TINGKAT PENGETAHUAN IBU HAMIL TERHADAP KUNJUNGAN PEMERIKSAAN ANTENATAL CARE

Background Antenatal care is important to ensure that natural processes continue to run normally during pregnancy. The fetus in the womb develops along with the gestational age, so if it is not properly monitored it can cause problems, both in pregnancy, childbirth and the puerperium, it can also result in the death of the mother and baby. Based on data from the Kenten Laut Banyuasin Health Center in 2020, the number of pregnant women who made ANC visits was 87 people. The purpose of this study was to determine the relationship between the level of knowledge of pregnant women and antenatal care examination visits. Methods This research method used a quantitative descriptive surver with a cross sectional approach and univariate and bivariate analysis using the chi square test. The population of this study were some pregnant women who visited were taken randomly at the Kenten Laut Banyuasin Health Center in 2020, with a total population of 32 people. The results of this study indicate that there is a relationship between the level of knowledge of pregnant women about ANC with ANC visits at the Kenten Laut Banyuasin Health Center in 2020 with a value of 0.008 <0.005. Therefore it is important for pregnant women to carry out prenatal examinations from the beginning so that it will be easier to know the baby's development and can detect signs of danger early to prevent complications early. Conclusion There is a relationship between the level of knowledge of pregnant women about ANC with ANC visits at the Kenten Laut Banyuasin Health Center in 2020 with a value of 0.008 < 0.005. Suggestions are expected for future researchers to conduct research on antenatal care with more interesting variables so that they can be studied more about antenatal care examinations and can be reviewed about the problems that exist in pregnant women so that pregnant women are healthier and of higher quality. Keywords : antenatal care visits,knowledge of pregnant women, maternal mortality ABSTRAK Latar Belakang Asuhan antenatal care penting untuk menjamin agar proses alamiah tetap berjalan normal selama kehamilan. Janin dalam kandungan berkembang seiring dengan besar usia kehamilan, maka apabila tidak dilakukan pengawasan yang tepat bisa menyebabkan masalah, baik dalam kehamilan, persalinan dan nifasnya, bisa juga mengakibatkan kematian ibu dan bayi. Berdasarkan data Puskesmas Kenten Laut Banyuasin Tahun 2020 jumlah ibu hamil yang melakukan Kunjungan ANC sebanyak 87 orang.Tujuan penelitian ini untuk mengetahui hubungan tingkat pengetahuan ibu hamil terhadap kunjungan pemeriksaan antenatal care.Metode Penelitian ini menggunakan Surver Deskriptif Kuantitatif dengan pendekatan Cross Sectional dan analisa univariat dan bivariat menggunakan uji chi square, Populasi penelitian ini adalah sebagian ibu hamil yang melakukan kunjungan diambil secara random sampling di Puskesmas Kenten Laut Banyuasin Tahun 2020, jumlah total populasi 32 orang.Hasil penelitian ini menjunjukkan bahwa ada hubungan tingkat pengetahuan ibu hamil tentang ANC dengan kunjungan ANC di Puskesmas Kenten Laut Banyuasin Tahun 2020 dengan ƿ value 0,008 < 0,005. Maka dari itu penting bagi ibu hamil untuk melakukan pemeriksaan kehamilan dari awal sehingga akan lebih mudah mengetahui perkembangan bayi dan dapat mendeteksi secara dini tanda-tanda bahaya untuk mencegah komplikasi secara dini.Kesimpulan Ada hubungan tingkat pengetahuan ibu hamil tentang ANC dengan kunjungan ANC di Puskesmas Kenten Laut Banyuasin Tahun 2020 dengan ƿ value 0,008 < 0,005.Saran diharapkan untuk peneliti selanjutnya untuk melakukan penelitian tentang antenatal care dengan variabel yang lebih menarik sehingga bisa dikaji lebih banyak lagi tentang pemeriksaan antenatal care dan bisa dikaji ulang tentang permasalahan yang ada pada ibu hamil supaya ibu hamil lebih sehat dan berkualitas Kata Kunci : Kunjungan Antenatal care, Pengetahuan ibu hamil, AKI

First Evaluation of a New Dynamic Scoring System Intended to Support Prescription of Adjuvant CytoSorb Hemoadsorption Therapy in Patients with Septic Shock

