Justyna Ber, A. Bienert, P. Sobczyński, M. Nowicka, Łukasz Żurański, M. Hołysz, E. Grześkowiak, P. Wiczling
Background. Dexmedetomidine (DEX) is a widely used sedative agent for treating post-surgery patients. It also acts on hemodynamic parameters like heart rate or cardiac output. This study aimed to develop a pharmacokinetic-pharmacodynamic (PK/PD) model of DEX using bispectral index (BIS) and cardiac output (CO) as a response. Methodology and results. 21 mechanically ventilated elderly cardiac patients undergoing abdominal aortic surgery were enrolled in the study. DEX was given to maintain moderate or deep sedation. Genotypes of ADR2A*55 were identified using real-time PCR-HRM. Data were analyzed using nonlinear mixed-effect modelling. A two-compartment model described DEX pharmacokinetics. The sigmoid Emax and linear models were used to describe BIS and CO measurements. The typical value of EC50 for DEX effects on BIS was 3.62 ng/ml, and the slope between CO and DEX concentrations was 0.819 (L/min)/(ng/ml). We were unable to show the effects of considered covariates on DEX pharmacodynamics. Conclusions. WE proposed the PK/PD model of DEX to understand better the BIS and CO changes observed after surgery. The measured CI values were in the reference range showing that the used doses of DEX ensured stable cardiac function in the studied patients.
{"title":"Population pharmacokinetic-pharmacodynamic model of dexmedetomidine in elderly patients undergoing sedation after abdominal aortic surgery","authors":"Justyna Ber, A. Bienert, P. Sobczyński, M. Nowicka, Łukasz Żurański, M. Hołysz, E. Grześkowiak, P. Wiczling","doi":"10.20883/medical.e770","DOIUrl":"https://doi.org/10.20883/medical.e770","url":null,"abstract":"Background. Dexmedetomidine (DEX) is a widely used sedative agent for treating post-surgery patients. It also acts on hemodynamic parameters like heart rate or cardiac output. This study aimed to develop a pharmacokinetic-pharmacodynamic (PK/PD) model of DEX using bispectral index (BIS) and cardiac output (CO) as a response.\u0000Methodology and results. 21 mechanically ventilated elderly cardiac patients undergoing abdominal aortic surgery were enrolled in the study. DEX was given to maintain moderate or deep sedation. Genotypes of ADR2A*55 were identified using real-time PCR-HRM. Data were analyzed using nonlinear mixed-effect modelling. A two-compartment model described DEX pharmacokinetics. The sigmoid Emax and linear models were used to describe BIS and CO measurements. The typical value of EC50 for DEX effects on BIS was 3.62 ng/ml, and the slope between CO and DEX concentrations was 0.819 (L/min)/(ng/ml). We were unable to show the effects of considered covariates on DEX pharmacodynamics.\u0000Conclusions. WE proposed the PK/PD model of DEX to understand better the BIS and CO changes observed after surgery. The measured CI values were in the reference range showing that the used doses of DEX ensured stable cardiac function in the studied patients.","PeriodicalId":16350,"journal":{"name":"Journal of Medical Science","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86868997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jufriady Ismy _, Muhammad Ridha _, Dahril _, Rayyan Al Faruqi _, Muyasir _
Pneumatic Lithotripsy (PL) is considered effective in fragmenting hard stones, and this procedure can also be performed transurethrally and percutaneously on large stones. This study aimed to see the percentage of Stone Free Rate (SFR) by administering force diuretics to ureteral stones that were crushed using PL. Previous studies have found that intravenous loop diuretic administration is effective, safe, and efficient in obtaining a much higher percentage of SFR and can reduce the average number of sessions per stone during extracorporeal shock wave lithotripsy (ESWL). We identified study subjects from early July-September 2022 and obtained as many as 38 study subjects (SP) with stones in the distal ureter <20mm. Subjects were randomly selected and divided into two groups: the group given diuretics (K2) and not given (K1). With a 90% confidence degree and 15% sampling error, based on Lameshow's formula, 30 SP can be observed; eight other subjects were excluded because they experienced a decrease in systolic pressure >25% (5 SP) and the remaining stones came out without splitting (3SP). The results obtained were SFR levels that were statistically significant (p<0.05) and clinically using the Mann-Whitney statistical test. Administration of diuretics to patients with distal ureteral stones undergoing URS with Pneumatic Lithotripsy is safe and effective as an anti-retropulsion method. It is the strategy of choice in centers that do not provide laser lithotripsy or flexible ureteroscope.
