RESPIRATORY PARAMETERS OF COVID-19 PATIENTS AFTER THE PRONE POSITION

<p>Hypoxemia is a condition when there is a lack of oxygen levels in the blood, especially from the arteries. In the early stages of COVID-19, several mechanisms such as intrapulmonary shunting, loss of pulmonary perfusion regulation, intravascular micro thrombus, and impaired diffusion capacity can contribute to the development of arterial hypoxemia, although there is no increase in respiratory work. The prone position is one of the most widely used therapies for patients with hypoxemia because the dorsal area has a large number of alveolar units that are not compressed by the weight of the abdominal cavity and mediastinum, thus creating a more efficient area for gas exchange. This study aimed to determine the effect of the prone position on changes in respiratory parameters of COVID-19 patients. This study used the descriptive correlation method on 27 respondents with purposive sampling. Each respondent was given a prone position for three hours and being observed before, during the three-hour, and after one hour of the prone position administration”. The results of the descriptive analysis of this study showed that the majority of respondents were middle adulthood (63%) with 70% of the respondents being male, 59% having a history of hypertension, and 85% experiencing coagulation disorders. The change in the mean respiratory rate during one hour of supination after three hours of prone position in males was greater than that in females although the mean decrease in oxygen saturation was the same. This shows that the prone position for three hours accompanied by oxygen therapy made an improvement in respiratory status in COVID-19 patients, although it needs further investigation with more respondents and different research methods.</p>

Comparative evaluation of the clinical effects of high Air-Through soft diaper and standard diaper in Indian babies with diaper rash

The incidence of diaper dermatitis (rash) in India is reported to be in the range of four to thirty-five per cent in children up to 2 years of age. To evaluate the clinical effect of using High Air-Through Soft Diaper and babies’ favourite diaper (Standard diaper) on Indian babies’ skin. This was a single-blinded, randomized, controlled, cross-over study. Eligible babies were randomized in two treatment groups. Babies in Group A used High Air-Through Soft Diaper for the first two weeks and then used standard diaper for the next 2 weeks. Babies in Group B used a standard diaper for the first two weeks and then used a High Air-Through Soft Diaper for the next 2 weeks. The study was completed with 105 babies. Theevaluation of the skin using the scoring system and photographs for representative purposes. At baseline, the mean total diaper rash scores were comparable in both Group A and Group B viz. 3.04 ± 1.00 and 3.30 ± 1.04 respectively and the difference was not statistically significant (p = 0.195). After 2 weeks, the mean total diaper rash score increased significantly from the baseline in both Group A and Group B (5.05 ± 1.97; p = 0.001 and 6.16 ± 2.22, p = 0.001 respectively); the rise in the mean total diaper rash score was significantly more in Group B than that in Group A (p = 0.045). After 4 weeks, a significant increase in the mean total diaper rash score (1.31 ± 2.69; p =0.001) was observed from what it was at 2 weeks in the Group A and there was an insignificant decrease in the mean total diaper rash score (-0.52 ± 2.54; p =0.153) in Group B from what it was at 2 weeks; the change in the mean total diaper rash score was significantly more in Group A than that in Group B (P = 0.001). Both High Air-Through Soft Diaper and standard diaper in babies caused a significant increase in mean total diaper rash score. However, the extent and the degree of rash induced with the use of High Air-Through Soft Diaper was significantly less than that during the usage of the standard diaper. Thus, High Air-Through Soft Diaper due to technologies used in it appears to be superior to the standard diaper in reducing the mean total diaper rash score.

