COVID-19 Time of Intubation Mortality Evaluation (C-TIME): A System for Predicting Mortality of Patients with COVID-19 Pneumonia at the Time They Require Mechanical Ventilation.

Background: An accurate system to predict mortality in patients requiring intubation for COVID-19 could help to inform consent, frame family expectations and assist end-of-life decisions. Research objective: To develop and validate a mortality prediction system called C-TIME (COVID-19 Time of Intubation Mortality Evaluation) using variables available before intubation, determine its discriminant accuracy, and compare it to APACHE IVa and SOFA. Methods: A retrospective cohort was set in 18 medical-surgical ICUs, enrolling consecutive adults, positive by SARS-CoV 2 RNA by reverse transcriptase polymerase chain reaction or positive rapid antigen test, and undergoing endotracheal intubation. All were followed until hospital discharge or death. The combined outcome was hospital mortality or terminal extubation with hospice discharge. Twenty-five clinical and laboratory variables available 48 hours prior to intubation were entered into multiple logistic regression (MLR) and the resulting model was used to predict mortality of validation cohort patients. AUROC was calculated for C-TIME, APACHE IVa and SOFA. Results: The median age of the 2,440 study patients was 66 years; 61.6 percent were men, and 50.5 percent were Hispanic, Native American or African American. Age, gender, COPD, minimum mean arterial pressure, Glasgow Coma scale score, and PaO2/FiO2 ratio, maximum creatinine and bilirubin, receiving factor Xa inhibitors, days receiving non-invasive respiratory support and days receiving corticosteroids prior to intubation were significantly associated with the outcome variable. The validation cohort comprised 1,179 patients. C-TIME had the highest AUROC of 0.75 (95%CI 0.72-0.79), vs 0.67 (0.64-0.71) and 0.59 (0.55-0.62) for APACHE and SOFA, respectively (Chi2 P<0.0001). Conclusions: C-TIME is the only mortality prediction score specifically developed and validated for COVID-19 patients who require mechanical ventilation. It has acceptable discriminant accuracy and goodness-of-fit to assist decision-making just prior to intubation. The C-TIME mortality prediction calculator can be freely accessed on-line at https://phoenixmed.arizona.edu/ctime.

Episode of Hepatitis C viral infection in the people of Swat, Pakistan

ABSTRACT Infectious agents cause serious diseases in humans worldwide and are responsible for the high rate of morbidity and mortality. The prevalence and epidemiology of infectious disease (HCV) in the hospital visited patients referred by the physicians through the initial findings and their associated risk factors were studied in Swat. The data of 174 infected patients were collected during the period of 2015 to 2017 from two clinical laboratories of Tehsil Matta Swat. Inform consent form was taken before blood collection. After taking informed consent blood samples were collected and ICT test was performed and then ICT positive cases were conform through PCR. A total of 174 ICT positive samples [106 male and 68 females] were included in this study. Age was considered from 10 to 72 years. Of the 174 ICT strip positive, 99 [63 males, 36 females] were confirmed through PCR. The prevalence rate was recorded 56.89%. I.V/I.M injection was recorded in 100% of the individuals. Visits to the barber shop was reported in (58%) of the individuals, married individuals were (81.0), surgical operation was reported in (44.8%), sharing toothbrush was observed in (29.9%), piercing was reported in (39.7%), family history was reported in (26.4%), dental treatment was observed in (21.8%), jaundice were (13.2%) and tattooing was (1.7%). Blood transfusion, surgical operations, Jaundice, family history and dental treatment were found significant risk factors for acquiring HCV infection. It was concluded that proper implementation of precautionary measures should be needed to control the spread of HCV in far near future.