{"title":"Pengaruh Diuretik Terhadap Stone-Free Rate Batu Ureter dengan Pneumatic Lithotripsy","authors":"Jufriady Ismy _, Muhammad Ridha _, Dahril _, Rayyan Al Faruqi _, Muyasir _","doi":"10.55572/jms.v3i2.82","DOIUrl":"https://doi.org/10.55572/jms.v3i2.82","url":null,"abstract":"Pneumatic Lithotripsy (PL) is considered effective in fragmenting hard stones, and this procedure can also be performed transurethrally and percutaneously on large stones. This study aimed to see the percentage of Stone Free Rate (SFR) by administering force diuretics to ureteral stones that were crushed using PL. Previous studies have found that intravenous loop diuretic administration is effective, safe, and efficient in obtaining a much higher percentage of SFR and can reduce the average number of sessions per stone during extracorporeal shock wave lithotripsy (ESWL). We identified study subjects from early July-September 2022 and obtained as many as 38 study subjects (SP) with stones in the distal ureter <20mm. Subjects were randomly selected and divided into two groups: the group given diuretics (K2) and not given (K1). With a 90% confidence degree and 15% sampling error, based on Lameshow's formula, 30 SP can be observed; eight other subjects were excluded because they experienced a decrease in systolic pressure >25% (5 SP) and the remaining stones came out without splitting (3SP). The results obtained were SFR levels that were statistically significant (p<0.05) and clinically using the Mann-Whitney statistical test. Administration of diuretics to patients with distal ureteral stones undergoing URS with Pneumatic Lithotripsy is safe and effective as an anti-retropulsion method. It is the strategy of choice in centers that do not provide laser lithotripsy or flexible ureteroscope.","PeriodicalId":16350,"journal":{"name":"Journal of Medical Science","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77123834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neuraxial block-associated infection is a rare complication, this could be due to better aseptic technique and possibility of unreported events. There are four mechanisms by which microorganisms enter the body during insertion of an epidural catheter, include inoculation of microorganisms on the skin surface, pathways along the insertion of epidural catheter, contamination of local anesthetic drugs, and hematogenous spread. The aim of the study is to find out incidence of infectious complications and risk factors for infection in patients who had an epidural catheter inserted in dr. Zainoel Abidin hospital Banda Aceh. A cross-sectional study was conducted over 3 months period with 45 total sampling patients who received epidural blocks. Analysis was done to know relationship beetwen age, number of attempts at insertion of epidural needles, duration of catheter in situ, comorbid DM, malignancy, duration of postoperative bed rest, and blood leukocyte count, signs of inflammation, neurological deficits, and bacterial culture of the epidural catheter. No infection was found, however there were 14 positive epidural catheter culture obtained Gram-negative rods. Nine of the 14 positive culture samples were patients with malignancy. All patients with positive culture samples had bed rest ≥2 days (p=0.004). No asociation between dependent and independent variables in this study (p>0.05). Positive culture results cannot be defined as an infection, however colonization at epidural catheter tip is an early sign of an imminent infectious process.