Introduction: Despite advances in critical care medicine, adjunctive approaches in sepsis therapy have failed to prove their efficacy. Notwithstanding promising results using hemoadsorption (CytoSorb), questions remain concerning timing and dosing. We created a dynamic scoring system (DSS) to assess patients with early septic shock and performed a first evaluation of the system in this patient population. Methods: Data from 502 patients with septic shock according to Sepsis-3 criteria were retrospectively analyzed. Score parameters were documented at the time of diagnosis (T0) and 6 h later (T6) to calculate a dynamic score. Survival on day 7 and 56 as well as ICU and hospital mortality were analyzed in regard to the score as well as the delay of hemoadsorption therapy. Results: Of the 502 patients analyzed, 198 received adjunctive CytoSorb treatment and 304 received standard therapy. Septic shock was typically represented by 5 points, while >6 points indicated a situation refractory to standard therapy with the worst outcome in patients shown by >8 points. The differences in mortality between the score groups (<6, 6–8, >8 points) were significant. Analysis further showed a significant 56-day, ICU and hospital survival advantage in CytoSorb patients when therapy was started early. Conclusion: We created a scoring system allowing for the assessment of the clinical development of patients in the early phase of septic shock. Applying this approach, we were able to detect populations with a distinct mortality pattern. The data also showed that an early start of CytoSorb therapy was associated with significantly improved survival. As a next step, this easy-to-apply scoring system would require validation in a prospective manner to learn whether patients to be treated with hemoadsorption therapy in the course of septic shock could thereby be identified.

THE EFFECT OF VIRTUAL REALITY ON COGNITIVE FUNCTIONS IN LADIES WITH DEMENTIA: LITERATURE REVIEW

Introduction: The decline in cognitive function that occurs in the elderly with dementia will have an impact on decreasing daily physical and social activities in the elderly resulting in decreased quality of life for the elderly. One of the interventions that can be used to maintain cognitive function in the elderly is by using virtual reality. Purpose: The purpose of this study is to explain the effect of virtual reality on cognitive function in elderly people with dementia based on empirical studies in the last five years. Method: the process of searching for journals or articles using a database indexed by Scopus, ProQuest, and Science Direct using adequate keywords. The framework used for the review was PICOS and the inclusion criteria used were English-language journals with issues from 2015 to 2020. Data analysis and tabulation were carried out in articles or journals. Title, abstract, full text, and methodology are assessed to determine the eligibility of the article or journal. Results: 758's articles were identified, ten articles fit the research criteria. Virtual reality affects cognitive function where it can improve memory, attention, executive function and can increase the overall scale of the MoCA. The advantage over the use of virtual reality for the elderly with dementia is that it not only improves cognitive but also improves motor coordination, reduces behavioral and psychological symptoms, and can be used to detect cognitive impairments early. Conclusion: In carrying out cognitive rehabilitation programs in the elderly can use technology-based interventions by using virtual reality.

COLLAGEN DRESSING VERSUS CONVENTIONAL DRESSINGS IN BURN AND CHRONIC WOUNDS: A COMPARATIVE STUDY

Objective: Biological dressings are water-resistant to bacteria, and generate the most physiological interfacebetween the wound surface and the environment. Collagen dressings have other superiority over conventional dressings in terms of ease of application and being natural, non-immunogenic, non-pyrogenic, hypoallergenic, and pain-free. Materials And Methods: The data of 120 patients with chronic wounds of diverse aetiologies and with signify age 43.7 years were accumulated and analyzed. The patients had been treated with collagen or other conventional dressing substance. The patients were split into two groups; 'Collagen group' and 'Conventional group', For the cause of comparison. 60 patients wereincluded in both groups. For assessment the wound characteristics in size, edge, oor, granulation tissue, and wound swab were recorded. With starting treatment, appearance of granulation tissue, completeness of healing, require for skin grafting, and patients' satisfaction was noted in both groups. Results: Sixty percentage of the 'collagen group' wounds and only forty-two percentage of the 'conventionalgroup' wounds were sterile (P=0.04) within two weeks of treatment. Healthy granulation tissue seemed earlier over collagen-dressed woundsthan over conventionally treated wounds (P=0.04). After eight weeks, (87%) of 'collagen group' wounds and (80%) of 'conventional group' wounds were >75% healed (P=0.21). In the 'collagen group' eight patients and twelvein the 'conventional group' required partial split-skin grafting (P=0.05). Collagen-treated patients enjoyed early. Conclusion: No remarkable better results were found in terms of complete of healing of burn andchronic wounds between collagen dressing and conventional dressing. Collagen dressing, however, mayavoid the require of skin grafting, and provides additional benet of patients' comfort.

