bluuebunny/crossref_metadata_2025 huggingface dataset:
Duration of the QT interval in healthy cats
Authors: Ware Wendy A. , Christensen William F.
Published: January 2024

Objective

To develop a clinically useful model for predicting QT interval duration as a function of heart rate in healthy cats.

Animals

20 healthy cats.

Procedure

For all cats, results of a physical examination, electrocardiography, and echocardiography were normal. Twenty-four hour heart rate and rhythm data were collected by means of ambulatory electrocardiography. Hourly ECG segments were obtained from the 24-hour recordings. Mean heart rate and the mean of 5 qt interval measurements were calculated for each of 479 usable ECG segments. Analysis of covariance was used to develop models to describe variability in qt interval duration.

Results

Prediction equations (R2 = 0.81) including terms for heart rate, (heart rate)2, age group (1 to 4 vs 8 to 14 years old), and their interactions were developed. Sex, individual cat, and time of day were of little value in predicting qt interval duration. A simplified prediction equation without age group (R2 = 0.71) also was developed and had better predictive ability than reported correction formulas for qt interval duration.

Conclusions and Clinical Relevance

Prediction equations with 95% prediction intervals for expected qt interval duration in healthy cats were generated. Abnormal qt interval duration can be associated with cardiac electrical instability, yet qt interval duration is greatly influenced by heart rate. Results of the present study provide reference ranges for expected qt interval duration as a function of heart rate in healthy cats. (Am J Vet Res 1999;60:1426–1429)
Airway reactivity measured by barometric whole-body plethysmography in healthy cats
Authors: Hoffman Andrew M. , Dhupa Nishi , Cimetti Linda
Published: January 2024

Objective

To assess the validity of barometric whole-body plethysmography (BWBP) as a means of monitoring airway responses to induced bronchoconstriction in healthy cats.

Animals

8 healthy cats without history of bronchopulmonary disease or exposure to indoor tobacco smoke.

Procedure

Cats were placed into a barometric plethysmograph with an internal volume of 38 L, and air flow was recorded at baseline and after carbachol (concentrations 0.005, 0.01, 0.02, 0.05, 0.1, and 0.2%) was introduced into the chamber. A dose-response curve was generated for several flow-derived measurements, and airway reactivity was determined by interpolation of the dose-response curve for enhanced pause.

Results

Peak inspiratory and expiratory flows increased significantly, but respiratory rate, inspiratory and expiratory times, relaxation time, and tidal volume did not differ significantly from baseline values. Flow-derived measurements (pause, enhanced pause, and end-expiratory pause) increased significantly at carbachol concentrations > 0.02%. Baseline measurements did not correlate with indices of airway reactivity.

Conclusions and Clinical Relevance

Airway reactivity can be measured by use of BWBP, which is non-invasive. Airway reactivity was highly variable among cats and was not a function of baseline airway caliber, suggesting that other intrinsic mechanisms may be important. (Am J Vet Res 1999;60:1487–1492)
Radiographic measurement of craniocaudal instability in stifle joints of clinically normal dogs and dogs with injury of a cranial cruciate ligament
Authors: de Rooster Hilde , van Bree Henri
Published: January 2024

Objective

To determine craniocaudal laxity of the stifle joint of dogs when joints were positioned in tibial compression or neutral position.

Sample Population

19 normal stifle joints in 10 clinically normal dogs, 29 stifle joints with varying injury to the cranial cruciate ligament (10 complete ruptures alone, 10 complete ruptures with concomitant damage to the medial meniscus, 6 partial ruptures alone, and 3 partial ruptures with concomitant meniscal tearing), and 19 unaffected contralateral stifle joints in those 29 dogs.

Procedure

Relative displacement of bony landmarks was measured on paired lateral radiographs (neutral and tibial compression positions). Two measuring techniques were customized for use in dogs.

Results

The first technique failed to distinguish results in normal stifle joints from those in stifle joints with partial deficiency of cranial cruciate ligaments. Significant differences were found for joints with complete rupture, compared with stifle joints in clinically normal dogs. The second technique detected differences between normal stifle joints and injured joints with partial or complete rupture of the cranial cruciate ligament. Significant differences were not detected between joints with partial versus complete rupture. Adjusting data to account for size of dog did not improve results.

Conclusions and Clinical Relevance

A wide range in measurements of laxity was found for stifle joints with intact cranial cruciate ligaments. Differences in degree of damage to the ligament and medial meniscus cannot be deduced from the amount of relative displacement measured on radiographs. Pathologic changes to the cranial cruciate ligament will not necessarily induce detectable changes in laxity of stifle joints in dogs. (Am J Vet Res 1999;60:1567–1570)
C-reactive protein concentration has limited value in the diagnosis of meningoencephalitis of unknown origin in dogs
Authors: Cavalerie Robin , Santos Alejandro Comesaña Dos , Leonardi Hugo , Blond Laurent , Beurlet Stéphanie , Dumont Renaud , Piazza Stéphanie
Published: January 2024

OBJECTIVES

To evaluate blood and cerebrospinal fluid (CSF) concentrations of C-reactive protein (CRP) in dogs with meningoencephalitis of unknown origin (MUO); to evaluate whether blood CRP concentration is associated with epidemiological, clinicopathologic, and MRI findings; and to investigate blood CRP predictive power in survival.

ANIMALS

30 client-owned dogs with MUO, 15 client-owned dogs with steroid-responsive meningitis arteritis (SRMA; positive control group), and 15 healthy dogs (negative control group).

METHODS

Blood CRP concentration was measured in each group, while it was performed in CSF only in the MUO and SRMA groups. The analysis of epidemiological data included breed, age, sex, duration of clinical signs, and history of seizures. Blinded analysis of MRI was performed based on a classification grid, and traditional CSF analysis parameters were assessed. The predictive power of blood CRP concentration regarding survival at 6 months was investigated.

RESULTS

Of the 30 dogs with MUO, 9 (30%) had an increased CRP concentration in blood, and 3 (10%) showed a measurable CRP in CSF. Median blood CRP concentration in dogs with MUO was 0.1 mg/L (range, 0.1 to 102 mg/L), which was not statistically different from the healthy dog group but significantly lower than the SRMA control group. Only the duration of clinical signs was positively associated with an increased blood CRP level. Blood CRP concentration was not associated with survival at 6 months.

