THE DIFFERENCES IN THE EFFECTIVENESS OF PROVIDING THICK BLANKETS AND ELECTRIC BLANKETS WITH REDUCING SHIVERING INCIDENCE ON POSTOPERATIVE PATIENTS IN SURGICAL INSTALLATIONS DR. SITANALA HOSPITAL TANGERANG, INDONESIA IN 2019

Introduction: Post Anesthetic Shivering (PAS) or the incidence of post-anesthetic shivering is reported to be around 33-65% in patients undergoing general anesthesia and about 33-56,7% in patients undergoing spinal anesthesia. The treatment can be done pharmacologically with drugs and non-pharmacologically one of them with a warm blanket. The purpose of this study was to determine the differences in the effectiveness of giving thick cloth blankets and 380C electric blankets with a reduction in the incidence of shivering in postoperative patients at the Surgical Installation dr. SitanalaTangerang Hospital. Methods: The research method was a quantitative study with a quasi-experimental design with a pre-test post-test with control group design. The number of samples were 30 patients. Data was collected by observing shivering responses. The intervention was carried out by firing 380C electric blankets and thick cloth blankets. Result: The results showed that of the 15 postoperative patients before being given an electric blanket, almost half were 7 (46,7%) having grade 3 shivering, where as in patients given thick cloth blankets almost half were 6 (40%) having grade 2 shivering. Electrical heating is almost half that is 6 (40%) does not experience shivering (grade 0), where as in patients given regular blankets almost half are 6 (40%) experiencing grade 2 shivering. Statistical test results were obtained (p-value = 0.001, ? : 0.05) and (p-value = 0.005, ?: 0.05). Conclusion: there was an electric warm blanket or thick cloth blanket that influences the incidence of shivering in postoperative patients at the Surgical Installation dr. Sitanala Tangerang Hospital, but electric blankets are more effective than thick blankets. Suggestion is that the hospital is expected to make an intervention to provide electric warm blankets with a temperature of 380C postoperatively can be used as a fixed procedure for the service of surgical patients to prevent complications of shivering

PERCEPTIONS OF UNDERGRADUATE DENTAL STUDENTS AND GRADUATE DENTISTS TOWARDS BEHAVIOURAL GUIDANCE TECHNIQUES IN PAEDIATRIC DENTISTRY: A CROSS-SECTIONAL STUDY

Objectives: This study aimed to evaluate perceptions of undergraduate dental students and graduate dentists towards behaviouralguidance techniques in paediatric dentistry. Materials & Methods: 225 subjects with previous experience in treating paediatricpatient were identified and invited to fill up a Likert-style questionnaire with 15 questions in total. The data was evaluated for descriptive analysis and statistical analysis using Pearson’s chi-square test and Fisher’s exact test(significance level, p<0.05). Results: 158 respondents were included in this study. 47.4% think that communication is the most effective non-pharmacological method of behavioural guidance, 62.6% and 45.6% think that tell-show-do is the most practical and most successful behaviour shaping techniques, respectively. 43.7% responded neutral to the use HOME or physical restraints in controlling child patient, 81.0% almost never used HOME method. 87.3% had explained procedures of dental treatment to child patientsduring treatment, 89.2% had used euphemism on the child. 40.5% of child patientssometimes struggled when receiving their treatment. 33.5% required some effort to get their child patient treated. 79.1% had never usedprotective stabilization method. 75.9% think that their working environment is favourable and conducive for child patients. 39.2% think that desensitization is the most effective method to reduce dental fear and anxiety in child patient. 59.5% preferpresence of parents during treatment. 56.35% of frightened cry was most commonly seen clinically. 73.4% would not consider further studies in paediatric dentistry. Conclusion: Generally, the respondents demonstrated satisfactory knowledge and acceptance of various behavioural guidance techniques in paediatric dentistry, but with some deficiencies.

A CASE REPORT: POSTPRANDIAL HYPOGLYCAEMIA IN INTERMITTENT FASTING DIET FOR TYPE 2 DIABETES MELLITUS PATIENT

This report illustrates a case of a 60-year-old lady with type 2 diabetes mellitus who performs intermittent fasting (IF) diet, with the aim to lose her weight and indirectly reverse her diabetes mellitus, hypertension, and hyperlipidaemia. She managed to get the optimum blood pressure, lose 6 kg, and reduce her glycaemic control from 7.8% to 5.8% within 10 months period. However, she started to get episodes of symptomatic post prandial hypoglycaemia when she is about to achieve her target.

CEREBRAL VENOUS THROMBOSIS SECONDARY TO SARS-COV-2 INFECTION

Cerebral venous thrombosis (CVT) is a relatively rare form of neurovascular emergency, and may present as headache, seizure, or focal neurological deficit. It typically has a higher occurrence in younger women. Recently, there are increasingly cases of CVTreported in association with COVID-19, which fall outside the typical demographics, suggesting a hyper-coagulable state attributable to COVID-19. Here, we present a case of CVTin a young gentleman with concomitant COVID-19, who presented with first-onset seizure.