MINUMAN RUMPUT LAUT DAN MADU DAPAT MENINGKATKAN HAEMOGLOBIN PADA IBU HAMIL

Background : Anemia in pregnancy is currently a global problem in Indonesia because it can cause maternal death. The role of iron is very important for pregnant women and fetuses. The risk of anemia in pregnant women can cause postpartum bleeding, prolonged labor and infection during the puerperium. Disorders of fetal development can also be caused by iron deficiency. The importance of efforts to reduce the problem of anemia in pregnant women can be pharmacologically and non pharmacologically. Non-pharmacological treatment can be know as complementary or alternative therapy by giving seaweed and honey drinks. Consumption of foods containing Fe such as seaweed and consumption of food containing Fe absorption aids (Fe enhancers) containing vitamin C can increase hemoglobin levels in pregnant women. Purpose: to determine the effectiveness of seaweed (Eucheuma Spinosum) and honey drinks on increasing haemoglobin levels in pregnant women.Methods : The research using a quasi-experimental research method with one group pre test-post test design. The sampling technique used was the non-probability sampling technique of "purposive sampling" with a sample of 30 pregnant women who were given 100 grams of seaweed drink and 25 grams of honey a day for 10 days.Results : The results showed that there was a change in the mean before being given treatment (Pre test) of 10.4 gr/dl after being given an intervention (post test) of 11.4 gr/dl. Hemoglobin levels after treatment increased on average by 1 g/dl with p-value (0.001) (P <0.05).Conclusion : consuming seaweed and honey drinks has an effect on increasing hemoglobin levels in pregnant women. Keywords: Haemoglobin, Seaweed , Honey ABSTRAK Latar Belakang : Anemia pada kehamilan saat ini menjadi masalah global di Indonesia karena dapat mengakibatkan kematian pada ibu. Peranan zat besi sangatlah penting bagi ibu hamil dan janin. Resiko anemia pada ibu hamil dapat menyebabkan terjadinya perdarahan pasca salin, persalinan lama dan infeksi pada masa nifas. Gangguan pada perkembangan janin dapat disebabkan juga karena kekurangan zat besi. Pentingnya dilakukan upaya mengurangi masalah anemia pada ibu hamil dapat secara farmakologi dan non farmakologi. Penanganan secara non farmakologi dapat kita kenal dengan therapi komplementer atau alternatif dengan pemberian minuman rumput laut dan madu. Konsumsi makanan yang mengandung Fe seperti rumput laut dan konsumsi makanan yang mengandung zat pembantu penyerapan Fe (enhancer Fe) yang mengandung vitamin C dapat meningkatkan kadar haemoglobin pada ibu hamil.Tujuan: penelitian ini bertujuan untuk mengetahui efektifitas minuman rumput laut (Eucheuma Spinosum) dan madu terhadap peningkatan kadar haemoglobin pada ibu hamil.Metode : penelitian ini menggunakan quasy experiment dengan one group pretest-post test design. Teknik pengambilan sampel dengan teknik Nonprobability sampling jenis “Purposive sampling” dengan jumlah sampel 30 orang ibu hamil yang diberikan minuman rumput laut 100 gr dan 25 gr sehari madu selama 10 hari.Hasil : Hasil penelitian menunjukkan bahwa terdapat perubahan mean sebelum diberikan perlakuan (Pre test) 10,4 gr/dl setelah di berikan intervensi (post test) 11,4 gr/dl. kadar haemoglobin setelah perlakuan rata-rata meningkat sebesar 1 gr/dl dengan p-value (0,001) (P <0,05). Kesimpulan : mengkonsumsi minuman rumput laut dan madu memiliki pengaruh terhadap peningkatan kadar haemoglobin pada ibu hamil. Kata kunci: Haemoglobin, rumput laut, madu

Game Techniques to Solve Students' Adjustment Problems: Evidance From Indonesia

This research is motivated by the problems of students who fail to achieve happiness in their lives; this is caused by the inability of students to make adjustments to all forms of change in maintaining survival. Efforts that can be made to overcome this problem are to provide group guidance services with game techniques. This study aims to test whether the game technique in group guidance services is effective for improving students' self-adjustment. The method used in this research is experimental research using Pretest-Posttest Control Group Design. The results showed that there was a change in the mean value at the pre-test of 93.43 for the experimental class and 92.57 for the control class and the mean value at the post-test of 151.64 for the experimental class and 98.71 for the control class. So that the mean value at the time of post-test increased by 58.21 for the experimental group and 06.14 for the control group. These changes mean that group guidance with game techniques is empirically proven to be effective in increasing student adaptation

PreSurgical and Surgical Planning in Neurosurgical Oncology - A Case-Based Approach to Maximal Safe Surgical Resection in Neurosurgery

Use of functional neuroimaging capabilities such as fMRI, DTI, MRP, MRS, AS-PET-CT, SPECT, and TMS as noninvasive tools to visualize intrinsic brain and spine morphology in relation to function have developed over the past 30 years. Amongst these imaging modalities, functional magnetic resonance imaging (fMRI) is of particular interest since it follows the physiological coupling between neuronal electrical activity and metabolic structural (cellular) activity as it relates to tissue vascularity and perfusion states. This structure–function synesis (from the Greek noun, σύνεσις = being together), leads to three effects that contribute to the fMRI signal: an increase in the blood flow velocity, a change in the mean blood volume, and most importantly, alterations in the blood oxygenation level. The latter effect has lent to the development of blood-oxygenation-level-dependent or BOLD fMRI, which has been used in establishing the topographic relationship between eloquent cortex and neurosurgical planning. As an adjunct to this modality, MRI-based diffusion tensor imaging (DTI) allows further detailed radiographic assessment of fiber tracts in the brain in relationship to the surgical lesion of interest. Herein we review the roles of fMRI and DTI for presurgical mapping to allow for maximal safe resection procedures in neurosurgery with case-based illustrations.