CLINICAL RELEVANCE

Blood CRP concentration is of limited value for the diagnosis and prognosis of dogs with MUO. Chronicity of the disease may be associated with an increased concentration of blood CRP.
Synovial extramedullary hematopoiesis in a dog
Authors: Talsma Bryce , Leela-arporn Rommaneeya , Rivera Indira Rojas , Sauerwein Leah K. , Elam Lindsay , Webb Craig B.
Published: January 2024

OBJECTIVE

Synovial extramedullary hematopoiesis is a rarely reported condition in humans and, to date, has never been reported in canines. This case report describes the clinical presentation, diagnostic work-up, treatment, and outcome of a canine case confirmed to have hematopoietic tissue within multiple joints.

ANIMAL

A client-owned canine.

CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES

The clinical presentation was most consistent with immune-mediated polyarthritis, and arthrocentesis was performed in multiple joints for cytological evaluation and culture. Cytology revealed evidence of extramedullary hematopoiesis, and shortly thereafter the dog was diagnosed with immune-mediated hemolytic anemia and thrombocytopenia.

TREATMENT AND OUTCOME

Pregabalin, prednisolone, clopidogrel, and cyclosporine were started, and after several recheck appointments and dose adjustments, the dog’s clinical signs resolved for all conditions.

CLINICAL RELEVANCE

Unusual sites of extramedullary hematopoietic tissue may result in a clinical presentation for which more traditional etiologies and differentials are not applicable.
Impact of early feed restriction and continued supplementation with coated organic acid and essential oils on sustainability of laying performance, egg quality, fertility, hatchability, immunity status, and gut microbiota of Japanese quail hens
Authors: Abo El-Maaty Hayam M. , Attia Youssef A. , Alhotan Rashed A. , Al-Banoby Mohamed A. , Bovera Fulvia , Sherif Sara Kh.
Published: January 2024

Three hundred and sixty, 42-day-old Japanese quail (JQ) hens were randomly divided into six experimental groups with 5 replicates/group. Each replicate consisted of 12 birds (8 females and 4 males). During the growing period, chickens were fed restricted (FR) during only the second week of age at days 7, 9, 11, and 13. Three levels of FR were applied: 0.0 (control), 12.5 (12.5FR), and 25.0% (25FR) of the ad libitum intake of chickens measured on the previous day (groups 1, 2 and 3). In the other three groups (4, 5 and 6) the control, 12.5FR and 25.0FR diets were supplemented with coated organic acid + essential oils (COAWEO ) at 100 g/ton feed. The trial lasted from 6 to 18 weeks of age. Feed intake was significantly reduced by 12.5% FR compared with the control group. FR improved all external and internal egg quality of JQ hens except for egg weight, while albumen % decreased in the group fed 12.5FR diet. Coated organic acid with essential oils did not affect all JQ hens’ external and internal egg quality. Feed restriction did not affect fertility, pipped and dead chicks, and hatchability, as total and fertile egg percentage. COAWEO increased fertility and hatchability percentage. FR did not affect blood serum biochemistry and immunity characteristics except for high density lipoprotein (HDL) and hemagglutination inhibition test for infectious bursal disease virus (HI IBDV). Coated organic acid with essential oils did not affect quail blood characteristics but significantly decreased total lipids and increased IL6 at 18 weeks of age. Dietary COAWEO decreased E. coli, Clostridia, and Salmonella while increasing Lactobacillus counts. It can be concluded that 25.0% FR supplemented with COAWEO considerably improved the sustainability of productive performance of JQ hens without adverse effects on egg production, quality, fertility and hatchability traits, serum biochemistry and immune markers, and gut microbiota.
Sodium butyrate supplementation in two-level fishmeal diets for rainbow trout (Oncorhynchus mykiss): growth performance, immunological responses, and intestinal investigation
Authors: Yarahmadi Peyman , Yousefi Morteza , Ghafarifarsani Hamed , Luque Marta Arredondo , Ahani Saman , Raeeszadeh Mahdieh , Baharloei Mina , Faggio Caterina
Published: January 2024

The dietary effect of sodium butyrate, Butirex®C4 (NaBT), on some physiological and immunological responses, as well as carcass and fillet quality were studied in rainbow trout, Oncorhynchus mykiss (initial body weight, 16.63±0.10 g; mean ± SE) fed two-level fishmeal (FM) diets. Six experimental diets were formulated to include two levels of FM (15% and 30%) and supplemented with incremental levels of NaBT (0%, 0.25%, and 0.5%). An improvement in growth performance was obtained in fish fed diet containing 0.5% NaBT+30% FM. Dietary NaBT inclusion significantly increased the digestive enzyme activity of fish compared to those without a NaBT diet. The highest immune parameters for mucus and serum were observed in fish fed with 0.25% NaBT+30% FM and 0% NaBT+30% FM diets, respectively. Fish fed diets containing 0.5% NaBT+15% FM and 0.25% NaBT+30% FM had significantly higher antioxidant enzymes activity (superoxide dismutase (SOD) and glutathione peroxidase activity (GPx)) in comparison to other groups. At selected NaBT levels, fish fed with FM (15% and 30%) showed higher bactericidal activity in comparison to group fed diet without NaBT supplementation. Based on the results of the intestine microflora, the highest gastrointestinal tract (GIT) total count and GIT lactic acid count were observed in groups included with 0% NaBT+15% FM and 0.5% NaBT+30% FM. Fish fed diets containing 0.5% NaBT+15% and 30% FM showed improvement in fillet quality in comparison to other groups. In conclusion, dietary NaBT supplementation, especially at the inclusion level of 0.5%, can improve physiological and immunological responses and reduce the adverse effects of the diets with the lower FM in rainbow trout.
Care of dental enamel for the orthodontic patient
Authors: Harvey William J. , Powell Keith R.
Published: January 2024

One of the many responsibilities of the orthodontist is to minimise the risk of dental caries development as a consequence of orthodontic treatment. Patients receiving orthodontic treatment are commonly at an age when many newly erupted teeth are present. Newly erupted teeth are particularly vulnerable to dental caries initiation but are also very responsive to topical fluoride therapy. For these reasons orthodontic patients should be exposed to preventive measures to protect enamel. A number of home care procedures and topical fluoride procedures appropriate to each phase of orthodontic treatment can be utilised to impart caries resistance.

