Propofol Autocoinduction and Midazolam Co-induction for Propofol Induction

Intoduction: The problem with induction during anaesthesia is decrease in blood pressure, apnea which could be detrimental to patient. Co-induction and autocoinduction are one of the modalities that are developed to overcome hypotension during induction. The study was carried out to observe heart rate, blood pressure response and propofol consumption following midazolam as co-induction or propofol autocoiniduction for propofol induction. Methods: This study was a conducted in 52 patients of ASA I and ASA II undergoing elective surgical procedures with general anesthesia. Patients were randomly allocated and group P received 0.5 mg/ kg of propofol and group M received 0.04 mg/ kg of midazolam intravenously as autocoindution and coinduction respectively. Results: The two groups were identical regarding age, weight, ASA status and base line vitals. This study showed that there was significant difference between 2 groups in terms of blood pressure. Decrease in blood pressure from baseline is more in Midazolam group compared to propofol. In terms of Heart Rate there was no statistically significant between two groups at any time of observation. Decrease in HR from baseline was almost similar in both groups. Consumption of Propofol was not statistically significant different between two groups. Propofol group required 8% lesser Propofol than Midazolam group. Conclusions: Our study concluded that blood pressure was decreased significantly in Midazolam group compared to Propofol group but heart rate was decreased almost similar in both groups and was not statistically significant. Consumption of Propofol was not statistically significant but Propofol group had 8 % lesser Propofol consumption than Midazolam group.

Analysis Of The Used Of Captopril Drug With Blood Pressure Of Hypertension Patients

Hypertension was a systolic blood pressure equal to or above 140 mmHg and or diastolic blood pressure equal to or above 90 mmHg. This research was done in one of Banyuwangi district Puskesmas with the purpose of analyzing the use of captopril drug to change blood pressure of hypertension patients at Banyuwangi district Puskesmas This research used a type of comparative, comparatively paired sample analytical research, with the design cohort retrospective. The instrument used in this research was a patient's medical record. Samples were calculated using the total sampling technique during the research period. The Data was processed using SPSS version 18 and analyzed use Wilcoxon test. The samples obtained during the research period were a number of 96 patients. The results showed that the use of captopril drugs gave a change in blood pressure marked with a value of P < 0.05. Captopril drugs provided changes in blood pressure decrease in hypertension patients, so it can be used as an antihypertensive recommendation according to the classification of patients in research.

Pengaruh Pemberian Jus Tomat Terhadap Tekanan Darah Lansia Penderita Hipertensi Di Puskesmas Kotabumi 2 Kecamatan Kotabumi Selatan Kabupaten Lampung Utara