{"title":"Analisis Komplikasi Infeksi Terkait Tindakan Blok Epidural pada Pasien Pasca Operasi Di RSUD Dr. Zainoel Abidin Banda Aceh","authors":"Zafrullah Khany Jasa _, Yusmalinda _, Hafizh Arief _","doi":"10.55572/jms.v3i2.88","DOIUrl":"https://doi.org/10.55572/jms.v3i2.88","url":null,"abstract":"Neuraxial block-associated infection is a rare complication, this could be due to better aseptic technique and possibility of unreported events. There are four mechanisms by which microorganisms enter the body during insertion of an epidural catheter, include inoculation of microorganisms on the skin surface, pathways along the insertion of epidural catheter, contamination of local anesthetic drugs, and hematogenous spread. The aim of the study is to find out incidence of infectious complications and risk factors for infection in patients who had an epidural catheter inserted in dr. Zainoel Abidin hospital Banda Aceh. A cross-sectional study was conducted over 3 months period with 45 total sampling patients who received epidural blocks. Analysis was done to know relationship beetwen age, number of attempts at insertion of epidural needles, duration of catheter in situ, comorbid DM, malignancy, duration of postoperative bed rest, and blood leukocyte count, signs of inflammation, neurological deficits, and bacterial culture of the epidural catheter. No infection was found, however there were 14 positive epidural catheter culture obtained Gram-negative rods. Nine of the 14 positive culture samples were patients with malignancy. All patients with positive culture samples had bed rest ≥2 days (p=0.004). No asociation between dependent and independent variables in this study (p>0.05). Positive culture results cannot be defined as an infection, however colonization at epidural catheter tip is an early sign of an imminent infectious process.","PeriodicalId":16350,"journal":{"name":"Journal of Medical Science","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81670226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Epilepsy is one of the most common neurological diseases that can affect people of all ages, races, social classes, and geographic locations. Epilepsy is caused by abnormal release of neurons in the brain characterized by seizures. Data from the World Health Organization shows that epilepsy accounts for a significant proportion of the world's disease burden, affecting nearly 50 million people worldwide. The goal of management of epilepsy patients is to control seizures and improve quality of life. However, the side effects of antiepileptic drugs can significantly impair quality of life. This study aims to determine the relationship between duration of treatment and types of antiepileptic drugs with side effects of drugs in epilepsy patients at RSUDZA Neurology outpatient clinic. This is an observational analytic study with a cross sectional design. The sample of this study was epileptic patients at RSUDZA Neurology Outpatient Clinic based on inclusion and exclusion criteria with a total of 42 samples. Sampling was carried out from May−September 2022 using a consecutive sampling technique and filling out the Liverpool Adverse Effect Profile (LAEP) questionnaire. Existing research sample data were tabulated and analyzed by univariate analysis to present the frequency and percentage. Spearman's correlation statistical test was used to test the relationship between variables. The patients consisting of 17 men (40.5%) and 25 women (59.5%). The average length of treatment that respondents had undergone was 52 months, all of whom experienced side effects of antiepileptic drugs. The results of the Spearman's correlation statistical test showed that there was no relationship between the length of treatment and the type of antiepileptic drug with drug side effects in patients diagnosed with epilepsy at RSUDZA Neurology Outpatient Clinic.
