A SYSTEMATIC REVIEW: THE ASSOCIATION BETWEEN URINE LEUKOCYTES AND THE TYPES OF URINARY TRACT INFECTION

Objective: This study aimed to determine the functional role of the urine leukocyte count on type of UTI. Material & Methods: This is a systematic review study with searches for articles from 2010-2020 through the PubMed, ProQuest, and EBSCO databases. The exclusion criteria in this study are patients using catheters (CAUTI), UTI patients in the Intensive Care Unit (ICU), and pediatric or infant patients. There were 1158 studies found and 3 studies synthesized. Results: There are 1130 patients studied. Age range from 18 to 89.1 years. Three studies showed that there was an association between the number of urinary leukocytes and the type of UTI (Tommaso Cai et al., p < 0.0001; and Alexander R. Levine et al., p < 0.001) and one study had no relationship. Conclusion: There is a relationship between the number of urinary leukocytes with the type of UTI. An increase in the number of urinary leukocytes above the normal limit is the sign of body’s immune response to eliminate uropathogens. The innate immune characteristic factors and the body’s immune response have an important role in causing symptoms in UTI patients.

Penerapan Tindakan Kompres Hangat Dalam Menurunkan Skala Nyeri Pada Penderita Gout Arthritis

Gouty Arthritis is a disease associated with an inborn errors of purine matabolism. Gout Arthritis occurs due to a buildup of uric acid that exceeds the normal limit in the joints. This can cause pain in gouty arthritis sufferers so giving warm compresses is necessary for gouty arthritis sufferers. This study was a descriptive case study aiming to describe the application of warm compresses in reducing pain scale in patirnts with Gouty Arthritis. A client assessment form, observation sheets, pain scales, WWZ (Warm Water Zak), and uric acid measurement kid were the instuments being used to collect data. The findings showed that there was a decrease in the pain scale in patiens with Gouty Arthritis. In case I, there was a decrease of pain scale from 5 to 2; meanwhile, in case II the pain scale decreased from 6 to 3. The conclusion from this study was that the application of warm compress therapy with WWZ (Warm Water Zak) could reduce the pain scale. Thus, patients of Gouty Arthritis are suggested to apply warm compress therapy with WWZ (Warm Water Zak) to reduce the pain because of the disease.Keywords: Warm compress, pain, gouty arthritis AbstrakGout Arthritis merupakan hasil metabolisme atau pecahan purin dari makanan yang tinggi purin. Gout Arthritis terjadi karena penumpukan asam urat yang melebihi batas normal dipersendian. Hal ini dapat menyebabkan nyeri pada penderita gout arthritis sehingga pemberian kompres hangat sangat diperlukan untuk penderita gout arthritis. Studi kasus ini bertujuan untuk menggambarkan penerapan tindakan kompres hangat dalam menurunkan skala nyeri pada penderita Gout Arthtitis. Metode studi kasus ini menggunakan studi kasus deskriptif. Instrumen studi kasus ini dengan menggunakan format pengkajian klien, lembar observasi, skala nyeri, WWZ (Warm Water Zak) dan alat ukur untuk mengukur kadar asam urat. Hasil studi kasus ini menunjukkan ada penurunan skala nyeri pada penderita Gout Arthritis pada kasus I terjadi penurunan skala nyeri awal 5 turun menjadi 2 sedangkan pada kasus II skala nyeri awal 6 turun menjadi 3. Simpulan dari studi kasus ini bahwa terapi kompres hangat dengan WWZ (Warm Water Zak) dapat menurunkan skala nyeri. Saran bagi klien yang mengalami Gout Arthritis agar dapat mengontrol dengan menggunakan terapi kompres hangat menggunakan WWZ (Warm Water Zak) secara mandiri.Kata kunci: Kompres hangat, nyeri, gout arthritis

The rationality behind performance of routine lumber puncture in simple febrile seizure in 6-18 months old children