Perception and Behavioural Outcome towards COVID-19 Vaccine among Students and Faculties of Nursing Colleges at Gujarat

Introduction: Perception and behaviour towards corona vaccine among peoples in India was poor due to some side effects and negative media publicity in primary phases of vaccination. India has developed two types of vaccine (Covaxin and Covishield). During primary phase of corona vaccine we don’t have appropriate research and literature, about side effects and how far vaccine is reliable that why due so some minor side effect and negative media publicity peoples are very scared to take vaccine. So few peoples were started denial get vaccinated. The researcher wan to explore the positivity through the research result to reduce the negative mindset of the peoples toward corona vaccine, Because in India few peoples has fear to take vaccine against corona due to negative media publicity and scared of side effect. Objective: To assess the existing level of perception and behaviour toward COVID-19 vaccine and to find out the association between selected socio-demographic variables. Methods: Descriptive cross sectional survey research design was used and non-probability (snowball) sampling method was used to drawn samples through online Google form, all questions were plots on Google form and inform consent form also has been taken online prior to data collection from the samples. Prior to data collection written setting permission obtain from nursing colleges principals, for the data collection researcher were selected total 03 nursing institutes. The total sample size was 254 nursing college students and faculties. The tool consist of following Section-01 Demographic variables, section-02 Nursing students and faculties information related to COVID-19 vaccination during 1st and 2nd dose and Section-3 Questions related to perception and behaviour towards COVID-19 vaccine. Descriptive statistics applied where, data were analyzed by using SPSS software, and Frequency, percentage, tables etc. were used to represent the statistical data in the tables. Chi-square test was used to assess the significant association between the demographic and level of perception to test the hypothesis. Results: Out of 254, 245(96.45%) were belong age 18-25 years, 8(3.14%) were belong to 26-35, 1 (0.34%) was belong to 46-60 age group. 219(86.22%) were females, 53(20.87%) were study Diploma course and 178(70.08%) were study degree course, regarding religion 223(87.79%) were Hindu, 5(1.97%) were Muslim and 26(10.24%) were Christian, Marital status 227(89.37%) were Unmarried and 24(9.47%) were Married, 134(52.75%) were from urban area, and rest 120 (47.24%) belongs to Rural area. Sources of information about COVID 19 vaccine 109(42.92%) got from online media, 44(17.32%) from television, 243(95.67%) received free of cost corona vaccine, 199(78.35%) mindset was not influenced by negative media publicity about vaccine, 248(97.63%) do not have any co-morbidities. 219(86.22%) taken Covid-19 vaccine empty stomach. 221(87%) of samples were taken willingly vaccine, 205(80.71%) of samples were received Covishield vaccine and others 49(19.29%) were taken Covaxin, 109(42.91%) samples noticed mild fever, 53(20.87%) samples noticed moderate fever, 18(7.08%) noticed severe fever and rest 74(29.13%) didn’t noticed fever. Conclusions Regarding perception and behaviour towards COVID-19 vaccine, the majority of samples has good perception and behaviour, 74% has good perception and only 23% had moderate to poor perception, majority of participant were willingly taken vaccine and agree to recommend to others, not evidence any serious side effect due to vaccination.

A STUDY OF KNOWLEDGE AND ATTITUDE ABOUT THE DIABETES, AMONG DIABETIC PATIENTS

Background: The present study was conducted with the aim to determine the knowledge, attitude and practice of diabetes amongst population. Methods: Hospital based study was conducted on DM patients attending the diabetes center, medicine OPD and medicine IPD within the study period were recruited in the study after taking written inform consent. Results: Regarding knowledge about complications of diabetes i.e. heart disease stated to be the highest in patients which was 201 (40.2%) followed by wound healing110(22.00%), eye disease 102(20.4%), peripheral neuropathy 96 (19.2%) and kidney diseases 92(18.4%). Conclusion: From our study it was concluded that Knowledge about what disease is, was good and regarding symptoms (frequent urination) was also good but complication(Heart disease, stroke, kidney disease, eye disease, peripheral neuropathy, wound healing) was poor. Keywords: DM, OPD, IPD.