ABSTRACT: THE EFFECT OF TOMATO JUICE CONSUMPTION TOWARD BLOOD PRESSURE DECREASE ON HYPERTENSIVE ELDER PATIENTS AT KOTABUMI 2 HEALTH CENTER OF KOTABUMI SELATAN SUBDISTRICT OF LAMPUNG UTARA REGENCY Introduction: Hypertension is a blood vessel disruption causing deficiency of oxygen and nutrition brought blood hampered to reach the target tissues. Based on the SP2TP of Kotabumi 2 Health Center of Kotabumi Selatan Sub district of Lampung Utara Regency, the health center placed the first rank for the hypertension number in the regency with 2,998 cases. Objective: This study was to identify the effect of tomato juice consumption toward blood pressure decrease on hypertensive elder patients at Kotabumi 2 Health Center of Kotabumi Selatan Sub district of Lampung Utara Regency in 2019. Method: This was a quantitative study with quasi experiment design and one group pretest and posttest approach. The population of the study consisted of 143 elder people complaining hypertension. The sampling technique was accidental sampling that resulted 30 respondents. The independent variable was giving tomato juice while the dependent variable was blood pressure decrease. The study was conducted at Kotabumi 2 Health Center of Kotabumi Selatan Sub district of Lampung Utara Regency. The data analysis was through univariate and bivariate (T-Test). Result: the result of the study found that the mean score of blood pressure before given intervention was 152.83 with 5.279 deviation standard. After the intervention was undertaken, the blood pressure average score was 133.00 with 5.072 deviation standard. It implied that there was an effect of tomato juice towards blood pressure decrease on elder patients at Kotabumi 2 Health Center of Kotabumi Selatan Sub district of Lampung Utara Regency in 2019 (t-test > t table, 19.833 > 4.197 p value = 0.000 (p value <α =0.05)). Conclusion: There was an effect of tomato juice towards blood pressure decrease on elder patients at Kotabumi 2 Health Center of Kotabumi Selatan Sub district of Lampung Utara Regency in 2019. The health practitioners at the health center should implement the non-pharmacologic management on hypertension patients by promoting tomato juice as an alternative. Keywords: hypertension, tomato juiceINTISARI: PENGARUH PEMBERIAN JUS TOMAT TERHADAP TEKANAN DARAH LANSIA PENDERITA HIPERTENSI DI PUSKESMAS KOTABUMI 2 KECAMATAN KOTABUMI SELATAN KABUPATEN LAMPUNG UTARA Pendahuluan : Hipertensi merupakan suatu gangguan pada pembuluh darah yang mengakibatkan suplai oksigen dan nutrisi yang dibawa oleh darah terhambat sampai ke jaringan tubuh yang membutuhkanya. Berdasarkan data SP2TP Puskesmas Kotabumi 2 Kecamatan Kotabumi Selatan Kabupaten Lampung Utara merupakan Fasilitas Kesehatan Tingkat Pertama yang memiliki kunjungan penyakit Hipertensi terbanyak, yaitu berjumlah 2.988 kasus.Tujuan Penelitian : diketahui pengaruh jus tomat terhadap tekanan darah lansia penderita hipertensi di puskesmas kotabumi 2 kecamatan kotabumi selatan kabupaten lampung utara tahun 2019Metode Penelitian : Jenis penelitian kuantitatif dengan rancangan quasy eksperimen dengan pendekatan one group pre dan post test design, Populasi seluruh lansia penderita hipertensi berjumlah 143 lamsia dengan sampel 30 responden teknik sampling accidental samplingvariabel independen pemberian jus tomat dan variabel dependen penurunan tekanan darah. dilakukan di Puskesmas Kotabumi 2 Kecamatan Kotabumi Selatan Kabupaten Lampung Utara. analisa data univariat dan bivariate (uji t-test)Hasil Penelitian : Dari hasil penelitian diketahui Rata-rata tekanan darah sebelum dilakukan intervensi adalah 152,83 dengan standar deviasi 5,279), dan setelah dilakukan intervensi 133,00 dengan standar deviasi 5,072. Bahwa ada pengaruh jus tomat terhadap tekanan darah lansia penderita hipertensi di Puskesmas Kotabumi 2 Kecamatan Kotabumi Selatan Kabupaten Lampung Utara tahun 2019 (t-test > t tabel, 19,833> 4,197 p-value = 0,000 (p-value < α = 0,05).Kesimpulan : Ada pengaruh jus tomat terhadap tekanan darah lansia penderita hipertensi di Puskesmas Kotabumi 2 Kecamatan Kotabumi Selatan Kabupaten Lampung Utara tahun 2019. Saran bagi petugas kesehatan puskesmas dapat menerapkan penatalaksanaan penurunan tekanan darah pada penderita hipertensi dengan cara non farmakologis yaitu dengan pemberian terapi jus tomat Kata kunci : hipertensi, jus tomat

P5470Studying target organ damage indices in newly diagnosed and never treated extreme dipper patients with essential hypertension

Background Cardiovascular risk estimation in arterial hypertension includes the investigation for target organ damage indices (TOD). 24h ambulatory blood pressure monitoring (ABPM) represents the gold standard method for the confirmation of the arterial hypertension disease. Dipping phenomenon, defined as blood pressure decrease >10% during night-time measurements, leads to hypertension burden reduce during night and carries a positive prognostic significance. However, there are doubts regarding its prognosis when it becomes augmented (extreme dipping defined as blood pressure decrease >20% during night-time measurements). Aim of our study is to explore TOD existence between extreme dipper and dipper hypertensive patients with newly diagnosed and never treated arterial hypertension. Methods From the 480 total patients with newly diagnosed and never treated arterial hypertension who subjected to ABPM, we excluded 190 non-dipper patients and we divided the rest 290 hypertensives (mean age 49±11 years, 193 males) in normal dippers (n=245, mean age 49±11 years, 160 males) and extreme dippers (n=45, mean age 49±10 years, 33 males). Both groups were subjected to the following measurements: arterial stiffness (PWV), 24h microalbumin levels (MAU), carotid intima-media thickness (IMT), diastolic dysfunction (E/Ea), left ventricular mass index (LVMI) and coronary flow reserve (CFR). Results We did not find any differences within groups regarding age, sex distribution, BMI, office SBP/DBP, cenrtal SBP/DBP and daytime average SBP/DBP as well as PWV, MAU, IMT, E/Ea and CFR. We noticed that extreme dippers had reduced 24h average SBP/DBP (p=0.001 and p=0.02, respectively) and increased LVMI (86±18 vs. 79±20 gr/m2, p=0.04) compared to normal dippers. Differences in LVMI Conclusions Extreme dipper hypertensive patients have an increased LVMI, probably as a result of myocardial hypoxia due to severe blood pressure reduction over night. Our results point to the possible increased cardiovascular risk in this group of hypertensive patients.

