Pub Date : 2022-12-30DOI: 10.47353/jsocmed.v1i3.10
Novrida Pratiwi Tarigan, E. R. Daulay, S. Nasution
Introduction: CT scan provides several three-dimensional images when reconstructed, high speed, accurate, less invasive, and relatively low cost. The size of renal arteries varies based on influencing factors such as age, gender, and location. Several studies reported variations in the dimensions of the renal arteries based on sex, age, and variations of the arteries. The purpose of research objectives is to analyze factors affecting the caliber of the renal artery in patients with abdominal CT Scan with intravenous contrast procedure. Method: A case-control study in patients with abdominal CT Scan with intravenous contrast procedure. Data was secondary data obtained by medical records of patients who have undergone a CT scan of the Abdomen with intravenous contrast. Results: The caliber of the right renal artery in subjects ≤40 years (5.19±0.53 mm) was greater than those> 40 years (4.58±0.66 mm). Statistically, based on the Independent T-test, found that there was a significant difference in the mean caliber of the right renal artery (p <0.01) and the left renal artery (p=0.01). The mean of the caliber of the right and left renal arteries in male subjects (5.05±0.69 mm) was greater than women (4.7±0.60 mm). The results of the Independent T-test showed that there was a difference in male subjects than women with a p-value of the right renal artery caliber (p=0.04) and left (p=0.02). Conclusion: There was a difference in the mean caliber of the renal arteries by the CT scan of the abdomen with intravenous contrast based on age and gender.
{"title":"Renal Artery Caliber In Abdominal CT Scan With IV Contrast Based on Age and Gender","authors":"Novrida Pratiwi Tarigan, E. R. Daulay, S. Nasution","doi":"10.47353/jsocmed.v1i3.10","DOIUrl":"https://doi.org/10.47353/jsocmed.v1i3.10","url":null,"abstract":"Introduction: CT scan provides several three-dimensional images when reconstructed, high speed, accurate, less invasive, and relatively low cost. The size of renal arteries varies based on influencing factors such as age, gender, and location. Several studies reported variations in the dimensions of the renal arteries based on sex, age, and variations of the arteries. The purpose of research objectives is to analyze factors affecting the caliber of the renal artery in patients with abdominal CT Scan with intravenous contrast procedure.\u0000Method: A case-control study in patients with abdominal CT Scan with intravenous contrast procedure. Data was secondary data obtained by medical records of patients who have undergone a CT scan of the Abdomen with intravenous contrast.\u0000Results: The caliber of the right renal artery in subjects ≤40 years (5.19±0.53 mm) was greater than those> 40 years (4.58±0.66 mm). Statistically, based on the Independent T-test, found that there was a significant difference in the mean caliber of the right renal artery (p <0.01) and the left renal artery (p=0.01). The mean of the caliber of the right and left renal arteries in male subjects (5.05±0.69 mm) was greater than women (4.7±0.60 mm). The results of the Independent T-test showed that there was a difference in male subjects than women with a p-value of the right renal artery caliber (p=0.04) and left (p=0.02).\u0000Conclusion: There was a difference in the mean caliber of the renal arteries by the CT scan of the abdomen with intravenous contrast based on age and gender.","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121464727","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}
Pub Date : 2022-12-30DOI: 10.47353/jsocmed.v1i3.16
A. Iqbal, D. W. Wijaya, B. Lubis
Introduction: Laparotomy is one of the most frequently performed surgical procedures. Surgery causes a stress response that increases the risk of experiencing malnutrition, especially in patients undergoing laparotomy. Malnutrition can increase the risk of adverse outcomes in postoperative patients. This study aims to evaluate perioperative nutritional status in patients who will undergo laparotomy surgery at Haji Adam Malik General Hospital Method:This research is an observational study with a prospective design. This study involved 65 research subjects withthe sampling technique was carried out by non-probability sampling, namely consecutive sampling. Results:The majority of study subjects had BMI ≥18.5, without weight loss >3.6 kg in the last 6 months, without a history of food intake <50% portion in the last 1 week, and albumin value ≥3.0 pre- and post- operative. Postoperatively. The number of subjects with PONS value ≥1 changed from 33.85% before surgery to 52.31% after surgery. There was a significant change in PONS values before and after laparotomy (p = 0.001). Conclusion:Statuspost-operative nutritional study subjects decreased compared to before surgery. A significant increase in PONS scores also occurred after laparotomy.