{"title":"Hubungan Lama Pengobatan Dan Jenis Obat Antiepilepsi Dengan Efek Samping Obat Pada Pasien Epilepsi Di Poliklinik Neurologi RSUDZA","authors":"Novarini ., Sri Hastuti _, Nurhafnita ,","doi":"10.55572/jms.v3i2.98","DOIUrl":"https://doi.org/10.55572/jms.v3i2.98","url":null,"abstract":"Epilepsy is one of the most common neurological diseases that can affect people of all ages, races, social classes, and geographic locations. Epilepsy is caused by abnormal release of neurons in the brain characterized by seizures. Data from the World Health Organization shows that epilepsy accounts for a significant proportion of the world's disease burden, affecting nearly 50 million people worldwide. The goal of management of epilepsy patients is to control seizures and improve quality of life. However, the side effects of antiepileptic drugs can significantly impair quality of life. This study aims to determine the relationship between duration of treatment and types of antiepileptic drugs with side effects of drugs in epilepsy patients at RSUDZA Neurology outpatient clinic. This is an observational analytic study with a cross sectional design. The sample of this study was epileptic patients at RSUDZA Neurology Outpatient Clinic based on inclusion and exclusion criteria with a total of 42 samples. Sampling was carried out from May−September 2022 using a consecutive sampling technique and filling out the Liverpool Adverse Effect Profile (LAEP) questionnaire. Existing research sample data were tabulated and analyzed by univariate analysis to present the frequency and percentage. Spearman's correlation statistical test was used to test the relationship between variables. The patients consisting of 17 men (40.5%) and 25 women (59.5%). The average length of treatment that respondents had undergone was 52 months, all of whom experienced side effects of antiepileptic drugs. The results of the Spearman's correlation statistical test showed that there was no relationship between the length of treatment and the type of antiepileptic drug with drug side effects in patients diagnosed with epilepsy at RSUDZA Neurology Outpatient Clinic.","PeriodicalId":16350,"journal":{"name":"Journal of Medical Science","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82074091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study examines the prevalence of infection in burn patients as represented by the clinical spesimen culture results. The purpose of this study was to obtain data on the prevalence, distribution and susceptibility pattern of microbes isolated from clinical spesimens of burn patients hospitalized at RSUD dr. dr. Zainoel Abidin. This study is descriptive observational. The retrospective data obtained from the Plastic Surgery Department and the Clinical Microbiology Laboratory. The results showed the prevalence of infection in burn patients who were hospitalized at RSUD dr. Zainoel Abidin based on clinical spesimen culture of 4.7%. Microbial patterns isolated from burn patients were Gram positive bacteria (37.5%) consisting of Staphylococcus aureus and Staphylococcus hominis. Gram negatif bacteria (62.5%) isolated consisted of Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae. The clinical spesimens that showed the most bacterial growth were pus followed by blood and joint fluid. Patients with less than 40% wound area, showed the growth of Staphylococcus aureus, Acinetobacter baumannii and Klebsiella pneumoniae. Patients with wound area above 40%, showed the growth of Staphylococcus aureus, Staphylococcus hominis, Acinetobacter baumannii and Pseudomonas aeruginosa was found. The group of Gram positive bacteria had good sensitivity to the antibiotics vancomycin (100%), linezolid (100%), tigecycline (100%), clindamycin (66.7%), tetracycline (66.7%) and trimethoprim-sulfamethoxazole (66, 7%). The group of Gram negatif bacteria showed high sensitivity to Amikacin (100%).
{"title":"Evaluasi Kejadian Infeksi pada Pasien Luka Bakar yang Dirawat Inap di RSUD dr. Zainoel Abidin","authors":"Wilda Mahdani, Syamsul Rizal _, Mirnasari Amirsyah _","doi":"10.55572/jms.v3i2.69","DOIUrl":"https://doi.org/10.55572/jms.v3i2.69","url":null,"abstract":"This study examines the prevalence of infection in burn patients as represented by the clinical spesimen culture results. The purpose of this study was to obtain data on the prevalence, distribution and susceptibility pattern of microbes isolated from clinical spesimens of burn patients hospitalized at RSUD dr. dr. Zainoel Abidin. This study is descriptive observational. The retrospective data obtained from the Plastic Surgery Department and the Clinical Microbiology Laboratory. The results showed the prevalence of infection in burn patients who were hospitalized at RSUD dr. Zainoel Abidin based on clinical spesimen culture of 4.7%. Microbial patterns isolated from burn patients were Gram positive bacteria (37.5%) consisting