Erythroderma and Skin Desquamation in Paederus Dermatitis

Exfoliative erythroderma is rare but serious condition, which requires close supervision. We report a rare case of 28-year-old man with kissing lesions of Paederus dermatitis at his right side of neck. The rash caused by Paederus beetle was improved after treatments. However, the patient developed generalized erythema with desquamation and scaling. The patient was successfully treated topically with moisturizing liquid soap and topical moisturizer with emollients and humectants, and triamcinolone lotion was applied on the bright red lesion. The patient was also treated with oral replacement solution and tropical azelaic cream was applied on the hyperpigmented kissing lesion. This case report shows the importance of a diagnostic practice with follow-up examination.

Violence Detection in Ranches Using Computer Vision and Convolution Neural Network

This study engaged the convolutional neural network in curbing losses in terms of resources that farmers spends in treating animals where injuries must have emancipated from violence among other animals and in worst case scenario could eventually lead to death of animals. Animals in a ranch was the target and the study proposed a method that detects and reports activities of violence to ranchers such that farmers are relieved of the stress of close supervision and monitoring to avoid violence among animals. The scope of the study is limited to violence detection in cattle, goat, horse and sheep. Different machine learning models were built for each animal. The models yielded good results; the horse violence detection model had an outstanding performance of 93% accuracy, 93% accuracy for the sheep model, 88% accuracy for the goat model and 84% accuracy for the cattle model.

Management of Ruptured Arteriovenous Malformation During Pregnancy- Case Report.

Background: Over the years care of pregnant woman has improved all over the world. However, still a significant percentage of the causes of pregnant mortality are subarachnoid haemorrhages due to rupture of arteriovenous malformation (AVM). According to available data, the percentage is as high as 5-12%. Neurosurgical operations in pregnant women require the cooperation of doctors of many specializations and are associated with close supervision of the patient due to the increased risk of complications. There are no guidelines regarding brain hemorrhages in pregnancy. This is the reason why case reports in this field are valuable as source of medical knowledge.Case presentation: A 28-year-old patient was admitted in a severe condition, GCS: 3, to the ICU due to massive intracerebral bleeding with a puncture into the ventricular system from the AVM in left frontal lobe. The family informed about the possibility of patient’s pregnancy, TVUS was performed and the sixth week fetus was visualized in the uterus. After gynaecological and neurosurgical consultation the successful surgery was made.The patient was hospitalized for 5 months at the ICU. The stay was complicated by pneumonia and an urinary tract infection that were successfully cured. The patient was under supervision of gynaecologists, the pregnancy was developing properly, tests were carried out as recommended. The patient underwent psychotherapy, rehabilitation and music therapy.At 35th week of gestation elective caesarean section was performed. A female infant of 2400 g was born, on the Apgar scale in 1st, 3rd, 5th minutes, 6,10,10 points respectively. Labour was complicated by mothers seizures and respiratory distress. After three days the patient's condition improved. Currently patient is rehabilitated as an outpatient.Conclusions: The above case emphasizes the need for cooperation between many specialties, physiotherapists and midwives, which enabled effective therapy of a pregnant woman and saving her life in such a critical situation. In addition interdisciplinary treatment ended positively for both mother and child.

Prescription Drugs Price Setting and Generic Drugs Prescription concerning Consumer Protection Law in Indonesia

<p>Health is one of the most important human rights in human life. Access to affordable prescription drugs is still a problem for people with out-of-pocket expenses. Generic prescription drugs that are much cheaper than non-generic drugs are still low, especially in non-government healthcare facilities. This research aims to provide suggestions of regulation on price control of prescription drugs and generic prescription drugs that will assure certainty and affordability for the public. The methodology is doctrinal legal research and is supported by empirical studies. The research finding consist of two things, namely the price of prescription drugs and the prescription of generic drugs. The first finding is that Highest Retail Price (HET) set by the manufacturer is potentially to be unlimited because there is no limit control. Currently, there are many drugs sold over HET with minimal supervision from the Government. The absence of law is found as the existing regulations are only for those listed in the National Formulary, while the rest have not been regulated. Therefore, the suggestion is to set ceiling prices for prescription drugs with comparison among generic drugs, branded generic drugs, and the originator; also create a refund mechanism for prices above HET to assure the consumers’ rights to get compensation under the Consumer Protection Law. The second finding is that only a few doctors prescribe generic drugs. Additionally, patients have not been involved in the treatment decisions.Therefore, the suggestion is to associate "the action of prescribing generic drugs" with the extension of doctor's license, namelythe Registration Certificate (STR); so that doctors will prescribe generic drugs without the need for close supervision due to their interests. With the increase of generic drugs’ prescription, the financing of health services, nationwide as well asindividually, can become more affordable.</p>