Background: Pediatrics seizures can be either due to febrile seizure or underlying serious infection such as meningitis. It is important to rule out meningitis in children presenting with fever and seizure. The aim of the study was conducted to assess the necessity of routine lumber puncture and to determine the incidence of meningitis among children aged 6 to 18 months presenting with first episode of febrile seizure.Methods: This prospective observational study was conducted among 47 children with first episode of simple febrile seizure presenting to emergency in Medical College Kolkata, West Bengal from April 2018 to September 2019.Results: Total 47 children were studied among 32 (68%) children were between 6-12 months and 15 (32%) were between 12-18 months of age. Only 1 child (2.1%) diagnosed as meningitis. Clinically 7 children (14.9%) showed signs of sepsis and meningitis like picture and 6 children (12.8%) were in 6-12 months of age and only 1 child (2.1%) was in 12-18month of age. Only 1 child in 6-12 months of age showed CSF positive and all other CSF studies were within normal limit. A significant association was seen between age group and hyponatremia and family history of febrile seizure (p<0.05). There was no statically significant between clinical diagnosis and CSF results (p=0.15).Conclusions: The risk of meningitis in children presenting with simple febrile seizure between 6-18 months of age is very low, specially in 12-18 months of age. Therefore, current guidelines regarding lumber puncture in simple febrile seizure should be reconsidered.

Asuhan Kebidanan pada Ibu Hamil Trimester III dengan Anemia

Anemia is a condition where the level of hemoglobin in the blood is less than the normal limit (<12 g%) caused by a lack of iron in the body due to malnutrition. While anemia in pregnancy is a condition where the hemoglobin level in pregnant women is <11gr% or <10.5gr% in third trimester pregnant women which generally occurs due to the hemodilution process. The purpose of this case to find out the cause of anemia in late pregnancy and the treatment that can be done to prevent complications that occur with care to routinely consume blood-added tablets (Fe) and recommend foods high in iron. This care design used a comprehensive care method for pregnant women in the third trimester who experience mild anemia (haemoglobin <10,5gr%) in Kalimade Village, Kesesi District, Pekalongan Regency. The results of this care showed an increase in hemoglobin levels in the mother. The conclusion of this case study shows that regularly consuming Fe tablets can increase hemoglobin levels in the blood so that it can prevent and treat anemia. For this reason, pregnant women are expected to routinely consume Fe tablets during pregnancy and midwives are expected to provide education about the benefits of Fe tablets to pregnant women to prevent anemia.Keywords: Haemoglobin; Anemia; Pregnancy AbstrakAnemia merupakan suatu kondisi dimana kadar haemoglobin dalam darah kurang dari batas normal (<12 gr%) yang disebabkan karena kurangnya zat besi didalam tubuh akibat kurang gizi. Sedangkan anemia pada kehamilan adalah kondisi dimana kadar haemoglobin pada ibu hamil <11gr% atau <10,5gr% pada ibu hamil trimester III yang umumnya terjadi karena adanya proses hemodilusi. Tujuan dari kasus ini yaitu untuk mengetahui penyebab terjadinya anemia pada kehamilan lanjut serta penanganan yang dapat dilakukan guna mencegah terjadinya komplikasi yang mungki terjadi dengan asuhan untuk rutin mengkonsumsi tablet tambah darah (Fe) serta anjuran mengkonsumsi makanan tinggi zat besi. Rancangan Asuhan ini menggunakan metode asuhan komprehensif pada ibu hamil trimester III yang mengalami anemia ringan (Haemoglobin <10,5gr%) di Desa Kalimade Kecamatan Kesesi Kabupaten Pekalongan. Hasil asuhan ini menunjukan adanya peningkatan kadar haemoglobin pada ibu. Simpulan studi kasus ini menunjukan bahwa dengan rutin mengkonsumsi tablet Fe dapat meningkatkan kadar Haemoglobin dalam darah sehingga dapat mencegah serta mengobati anemia. Untuk itu ibu hamil diharapkan agar rutin mengkonsumsi tablet Fe selama kehamilan. Bidan diharapkan agar bisa memberikan edukasi tentang manfaat tablet Fe pada ibu hamil guna mencegah terjadinya anemia.Kata kunci: Haemoglobin; Anemia; Kehamilan