剖腹手术是最常见的外科手术之一。手术引起的应激反应增加了营养不良的风险，尤其是在接受剖腹手术的患者中。营养不良可增加术后患者不良后果的风险。本研究旨在评估Haji Adam Malik综合医院剖腹手术患者围手术期营养状况。方法:本研究为前瞻性观察性研究。本研究共涉及65名研究对象，抽样技术采用非概率抽样，即连续抽样。结果:大多数研究对象BMI≥18.5，最近6个月无体重减轻>3.6 kg，最近1周无食物摄入史<50%，术前和术后白蛋白值≥3.0。术后。PONS值≥1的受试者比例由术前的33.85%上升至术后的52.31%。剖腹手术前后PONS值有显著变化(p = 0.001)。结论:与术前相比，术后营养状况有所下降。剖腹手术后PONS评分也显著增加。
{"title":"Perioperative Nutritional Status of Digestive Surgery Laparotomy Surgery","authors":"A. Iqbal, D. W. Wijaya, B. Lubis","doi":"10.47353/jsocmed.v1i3.16","DOIUrl":"https://doi.org/10.47353/jsocmed.v1i3.16","url":null,"abstract":"Introduction: Laparotomy is one of the most frequently performed surgical procedures. Surgery causes a stress response that increases the risk of experiencing malnutrition, especially in patients undergoing laparotomy. Malnutrition can increase the risk of adverse outcomes in postoperative patients. This study aims to evaluate perioperative nutritional status in patients who will undergo laparotomy surgery at Haji Adam Malik General Hospital Method:This research is an observational study with a prospective design. This study involved 65 research subjects withthe sampling technique was carried out by non-probability sampling, namely consecutive sampling. Results:The majority of study subjects had BMI ≥18.5, without weight loss >3.6 kg in the last 6 months, without a history of food intake <50% portion in the last 1 week, and albumin value ≥3.0 pre- and post- operative. Postoperatively. The number of subjects with PONS value ≥1 changed from 33.85% before surgery to 52.31% after surgery. There was a significant change in PONS values before and after laparotomy (p = 0.001). Conclusion:Statuspost-operative nutritional study subjects decreased compared to before surgery. A significant increase in PONS scores also occurred after laparotomy.","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121579497","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}
Pub Date : 2022-12-30DOI: 10.47353/jsocmed.v1i3.19
Dion Ricardo, A. Hanafie, Tasrif Hamdi
Introduction: Caesarean section (SC) is defined as the birth of a baby through an incision in the abdomen (laparotomy) and uterus (hysterotomy). Spinal anesthesia is the choice for elective SC because it is considered effective and efficient considering its simple technique and ability to provide adequate surgical anesthesia, easy administration, faster onset, and safety. Spinal anesthesia also provides early skin to skin contact which increases maternal satisfaction although the hypotension risk is higher compared to epidural anesthesia which is countered by sympathomimetic vasopressors administration. The aim to research was to compare the administration of 10 IU oxytocin diluted in 10 cc of 0.9% NaCl for 15 seconds with 60 seconds on hemodynamics in sectio caesarean patients under spinal anesthesia. Method: This study used an RCT (Randomized Clinical Trial) design with double blind, meaning that neither the research subjects nor the observers were aware of the treatment or intervention given. The study sample was patients who underwent Sectio Caesaria at Haji Adam Malik General Hospital Medan, and the Universitas Sumatera Utara Hospital which fulfilled the inclusion and exclusion criteria. Results: It was found that there was not a significant difference in MAP values between the 15-second and 60-second bolus groups with p-values for the 1st, 3rd, 5th, and 10th minutes respectively 0.804, 0.692, 0.568 , 0.216, 0.754, and 0.390. In addition, it is known that there was a significant difference in pulse values between the 15-second and 60-second bolus groups at 1, 3, 5, 10 and 15 minutes, with the results of the p-value before, 1, 3, 5, 10, and 15 minutes are 0.509, 0.464, 0.805, 0.055, 0.475 and 0.857 respectively. In this study, no side effects were found in either group between 15 second and 60 second boluses. Conclusion: There were no significant hemodynamic changes in both test groups (15 second and 60 second boluses), at 1, 3, 5, 10 and 15 minutes.