of Staphylococcus aureus and Staphylococcus hominis. Gram negatif bacteria (62.5%) isolated consisted of Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae. The clinical spesimens that showed the most bacterial growth were pus followed by blood and joint fluid. Patients with less than 40% wound area, showed the growth of Staphylococcus aureus, Acinetobacter baumannii and Klebsiella pneumoniae. Patients with wound area above 40%, showed the growth of Staphylococcus aureus, Staphylococcus hominis, Acinetobacter baumannii and Pseudomonas aeruginosa was found. The group of Gram positive bacteria had good sensitivity to the antibiotics vancomycin (100%), linezolid (100%), tigecycline (100%), clindamycin (66.7%), tetracycline (66.7%) and trimethoprim-sulfamethoxazole (66, 7%). The group of Gram negatif bacteria showed high sensitivity to Amikacin (100%).","PeriodicalId":16350,"journal":{"name":"Journal of Medical Science","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87049833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Psoriasis vulgaris is an autoimmune disease that is influenced by multifactor, namely environmental, genetic (HLA-Cw6), and immune system dysregulation (IL-17 or IL-22), resulting in increased proliferation of keratinosit in the epidermis. Histologically characterized by parakeratosis, hyperkeratosis, elongated rete ridge, Monro micro abscess, and Kogoj micro abscess. The clinical picture is red patches with thick scales, especially in the trauma area. Platelet Rich Plasma (PRP) is an autologous preparation of platelets that strengthens in plasma and is a powerful anti-inflammatory agent. The immunomodulatory and anti-inflammatory effects of PRP are believed to play a role in the treatment of chronic inflammation patients. One of the important mediators in the pathogenesis of psoriasis is nuclear factor kappa B (NF-κB) and PRP exerting an inhibitory effect on NF-κB. The aim of the study was to assess the effect of PRP on the severity and quality of life of psoriasis vulgaris patients. The design of this study is a paired numerical comparative analysis using two groups with two measurements. The research design was a randomized, undisguised clinical trial and a parallel design. The study lasted for 6 weeks. Sampling was done by total sampling involving 20 psoriasis Vulgaris patients, then divided into two groups: intervention group and control group. The test group received 2 PRP injections and topical combination therapy (salicylic acid 3% + Vaseline album cream), while the control group only received topical combination therapy. The results of this study found a decrease in PASI and DLQI scores in the intervention group compared to the control group (p<0.005). This study concludes that the administration of PRP can reduce the severity of psoriasis Vulgaris as well as improve the quality of life of psoriasis Vulgaris patients.
{"title":"Pengaruh Pemberian Platelet-Rich Plasma Terhadap Derajat Keparahan Psoriasis Vulgaris","authors":"Nanda Earlia _, Cut Yunita _, Mikyal Bulqiah _, Aqil Yuniawan Tasrif _, Karamina Maghfirah _","doi":"10.55572/jms.v3i2.79","DOIUrl":"https://doi.org/10.55572/jms.v3i2.79","url":null,"abstract":"Psoriasis vulgaris is an autoimmune disease that is influenced by multifactor, namely environmental, genetic (HLA-Cw6), and immune system dysregulation (IL-17 or IL-22), resulting in increased proliferation of keratinosit in the epidermis. Histologically characterized by parakeratosis, hyperkeratosis, elongated rete ridge, Monro micro abscess, and Kogoj micro abscess. The clinical picture is red patches with thick scales, especially in the trauma area. Platelet Rich Plasma (PRP) is an autologous preparation of platelets that strengthens in plasma and is a powerful anti-inflammatory agent. The immunomodulatory and anti-inflammatory effects of PRP are believed to play a role in the treatment of chronic inflammation patients. One of the important mediators in the pathogenesis of psoriasis is nuclear factor kappa B (NF-κB) and PRP exerting an inhibitory effect on NF-κB. The aim of the study was to assess the effect of PRP on the severity and quality of life of psoriasis vulgaris patients. The design of this study is a paired numerical comparative analysis using two groups with two measurements. The research design was a randomized, undisguised clinical trial and a parallel design. The study lasted for 6 weeks. Sampling was done by total sampling involving 20 psoriasis Vulgaris patients, then divided into two groups: intervention group and control group. The test group received 2 PRP injections and topical combination therapy (salicylic acid 3% + Vaseline album cream), while the control group only received topical combination therapy. The results of this study found a decrease in PASI and DLQI scores in the intervention group compared to the control group (p<0.005). This study concludes that the administration of PRP can reduce the severity of psoriasis Vulgaris as well as improve the quality of life of psoriasis Vulgaris patients.","PeriodicalId":16350,"journal":{"name":"Journal of Medical Science","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73329606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
