicillin is a broad-spectrum, bactericidal, beta-lactam antibiotic, widely used for combating various infections. Cutaneous drug eruptions are known to be reported common while using penicillin class of drugs, specifically among children. These immune-mediated bizarre drug eruptions were range from mild to severe drug-induced cutaneous reactions, such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). The present case reported with maculopapular, erythematous rashes induced by amoxicillin in a nine-year-old male patient. Amoxicillin was prescribed for his hyperactive respiratory disease and subsequently after three days developed generalized maculopapular erythematous rashes as a result of an antibiotic-induced skin rash. The present case is being reported to add more data, also to emphasize and gather the information for evidence-based practice and to promote efficient pharmacovigilance adverse drug reaction reporting.
A case of nimesulide induced toxic epidermal necrolysis
Authors: Xaviar Suja , Ravichandran Mirunalini
Published: April 2020

Toxic epidermal necrolysis (TEN) is a rare life-threatening drug-induced mucocutaneous skin disease with a mortality rate of approximately 30%. Nimesulide is a preferential cyclo-oxygenase (COX-2) inhibitor which is frequently used for its antipyretic, anti-inflammatory and analgesic activity. Here, we report a case of nimesulide induced toxic epidermal necrolysis in a 57 years old male patient. This patient was admitted in the hospital with symptoms of epidermal sloughing and fluid filled blisters all over the body following over the counter intake of nimesulide for fever. The drug was promptly stopped, and patient was managed with steroids, antibiotics and other adequate supportive measures. The patient showed significant recovery following stoppage of drug and adequate management. This case highlights the importance of nimesulide and other NSAIDs as possible cause of TEN.
Comparison between two mixtures of lidocaine and bupivacaine for infraclavicular block: a double blind randomized trial
Authors: Jaber El Kaissi , Amine El Moqaddem , Mounir Khalil , Hicham Kechna , Moulay Ahmed Hachimi , Jaouad Laoutid
Published: April 2020

Background: We compare the two mixtures in terms of efficiency, analgesia, and side effects.Methods: 30 patients scheduled for upper limb surgery were randomized in 2 groups. the group A received a mixture of 50% lidocaine 2% and 50% of bupivacaine 0.5% the group B received a mixture of 75% lidocaine 1% and 25% of bupivacaine 0.5%. Volumes, block onset times, blocks duration times, analgesia, and toxicity were compared.Results: The volumes were equals in both groups. Sensory block onset was 5.43 min in the group A versus 6.73 min in the group B, motor block onset was 11.93 for the group A versus 13.46 min for the group B. Sensory block duration was 5.48 hours in the group A versus 4.05 hours for the group B (p=0.037), motor block duration was 7.75 hours for group A versus 5.50 hours for group B (p=0.014). Analgesia levels are equals between the two groups, there was no side effects listed.Conclusions: The use of low concentrated lidocaine and bupivacaine mixture induces an adequate anaesthesia and decreases the duration of motor block with a reduced level of pain and an equal level of analgesia.
Clinical profile of patients with forearm and hand injuries
Authors: Bisht Bhaskar , Rajan Manu , Dvivedi Sanjay , A. V. Rawat Kinnari , Konda Sireesha
Published: April 2020

Background: Hand injuries are among the most frequent injuries, constituting between 6.6% and 28.6% of all injuries. Hand and forearm injuries, however small or large they may be do have a significant impact on the society in terms of cost of treatment, hospital stay and costs of lost production and hence the importance of this study.Methods: The study was conducted in the Department of Surgery, Himalayan Institute of Medical Sciences (HIMS), Swami Ram Nagar, Dehradun, over the period of 12 months. Subjects were recruited from patients presenting in emergency/surgery OPD, HIMS, Dehradun with a primary diagnosis of soft tissue injuries in the forearm and the hand. A total of 114 patients were included in the study.Results: Overall mean age of the subjects in our study was 28.21±15.71. The highest incidence was in the age group of (20-40) years i.e. 62 (54.30%). Male to female ratio in our study was 6.6:1. Maximum injuries occurred as workplace and industrial injuries. This contributed to 34.2% (39 subjects) of overall injuries. 50% patients had crush injuries while lacerations, burn and avulsion were other form of injuries. 43 patients had bone and joint involvement,16 patients had neurovascular injuries and 20 patients had tendon injuries.   Conclusions: Hand and forearm injuries are more common in males and in the age group of 20 to 40 years leading to loss of productive working days causing a significant financial burden on the society.
Assessment of preoperative serum albumin level and its correlation with postoperative wound complication in major elective abdominal surgeries
Authors: Ramole Yashpal , Chaudhary Anuradha , Patel Badri Prasad , Divan Abhijeet Singh , Jain Amit , Songra M. C.
Published: April 2020

Background: Patients who have signs of malnutrition have a higher risk of complications and an increased risk of death in comparison with patients who have adequate nutritional reserves. It is common and occurs in about 30% of surgical patients with gastrointestinal diseases and in up to 60% of those in whom hospital stay has been prolonged because of postoperative complications. The serum albumin level is the most readily available and clinically useful parameter. A serum albumin level greater than 3.5 g% suggests adequate protein stores and it confers a protective effect through several biological mechanisms. It predicts perioperative morbidity and mortality.Methods: Our study was conducted on a cohort of 100 Patients admitted in Department of General surgery Hamidia Hospital for major elective surgery between October 2016 and September 2017. Sample size taken was 100.Results: The present study shows that patients with serum albumin less than 3 g/dl has more postoperative complications and patients with serum albumin >3.5 g/dl has less postoperative complications which was statistically significant. The study concludes that as the serum albumin level increases the complication rate decreases.Conclusions: Our study shows that sr. albumin is a good indicator of postoperative complications. The patients with sr. albumin <3.0 g/dl had a higher complication rate which was statistically significant (p<0.05). Patients with sr. albumin >3.5 g/dl had less complications which was statistically significant (p<0.05). The correlation between the serum albumin and complication rate was statistically significant in the malignant diseases when considered separately.