Penerapan Kompres Hangat Terhadap Penurunan Suhu Tubuh Anak Demam Usia Pra-Sekolah

Fever is a condition where body temperature exceeds normal limit, caused by an increase in the temperature-regulating center in the hypothalamus. Warm compress is an easy way to lower body temperature. This type of compress involves a clean cloth soaked in warm water, which is applied to the skin. The purpose of this case study is to evaluate a warm compress method in reducing fever. Two preschool-aged children with fever were treated by warm compresses. The results of this case study showed that the first and second patients experienced a decrease in body temperature after warm compresses. Body temperature for the first patient was 39ºC and dropped to normal (37ºC). meanwhile, the second patient temperature was 38,7ºC dropped to 36,5ºC. The conclusion of this study is warm compress can reduce body temperature in children with fever. Nurses or patients may be albe to apply warm compresses as a first ald in reducing fever.Keywords: Preschool Age Children, Fever, Warm Compress AbstrakDemam adalah kondisi suhu tubuh melebihi batas normal yang diakibatkan oleh meningkatnya pusat pengatur suhu di hipotalamus. Salah satu tindakan untuk menurunkan suhu tubuh anak yaitu dengan kompres hangat. Kompres adalah pemeliharaan suhu tubuh dengan menggunakan cairan atau alat yang dapat menimbulkan hangat atau dingin pada bagian tubuh. Tujuan dilakukan penerapan ini untuk mengambarkan penerapan kompres hangat terhadap penurunan suhu tubuh anak demam usia prasekolah. Metode yang digunakan dalam studi kasus ini adalah penelitian deskriptif dengan subyek dua pasien anak usia prasekolah yang mengalami demam. Hasil dari studi kasus ini menunjukan bahwa klien pertama dan kedua mengalami penurunan suhu tubuh setelah dilakukan kompres hangat, pada kasus 1 suhu awal 39ºC setelah dilakukan kompres hangat suhu menjadi 37,1ºC, sedangkan pada kasus 2 dengan suhu awal 38,7ºC setelah dilakukan kompres hangat suhu menjadi 36,5ºC. Kesimpulannya adalah pemberian kompres hangat dapat menurunkan suhu tubuh pada anak dengan demam. Saran bagi perawat dan orangtua untuk dapat menerapkan kompres hangat sebagai alternatif menurunkan suhu tubuh anak dengan demam.Kata kunci: Anak Usia Prasekolah, Demam, Kompres Hangat

A rare case of bilateral ocular manifestations of Sturge-Weber syndrome

Sturge–Weber syndrome (SWS) is a group of phakomatoses characterized by hamartomas involving brain, skin and eyes. A 36 years old female presented with pain and diminution of vision in both eyes since last 1 year. On examination she has bluish sclera in B/L eyes with characteristic facial port-wine stain. Best corrected visual acuity (BCVA) in R/E- 6/18, N6 and in L/E- 6/6, N6. Intra-occular pressure (IOP) in R/E – 27 mm Hg and in L/E –18 mmHg. On gonioscopy – open angle B/E. On direct ophthalmoscopy and slit-lamp examination with 90 D lens, cup-disc ratio in R/E – 0.9 and in L/E – 0.7 with thinning of neuro-retinal rim in B/E. In optical coherence tomography (OCT), retinal nerve fibre layer (RNFL) and optic nerve head (ONH) it was confirmed. Other systemic examination – within normal limit. Initially, she had been on conservative treatment. As intraocular pressure remained high after several weeks of treatment, trabeculectomy in R/E done under local anaesthesia. No post-operative complications were seen. After 7 days of follow-up IOP – within normal limit, vision in R/E unchanged and had been frequently followed-up.