Nucleic Acids Aptamer Application in Diagnosis and Therapy of Cancer Based on Cell-SELEX Technology

The "labeling" of nucleic acids (cell genetic information such as RNA or DNA) is not a new technology for monitoring them. However, current capabilities do not provide a complete picture of how tumor cells develop. What this platform, known as Clon Mapper, can do that was not possible before, is to go back in time and track how tumor cells change over time. This gives researchers the ability to see which cells "win" over fewer resistant cells, continue to clone themselves, and make the tumor more dangerous. By isolating these cells, researchers can better test which therapies work against them. Monitoring changes over time is the key to successful transmission therapies. Tumor cells adapt and become resistant to therapies, which is why patients can recover but experience a relapse later. This is one of the reasons why cancer treatment is so challenging; we do not have very good methods for early detection of cells sensitive to a drug and measuring their resistance. This resistance is the main cause of treatment failure in many cancer patients. CLL is a low-grade B cancer that is often monitored for months or even years before active treatment is needed. This treatment depends a lot on the patient's close supervision. In this study, Clon Mapper focuses on identifying cells that mimic themselves, the speed at which this process takes place, and its effect on the growth rate of surrounding cells over time. This allows for a more accurate analysis of the cell population and may lead to more customized treatment plans for patients. Keywords: Cancer; Cells; Tissues; Tumors; Prevention; Prognosis; Diagnosis; Imaging; Screening; Treatment; Management

EP.TU.373What We Do In The Shadows: Night Surgical Registrars and Abdominal Pain

Aim Surgical cover at night differ according to hospitals and are often performed by junior registrars. This can be challenging as a certain amount of independence is required in decision making. Abdominal pain remains one of the most common surgical presentations in the Emergency Department. This study analyses the type of abdominal pain presentations that were reviewed overnight in a regional Australian hospital. Method All patient presentations requiring surgical review from 9.00pm to 7.00am over a period of 4 months are prospectively collected and analysed. Patient details collected comprised of gender, date of review, blood tests, imaging results, histopathology, and intra-operative findings. Results Of the 114 patients who presented with abdominal pain, the majority of them were undifferentiated abdominal pain (n = 20, 17.1%). This is then followed by appendicitis (n = 17, 14.5%), diverticulitis (n = 13, 11.1%), pancreatitis (n = 8, 6.8%) and cholecystitis (n = 6, 5.1%). Among the others, a total of 8 presentations required urgent surgical review which resulted in three emergency surgeries being performed overnight, a laparotomy for closed loop small bowel obstruction, a Hartmann's procedure and a laparoscopic appendicectomy on a septic patient. Conclusion Common presentations for abdominal pain overnight include undifferentiated abdominal pain, appendicitis, diverticulitis, cholecystitis and pancreatitis. Hence education for night surgical registrars should be focused on management of these common conditions and also on surgical emergencies such as closed loop bowel obstructions, septic patients and perforated viscus to ensure optimal patient outcome without the need for close supervision.

Characteristics and Determinants of Treatment Default Among Smokers With Tuberculosis in an Industrial State of Malaysia: A Registry-based Study of the Years 2013-2017

Background: The increased risk of treatment default among smokers raises concern over the secondary spread within the community. This study aimed to determine the prevalence and factors associated with treatment default among TB patients who smoke.Methods: A retrospective cohort of all registered TB patients who smoke in the state of Selangor between 2013 and 2017 via the Malaysian National MyTB database was included for analysis. TB patients who smoke were considered those with an active smoking status during the notification, while treatment default was defined as a TB patient who had interrupted treatment for 2 months or longer. There were 4 main variable domains included for analysis: sociodemographic profiles, disease profiles, treatment profiles, and comorbidities. Logistic regression analysis was used to identify determinants of treatment default among TB patients who smoke.Results: A total of 27.6% (N=6278) of the TB patients registered in Selangor were active smokers, and 15.1% (N=813) of the TB patients who smoke experienced defaulted TB treatment. The determinants of treatment default among TB patients who smoke were patients staying in an urban area (AOR 1.47; 95% CI 1.11,1.96), median income level less than RM2160 (AOR 2.0; 95% CI 1.34,2.99), no formal education (AOR 2.12; 95% CI 1.31,3.44), previously treated cases (AOR 2.78; 95% CI 1.99,3.88), active TB case detection methods (AOR 2.05; 95% CI 1.21,3.47), treatment duration of less than 6 months (AOR 7.56; 95% CI 5.74,9.92), and patients not on DOTS during the continuation phase (AOR 27.96; 95% CI 21.1,37.1). All the significant factors gave rise to the final model of determinants, with a predictability of 92.9% (95% CI 92.0,93.7).Conclusions: Our findings highlighted the high prevalence of treatment default among TB patients who smoke compared to the general TB population. Early risk detection that examines the two main domains of risk factors (socioeconomic factors and treatment profiles) should be provided for those who smoke in the TB population. Interventions should aim to reduce the prevalence of smoking among TB patients, together with close supervision during DOTS.