COVID-19 pandemic is an extraordinary issue and attacks almost the entire world population. Mental health problems such as behavioral disorders and cognitive disorders that arise as a result of the pandemic can develop into health problems that can last long time and potential to cause heavy social burden. This study aims to analyze factors that influence behavioral and cognitive function disorders during COVID-19 pandemic in patients at Neurology Outpatient Clinic RSUD dr. Zainoel Abidin. This study used a descriptive-analytic research method with a cross-sectional design. Bivariate data were analyzed using t-test. Totaled participants during July−September 2022 was 122 respondents, consisting of males (n=68) and females (n=54). Based on Moca Ina score’s result, respondents aged <40 years (14.8%), higher education level (24.6%), had no history of chronic disease ( 25.4%), and have coping skills (27%) showing normal cognitive function. Based on Abe's BPSD score’s result, higher education level (26.2%) and coping abilities (24.6%) show normal behavior. Age, level of education, history of chronic disease, and coping abilities are associated with impaired cognitive function, while educational level and coping abilities are associated with behavioral disorders.
{"title":"Analisis Faktor-Faktor yang Mempengaruhi Gangguan Perilaku dan Fungsi Kognitif di Masa Pandemi COVID-19 Pada Pasien Poliklinik Neurologi RSUD dr. Zainoel Abidin","authors":"Ika Marlia _, S. ., F. _","doi":"10.55572/jms.v3i2.96","DOIUrl":"https://doi.org/10.55572/jms.v3i2.96","url":null,"abstract":"COVID-19 pandemic is an extraordinary issue and attacks almost the entire world population. Mental health problems such as behavioral disorders and cognitive disorders that arise as a result of the pandemic can develop into health problems that can last long time and potential to cause heavy social burden. This study aims to analyze factors that influence behavioral and cognitive function disorders during COVID-19 pandemic in patients at Neurology Outpatient Clinic RSUD dr. Zainoel Abidin. This study used a descriptive-analytic research method with a cross-sectional design. Bivariate data were analyzed using t-test. Totaled participants during July−September 2022 was 122 respondents, consisting of males (n=68) and females (n=54). Based on Moca Ina score’s result, respondents aged <40 years (14.8%), higher education level (24.6%), had no history of chronic disease ( 25.4%), and have coping skills (27%) showing normal cognitive function. Based on Abe's BPSD score’s result, higher education level (26.2%) and coping abilities (24.6%) show normal behavior. Age, level of education, history of chronic disease, and coping abilities are associated with impaired cognitive function, while educational level and coping abilities are associated with behavioral disorders.","PeriodicalId":16350,"journal":{"name":"Journal of Medical Science","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86260351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dr. Azzaki Abubakar, Sp.PD-KGEH _, Dr. Andrie Gunawan, SpPD _, J. _
Hepatitis C is a world health problem with a high mortality rate. The Indonesian Ministry of Health has been controlling hepatitis C infection since 2017 using Direct Acting Antiviral (DAA) drugs which have lower side effects and a higher cure rate. This study aims to determine incidence, patient demographic data, and liver fibrosis scores on the successful treatment of hepatitis C infection at RSUD dr. Zainoel Abidin Hospital. Inclusion criteria in this retrospective cohort design was patients with positive anti hepatitis C virus (Anti-HCV). Treatment was carried out when the viral load was detected by giving Sofosbuvir 400 mg per day and Daclatasvir 60 mg per day for 12 weeks, then patient returns to be examined to assess the successful therapy. Thirty eight out of 5002 patients (0.76%) showed positive Anti-HCV, most patients aged over 60 years (39.47%), was dominated by male (55.26%), and most of them are located in Banda Aceh (47 ,36 %). Thirty out of 38 positive anti-HCV patients (78.95%) had HCV RNA, but 15 patients (50%) were not eligible for treatment. Seven out of 15 patients (46.7%) completed DAA treatment. All HCV RNA were undetectable, improved AST values and decreased aspartate aminotransferase-platelet ratio index (APRI) scores which showed improvement in liver fibrosis, after completing therapy. Hepatitis C patients who adhere to treatment and management of hepatitis C will get good results marked by improvement in liver fibrosis and undetectable HCV RNA.
