A process evaluation of patient care needs using the Post- Stroke Checklist: a prospective study

Objective: To assess the utility of the modified Post-Stroke Checklist (mPSC) to identify impairments and care needs of patients with stroke (PwS) in an inpatient rehabilitation setting. Methods: Prospective observational design with consecutive admission of PwS (n = 44) at a tertiary rehabilitation facility. The post-stroke checklist was administered at hospital discharge (T1) and 3 months post-discharge (T2). Furthermore, validated questionnaires assessed function and participation, including the Clinical Functioning Information Tool (ClinFIT) on admission (T0), T1 and T2. Results: Participants’ mean age was 67.7 years (standard deviation; SD) 14.6), 58% of participants were female, and the mean length of inpatient stay was 32.7 days (SD 22.4). At T1, 80% and at T2 only 60% of participants reported ≥1 stroke-related problem (mean 5.3 (SD 3.3) and 3.6 (SD 2.8), respectively). Half of participants were referred to physiotherapy/occupational therapy, and 36% to specialist clinics following discharge. The most prevalent problems included: life after stroke (62.2%), fatigue (55.6%), activities of daily living, and mobility (51.1% each). Compared with T1, at T2 there was an observed reduction in all mPSC items, except pain and incontinence. Participants showed improved function at T1 and T2 (Extension Index, ClinFIT set), from T0 to T1 and T0 to T2 (p<0.001, with large effect sizes). Conclusion: The mPSC is feasible to implement in an inpatient rehabilitation setting and community. It can identify relevant stroke-related problems, and hence facilitate targeted intervention.

Model latihan fisik jalan kaki dengan pemberian jus galoba terhadap komposisi lemak tubuh dan status antioksidan pada wanita usia >55 tahun

Walking can affect the muscles to stretch which can improve physical fitness for prevention in elderly women. Galoba contains flavonoids that have anti-oxidative properties and play a role in preventing damage to cells and their cellular components by reactive free radicals. The aim of the study was to determine the effectiveness of the physical exercise model walking by giving galoba juice on body fat composition and antioxidant status in women aged > 55 years. This study was a true experiment with a pre-posttest with a control group. Consecutive admission sampling technique, as many as 20 people. Data collection was carried out by observing mothers who did walking sports by giving galoba juice for 14 consecutive days with a walking time of 25 minutes. Statistical was using the Independent t-test. The results obtained that the average value of body fat composition after walking was 38,1% <after walking with galoba juice 42,2%, p= 0,372 (p > 0,05). The average value of total anti-oxidants after walking was 1,58 µg/mL <after walking with galoba juice was 1,59 µg/mL, p= 0,527 (p > 0,05). The conclusion is that there is no effect of walking physical exercise on body fat composition and there is no effect of the physical exercise model walking with the provision of galoba juice on total antioxidant levels.

Detection of Free Toxin B in the Stool of Asymptomatic Clostridioides difficile Carriers by the Cell Cytotoxicity Neutralization Assay

Cell cytotoxicity neutralization assay (CCNA) is considered to be a gold standard to diagnose Clostridioides difficile infections. We performed CCNA on 77 consecutive admission screening rectal swabs from asymptomatic toxigenic C. difficile carriers. 39% of specimens from asymptomatic carriers were positive. Thus, CCNA specificity may be lower than previously thought.

Hubungan Hiperglikemia Reaktif pada Stroke Iskemik Fase Akut dengan Gangguan Motorik Terhadap Keluaran Pasien Stroke Berdasarkan Indeks Barthel di Rumah Sakit Siti Khodijah Sepanjang

Pendahuluan: Menurut data WHO tahun 2012, stroke merupakan penyakit yang menyebabkan kematian terbesar ketiga di seluruh dunia setelah kanker dan penyakit jantung koroner serta terdapat 6,2 juta kematian disebabkan oleh stroke. Pada kondisi stroke akut sering kali mengalami hipertensi, hiperglikemia,dan leukositosis. Kenaikan kadar gula darah pada pasien stroke yang tidak memiliki riwayat diabetes sebelumnya disebut dengan hiperglikemia reaktif. Hal ini dapat mempengaruhi mortalitas dan morbiditas dari penderita stroke. Dimana kelainan ini kemungkinan disebabkan oleh peningkatan drastis sekresi kortisol sebagai respon terhadap segala jenis situasi stress yang diperantarai oleh susunan sistem saraf pusat melalui peningkatan aktivitas sistem aksis hipotalamus-pituitari-adrenal. penelitian ini dilakukan untuk melihat outcome atau hasil keluaran dari pasien stroke akut yang mengalami hiperglikemia dan akan dievaluasi dengan Indeks Barthel. Tujuan: Untuk mengetahui adanya hubungan antara hiperglikemia reaktif pada stroke fase akut dengan keluaran pasien stroke berdasarkan Indeks Barthel di Rumah Sakit Siti Khodijah Sepanjang Metode: Menggunakan desain cross sectional dengan teknik pengambilan sampel sampling from consecutive admission yaitu menurut kasus yang datang berturut-turut sampai jumlah sampel terpenuhi. Penelitian ini dimulai dengan mengambil daftar pasien yang mengalami stroke iskemik di Instalasi Gawat Darurat, kemudian mengambil data pasien di ruangan rawat inap dengan melihat berkas rekam medis pasien untuk melihat nilai gula darah acak pasien pada fase akut serangan stroke, setelah itu melakukan penilaian Indeks Barthel pada hari kelima pasien dirawat. Hasil: Hasil uji statistik menggunakan Koefisien Kontingensi didapatkan nilai signifikan p: 0.039 (p<0,05) Kesimpulan:Hasil penelitian ini menunjukkan adanya hubungan antara hiperglikemia reaktif pada stroke fase akut dengan keluaran pasien stroke berdasarkan Indeks Barthel di Rumah Sakit Siti Khodijah Sepanjang