Causes and Management of Uterine Perforation- A Review

Uterine perforation is an intrauterine problem that can occur with any therapy. It is a rare but possibly dangerous consequence of uterine manipulation, evacuation of retained products of conception or pregnancy termination (TOP), hysteroscopic treatments, and coil implantation. Injury to blood arteries or viscera, such as the bladder or the intestine, might be related. Severe bleeding or infection may ensue if not discovered at the time of surgery; nevertheless, the most majority of uterine drilling is subclinical and safe without treatment, with no substantial long-term damage. Perforation can be caused by cervical stenosis during trans-cervical operations or by a reduction in myometrial wall strength during pregnancy or menopause. Uterine abnormalities, infection, recent pregnancy, and postmenopause are all factors that raise the chance of uterine perforation. The treatment of uterine perforation is determined by the operation and the equipment employed. Admission to the hospital, intravenous antibiotics, and close supervision are required following a uterine perforation and any accompanying injuries. In this paper, we overview common causes and updated management of uterine perforation. Data was collected during a period of 6 months searching Pubmed, EPISCO, Web of science data bases to include studies with relative topics.

KAJIAN KEBERLANJUTAN PROGRAM YAYASAN PEMBANGUNAN BERKELANJUTAN SULAWESI UTARA (YPBSU) PASCA PENUTUPAN TAMBANG PT. NEWMONT MINAHASA RAYA (PT. NMR) DI KECAMATAN RATATOTOK MINAHASA TENGGARA

This study aims to examine the effectiveness of the programs carried out by the Yayasan Pembangunann Berkelanjutan Sulawesi Utara (YPBSU) after the closure of the gold mine of PT. Newmont Minahasa Raya (PT. NMR). This research was conducted from December 2019 to February 2020 in Ratatotok Sub-District, Southeast Minahasa district by tracing information from the Ratatotok Sub-District community who had received assistance from Yayasan Program Pembangunan Berkelanjutan Sulawesi Utara (YPBSU). The selection of respondents was 13 people using snow balling technique. Analysis of the data used in this study is descriptive analysis. The results showed that only two out of seven economic assistance distributed to the community was effective and five of which were ineffective (unable to continue). This is due to the lack of close supervision from the Yayasan Pembangunan Berkelanjutan Sulawesi Utara (YPBSU) for the assistance that has been distributed to the community

Nuns and Convents in Colonial Latin America

Soon after European settlements were established in Latin America, the Catholic Church became the most important colonial institution, extending its power to all aspects of life. Prevalent views on gender among the new settlers and religious authorities, and an environment of religious fervor, fostered the rapid creation of female convents in the urban centers of Mexico and Peru in the mid-16th century, spreading to other areas of the continent later during the colony. Female cloisters were already common in the Iberian Peninsula since the Middle Ages, yet they became more popular after the religious revival of the Counter-Reformation (1545–1648). The Spanish mystic Teresa of Avila (b. 1515–d. 1582) became the model for many women to follow in the Hispanic world. Her reform of the Carmelite order brought even more popularity to the already widespread practice of life in the convent for women of all social classes. Nuns followed a religious rule that emulated the life of the saints and Jesus; they kept a strict schedule that included prayer, spiritual exercises, and physical penitence. The reformed orders would also harvest their food, make their clothes, and take care of housekeeping, while the unreformed cloisters allowed servants and slaves to perform those chores. The nuns who entered the latter convents had to provide a dowry, while nuns in reformed convents lived out of charity. Choosing conventual life was common during this time period. However, their choice was not always informed by religious devotion; many times it responded to social circumstances. The convent became a solution for the increasing number of women of European descent who could not find suitable husbands in the postconquest years in Latin America. Religious and gendered views of the time encouraged the protection of women from the dangers of the world. Women were considered weak and more prone to sin, therefore their enclosure and close supervision by male religious authorities was not only deemed ideal but also necessary; at the same time women were seen as simpleminded and therefore more likely to receive spiritual favors from God. Nuns’ prayers were considered beneficial for those whom they interceded for. Ultimately it became a matter of social and spiritual status for a city to be able to establish a convent. However, convents were not monolithic institutions, and significant differences existed between them depending on the place where they were established, the rule they followed, and the political and economic circumstances of the times.