The effectiveness of dexmedetomidine in patients with severe COVID-19

Rationale: Mortality in patients with severe COVID-19 remains high. Finding therapies that can improve the outcome in these patients is an urgent function. Objective: To evaluate the clinical efficacy of dexmedetomidine in the results of complex treatment with a severe course of COVID-19. Materials and Methods: The retrospective study included 50 adult patients with severe COVID-19 admitted to the intensive care unit (ICU). The primary outcome of the study was the incidence of delirium. The secondary results of the study were dynamics of gas exchange indicators (PaO2 and PaCO2) and inflammatory markers (C-reactive protein (CRP), procalcitonin, lymphocyte count and neutrophil-lymphocyte ratio (NLR)) for 3 and 5 days of treatment, as well as the duration of mechanical ventilation (MV), length of stay (LOS) in the ICU and hospital and mortality. Results: The incidence of delirium did not differ between the dexmedetomidine group and the control group (41% and 48%, respectively; p = 0,661). The LOS in the ICU and the hospital, as well as the duration of MV, was comparable between the groups. However, hospital mortality in the dexmedetomidine treatment group was lower than in the control group (10,3% and 42,9%, respectively; p = 0,008). The addition of dexmedetomidine to the complex of therapy did not affect the change in blood gas, but contributed to an increase in the number of lymphocytes (p = 0,006) and a decrease in NLS (p = 0,002) by the fifth day of treatment. At the same time, no significant changes in CRP and procalcitonin levels were observed. Conclusion: Therapy with dexmedetomidine was not accompanied by a decrease in the frequency of delirium, LOS in the ICU and the hospital, and the duration of MV in patients with severe COVID-19. Prospective randomized trials are needed to confirm the beneficial effects of dexmedetomidine on the immune system and mortality.

The Role of Lampung Provincial Government in Controlling Plastic Waste Disposal Land

Purpose: Plastic waste is a major threat to the environment, and the growing amount of plastic waste, particularly during the Covid-19 pandemic that has been ravaging Indonesia since the beginning of 2020, has compelled the government to implement a variety of measures to rein in the surge in plastic waste, including paying close attention to land designated for plastic waste disposal. Since 2019, residents of Lampung Province have generated more than 7,000 tons of waste per day. To ascertain the Lampung Provincial government's role in controlling land for plastic waste disposal, it is necessary to conduct this study. Research Methodology: The research method used in this study is qualitative, and the data collection method is secondary. Results: It can be concluded that the Lampung Provincial government is continuing to work on developing a system for the management of plastic waste.

Lightning Protection for Buildings Threatened with Explosion of Solid Explosives

This paper presents the overview of current regulations pertaining to lightning protection of all facilities threatened with explosion of solid explosives, that is buildings where such materials are manufactured or stored. Lightning hazard due to possible thunderbolt striking directly into the building or into its neighbourhood has been analysed. Direct results of lightning current flow have been considered as well as secondary results arising from thermal, electrodynamic and inductive actions of this current. In order to eliminate the existing hazards, application of recognized lightning protection designs has been proposed and justified.

Post-Islamism: The New Face of Political Islam in Indonesia

Movement of Islamic politics in post- Islamism is movement ideology in the discourse of contemporary Islamic studies in Indonesia are being crowded discussed. Post-Islamism first time emerged as the faces of Islam political supporters of the ideology of Islamism in contensasi election of the general governor of Jakarta in 2017 through action to defend Islam on 2nd December 2016 or what is known as the 212 movement. This article aims to examine in detail the emergence of post-Islamism as the new face of political Islam in Indonesia and how post-Islamism is built into a "new manifesto" in the Political Islam movement in Indonesia, based on the reading of political anthropological theory. The method that is used is a literature review by using primary data and secondary. Results of the study showed that the movement of political Islam, post-Islamism, still need further study and comprehensive. The term post- Islamism has not been able to uncover the basic facts about how the terms of the force, lived, and could become the ideological basis for the movement of Islam politics its self.

Evaluation of low dose prazosin for PTSD-associated nightmares in children and adolescents

Introduction Knowledge about fundamental sleep disorders and dysregulation that occurs in children with PTSD is limited. Prazosin is an alpha-1 receptor antagonist often used off label for the treatment of PTSD-associated nightmares in adults; however, evaluation of its use in pediatrics and adolescents is limited. The primary objective of this study was to assess the impact of prazosin on nightmares associated with PTSD in this population. Secondary objectives included assessing side effects, changes in blood pressure, and 30-day readmission rates. Methods This was a retrospective, single-center chart review of inpatients diagnosed with PTSD nightmares from January 1, 2017, to July 31, 2019. Patients 4 to 18 years old with a PTSD diagnosis, experiencing nightmares, and initiating any dose of prazosin were assessed to determine efficacy and tolerance. Results Forty-two patients were evaluated to determine symptom improvement after initiation of prazosin for PTSD nightmares in children and adolescents. Of the 42 patients, 24 (57.1%) reported improvement in nightmares (average dose 1.05 mg). For secondary results, 38 (90.5%) patients continued prazosin at discharge, and 2 (5%) were readmitted within 30 days for reasons other than PTSD-associated nightmares. Thirty-four (81%) reported having no adverse effects to prazosin. There was no significant difference in systolic (P = .1883) or diastolic (P = .2777) blood pressure preinitiation and postinitiation of prazosin. Discussion Despite the limitations of this retrospective study, the data suggests that prazosin may be associated with an improvement in nightmares in children and adolescents with PTSD. Adverse events were rarely reported, and there was no significant change in blood pressure with initiation of prazosin.