PEMETAAN JENIS DONGENG NUSANTARA DALAM INFOGRAFIS

AbstrakDongeng merupakan warisan budaya lisan yang bersifat mendidik sekaligus menghibur. Sebagai warisan budaya lisan, keberadaan dongeng wajib dilestarikan agar tidak punah. Pada kenyataannya, generasi Z (Gen Z) Indonesia memiliki jarak dengan dongeng. Hal ini diketahui melalui kuesioner yang dibagikan kepada 70 siswa sekolah dasar kelas 3, 4, dan 5. Menurut responden dongeng hanya diketahui melalui pelajaran Bahasa Indonesia. Selain itu, responden tidak mengetahui secara pasti jenis-jenis dongeng nusantara. Penelitian ini bertujuan untuk memantik perhatian (awareness) Gen Z Indonesia terhadap jenis-jenis dongeng nusantara. Pendekatan dilakukan melalui bentuk infografis yang diasumsikan dapat mempermudah Gen Z Indonesia dalam memperoleh informasi, memahami hingga menyadari adanya dongeng. Metode yang digunakan dalam penelitian adalah metode campuran. Hasil pendekatan kuantitatif melalui kuesioner kemudian dianalisa dan dikonfirmasi ulang melalui wawancara dengan para responden melalui pendekatan kualitatif. Hasil wawancara menjadi rujukan dalam mengolah data menjadi pemetaan jenis-jenis dongeng nusantara ke dalam bentuk infografis. Selanjutnya infografis peta jenis dongeng nusantara diujicobakan melalui diskusi dengan kelompok responden yang terdiri dari generasi Z yang dipilih secara acak. Meskipun hasil yang didapat belum optimal, namun simpulan awal dari penelitian ini adalah generasi Z Indonesia mulai memperhatikan (aware) berbagai jenis dongeng nusantara sebagai warisan budaya lisan bangsa Indonesia yang harus dilestarikan. Kata Kunci: generasi Z, infografis, dongeng nusantara, pemetaan AbstractFairy tales are a verbal cultural heritage that is educating and entertaining. As a verbal cultural heritage, fairy tales' existence must preserve so as not extinct. In reality, Indonesian generation Z (Gen Z) has a distance from fairy tales. It's known through a questionnaire distributed to 70 elementary school students in grades 3, 4, and 5. According to them, fairy tales are known only through Bahasa Indonesia subjects. Besides, they do not know for sure the types of Indonesian archipelago fairy tales. This research aims to arise Indonesian Gen Z awareness towards the types of Indonesian archipelago fairy tales. The approach taken through the form of infographics is assumed to facilitate the Indonesian Gen Z in obtaining information, understanding, and being aware of Indonesian fairy tales. The method used in this study is a mixed-method. The quantitative approach research through a questionnaire was then analyzed and reconfirmed through interviews with respondents with a qualitative approach. The interview results referred to processing the data into mapping the types of tales of the Indonesian archipelago into infographics. Furthermore, the Indonesian archipelagos fairy tale type of infographic map was tested through a group discussion consist of randomly selected Gen Z respondences. Although the result not optimal, the early conclusion indicates that Indonesian Gen Z starting to become aware of the Indonesian archipelago fairy tales as the verbal cultural heritage of Indonesia that must be preserved. Keywords: Z generation, infographic, nusantara folktales, mapping

What issues must we address if we are to further accelerate recovery and shorten length of stay in total hip and knee replacement ERAS?

Objectives UK ERAS pathways are well established but length of stay (LOS) is still longer than for international exemplar sites. This survey asked staff what they felt were the issues that needed to be addressed in order to reduce LOS further. Methods Attendees at a multi-disciplinary meeting (Enhanced Recovery in Orthopaedic Surgery Conference, Glasgow, Scotland, 20/01/15) were surveyed. Results 58 respondents from 23 hospitals in England, Scotland and Ireland were made up of nurses (27), physiotherapists (18), anaesthetists (7), occupational therapists (3), surgeons (2) and a pharmacist. 54 respondents had two or more years experience working in ERAS. The staff surveyed thought that the most important factors in order to achieve a short LOS within their own hospitals were: When the respondents were asked which issues they felt they needed to improve within their own hospitals to shorten current LOS, 35 thought that better post-operative analgesia was required and 29 thought better pre-operative patient education and expectation management were required. There were three other major themes: One respondent commented Sometimes people can have severe pain but achieve goals and go home early. Conclusion Experienced ERAS staff cited pre-operative patient education and post-operative analgesia most frequently as key factors in achieving a short LOS, but as a group also identified these two steps as the ones most needing to be improved. Managing the side effects of anaesthesia, improving physiotherapy access, and greater social and community support post-discharge were also deemed important.