Frequency of Hypocalcaemia following total Thyroidectomy

Background: The most common post-thyroidectomy complication is hypocalcaemia. It could be permanent or transitory. Permanent hypocalcaemia has a prevalence of 0-13% and transient hypocalcaemia has a prevalence of 1-6%. Aim: The study objective was to ascertain the prevalence of postoperative hypocalcaemia in patients following total thyroidectomy. Materials and Methods: This cross-sectional study was carried out on 84 thyroid patients who underwent total thyroidectomy in the surgical department of HBS General Hospital, Islamabad for period of nine months during from September 2020 to May 2021. Patients within the age range of 15-69 years and had indicated thyroidectomy caused by carcinoma thyroid, multinodular goiter, and recurrent goiter were enrolled. Inform consent was obtained from each participant. Ethical approval was taken from the institutional ethical committee. Thyroid profile and serum calcium were done for a routine investigation. Serum calcium levels were measured 24 hours, 48 hours, and 7 days after total thyroidectomy. Signs and symptoms in hypocalcaemia patients were recorded on a proforma. Patients with hypocalcaemia were followed for six months. SPSS version 20 was used for data analysis. Results: The mean age of the patients was 46.7 ± 4.6 years with an age range of 16 to 69 years. Of the total 84 patients, 38 (45.2%) underwent total thyroidectomy and 46 (54.8%) underwent a complete thyroidectomy. The prevalence of male and female patients was 22 (26.2%) and 62 (73.8%) respectively. Malignant and benign were present in 71 (84.5%) and 13 (15.5%) respectively. Of the total 84 patients, 68 (81%) developed hypocalcaemia. Out of 68 hypocalcaemia patients, 29 (42.6%) and 39 (57.4%) were from the benign and malignant groups respectively. Conclusion: Postoperatively hypocalcaemia was prevalent following thyroidectomy. Malignant patients (84.5%) were more prevalent compared to benign patients (15.5%) after total thyroidectomy. Careful surgical procedures, parathyroid gland vascularity preservation, and identification are critical in preventing hypocalcaemia following total thyroidectomy. Keywords: Hypocalcaemia; Total thyroidectomy; Complete Thyroidectomy

Analisis biomekanika free throw basket sesuai kaidah Dave Hopla

Penelitian ini bertujuan untuk menganalisis gerakan free throw sesuai dengan kaidah Dave Hopla. Metode penelitian ini menggunakan eksperimen dengan teknik tes dan pengukuran. Total sampel berjumlah 5 atlet PPLP Basket Kota Semarang yang telah mengisi inform consent dan menyetujui prosedur penelitian. Hasil penelitian ini didapatkan rata rata waktu pada tahap persiapan sebesar 0,53 ± 0,13 detik dengan sudut ayunan sebesar 120°. Gerakan awalan sudut lengan 90° dan rata rata waktu 0,25 ± 0,04 detik dengan sudut fleksi lutut sebesar 99,04 ± 0,04 derajat. Data pada tahap pelaksanaan untuk waktu yang diperoleh sebesar 0,29 ± 0,07 detik dengan sudut fleksi lengan sebesar 55,74 ± 5,54 derajat sedangkan pada tahap akhir dengan rata rata waktu 0,24 ± 0,04 detik dengan jarak shooting 3,64 ± 4,64 meter. Kesimpulan dalam penelitian ini menunjukkan bahwa gerakan free throw sudah sesuai dengan kaidah dari Dave Hopla. Hasil free throw juga menunjukkan bahwa shooting precision pada kategori Cukup. Keterbatasan dalam penelitian ini yaitu jumlah sampel yang sedikit terkendala pembatasan social pada masa pandemic Covid-19. Penelitian selanjutnya diharapkan bahwa kaidah Dave Hopla dapat dijadikan sebagai rujukan dalam melakukan free throw untuk efektivitas dan efisiensi gerakan serta akurasi shooting.Biomechanical Analysis of Basketball Free Throw According to The Rules of Dave HoplaAbstractThis aims of this study was to analyze the free throw motion according to Dave Hopla's rules. This research method uses descriptive quantitative with survey tests and measurements. The total sample consisted of 5 PPLP Basket athletes in Semarang who had filled the informed consent and approved the research procedure. The results of this study found an average time in the preparation phase was 0.53 ± 0.13 seconds with a swing angle of 120°. The prefix movement of the arm angle was 90° and an average time was 0.25 ± 0.04 seconds with a knee flexion angle of 99.04 ± 0.04 degrees. The data at the implementation phase for the time obtained were 0.29 ± 0.07 seconds with an arm flexion angle was 55.74 ± 5.54 degrees while in the follow through phase an average time was 0.24 ± 0.04 seconds with a shooting distance of 3.64 ± 4.64 meters.The conclusion of this study showed that the free throw motion is in accordance with Dave Hopla's rules. The free throw result also showed that the shooting precision is in the Moderate category. The limitation in this study was the sample size is slightly constrained by social restrictions during the Covid-19 pandemic. Further research is expected that Dave Hopla's rule can be a reference in making effective and efficient free throws.