{"title":"Keberhasilan Tatalaksana Infeksi Virus Hepatitis C di Rumah Sakit Umum Daerah dr. Zainoel Abidin Banda Aceh","authors":"Dr. Azzaki Abubakar, Sp.PD-KGEH _, Dr. Andrie Gunawan, SpPD _, J. _","doi":"10.55572/jms.v3i2.87","DOIUrl":"https://doi.org/10.55572/jms.v3i2.87","url":null,"abstract":"Hepatitis C is a world health problem with a high mortality rate. The Indonesian Ministry of Health has been controlling hepatitis C infection since 2017 using Direct Acting Antiviral (DAA) drugs which have lower side effects and a higher cure rate. This study aims to determine incidence, patient demographic data, and liver fibrosis scores on the successful treatment of hepatitis C infection at RSUD dr. Zainoel Abidin Hospital. Inclusion criteria in this retrospective cohort design was patients with positive anti hepatitis C virus (Anti-HCV). Treatment was carried out when the viral load was detected by giving Sofosbuvir 400 mg per day and Daclatasvir 60 mg per day for 12 weeks, then patient returns to be examined to assess the successful therapy. Thirty eight out of 5002 patients (0.76%) showed positive Anti-HCV, most patients aged over 60 years (39.47%), was dominated by male (55.26%), and most of them are located in Banda Aceh (47 ,36 %). Thirty out of 38 positive anti-HCV patients (78.95%) had HCV RNA, but 15 patients (50%) were not eligible for treatment. Seven out of 15 patients (46.7%) completed DAA treatment. All HCV RNA were undetectable, improved AST values and decreased aspartate aminotransferase-platelet ratio index (APRI) scores which showed improvement in liver fibrosis, after completing therapy. Hepatitis C patients who adhere to treatment and management of hepatitis C will get good results marked by improvement in liver fibrosis and undetectable HCV RNA.","PeriodicalId":16350,"journal":{"name":"Journal of Medical Science","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87853649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Determining the time of death plays a crucial role in a forensic post-mortem examination. Many methods for the time of death (TOD) determination have been developed. However, most are not applicable during the first hours after death and produce large post-mortem interval (PMI) ranges. Eye examination makes it possible to precisely determine the time of death during the initial period after death with half-hour accuracy.. In recent years methods for estimating the time of death by measuring the changes in the eye have made great strides. Those methods use the changes in the reaction to drugs and macroscopically visible morphological changes. Experimental studies also produced equations that can estimate the post-mortem interval using biochemical, electrochemical and thermal changes within the eye.