Within two weeks of band placement, a general topical fluoride application with SnF2 solution or APF solution should be carried out. Newly erupted teeth or surfaces with early lesions can be treated with a prolonged fluoride application procedure. While fixed appliances are in place, the referring general practitioner should continue semi-annual topical applications of 2% NaF or APF solutions. As a part of home care, patients may use NaF mouthrinses daily or weekly or, as an alternative, use a self-applied 5% MFP paste weekly. If areas of enamel decalcification are apparent after band removal, a number of effective chemical treatments can be performed to promote remineralisation and to prevent further caries progression. The importance of sensible diet and good oral hygiene should be stressed for orthodontic patients. A number of plaque control measures are available but thorough toothbrushing is the most practical and acceptable method.
Malocclusion and the “tongue-to-lower-lip behaviour”
Authors: Becker Adrian
Published: January 2024

One of the possible causal factors of class 2 division 1 malocclusion is an abnormal form of anterior oral seal, known as the “tongue-to-lower-lip behaviour”. The elevating movement of the lower lip between the upper and lower incisor teeth, towards the forward-posturing tongue, produces an increased overjet and an incomplete overbite. The method of treatment described exploits the forces produced by the hyperactive lower lip. In achieving its special form of anterior oral seal, it can provide anchorage to the teeth of the lower arch in resisting the forward movement encouraged by the use of class 2 elastic force. Equally important is the manner in which the continued achievement of this type of abnormal anterior oral seal is made progressively mare difficult for the patient, encouraging the establishment of a normal lip-to-lip seal, upon which the prognosis of the treated result will become dependent.
Development of Critical Thinking Skills Based Handout on the Topic of the Human Respiratory System to Improve Science Literacy in Junior High School Students
Authors: Antika Rizky , Fardhani* Indra , Muttaqiin Arief , Nugraheni Dian , Fiel'ardh Khalifatulloh
Published: January 2024

This research focuses on developing handout teaching materials based on critical thinking skills to enhance students' scientific literacy. The study employed the RD development method, along with the ADDIE model. The research subjects included material and media validators, science teachers, and eighth-grade of Junior high school students. The research utilized validation forms, questionnaire responses, pretest, and posttest as instruments. Data analysis techniques involved percentage equation, independent sample t-test, N-gain test, and effect size test. The results indicated that the handouts' quality, as assessed by material validators, was 92.31%, while media validators reported a score of 90.89%, placing both categories in the very decent range. There was a significant difference in average learning outcomes between students who utilize handouts and those who did not. The increase in scientific literacy ability was 0.7, indicating a high category, and the effect size of using handouts is 2.8, denoting a large category. Consequently, handout teaching materials based on critical thinking skills are deemed suitable for improving students' scientific literacy.
PROFIL PASIEN PAP SMEAR DI LABORATORIUM PATOLOGI ANATOMI RSUP SANGLAH DENPASAR TAHUN 2018 – 2019
Authors: Suastini Kadek Denik , Sriwidyani Ni Putu , Iin Indrayani Maker Luh Putu , Mahastuti Ni Made
Published: January 2024

ABSTRAK

Kanker serviks uteri merupakan penyakit keganasan ginekologi yang menimbulkan masalah dalam kesehatan reproduksi yang dihadapi oleh wanita-wanita di dunia termasuk di Indonesia. Kanker serviks diperkirakan menduduki posisi ke-2  dari penyakit kanker yang menyerang wanita di dunia serta posisi ke-1 bagi perempuan di negara berkembang. Pemeriksaan pap smear dapat dilaksanakan guna mengetahui perubahan-perubahan prakanker yang memungkinkan terjadi dalam serviks uteri. Penelitian ini memiliki tujuan guna mengetahui data profil pasien pap smear di Laboratorium Patologi Anatomi RSUP Sanglah Denpasar tahun 2018 – 2019. Penelitian ini adalah penelitian deskriptif menggunakan rancangan penelitian cross sectional. Teknik pengambilan sampel yaitu total sampling yang mana data penelitian bersumber melalui data sekunder pasien yang tercatat di buku registrasi sitologi hasil pemeriksaan Laboratorium Patologi Anatomi RSUP Sanglah Denpasar periode 1 Januari 2018 – 31 Desember 2019. Data pasien yang dikumpulkan berupa usia, alasan melakukan pap smear, dan hasil pap smear menurut sistem Bethesda 2014. Sampel yang terkumpul pada penelitian ini sebanyak 1501 sampel pasien pap smear, dengan hasil paling banyak di kelompok umur 41 hingga 50 tahun yakni 487 individu (32,4%), memiliki alasan melakukan pap smear paling banyak yaitu skrining dengan jumlah 1285 orang (85,6%), dan hasil sitologi pap smear terbanyak yaitu dengan gambaran Reactive cellular changes associated with inflammation yang tercatat sebanyak 541 orang (36,0%).

Kata kunci :  Kanker Serviks, Pap Smear, Sistem Bethesda 2014, RSUP Sanglah Denpasar
Community Understanding Regarding Covid-19 In Urban And Rural Areas
Authors: Savitri Triana
Published: January 2024

Corona Virus Disease (Covid-19) merupakan virus corona jenis baru yang menyerang saluran pernapasan dengan manifestasi akut yang menimbulkan keluhan ringan hingga berat. Covid-19 pertama kali ditemukan di kota Wuhan provinsi Hubei Tiongkok kemudian menyebar ke berbagai negara didunia secara cepat dan massif. Tujuan artikel ini adalah untuk mengumpulkan dan menganalisis informasi dari artikel yang menyediakan informasi mengenai pemahaman masyarakat terkait Covid-19 pada urban and rural area. Penulisan artikel ini menggunakan metode literature review dengan tiga data base yaitu ProQuest, Google Scholar, dan Springer. Kata kunci yang digunakan dalam penulisan artikel ini yaitu “Understanding AND Covid-19 AND In Urban and Rural Areas”. Proses pencarian artikel dengan rentan waktu dari tahun 2019 sampai 2021. Hasil pencarian dari 3 database yaitu ProQuest (n=1096), Google Sholar (n= 980), dan Springer (569). Didapatkan artikel sebanyak N=2.645. Setelah itu dilakukan screening berdasarkan judul didapatkan 385 artikel. Literatur yang sesuai dengan judul, abstrak, tahun publikasi, bahasa, free full text dan di disimpan atau download untuk diidentifikasi. Secara keseluruhan, 15 artikel dinilai secara komprehensif untuk ketelitian dan relevansi dengan kriteria dan berhubungan dengan topik dipertahankan. Kemudian dilakukan penilaian kritis untuk menilai kelayakan dan didapatkan hasil 7 artikel. Kesimpulan : Pemahaman masyarakat terkait Covid-19 pada daerah Urban lebih baik dibandingkan daerah Rural, dapat dilihat dari sikap dan perilaku masyarakat dalam menyikapi pandemi. Pemahaman masyarakat terkait Covid-19 sebagian ada yang baik dengan menerapkan protokol kesehatan terkait Covid-19 dan sebagian masih belum menerapkan perilaku pencegahan Covid-19 hal ini terjadi karena keterbatasan terpapar dan mengakses informasi terkait Covid-19 pada daerah pedesaan.