Levels of Interleukin 6 as a Predictor of Metabolic Syndrome in Schizophrenic Patients Receiving Combination Therapy of Typical and Atypical Antipsychotics

BACKGROUND: Schizophrenia is a severe psychiatric disorder that causes disability and is often accompanied by physical illness. Based on the American Heart Association criteria, metabolic syndrome is common in schizophrenic patients, with a prevalence of 43% in Clinical Antipsychotic Trials of Intervention Effectiveness. The metabolic syndrome in patients with schizophrenia results from the side effects of antipsychotics. The metabolic syndrome will also show high levels of IL-6. This situation can have biological implications, which can then affect the health of schizophrenic patients. AIM: This study aims to determine serum IL-6 levels as a predictor of metabolic syndrome in patients with metabolic syndrome due to side effects of using antipsychotic therapy. METHODS: This prospective cohort study was not randomized, with the number of subjects was 28 schizophrenic patients who were evenly divided into two groups, namely, the group receiving atypical and typical combination therapy. Therapy was given to both groups for 3 months, and measurements and checks of bodyweight, abdominal circumference, blood pressure, BMI, TG, GDP, and Il-6 levels were carried out at baseline and 3rd month. Comparative and correlation tests were carried out between groups. RESULTS: Some schizophrenic patients were categorized as metabolic syndrome and not a metabolic syndrome in both therapy groups (p < 0.020). However, atypical antipsychotic drug combinations are more likely to experience the metabolic syndrome. There was a change in the mean Il-6 levels at baseline and the 3rd month in both groups (p < 0.0001). There was a more excellent mean value of IL-6 levels at 3rd month with metabolic syndrome than those without metabolic syndrome. There was a greater mean value of IL-6 levels at third month with metabolic syndrome compared with those without metabolic syndrome in the haloperidol and chlorpromazine groups (p <0.005), the risperidone and clozapine groups (p <0.002). CONCLUSION: Metabolic syndrome is more common in schizophrenic patients receiving atypical than typical combination therapy. The body’s response to the metabolic syndrome results in an increase in IL-6 levels due to an inflammatory process in visceral fat which accumulates due to weight gain due to the administration of antipsychotics. In schizophrenic patients with metabolic syndrome, IL-6 levels are higher than those without metabolic syndrome, so that IL-6 levels can be used as a predictor of metabolic syndrome in schizophrenic patients receiving antipsychotic therapy.

Efficacy and Safety of Percutaneous Pulmonary Artery Subtotal Occlusion and Chronic Total Occlusion Intervention in Chronic Thromboembolic Pulmonary Hypertension

Background: Balloon pulmonary angioplasty (BPA) is an emerging percutaneous therapy for patients with inoperable chronic thromboembolic pulmonary hypertension, and patients with mean pulmonary artery pressure ≤30 mm Hg have an excellent survival. Common vascular lesion types are ring-like stenoses (type A), web lesions (type B), subtotal occlusions (type C), chronic total occlusions (CTOs; type D), and tortuous lesions (type E). Occlusive lesions (ie, subtotal occlusions and CTOs) are the most challenging. Risk and benefit of pulmonary occlusive lesion intervention in chronic thromboembolic pulmonary hypertension has not been studied. We evaluated the impact of percutaneous pulmonary artery subtotal occlusion and CTO intervention on BPA treatment response. Methods: One hundred twenty patients underwent 712 BPA procedures between April 2014 and October 2019 at the Medical University of Vienna. Clinical features and hemodynamics were assessed at baseline and 6 to 12 months after the last BPA session. Results: A total of 2542 lesions were targeted: 720 occlusions (28.3%; 352 CTOs and 368 subtotal occlusions) and 1822 nonocclusion lesions (71.7%). Complications occurred in 6.0% of all procedures (severe complications in 0.4% of all procedures). The overall success rate for recanalization of occlusions was 81% (subtotal occlusions [type C lesions], 98%; CTOs [type D lesions], 50%). Number of successfully treated lesions of any type (β, −0.86 [−1.19 to −0.53]; P <0.001), number of successfully treated occlusions (β, −2.17 [−3.38 to −0.97]; P =0.001), and number of successfully treated nonocclusion lesions (β, −0.81 [−1.25 to −0.37]; P <0.001) emerged as predictors of relative change in the mean pulmonary artery pressure. The impact on relative change in the mean pulmonary artery pressure was higher for CTOs (β, −5.88 [−10.49 to −1.26]; P =0.014) than for subtotal occlusions (β, −2.51 [−4.18 to −0.83]; P =0.004). Conclusions: The number of successfully treated vascular lesions predicts treatment response to BPA. The number of successfully recanalized occlusions (particularly CTOs) appears to have the strongest impact on change in mean pulmonary artery pressure, highlighting the importance of advanced BPA technique.