A Toddler with Juvenile Ocular Myasthenia Gravis: Clinical Experience

Background:Myasthenia gravis is an extremely rare autoimmune disorder affecting the neuromuscular junction. The incidence rate is 0.9-2.0 cases per 1 million children per year.Ocular myasthenia gravispresents as ptosis with extraocular motility restriction and is prone to be misdiagnosed as third nerve palsy and is difficult to diagnose in very young children. Case: A girl aged 2 years 6 months with clinical features with bilateral ptosis and was diagnosed as juvenile ocular myastenia gravis based on history, physical examination and other diagnostic proceduressuch as chest X-raywithin normal limit and no thymoma, the ice test showed positive result, electromyography (EMG) showed decrement response >10%,progstigmin test showed positive result, andserum acetylcholine receptor antibody levels was 0.43 nmol/L (reference range : positive as >0.40 nmol/L). Conclusion:Juvenile ocular myastenia gravis diagnostics can be established using simple examinations such as ice tests,prostigmin test to sophisticated examinations as systemic acetylcholinesterase antibodies. Management begins with a first-line drug, pyridostigmine, that is safe and effective. Disease monitoring and looking for etiology are very important for successful treatment.

Twenty-Four–Hour Central (Aortic) Systolic Blood Pressure: Reference Values and Dipping Patterns in Untreated Individuals

Central (aortic) systolic blood pressure (cSBP) is the pressure seen by the heart, the brain, and the kidneys. If properly measured, cSBP is closer associated with hypertension-mediated organ damage and prognosis, as compared with brachial SBP (bSBP). We investigated 24-hour profiles of bSBP and cSBP, measured simultaneously using Mobilograph devices, in 2423 untreated adults (1275 women; age, 18–94 years), free from overt cardiovascular disease, aiming to develop reference values and to analyze daytime-nighttime variability. Central SBP was assessed, using brachial waveforms, calibrated with mean arterial pressure (MAP)/diastolic BP (cSBP MAP/DBPcal ), or bSBP/diastolic blood pressure (cSBP SBP/DBPcal ), and a validated transfer function, resulting in 144 509 valid brachial and 130 804 valid central measurements. Averaged 24-hour, daytime, and nighttime brachial BP across all individuals was 124/79, 126/81, and 116/72 mm Hg, respectively. Averaged 24-hour, daytime, and nighttime values for cSBP MAP/DBPcal were 128, 128, and 125 mm Hg and 115, 117, and 107 mm Hg for cSBP SBP/DBPcal , respectively. We pragmatically propose as upper normal limit for 24-hour cSBP MAP/DBPcal 135 mm Hg and for 24-hour cSBP SBP/DBPcal 120 mm Hg. bSBP dipping (nighttime-daytime/daytime SBP) was −10.6 % in young participants and decreased with increasing age. Central SBP SBP/DBPcal dipping was less pronounced (−8.7% in young participants). In contrast, cSBP MAP/DBPcal dipping was completely absent in the youngest age group and less pronounced in all other participants. These data may serve for comparison in various diseases and have potential implications for refining hypertension diagnosis and management. The different dipping behavior of bSBP versus cSBP requires further investigation.

Evaluation of Multivariable Modeling Methods for Monitoring the Health of Guyed Towers in Overhead Power Lines

This article proposes a methodology for monitoring the structural stability of each tower of an electric power transmission line through sensor measurements which estimates the different situations that may indicate the need for intervention to prevent the structure collapsing. The extended Kalman filter was adopted to predict the failures, considering sensor fusion techniques such as the displacements of the upper central position of the tower above certain limits. The load of the stay cables is calculated from the natural frequencies, which are determined by the accelerometers connected to the cables. The average value of these forces, which must be higher than a normal limit, were calculated to predict a failure. All guyed towers of a power transmission line thousands of kilometers long will be individually monitored considering the methodology described in this study, which makes this article one of the first relevant research studies in this area. Typically, guyed towers must often be manually inspected to ensure that the stay cables have acceptable pretension to prevent a lack of stability in the transmission line towers.