Kata kunci : Understanding Covid-19, In Urban and Rural Areas
TINGKAT KECEMASAN IBU HAMIL SELAMA MASA PANDEMI COVID-19 DI KOTA DENPASAR, BALI, INDONESIA
Authors: Harini I Gusti Ayu Agung Diah , Aryani Putu , Cintya Denny Yuliyatni Putu , Citra Wulan Sucipta Putri Wayan
Published: January 2024

During the coronavirus disease 2019 (COVID-19) pandemic, changes in income, employment, and social interactions have affected the psychological condition of all groups of people, including pregnant women. In pregnant women, anxiety during the pandemic is related to the threat of COVID-19 to the lives of mothers and babies as well as concerns about unmet prenatal care needs, relationship tensions, and social isolation during the COVID-19 pandemic. Unfortunately, data on the prevalence of anxiety levels of pregnant women during the COVID-19 pandemic are still quite limited. The purpose of this study is to find out the level of anxiety of pregnant women during the COVID-19 pandemic, especially in Denpasar City, Bali, Indonesia. This research is a descriptive research with cross sectional approach conducted on 140 pregnant women who examined their pregnancy at several health centers in Denpasar during February - November 2020 by using a google form containing questions about maternal characteristics and hamilton rating scale for anxiety (HRS-A) questionnaire to measure maternal anxiety levels. The data is analyzed using SPSS 22 program and presented in the form of frequency and percentage tables and graphs. The results showed that 55% of mothers did not experience anxiety, 28.6% of mothers experienced mild anxiety, 12.9% of mothers experienced moderate anxiety and 3.6% of mothers experienced severe anxiety. In general, anxiety in pregnant women can be influenced by the pregnant mother’s characteristics such as age, recent education, occupation, income, pregnancy trimester and maternal gravida status whose prevalence will be further explained in this study. The results of this study present data on the prevalence of anxiety levels in pregnant women during the COVID-19 pandemic that may have differences with the prevalence of anxiety of pregnant women before the COVID-19 pandemic.

Keywords : Anxiety, Pregnancy, Pandemic, COVID-19
KUALITAS DAN DERAJAT NYERI PADA INJEKSI PROPOFOL INTRAVENA DENGAN PEMBERIAN LIDOKAIN INTRAVENA DI RSUP SANGLAH DENPASARr
Authors: Pratiwi Made Sindy Astri , Suranadi I Wayan , Sinardja I Ketut , Kurniyanta I Putu
Published: January 2024

Induksi anestesi menggunakan propofol secara intravena menyebabkan nyeri yang dapat diatasi dengan premedikasi lidokain intravena. Hingga kini, belum ada penelitian terbaru mengenai derajat dan kualitas nyeri akibat induksi propofol dengan premedikasi lidokain intravena di RSUP Sanglah Denpasar. Penelitian ini bertujuan untuk mengukur kedua hal di atas. Desain penelitian ini adalah deskriptif observasi cross-sectional  bertempat di RSUP Sanglah Denpasar. Subjek penelitian dipilih dengan consecutive sampling berjumlah 39 pasien berjenis kelamin laki-laki atau perempuan, berusia 18-64 tahun, BMI 18,5-22,9 kg/m2, status fisik ASA I atau II, menjalani operasi elektif dengan propofol intravena dan premedikasi lidokain intravena, serta menandatangani informed consent. Penilaian kualitas nyeri menggunakan SFMP-Q sementara derajat nyeri dinilai menggunakan kombinasi VAS dan NRS. Data yang terkumpul akan dianalisis secara univariat. Nyeri akibat propofol intravena dengan premedikasi lidokain penelitian ini ditemukan tidak nyeri 23,1%, nyeri ringan 74,4%, nyeri sedang 2,6%, dan tidak ada yang mengalami nyeri berat. Lidokain menyebabkan sensitisasi nyeri sensori yang rendah terhadap 80% pasien dan tidak mengalami gangguan afeksi pada 80% pasien. Pada penelitian ini, propofol intravena dengan premedikasi lidokain dapat mengurangi rasa nyeri dengan sensitisasi nyeri yang rendah tanpa gangguan afeksi.
GAMBARAN KUALITAS HIDUP PASIEN STRABISMUS MENGGUNAKAN KUESIONER ADULT STRABISMUS 20 DI RUMAH SAKIT UMUM PUSAT SANGLAH PERIODE JANUARI 2019 - DESEMBER 2020
Authors: Elvira . , Surasmiati Ni Made Ayu , Putrawati Triningrat Anak Agung Mas , Sutyawan I Wayan Eka , Manuaba Ida Bagus Putra
Published: January 2024

Latar Belakang: Strabismus merupakan keadaan posisi kedua mata tidak sejajar yang disebabkan oleh abnormalitas penglihatan binokuler atau anomali kontrol neuromuskuler terhadap motilitas okuler. Seseorang dengan strabismus dapat mengalami penurunan kualitas hidup, memiliki tingkat pendidikan yang lebih rendah dan keterbatasan dalam pengembangan diri. Tindakan pembedahan merupakan salah satu tatalaksana pada pasien strabismus.

Tujuan: Mengetahui karakteristik kualitas hidup pasien dengan strabismus sebelum dan sesudah operasi strabismus dengan menggunakan kuesioner Adult Strabismus (AS-20).

Metode: Penelitian deskriptif analitik dengan desain potong lintang. Data dikumpulkan restrospektif berdasarkan rekam medis dan kuesioner AS-20 di Poliklinik Mata Divisi Strabismus RSUP Sanglah. Data karaktristik pasien menggunakan analisis deskriptif dan analisis kuesioner AS-20 menggunakan uji T tes berpasangan dan tes wilcoxon sign rank.