Thermomodernization of the school and change of the level of thermal comfort

The paper highlights the topical issue of ensuring the appropriate thermal comfort level and reducing energy consumption by public buildings. Thermal modernization, in turn, allows increasing the level of thermal comfort, which is not taken into account and evaluated in practice, although the relevant standards for comfort conditions and categories of buildings to ensure comfort have been introduced in Ukraine. The aim of the study is to analyze the impact of thermal modernization on the level of energy consumption and thermal comfort. The paper analyzes the change in the level of comfort before and after thermal modernization, defines the comfortable conditions category of the building, presents the change in the mean radiant temperature, as one of the main factors of PMV change in these conditions. PMV has been found to vary from -0.7 in the cold months to 0.2 in the off-season. Changing the thermal resistance can increase the PMV. The wall of the S orientation is characterized by larger fluctuations of PMV, which is due to the inflow of solar radiation and as a consequence of increasing the mean room radiant temperature. The change in the value of energy consumption is analyzed, the class of energy efficiency and the category for providing comfortable conditions are determined. Such an approach on the example of a real building is an example for conducting energy audits and certification taking into account comfort indicators.

Relative Hand Grip and Back Muscle Strength, but Not Mean Muscle Strength, as Risk Factors for Incident Metabolic Syndrome and Its Metabolic Components: 16 Years of Follow-Up in a Population-Based Cohort Study

Muscle strength is associated with health outcomes and can be considered an important disease predictor. There are several studies examining the relationship between hand grip strength (HGS) and metabolic syndrome (MetS). However, no results have been reported for long term longitudinal studies. In this study, we investigated the relationship between mean HGS, back muscle strength (BMS), relative HGS and BMS, and MetS. A total of 2538 non-MetS subjects aged 40–69 years (1215 women and 1323 men) in the Korean Genome and Epidemiology Study (KoGES) Ansan cohort were followed for 16 years. The relationships between incident MetS (iMetS) and muscle strength were estimated using Cox proportional hazard regression models after adjusting for the confounding factors. Increases in standard deviation (SD) and the lower quartile groups for relative HGS and BMS were significantly associated with iMetS in men and women. Moreover, increases in SD and high quintile groups (decreased HGS group) for the delta change in the mean and relative HGS were significantly associated with iMetS in men only. In addition, SD increases for the relative HGS and BMS were significantly associated with iMetS components in men and women. The present study suggests that lower relative HGS and BMS are associated with high risk for the future development of MetS.

Seven years follow-up of corneal cross-linking (CXL) in pediatric patients: Evaluation of treated and untreated eye

Background: Retrospective cohort study evaluating long term keratoconus progression amongst cross-linking (CXL) treated pediatric patients in the treated and the fellow untreated eyes. Methods: Data on 60 eyes of 30 patients, 18 years old or younger, who underwent CXL in at least one eye was collected and analyzed. Follow-up measurements taken from the treated and untreated eye up to 7 years after CXL treatment, were compared to baseline measurements. Parameters included uncorrected distance visual acuity (UCDVA), best-corrected spectacle visual acuity (BCSVA), manifest refraction, pachymetry, corneal tomography, and topography. Results: Mean age of patients was 16 ± 2.1 years. For the treated eyes, during follow-up period mean UCDVA had improved (from 0.78 ± 0.22 at baseline to 0.58 ± 0.26 logMAR at 7 years; p = 0.13), as well as mean BCSVA (from 0.23 ± 0.107 at baseline to 0.172 ± 0.05 logMAR at 7 years; p = 0.37). The mean average keratometry showed a significant flattening (from 49.95 ± 4.04 to 47.94 ± 3.3 diopters (D); p < 0.001), However there was no change in the mean maximal keratometry. The mean minimal corneal thickness (MCT) showed a significant mild reduction of 26 µm ( p = 0.006). Although statistically insignificant, the mean manifest cylinder was also reduced to 2D ( p = 0.15). During the follow-up period, eight untreated eyes (26.6%) deteriorated and underwent CXL, while only one treated eye (3.33%) required an additional CXL. Conclusion: CXL is a safe and efficient procedure in halting keratoconus progression in the pediatric population, the fellow eye needs to be carefully monitored but only a 25% of the patients will require CXL in that eye during a period of 7 years.