Adiponection Serum Levels in Severe Preeclampsia

Objective : To determine the difference adiponectin serum levels in pregnant patient with severe preeclampsia and normotency in Manado. Methods : This study is a cross sectional study which the number of samples obtained was 52 samples in which the sample was divided into 26 pregnant samples with severe preeclampsia and 26 control samples. Samples were taken from Prof. dr. R. D. Kandou Manado Hospital and network hospitals around Manado within the inclusion and exclusion criteria. All patients were explained about the research procedure and singning the informed consent and take a blood sample by using the ELIZA method. After the data is collected, it is entered into the SPSS version 23.0 program for data analysis. Results : There was a significant relationship between adiponection serum levels with the incidency of severe preeclampsia and normotency. But for body mass index variables there were no significant differences by using T test (independent sample) in each severe preeclampsia and normotency pregnancy group where p=0.903. Body mass index, height, weight, and weight gain during pregnancy showed that there is no difference between cases and controls (p>0.05) which means that body mass index is not related to the stete of the severe preeclampsia and normotency. Conclusions : There was no relationship between BMI, age, parity, smoking, baby outcomes, delivery method and gestational age with the incidence of severe preeclampsia and normotency against adiponectin in this study. Keywords: adiponectin, obstetrics, preeclampsia. Abstrak Tujuan : Untuk mengetahui perbedaan kadar adiponektin serum pada pasien hamil preeklamsia berat dengan hamil normal di Kota Manado. Metode : Studi ini merupakan studi potong lintang. Jumlah Sampel yang didapatkan sebesar 52 sampel dimana sampel dibagi menjadi 26 sampel hamil dengan preeklamsia berat dan 26 sampel kontrol. Sampel diambil dari RSUP Prof. dr. R. D. Kandou Manado dan rumah sakit jejaring sekitar manado yang memenuhi kriteria inklusi dan eksklusi. Semua pasien dijelaskan mengenai prosedur penelitian dan penandatanganan inform consent baru dilakukan pengambilan sampel darah untuk dilakukan pemeriksaan laboratorium dengan menggunakan metode ELISA. Setelah data dikumpulkan, maka dimasukkan ke dalam program SPSS versi 23.0 untuk data analisis. Hasil : Perhitungan dengan menggunakan uji statistik Mann - Whitney menunjukkan bahwa terdapat perbedaan bermakna nilai rata-rata kadar adiponektin pada pasien hamil normal dengan pasien PEB (p = 0,000). Adanya hubungan bermakna kadar adiponektin dengan kejadian preeklamsia berat. Namun untuk variabel IMT yang dilakukan secara uji t (sampel independen) didapatkan kesimpulan tidak terdapat perbedaan bermakna pada masing-masing kelompok normotensi dan kelompok preeklamsia berat di mana p= 0,903, indeks massa tubuh, tinggi badan, berat badan, serta pertambahan berat badan selama kehamilan tidak berbeda antara kasus dan kontrol (p>0,5). Ini berarti bahwa IMT tidak berhubungan dengan keadaan terjadinya preeklamsia berat. Kesimpulan: Tidak didapatkan hubungan antara IMT, usia, paritas, merokok, luaran bayi, cara persalinan dan usia kehamilan dengan kejadian preeklamsia berat dan normotensi terhadap adiponektin pada penelitian ini. Kata kunci : adiponektin, obstetri, preeklamsia.