Hasil: Subjek penelitian berjumlah 15 orang, terdiri atas delapan (53,3%) laki-laki dan mayoritas berusia 20-29 tahun. Sembilan (60%) subjek penelitian mengeluhkan penglihatan buram dan empat (26,7%) mengeluhkan diplopia. Mayoritas subjek memiliki deviasi lebih besar dari 20 prisma dioptri dengan diagnosis terbanyak adalah eksotropia intermiten (46,7%). Penilaian kualitas hidup menggunakan kuesioner AS-20 didapatkan peningkatan signifikan antara sebelum dan setelah operasi secara umum, aspek psikososial, dan fungsional (P<0,05). Tidak didapatkan hubungan jenis kelamin atau jenis strabismus dengan kualitas hidup pasien.

Simpulan: Pasien strabismus mengalami penurunan kualitas hidup pada aspek fungsional dan psikososial. Terapi pembedahan dapat memperbaiki manifestasi strabismus. Berdasarkan kuesioner AS-20 didapatkan peningkatan kualitas hidup pasien seiring dengan perbaikan manifestasi klinis setelah pasien menjalani operasi strabismus.
PREVALENSI ESCHERICHIA COLI PADA SPESIMEN URIN PENDERITA INFEKSI SALURAN KEMIH DI RSUP SANGLAH TAHUN 2019
Authors: Arta Putra I Putu Willy Ganang
Published: January 2024

Introduction: Urinary tract infection is the second most common infectious disease in the world with high mortality and morbidity, including in Indonesia. Escherichia coli is one of the Gram negative bacteria which often causes urinary tract infections. Urinary tract infections risks will increases as a person ages. This study is intended to determine prevalence of Escherichia coli in urine specimens of urinary tract infections at Sanglah General Hospital in 2019.

Methods: The design of this0study was a descriptive observational study with a cross-sectional design that was carried out at Sanglah General Hospital in October 2020. The sample of this study came from urine samples patients with urinary tract infections at Sanglah General Hospital for the period of January - December 2019. Where the data was taken retrospectively from the register of the Clinical Microbiology Installation of Sanglah Hospital. The prevalence of Escherichia coli in urine specimens of urinary tract infections is presented in tables and graphs.

Results: Most of the patients with urinary tract infections were female (53.06%). The 40-59 years age group is the age group with the most incidence of urinary tract infections (36.7%). Based on the results of urine culture urinalysis, 49 patients (81.7%) had a result of 105 CFU / mL which indicated a positive urinary tract infection. According to the study results, the prevalence of Escherichia coli causing urinary tract infections was 67.3%.

Conclusion: Based on the research that has been done, the conclusion is that the prevalence of Escherichia coli in urine specimens of urinary tract infections at Sanglah General Hospital in 2019 was 67.3%, dominated by female patients aged 40-59 years.
EFEKTIVITAS PENGGUNAAN DAUN KEMANGI (Ocimum Sanctum) SEBAGAI KRIM OBAT ANTI-NYAMUK Aedes aegypti
Authors: William Kristoforus , Asri Damayanti Putu Ayu , Wardani Ni Putu
Published: January 2024

Penggunaan krim anti-nyamuk yang mengandung DEET dapat menimbulkan efek samping bagi penggunanya, Bahan dasar alternatif alami yang dapat memberikan perlindungan terhadap gigitan nyamuk Ae. aegypti perlu dikaji dan diteliti lebih lanjut.  Daun kemangi berpotensi sebagai bahan dasar krim obat anti-nyamuk karena mengandung minyak atsiri. Sediaan krim memiliki efek yang lebih baik dibandingkan sediaan losion. Penelitian ini bertujuan untuk menguji efektifitas krim anti-nyamuk dengan bahan dasar kemangi (Ocimum sanctum) 75.000 ppm dengan krim anti-nyamuk AutanÒ  dengan bahan dasar DEET dalam memberikan perlindungan terhadap gigitan nyamuk pada menit ke-30, 60, dan 120. Metode penelitian yang digunakan dalam penelitian ini adalah metode eksperimental dengan desain penelitian Post Test Only Control Group Design. Hasil penelitian ini adalah jumlah gigitan nyamuk pada menit ke-30, 60, dan 120 pada krim kemangi 75.000 ppm berbeda bermakna dibandingkan dengan kontrol/plasebo dengan p<0,05. Sedangkan jumlah gigitan nyamuk pada menit ke-30, 60, dan 120 pada krim kemangi 75.000 ppm tidak berbeda dibandingkan dengan AutanÒ dengan p>0,05. Kesimpulan pada penelitian ini adalah krim kemangi 75.000 ppm efektif sebagai krim anti nyamuk dan memiliki efektifitas yang sama dengan AutanÒ selama kurun waktu 120 menit.
GAMBARAN PASIEN KARSINOMA TIROID BERDIFERENSIASI DI RSUP SANGLAH TAHUN 2015-2020
Authors: Wisescistiati Made Visvayoni , Yuniawaty Wetan Ni Gusti Ayu Agung Manik , Manuaba Ida Bagus Tjakra Wibawa , Adiputra Putu Anda Tusta
Published: January 2024

ABSTRACT

Background: differentiated thyroid carcinoma (DTC) is the most common type found in thyroid malignancies. Onset of the disease is influenced by several factors such as history of radiation exposure, environmental influences and iodine intake in certain areas. Due to the limited data in Indonesia related to the mapping of differentiated thyroid cancer cases, the author is interested in conducting this study. Objective: to determine the description of differentiated thyroid carcinoma patients in Sanglah General Hospital year 2015-2020. Methods: cross-sectional descriptive study. The population and samples were all patients diagnosed with differentiated thyroid cancer treated at the SMF/Surgery Department of Sanglah General Hospital year 2015 -2020. The variables in this study are age, gender, area of residence, main diagnosis, staging and therapy. Results: total sample obtained 223 patients. Most common age group were 41-50 years old with 52 people (23.3%). Women are more common with 173 people (77.6%). Denpasar City has the highest number of cases with 75 people (33.6%). The main diagnosis is papillary thyroid cancer (PTC) with 215 cases (96.4%). Stage I are most found with 140 cases (62.8%). Most widely given therapy is total thyroidectomy in 183 people (82.1%) and 124 people (55.6%) received radio ablation. Conclusion: In this study, differentiated thyroid carcinoma was mostly found in women, at the age of 41-50 years, residents living in Denpasar. Papillary thyroid cancer (PTC) as the most common type in stage I and mostly treated with total thyroidectomy.