{"title":"Keep an eye on the crime – a new look at the forensic use of post-mortem eye examination to estimate time of death","authors":"Jacob Van der Veer, Szymon Rzepczyk, C. Żaba","doi":"10.20883/medical.e753","DOIUrl":"https://doi.org/10.20883/medical.e753","url":null,"abstract":"Determining the time of death plays a crucial role in a forensic post-mortem examination. Many methods for the time of death (TOD) determination have been developed. However, most are not applicable during the first hours after death and produce large post-mortem interval (PMI) ranges. Eye examination makes it possible to precisely determine the time of death during the initial period after death with half-hour accuracy.. In recent years methods for estimating the time of death by measuring the changes in the eye have made great strides. Those methods use the changes in the reaction to drugs and macroscopically visible morphological changes. Experimental studies also produced equations that can estimate the post-mortem interval using biochemical, electrochemical and thermal changes within the eye.","PeriodicalId":16350,"journal":{"name":"Journal of Medical Science","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82049379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Klaudia Gutowska, Zuzanna Wojdyńska, Sebastian Szewczyk, Justyna Milczarek-Banach, P. Miśkiewicz
ABSTRACT Background: Intravenous glucocorticoids pulses administration is the main therapeutic option in the treatment of Graves’ orbitopathy. Such therapy could relate to the multiple adverse effects. The aim of the study is evaluation the influence of intravenous methylprednisolone (IVMP) pulse therapy on the heart rhythm (HR) changes in patients with active, moderate-to-severe Graves’ Orbitopathy (GO). Methods: We studied 20 patients with moderate-to-severe GO. All patients received 12 IVMP pulses (6x500 mg plus 6x250mg) at equal time intervals in a weekly schedule. We performed Holter ECG monitoring for 3 consecutive days (the day before, the day of IVMP and day after IVMP) to monitor HR and arrhythmias. We compared changes in HR between these 3 days and set time interval when the alteration was significant. This evaluation was performed during the 1st, 6th and 12th IVMP pulse. Results: Increased HR, in comparison with the day before, was registered on the day of IVMP administration. The most significant increase in HR started 5 hours (h) after a pulse administration and lasted 12 h. There were no significant differences in HR between the day before and the day after IVMP. We did not notice any major adverse cardiac events including severe arrhythmias. Conclusions: IVMP therapy is associated with increased HR, that occurs a few hours after infusion, lasts several hours and is transient. Keywords: Graves’ ophthalmopathy; Graves’ disease; glucocorticoids; heart rate
{"title":"Increased heart rhythm in response to high-dose intravenous methylprednisolone pulse therapy of moderate-to-severe Graves’ orbitopathy.","authors":"Klaudia Gutowska, Zuzanna Wojdyńska, Sebastian Szewczyk, Justyna Milczarek-Banach, P. Miśkiewicz","doi":"10.20883/medical.e774","DOIUrl":"https://doi.org/10.20883/medical.e774","url":null,"abstract":"ABSTRACT \u0000Background: Intravenous glucocorticoids pulses administration is the main therapeutic option in the treatment of Graves’ orbitopathy. Such therapy could relate to the multiple adverse effects. The aim of the study is evaluation the influence of intravenous methylprednisolone (IVMP) pulse therapy on the heart rhythm (HR) changes in patients with active, moderate-to-severe Graves’ Orbitopathy (GO). \u0000Methods: We studied 20 patients with moderate-to-severe GO. All patients received 12 IVMP pulses (6x500 mg plus 6x250mg) at equal time intervals in a weekly schedule. We performed Holter ECG monitoring for 3 consecutive days (the day before, the day of IVMP and day after IVMP) to monitor HR and arrhythmias. We compared changes in HR between these 3 days and set time interval when the alteration was significant. This evaluation was performed during the 1st, 6th and 12th IVMP pulse. \u0000Results: Increased HR, in comparison with the day before, was registered on the day of IVMP administration. The most significant increase in HR started 5 hours (h) after a pulse administration and lasted 12 h. There were no significant differences in HR between the day before and the day after IVMP. We did not notice any major adverse cardiac events including severe arrhythmias. \u0000Conclusions: IVMP therapy is associated with increased HR, that occurs a few hours after infusion, lasts several hours and is transient. \u0000Keywords: Graves’ ophthalmopathy; Graves’ disease; glucocorticoids; heart rate","PeriodicalId":16350,"journal":{"name":"Journal of Medical Science","volume":"83 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83986369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：