Hygroma Colli

Background : Hygroma coli is a malformation of the lymphatic system in the form of a membrane cyst filled with fluid, limited by the epithelium that is located in the anterolateral or occipito-cervical region. The prenatal diagnosis of cystic hygroma coli by ultrasound is based on an apparently bilateral, mostly symmetrical, and sometimes unilateral cystic structure located in the occipitocervical region. Large hygroma coli can cause pressure on the respiratory tract and digestion, so it requires management as soon as possible.The main treatment modality is surgical excision to remove the cystic lesion. The prognosis of a hygroma coli cyst depends on its size and the action taken because it is rare for cases to experience spontaneous regression.Destination : Reported a case of hygroma colliMethods : Case ReportCase Report : Case 24 years old women with preterm G1P0A0L0 26-27 weeks + Hygroma colli + IUFD + Suspected COVID-19. On ultrasound examination, it was found that BPD =4,71; AC = 15,91; FL = 2,89; EFW = 330 gr; FHR = (-); Cyst = 5,06 x 3,26. The presence of head presentation, IUFD, hygroma colli was found. The patient was planned for labor induction and the progress of labor was followed. Patient provided inform consent that baby was death during pregnancy and need to be labored. The baby was born, weight 300 gr, body length 14 cm and A/S 0/0. Postmortem physical examination revealed findings of hygroma colli infants such membrane cyst filled with fluid that located in the occipito-cervical region. Conclusion: Hygroma colli is a malformation of the lymphatic system and the prognosis or complications depends on the size of cyst. Careful prenatal examination is required in diagnosis and termination of pregnancyKeywords: Hygroma Colli, prenatal diagnosis

Potential Use of Cell Free Fetal DNA at 13 Short Tandem Repeats Loci for Noninvasive Prenatal Paternity Test

Background : Prenatal paternity test is mostly performed by using Amniocentesis or Chorionic Villus Sampling (CVS) methods. However, these methods require invasive procedures, which are potentially harmful for both the mother and the fetus. Currently, the invention of of Cell-Free Fetal DNA (cffDNA) has offered the opportunity of performing prenatal paternity test non-invasively. Materials and Methods : This study is a cross sectional descriptive study to detect cell free fetal DNA at 13 STR loci and at amelogenin gene to evaluate fetus gender, which will be compared to the baby gender afterbirth. Healthy third semester pregnant women were included as participants. Inform consent for both the mother and the biological father has been provided. Result : Four participants has been evaluated. In this study, in all participants, we found the presence of cffDNA in almost all of the STR loci. Some loci cannot be detected due to the small amount of cffDNA in the loci. All fetus genders detected by cffDNA in the amelogenin gene macthed the gender of the four babies afterbirth. Conclusion : The use of Cell-Free Fetal DNA (cffDNA) is a potential non-invasive methods in prenatal paternity test. Additionally, the ability of the method to evaluate fetus gender has been suggested.

Penerapan Intervensi Picture Plus Discussion pada Anak Retardasi Mental Ringan

Tujuan dari penelitian ini adalah untuk mengetahui pengaruh intervensi Picture Plus Discussion (PPD) dalam meningkatkan kemampuan pemahaman bacaan anak retardasi mental ringan. Penelitian ini menggunakan single case experimental design jenis A-B. Partisipan penelitian berjumlah tiga orang anak retardasi mental ringan. Partisipan dipilih berdasarkan kriteria tertentu yakni memiliki kemampuan membaca minimal pada tahap kata dan bersedia mengikuti proses intervensi dengan menandatangani inform consent. Pengumpulan data dilakukan dengan teknik wawancara, observasi, tes kecerdasan, tes informal akademik. Intervensi Picture Plus Discussion (PPD) dilakukan selama sepuluh kali pertemuan. Instrumen pengukuran menggunakan alat tes ASER. Pengukuran skor 1 atau 0 didasari oleh ketepatan partisipan dalam menjawab alat tes ASER. Follow up dilakukan sepuluh hari setelah dilakukan intervensi dengan memberikan 16 soal pertanyaan pemahaman teks bacaan. Hasil analisis data menunjukkan bahwa intervensi PPD dapat meningkatkan kemampuan pemahaman anak retardasi mental ringan. Median skor masing-masing partisipan mengalami kenaikan.