Keywords : description, differentiated thyroid carcinoma, sociodemographic
EFEK PEMBERIAN TEH KOMBINASI EUPHORBIA MILII DAN PROPOLIS TERHADAP GAMBARAN HISTOPATOLOGI HEPAR TIKUS WISTAR JANTAN
Authors: Rastika I Gede Agus , Linawati Ni Made , Ratnayanti I Gusti Ayu Dewi , Sugiritama I Wayan
Published: January 2024

ABSTRAK

Pendahuluan: Indonesia mempunyai sumber daya  melimpah yang dapat digunakan sebagai pengobatan tradisional. Dua diantaranya yaitu tanaman Euphorbia milii dan propolis. Euphorbia milii dan propolis mempunyai beragam manfaat  seperti antioksidan, antibakteri, dan imunomodulator. Efek toksik dari teh kombinasi Euphorbia milii dan propolisx terhadap hepar belum dilaksanakan penelitian sebelumnya. Tujuan dari dilaksanakannya penelitian ini yaitu untuk mengetahui efek pemberian teh kombinasi dari bunga Euphorbia milii dan propolis terhadap gambaran histopatologi hepar tikus wistar jantan. Metode: Penelitian ini merupakan penelitian analitik eksperimental dengan rancangan penelitian berupa randomized post-test only control group design. Dua puluh empat tikus wistar jantan berusia 8 sampai 12 minggu dengan berat badan ± 0.2 kg dibagi menjadi 4 kelompok, yaitu; kelompok kontrol (pakan standar + aquabidest), P1 (teh kombinasi Euphorbia milii dan propolis 40mg/100grbb selama 2 minggu), P2 (teh kombinasi Euphorbia milii dan propolis 40mg/100grbb selama 4 minggu), dan P3 (teh kombinasi Euphorbia milii dan propolis 40mg/100grbb selama 6 minggu). Hasil: Berdasarkan analisis data dari rerata skoring degenerasi dan nekrosis sel hepatosit, tidak ditemukan perbedaan rerata yang signifikan diantara kelompok kontrol dan kelompok perlakuan P1, P2, dan P3 (p>0,05). Simpulan: Berdasarkan hasil yang diperoleh, dapat disimpulkan bahwa pemberian teh kombinasi Euphorbia milii dan propolis dengan dosis 40mg/100grbb tidak menimbulkan kerusakan yang bermakna terhadap hepar tikus wistar jantan.

Kata kunci :  Teh kombinasi, Euphorbia milii dan propolis, Histopatologi hepar
FAKTOR RISIKO KANKER KOLOREKTAL DI RSUP SANGLAH DENPASAR
Authors: Mark Antony , Ayu Dewi Ni Nyoman , Surudarma I Wayan , Sumadi I Wayan Juli
Published: January 2024

Kejadian kanker kolorektal yang meningkat dengan pesat dan merupakan jenis kanker ketiga terbanyak pada laki-laki maupun perempuan. Meningkatnya kejadian kanker kolorektal terjadi akibat dari perubahan gaya hidup modern. Oleh sebab itu, penelitian ini memiliki tujuan menggambarkan faktor risiko pasien kanker kolorektal di RSUP Sanglah Denpasar pada tahun 2017 berdasarkan kelompok usia, jenis kelamin, dan kadar gula darah acak. Penelitian ini bersifat deskriptif retrospektif. Subjek penelitian adalah pasien kanker kolorektal yang dirawat di RSUP Sanglah pada tahun 2017. Data penelitian diambil menggunakan metode total sampling di Laboratorium Patologi Anatomi dan Instalasi Rekam Medis RSUP Sanglah Denpasar, kemudian diolah dan dikelompokkan sesuai variabel yang sudah ditetapkan, kemudian ditampilkan dalam bentuk tabel dan penjelasan. Dari 109 pasien kanker kolorektal di RSUP Sanglah Denpasar pada tahun 2017, kejadian kanker kolorektal paling banyak pada kelompok lansia (46 – 65 tahun) sebanyak 65 orang (59,6%), diikuti dengan kelompok manula (diatas 65 tahun) sebanyak 27 orang (24,8%), dilanjutkan oleh kelompok dewasa (26 – 45 tahun) sebanyak 15 orang (13,8%), kemudian pada kelompok remaja (12 – 25 tahun) dengan jumlah 2 orang (1,8%), dan tidak ditemukan pasien pada kelompok balita dan kanak-kanak. Untuk jenis kelamin laki-laki sebanyak 63 orang (57,8%) dan perempuan sebanyak 46 orang (42,2%). Kelompok dengan kadar gula darah acak dibawah 200 mg/dL sebanyak 104 orang (95,4%) dan diatas 200 mg/dL sebanyak 5 orang (4,6%). Hasil penelitian ini menunjukkan bahwa kanker kolorektal cenderung terjadi pada pasien dengan usia tua dan berjenis kelamin laki-laki, akan tetapi tidak pada pasien kanker kolorektal dengan hiperglikemia.

Kata kunci: penelitian deskriptif., kanker kolorektal., faktor risiko
HUBUNGAN OLAHRAGA AEROBIK DAN STATUS GIZI DENGAN KEBUGARAN FISIK PADA MAHASISWA PROGRAM STUDI SARJANA KEDOKTERAN FAKULTAS KEDOKTERAN UNIVERSITAS UDAYANA
Authors: Sutanto Grace Abigail , Weta I Wayan , Duarsa IDyah Pradnyaparamita
Published: January 2024

Kebugaran fisik adalah kemampuan tubuh melakukan tuntutan tugasnya tanpa mengalami kelelahan yangisignifikan. Kebugaran yang baik penting dimiliki sumberidayaimanusiaiuntuk dapatibekerjaisecaraimaksimal. Penelitianiiniibertujuan untuk mengetahuiipengaruhiolahraga aerobik dan status gizi terhadap kebugaran fisik mahasiswa. Penelitian ini merupakan studi cross-sectional dengan populasi terjangkau mahasiswa program studi sarjana kedokteran Universitas Udayana angkatan 2016-2018. 260 responden dipilih dengan teknik proportional simple random sampling berdasarkan absen dari kelas yang berkaitan yaitu 86 mahasiswa dari angkatan 2016, 84 mahasiswa dari angkatan 2017, dan 90 mahasiswa dari angkatan 2018. Hubungan antar variabel dianalisis dengan ujiiChi-Square. Variabel olahraga dihitung berdasarkan kuesinoer Baecke, status gizi berdasarkan massa index tubuh, dan kebugaran berdasarkan denyut nadi. Didapatkan hubunganiyang signifikaniantara olahraga aerobik dan kebugaran fisik (pi<0,001) dan didapatkan hubungan yang tidak signifikan antar status gizi dan kebugaran fisik dimana ada 2 perbandingan pada statusigizi yaituistatus giziikurang dibandinginormal (p=0,742) dan status giziilebih dibanding normal (p=0,215) dimana status gizi normal adalah dari rentang 18,5-24,99. Dapat disimpulkan olahraga aerobik berpengaruh terhadap kebugaran fisik, sedangkan status gizi tidak.  