Haematological profile in clinically suspected cases of neonatal Sepsis

Neonatal septicemia is one of the major factors contributing to the high perinatal and neonatal mortality and morbidity in newborns and is recognized as global health challenge. Study was aimed the changes in hematological profile along with blood culture and C-reactive proteins in clinically suspected cases of neonatal sepsis. The present study were included 108 neonates clinically suspicious to have sepsis and admitted in NICU. Avacutainer, Glass slides, Leishman’s stain, Automated Hematology analyzer, Staining Kit was used. Maximum number of neonates i.e. 80 (74%) were less than 2 days old. 70 (64.82%) were males and 38 (35.18%) were females. Maximum number (53.70%) were preterm, respiratory distress seen in (76.11%) Premature rupture of membranes was observed in 39 (36.11%). The clinical suspicion of sepsis, 24 (22.22%) had proven sepsis, . Rodwell’s hematological score of > 3 identified 23 out of 24 (95.83%) proven sepsis group neonates, 24 (88.89%) probable sepsis group neonates. Of the 108 neonates with clinical suspicion of sepsis, 24 (22.22%) had positive blood cultures. The most common pathogen isolated in the blood culture was Klebsiella pneumonia in 12 (50%). Leucocytosis was seen in 4 (16.6%). The total WBC count has low sensitivity (37%) but a high specificity (96%) as indicator of sepsis. Elevated immature PMN count was observed (79.2%) Elevated .Thrombocytopenia was noted in 9 cases (37.5%) proven sepsis. CONCLUSION- Rodwell’s hematological scoring framework is a straightforward, speedy, financially savvy instrument which can be utilized as screening test for early conclusion of neonatal sepsis.

Do medical interns feel prepared to work in the COVID-19 pandemic?

SUMMARY OBJECTIVE To learn about the perceptions of medical internship students about the early conclusion of the course and their preparation to act in the fight against COVID-19. METHODS An online questionnaire was applied with questions about the socioeconomic profile and the object of investigation. The data were analyzed using the Bioestat 5.0 software. RESULTS 111 students participated, most of whom (61.3%) were male, aged 20 to 25 years (80.2%), of Catholic religion (57.5%), and attending the 2nd year of internship (50.5%). A small portion (22.5%) reported being in total social isolation. The majority (57.5%) considered themselves unprepared to act in the fight against the pandemic, and 86.8% of the students believe that the early conclusion of the course will contribute to the fight against COVID-19 in the country. CONCLUSION This scenario points to the urgency of measures that provide, to recent graduates, timely technical preparation, safe work conditions, and emotional support even at the beginning of their professional career, leading them to competent, dignified and healthy work, during and after the pandemic.

Simplified management of a giant forehead congenital nevus allows for early reconstruction

We report simplified surgical management of giant congenital forehead nevus that customarily requires the use of tissue expander for complete excision. Commencing treatment at the age of 3 months, the TopClosure tension relief system (TRS) was applied as an external tissue expander allowing preoperative skin stretching by mechanical creep. This was followed by partial excision of the nevus. Intraoperative stress-relaxation allowed further expansion of the skin. Postoperative wound closure was secured with the aid of the TRS. Repeated, six simple staged excisions of the forehead lesion and a minor skin graft to the eyelid part, allowed for delayed primary closure of the entire lesion by the age of 2. This simple alternative approach, which allows the early start and early conclusion of the reconstructive process, should be considered as the primary option in the treatment of these patients.

On the role of reduced wind mass-loss rate in enabling exoplanets to shape planetary nebulae

ABSTRACT We use the stellar evolution code MESA–binary and follow the evolution of three exoplanets and two brown dwarfs (BDs) to determine their potential role in the future evolution of their parent star on the red giant branch (RGB) and on the asymptotic giant branch (AGB). We limit this study to exoplanets and BDs with orbits that have semimajor axis of $1 {~\rm au}\lesssim a_0 \lesssim 20 {~\rm au}$, a high eccentricity, $e_0 \gtrsim 0.25$, and having a parent star of mass M*,0 ≥ 1 M⊙. We find that the star HIP 75 458 will engulf its planet HIP 75 458b during its RGB phase. The planet will remove the envelope and terminate the RGB evolution, leaving a bare helium core of mass 0.4 M⊙ that will evolve to form a helium white dwarf. Only in one system out of five, the planet beta Pic c will enter the envelope of its parent star during the AGB phase. For that to occur, we have to reduce the wind mass-loss rate by a factor of about four from its commonly used value. This strengthens an early conclusion, which was based on exoplanets with circular orbits, which states that to have a non-negligible fraction of AGB stars that engulf planets we should consider lower wind mass-loss rates of isolated AGB stars (before they are spun-up by a companion). Such an engulfed planet might lead to the shaping of the AGB mass-loss geometry to form an elliptical planetary nebula.