Hubungan antara Kadar Albumin dan Kalsium Serum pada Sindrom Nefrotik Anak

Latar belakang. Salah satu komplikasi sindrom nefrotik (SN) adalah gangguan metabolisme mineral, yaitu hipokalsemia, yang dapat menyebabkan tetani, gangguan pembentukkan tulang, dan penyakit tulang metabolik. Penyakit SN merupakan kelainan glomerulus yang ditandai dengan proteinuria, hipoalbuminemia, dan edema. Pada proteinuria, protein-binding berukuran sedang ikut terbuang. Setengah jumlah kalsium total serum berikatan dengan protein (terutama albumin), akibatnya hipoalbuminemia yang terjadi pada anak SN dapat menyebabkan hipokalsemia.Tujuan. Penelitian untuk mengetahui hubungan antara kadar albumin dan kalsium serum pada anak SN.Metode. Penelitian dengan rancangan cross-sectional terhadap 43 anak SN yang memenuhi kriteria inklusi dan diambil secara consecutive admission yang berobat/dirawat di Bagian Ilmu Kesehatan Anak RS dr. Hasan Sadikin Bandung mulai bulan Juli sampai September 2007 kemudian dilakukan pemeriksaan kadar albumin dan kalsium serum. Untuk melihat keeratan hubungan antara kadar albumin dan kalsium serum dilakukan analisis dengan menggunakan uji korelasi Pearson, serta untuk melihat bentuk hubungannya dilakukan analisis regresi linier.Hasil. Subjek terdiri dari 33 (77%) anak laki-laki dan 10 (23%) anak perempuan, berusia rata-rata 6,80 (SB 3,39) tahun. Diperoleh hasil rata-rata kadar albumin serum 1,50 (SB 0,377) g/dL, dan kalsium serum 7,27 (SB 0,772) mg/dL. Hasil analisis korelasi Pearson menunjukkan korelasi (r=0,547) yang sangat bermakna (p=0,000) antara kadar albumin dan kalsium serum. Hasil analisis regresi menunjukkan hubungan linier yang positif antara kadar albumin (x) dan kalsium serum (y), dengan persamaan Ý = 5,59 + 1,12 x.Kesimpulan. Semakin menurun kadar albumin serum pada anak yang menderita sindrom nefrotik, semakin menurun kadar kalsium serum.

Outcome studies in schizophrenia

Objectives:To outline the limitations of traditional studies of outcome in schizophrenia and to review the findings arising from ‘first episode’ psychosis studies.Method:An extensive literature search was performed and relevant papers were examined and analysed.Results:Current knowledge regarding outcome predictors in schizophrenia has primarily been derived from a series of ‘consecutive admission’ and ‘long-term follow-back’ studies. However, methodological considerations may limit the generalisability of these studies' findings. The prospective evaluation of first episode cohorts has advanced our knowledge regarding the relative importance of premorbid and intercurrent factors in determining outcome in schizophrenia.Conclusions:To date, the ‘first episode’ strategy has highlighted some potentially clinically modifiable outcome predictors. These findings may open the way for targeted introduction of measures aimed at preventing poor outcomes in schizophrenia.

Psychosocial Adjustment of the Offspring of Psychiatric Inpatients

While there is a growing body of literature describing the plight of being the child of a particular diagnostic group of psychiatrically ill parents, little is yet known about the comparable vulnerability of the children of various diagnostic groups. This study includes data collected on 90 psychiatric inpatients, their spouses and children. For each consecutive admission of fifteen male and fifteen female alcoholics with a child less than age 21, a schizophrenic and a depressive parent were matched by sex, age and time of admission. Data were collected on the parents and their children from the patient's chart and through a structured interview with the spouse. A medical history, Rutter's parental questionnaire on children's behaviour and the Randall-McClure behaviour checklist were filled out on 231 children. Some of the findings of the study include that the adjustment of the children based on checklist information is not affected by the psychiatric diagnosis of the parents; controlling for sibship size is important in this type of research; the boys of sick fathers score almost two times higher on the checklists compared to the boys of sick mothers. The results argue for the provision of coordinated services between adult and child psychiatry departments for the children of the psychiatrically ill parents.