Kata Kunci: Olahraga Aerobik., Status Gizi, Kebugaran
PREVALENSI SINUSITIS MAKSILARIS DITINJAU DARI GAMBARAN RADIOLOGIS PASIEN RINITIS DI RSUP SANGLAH
Authors: Jelita Kadek Intan , Sitanggang Firman Parulian , Martadiani Elysanti Dwi , Ayusta I Made Dwijaputra
Published: January 2024

Kondisi rinitis dapat diperburuk dengan adanya komorbiditas dengan sinusitis yang dapat juga menjadi satu istilah rinosinusitis. Sinusitis maksilaris merupakan jenis sinusitis yang paling banyak dijumpai. Saat ini, Foto Waters dan MSCT (Multisliced Computerized Tomography) Scan merupakan modalitas radiologis yang umum digunakan untuk mendiagnosis sinusitis maksilaris. Tujuan penelitian ini adalah untuk mengetahui prevalensi sinusitis maksilaris pada pasien rinitis dengan menggunakan Foto Waters dan MSCT scan sebagai alat diagnosis. Pasien rinitis yang diperiksa di RSUP Sanglah dari bulan Januari 2018 hingga bulan Agustus 2019 digunakan sebagai sampel penelitian. Kemudian dilakukan pengumpulan data sekunder tentang jumlah pasien rinitis yang melakukan pemeriksaan radiologis, jenis kelamin, usia, dan gambaran radiologis yang didapatkan. Gambaran radiologis yang didata adalah penebalan mukosa, perselubungan dan air-fluid level. Dari 50 sampel pasien rinitis yang diteliti, didapatkan 17 pasien rinitis (34%) mengalami deviasi septum, dan 18 pasien (36%) mengalami hipertrofi konka. Sebanyak 16 pasien (32%) melakukan pemeriksaan radiologis, dan sebanyak 34 pasien (68%) tidak melakukan pemeriksaan radiologis. Sebanyak 13 pasien (26%) menderita sinusitis maksilaris dan 37 pasien (74%) tidak mengalami kelainan. Didapatkan juga adanya perbedaan hasil pada pasien yang melakukan kedua pemeriksaan (Foto Waters dan MSCT Scan). Sinusitis maksilaris diderita lebih banyak pada perempuan sebanyak 7 orang (53,85%) dan pada laki-laki sebanyak 6 orang (46,15%). Penderita terbanyak didapatkan pada kelompok usia 15-29 tahun sebanyak 5 pasien (38,46%). Gambaran terbanyak pada Foto Waters adalah perselubungan sebanyak 3 penderita (75%), dan pada MSCT Scan adalah penebalan mukosa sebanyak 8 penderita (80%). Terdapat 2 sampel (4%) menderita sinusitis etmoidalis dan 1 pasien (2%) menderita pansinusitis.

Kata Kunci: Rinitis, Sinusitis Maksilaris, Foto Waters, MSCT Scan
EFEK PROTEKTIF BEKUL BALI (Ziziphus jujuba Mill.) TERHADAP SKOR KERUSAKAN PANKREAS DAN HISTOPATOLOGI PULAU LANGERHANS TIKUS TERINDUKSI DIET TINGGI LEMAK
Authors: Tri Pramartha I Nyoman , Sutirta Yasa I Wayan Putu , Dharma Santhi Desak Gde Diah , Wiradewi Lestari Anak Agung
Published: January 2024

Diet tinggi lemak merupakan faktor risiko sindrom metabolik yang dapat menimbulkan penyakit diabetes melitus tipe 2. Prevalensi diabetes terus meningkat dan merupakan penyebab utama dari 1,6 juta kematian global serta komplikasi diantaranya gagal ginjal, kebutaan, gagal jantung, hingga amputasi tungkai bawah. Tujuan penelitian ini menguji efek protektif buah bekul bali atau=Ziziphus jujuba Mill. (Zj) terhadap skor kerusakan pankreas dan histopatologi pulau Langerhans tikus yang diberikan diet tinggi lemak. Desain penelitian yang digunakan yaitu post-test dengan grup kontrol. Populasi dalam penelitian (n=25) tikus:Wistar jantan”(Rattus norvegicus).berumur 3-4 bulan dengan berat 180-200 g. Tikus secara acak dibagi kedalam lima kelompok yaitu: normal dengan diet standar (K-) dan diet tinggi lemak yang diberikan selama 56 hari dan perlakuan selama 14 hari berupa: plasebo (K+); ekstrak dosis 200 mg/kg Zj(rendah); ekstrak dosis 400 mg/kg Zj(sedang); ekstrak dosis 800 mg/kg Zj(tinggi). Data hasil pengamatan skor kerusakan pankreas kemudian dianalisis menggunakan SPSS versi 23. Hasil penelitian menunjukkan kelompok K+ memiliki skor kerusakan pankreas yang tinggi dan bermakna dibandingkan kelompok K- (p<0,01). Pada kelompok perlakuan, pemberian ekstrak dosis tinggi berhasil menunjukkan skor kerusakan pankreas paling rendah dan bermakna dibandingkan K+ (p<0,01). Sedangkan ekstrak dosis sedang dan rendah, meskipun menunjukkan skor yang lebih rendah dibandingkan K+, namun secara statistik tidak berbeda bermakna. Hal ini menunjukkan adanya efek terapi yang dose-dependent. Berdasarkan hasil tersebut dapat disimpulkan ekstrak etanol bekul bali (Ziziphus jujuba Mill.) memiliki potensi untuk dapat dikembangkan sebagai obat terkait efek protektifnya.