HYDRONEPHROSIS: A CASE OF URETERAL METASTASISOF PROSTATE CANCER

HYDRONEPHROSIS: A CASE OF URETERAL METASTASIS OF PROSTATE CANCER

EYES CANNOT SEE WHAT THE BRAIN DOES NOT KNOW

Background: Intraocular foreign body (IOFB) is a common ocular trauma and is a leading cause of visual impairment. Majority of the cases reported the occurrence at the workplace and usually related to activities involving metallic objects. Hammering, drilling, explosion and usage of machining tools are among the causes of IOFB. Foreign body in the angle are frequently missed as it is not visualised directly during a routine examination. Thus, a thorough examination which includes gonioscopy and imaging must be done in all penetrating and full thickness cornea laceration cases. Purpose: We report a case of self-sealed full thickness cornea laceration with presence of metal foreign body in the angle. Method: Case Report Result: A 19 year-old boy, presented with right eye discomfort following trauma 1 week prior to presentation. Examination revealed a self-sealed full thickness cornea laceration at 1-2 o’clock with a foreign body found seated on the angle from gonioscopy. A foreign body consist of metal had successfully removed surgically with the facilitation of intraocular magnet. Conclusion: All self-sealed penetrating injury to the eye required a high index of suspicious of intraocular foreign body. An imaging and complete examination with dilated fundus examination and gonioscopy will be helpful to identify the location of foreign body. Hence, definitive treatment will prevent long term complication related to intraocular foreign body.

DESCRIPTION OF PATIENT SATISFACTION HEALTH SOCIAL SECURITY AGENCY (BPJS) OUT PATIENT TO PHARMACEUTICAL SERVICES AT KANUDJOSO DJATIWIBOWO HOSPITAL BALIKPAPAN WITH IMPORTANCE PERFORMANCE ANALYSIS (IPA) METHOD

DESCRIPTION OF PATIENT SATISFACTION HEALTH SOCIAL SECURITY AGENCY (BPJS) OUT PATIENT TO PHARMACEUTICAL SERVICES AT KANUDJOSO DJATIWIBOWO HOSPITAL BALIKPAPAN WITH IMPORTANCE PERFORMANCE ANALYSIS (IPA) METHOD

METHYLENE BLUE INHIBITS THE INTERACTION BETWEEN HEPARAN SULFATE AND SARS-COV-2 SPIKE PROTEIN; A REVIEW OF EVIDENCE FOR A HYPOTHESIS.

The addition of methylene blue to the standard treatment protocol has been shown to improve respiratory rate and oxygen saturation in COVID-19 patients, reducing morbidity and mortality. Evidence to date suggests that methylene blue inhibits protein-protein interactions between SARS-CoV-2 Spike protein and angiotensin-converting enzyme 2, which in turn inhibits the cell entry of SARS-CoV-2. However, the methylene blue dye-binding characteristics of sulfated glycosaminoglycans suggest additional inhibitory effects of the spike protein-heparan sulfate interaction. We hypothesize that the binding of cationic methylene blue neutralizes polyanionic heparan sulfate molecules on the host cell surface. As a consequence, electrostatic interactions between negatively charged heparan sulfate and the positively charged receptor binding domain of SARS-CoV-2 spike protein will be inhibited. Thus, methylene blue will exhibit a "shielding effect" on the heparan sulfate proteoglycans, inhibiting viral attachment to the cell surface. The proposed mechanism corroborates the possible broad-spectrum antiviral activity of methylene blue against multiple human coronaviruses that exploit the electrostatic interactions with sulfated glycosaminoglycans for virus entry. Methylene blue would exhibit the same anti-adhesive activity at the blood-brain-barrier and olfactory neuroepithelium, corroborating potential benefits in ameliorating post-COVID-19 neurological impairment. However, as cationic dyes can bind to both free glycosaminoglycans in circulation as well as proteoglycans attached to the cell surface, co-administration of intravenous heparin could possibly antagonize the proposed antiviral activity. This critical review focuses on empirical evidence to support the hypothesized heparan sulfate-dependent antiviral activity of MB.

IMPACT OF COVID-19 PANDEMIC ON MENTAL AND EMOTIONAL WELLBEING AMONG CHILDREN: A SYSTEMATIC REVIEW

Background: Coronavirus pandemic represents a huge threat and phenomenal risks on mental and emotional wellness among children. This systematic review expects to integrate academic research literature that provides details regarding the impact of COVID-19 on emotional wellbeing and mental status among children. Methods: A systematic research engine was escorted on PubMed, Proquest, ScienceDirect, and Google Scholar with keywords: Children, COVID-19, Mental Status, Psychological Status from December 2019 to 18 November 2020 following the PRISMA guidelines. Articles were chosen dependent on the predetermined eligibility criteria. The included articles to review used the Quality Assessment Tool Adapted from the National Institutes of Health (NIH). Results: A total of 17,059 records were identified using the keywords. After removal of duplicates and initial screening, seven articles met the inclusion criteria of COVID-19 influence on mental and emotional wellbeing among children. The research design was a longitudinal and cross-sectional online survey with the children age range was 3 – 18 years old. Conclusions: COVID-19 Pandemic has a significant influence on mental and emotional wellbeing among children. Some children experienced depressive indication, difficulty concentrating, anxiety, touchy and easy to get irritated. Limitations: Online survey generalized the results, younger children might need assistance from parents during filling up the questionnaire, small sampling size.

PRESCRIBING PATTERN OF INTRAVENOUS ANTIBIOTICS FOR HOSPITALIZED PATIENT IN HOSPITAL JERANTUT

Hospitalized patients are often prescribed with antibiotics and it can be a challenge for the prescriber. This study is conducted to review the prescribing pattern of intravenous antibiotics for hospitalized patients in Jerantut Hospital in accordance to the National Antibiotic Guideline and Antimicrobial Stewardship Program.