Mathematical Modeling of the Antihypertensive Drugs Action

Arterial hypertension is one of the most common diseases of the human cardiovascular system and is characterized by persistent increase in blood pressure. Normalization of blood pressure can be achieved by using antihypertensive drugs with various mechanisms of action. In this work, we investigated a modular mathematical model of the human cardiovascular system created earlier, and complemented it with pharmacodynamic models of five different classes of antihypertensive drugs with such exemplars as aliskiren, losartan, bisoprolol, enalapril and amlodipine. We used clinical trials found in the literature in order to validate the resulting model. Specifically, we generated a population of virtual patients with high blood pressure and modeled their treatment with these antihypertensive drugs. Eventually, the model predicted blood pressure decrease in good agreement with clinical trials. In this way, our model can be further used to optimize the choice of drugs for a particular patient.In silico

PENGARUH TERAPI RELAKSASI GENGGAM JARI DAN NAFAS DALAM TERHADAP PENURUNAN TEKANAN DARAH PADA PENDERITA HIPERTENSI DI WILAYAH KERJA PUSKESMAS KARTASURA

Hipertensi merupakan suatu gangguan pada sistem peredaran darah yang sering terjadi pada masyarakat. Salah satu penanganan dalam penurunan tekanan darah adalah menggunakan terapi relaksasi genggam jari dan nafas dalam. Terapi relaksasi genggam jari dan nafas dalam merupakan terapi yang dapat menenangkan jiwa dan tubuh sehingga dapat menimbulkan efek relaks dalam tubuh. Tujuan penelitian untuk mengetahui pengaruh terapi relaksasi genggam jari dan nafas dalam terhadap penurunan tekanan darah pada penderita hipertensi di Wilayah Kerja Puskesmas Kartasura. Jenis penelitian adalah penelitian kuantitatif dengan rancangan penelitian pre eksperimen design dengan One Group Pre-Post test design. Sampel penelitian adalah 18 orang dengan menggunakan purposive sampling. Penelitian dilakukan di wilayah Kerja Puskesmas Kartasura. Analisis yang digunakan adalah uji Wilcoxon. Hasil penelitian menunjukan bahwa tekanan darah sistole dan diastole menunjukan penurunan yang signifikan sebelum dan sesudah dilakukan terapi relaksasi genggam jari dan nafas dalam dimana P Value Sistole = 0,000 dan P Value Diastole = 0,001. Hasil penelitian <0,05 sehingga dapat disimpulkan terdapat pengaruh terapi relaksasi genggam jari dan nafas dalam terhadap penurunan tekanan darah pada penderita hipertesi di wilayah kerja Puskesmas Kartasura. Kata Kunci : terapi relaksasi genggam jari, nafas dalam, tekanan darah Hypertension is a blood circulation system disorder, which is frequently encountered by community. One of the interventions to decrease blood pressure is handheld Þ nger relation and deep breathing therapy. This therapy can soothe soul and body so that the relaxing effects in the body occur. The objective of this research is to investigate the effect of handheld finger relaxation and deep breathing therapy on the blood pressure decrease of the hypertension sufferers in the work region of Community Health Center of Kartasura. This research used the quantitative pre-experimental research method with one group pre-and post-test design. It was conducted in the work region of Community Health Center of Kartasura. Purposive sampling technique was used to determine its samples. The samples consisted of 18 hypertension sufferers. The data of the research were analyzed by using the Wilcoxon’s Test.The result of the research shows that the systole and diastole blood pressures decreased significantly prior to and following the handheld finger relaxation and deep breathing therapy where the p-value of the systole = 0.000, and that of the diastole = 0.001. Thus, there was an effect of the handheld Þ nger relaxation and deep breathing therapy on the blood pressure decrease of the hypertension sufferers in the work region of Community Health Center of Kartasura. Keywords: handheld finger relaxation, deep breathing therapy, blood pressure

Antihypertension drugs in prevention of cognition disorder and dementia: focus on calcium channel blockers and diuretics

Arterial hypertension is associated with elevated risk of cognition decline and vascular dementia development, as the Alzheimer disease development. Therefore, antihypertension therapy might be of preventive value. The review is focused on literary data that witness on, despite controversial, evidence of cerebroprotective action of the range of antihypertension medications. Especially, dihydropyridine calcium antagonists, diuretics and some blockers of renin-angiotensin-aldosterone system. These act not only via blood pressure decrease, but due to additional specific neuroprotective mechanisms. This makes it to consider calcium antagonists and diuretics as a major component of systemic hypertension management, incl. elderly and senile patients, aiming to prevent cognition decline and dementia of various types development.Nitrendipine, among the calcium channels antagonists, and indapamide among diuretics have acquired the broadest evidence that points on their cerebroprotective properties.