 

Kata Kunci: bekul bali (Ziziphus jujuba mill.), skor kerusakan pankreas, histopatologi pulau langerhans, diet tinggi lemak
Factors that Affect Quality Of Life of Post Mastektomic Breast Cancer Patients at Sanglah Hospital
Authors: Larasati Made Syanindita Putri , Setiawan I Gede Budhi , Wetan Ni Gusti Ayu Agung Manik Yuniawaty , Manuaba Ida Bagus Tjakra Wibawa
Published: January 2024

Background: Breast cancer is a malignancy of breast tissue that starts from the lobules or epithelial glands of the breast, where cancer cells grow out of control. Quality of life is a functional representation of physical, psychological, and social responses. Breast cancer affects a person's quality of life which is influenced by various factors, so it is necessary to conduct further research on the quality of life of post-mastectomy breast cancer patients at Sanglah Hospital to determine the quality of life of post-mastectomy breast cancer patients at Sanglah Hospital. Methods: This research is a cross sectional descriptive analytic study with primary and secondary data collection. The sample collection technique is total sampling with inclusion and exclusion criteria considerations, in order to obtain 92 respondents who then answered the EORTC QLQ-C30 questionnaire which was distributed for 3 months (July-September). The variables measured included quality of life, age, KPS, education level, occupation, stage, therapy, economic condition, and physical activity of breast cancer patients. Results: This study was analyzed by univariate, bivariate, and multivariate. From 92 respondents, the quality of life of breast cancer patients was found to be functional in good condition, symptoms and complaints were in poor condition, and overall quality of life and health were in good condition. In the bivariate analysis, therapy, occupation, physical activity, and KPS affect quality of life. In multivariate analysis, KPS affects the condition of symptoms and complaints, and physical activity affects the condition of quality of life and overall health. Conclusion: The quality of life of post-mastectomy breast cancer patients at Sanglah Hospital is generally in good condition, but there are several factors that affect the quality of life of post-mastectomy breast cancer patients at Sanglah Hospital.

Keywords : Breast cancer, quality of life, questionnaire EORTC QLQ-C30
KORELASI KADAR MAGNESIUM, ZINK DAN TEMBAGA DALAM ASI DENGAN PENAMBAHAN BERAT BADAN BAYI USIA 0-6 BULAN DI PUSKESMAS LUBUK BUAYA PADANG
Authors: Amir Aprima Yona , Manila Hartati Deri
Published: January 2024

Pemberian ASI ekslusif salah satu cara untuk meningkatkan status gizi bayi. Kanduangan ASI sangat ditentukan dari Magnesium, Zink dan Tembaga. Kekurangan zat gizi mikronutrien sangat berdampak khususnya bagi ibu menyusui dan bayi. Bagi ibu menyusui kekurangan mikronutrien (magnesium, zink dan tembaga) mengakibatkan terserang penyakit menular, malaria, paru-paru dan kematian, sedangkan bagi bayi kekurangan mikronutrian (magnesium, zink dan tembaga dalam ASI) berdampak tidak naiknya berat badan bayi dan panjang badan yang akan berakibat lambatnya pertumbuhan dan perkembangan tumbuh kembang bayi dan dampak buruknya akan mengakibatkan stunting. Tujuan penelitian ini untuk melihat korelasi kadar Magnesium, Zink dan Tembaga dalam ASI dengan penambahan berat badan bayi usia 0-6 bulan. Metode penelitian ini adalah cross sectional study. Responden penelitian adalah ibu yang mempunyai bayi usia 0-6 bulan yang menyusui secara ekslusif di Puskesmas Lubuk Buaya Padang dengan . Kadar magnesium Zink dan Tembaga dalam ASI di analisa di Balai Laboratorium Kesehatan (BLK) Kota Padang. Total sampel sebanyak 20 orang. Hasil penelitian ini menunjukkan korelasi kadar magnesium (r= 0,494). Berdasarkan uji statistik, hasil yang didapatkan adalah signifikan antara kadar magnesium dalam ASI dengan penambahan berat badan bayi usia 0-6 bulan, korelasi kadar zink (r= 0,518). Berdasarkan uji statistik, hasil yang didapatkan adalah signifikan antara kadar zink dalam ASI dengan penambahan berat badan bayi usia 0-6 bulan dan korelasi kadar tembaga (r= 0,469). Berdasarkan uji statistik, hasil yang didapatkan adalah signifikan antara kadar zink dalam ASI dengan penambahan berat badan bayi usia 0-6 bulan. Pada penelitian ini dapat disimpulkan terdapat Korelasi Kadar Magnesium, zink dan tembaga dalam ASI dengan penambahan berat badan bayi usia 0-6 bulan
TINGKAT PENGETAHUAN DAN SIKAP PETANI DI SUBAK SEMPIDI TENTANG SINAR MATAHARI SEBAGAI FAKTOR RISIKO KANKER KULIT
Authors: Richard Richard , Darmaputra I Gusti Nyoman , Wardhana I Made , Winaya Ketut Kwartantaya
Published: January 2024

Skin cancer is one of the most common cancers found in Indonesia. The most common skin cancers in Indonesia are basal cell carcinoma, squamos cell carcinoma, and melanoma. One of the harms caused by waves of solar radiation is damaging the DNA which later activates oncogene cells that could lead to cancer. One of the livelihoods that are abundant in Indonesia is agriculture. Farmers that are exposed to direct sunlight with excessive intensity are very susceptible to skin cancer which main risk factor is sunlight. The amount of outdoor activities with a superfluity intensity plus ignorance and the incapability to protect oneself from the sun causes the risk of getting skin cancer to be higher. Methods: The study was conducted using a descriptive approach with a transverse study design. Respondents took a total sampling of 64 respondents. Data collection was executed using a self-administered questionnaire instrument. The questionnaire consists of 20 numbers for the level of knowledge and 20 numbers for the attitude. Results: The level of good knowledge about sunlight as a risk factor for skin cancer as many as 45 people (70.31%), sufficient knowledge 17 people (26.56%), lack of knowledge 2 people (3.13%). Attitude about sunlight as a risk factor for skin cancer was 38 people (59.38%), 23 people (35.94%), a bad attitude was 3 people (4.68%). Conclusion: The level of understanding of farmers in Subak Sempidi, Sempidi Village, Mengwi District, Badung Regency regarding sunlight as a risk factor for skin cancer is in a good category.