剖宫产术(SC)的定义是通过腹部切口(剖腹)和子宫(子宫切开术)分娩婴儿。脊髓麻醉是选择性SC的选择，因为它被认为是有效和高效的，因为它技术简单，能够提供足够的手术麻醉，给药容易，起效快，安全。脊髓麻醉还提供早期皮肤与皮肤的接触，这增加了产妇的满意度，尽管与硬膜外麻醉相比，低血压的风险更高，这是由拟交感神经加压药物治疗的结果。研究的目的是比较脊髓麻醉下剖宫产患者使用10 IU后叶催产素稀释10 cc 0.9% NaCl 15秒和60秒对血液动力学的影响。方法:本研究采用双盲RCT(随机临床试验)设计，即研究对象和观察者都不知道所给予的治疗或干预。研究样本为棉兰哈吉·亚当·马利克综合医院和苏门答腊Utara大学医院接受剖腹产手术的患者，符合纳入和排除标准。结果:15秒注射组与60秒注射组的MAP值无显著性差异，第1、3、5、10分钟的p值分别为0.804、0.692、0.568、0.216、0.754、0.390。此外，已知15秒和60秒注射组在1、3、5、10和15分钟的脉冲值有显著性差异，1、3、5、10和15分钟前的p值分别为0.509、0.464、0.805、0.055、0.475和0.857。在这项研究中，在15秒到60秒的时间里，两组都没有发现副作用。结论:在1、3、5、10、15分钟时，两组患者(15秒和60秒)的血流动力学均无明显变化。
{"title":"Comparison of Oxytocin 10 IU Intravena Dilution of 10 ml Nacl 0.9% Bolus for 15 Seconds and 60 Seconds to Hemodynamics in Sectio Caesaria Patients with Spinal Anesthesia","authors":"Dion Ricardo, A. Hanafie, Tasrif Hamdi","doi":"10.47353/jsocmed.v1i3.19","DOIUrl":"https://doi.org/10.47353/jsocmed.v1i3.19","url":null,"abstract":"Introduction: Caesarean section (SC) is defined as the birth of a baby through an incision in the abdomen (laparotomy) and uterus (hysterotomy). Spinal anesthesia is the choice for elective SC because it is considered effective and efficient considering its simple technique and ability to provide adequate surgical anesthesia, easy administration, faster onset, and safety. Spinal anesthesia also provides early skin to skin contact which increases maternal satisfaction although the hypotension risk is higher compared to epidural anesthesia which is countered by sympathomimetic vasopressors administration. The aim to research was to compare the administration of 10 IU oxytocin diluted in 10 cc of 0.9% NaCl for 15 seconds with 60 seconds on hemodynamics in sectio caesarean patients under spinal anesthesia.\u0000Method: This study used an RCT (Randomized Clinical Trial) design with double blind, meaning that neither the research subjects nor the observers were aware of the treatment or intervention given. The study sample was patients who underwent Sectio Caesaria at Haji Adam Malik General Hospital Medan, and the Universitas Sumatera Utara Hospital which fulfilled the inclusion and exclusion criteria.\u0000Results: It was found that there was not a significant difference in MAP values between the 15-second and 60-second bolus groups with p-values for the 1st, 3rd, 5th, and 10th minutes respectively 0.804, 0.692, 0.568 , 0.216, 0.754, and 0.390. In addition, it is known that there was a significant difference in pulse values between the 15-second and 60-second bolus groups at 1, 3, 5, 10 and 15 minutes, with the results of the p-value before, 1, 3, 5, 10, and 15 minutes are 0.509, 0.464, 0.805, 0.055, 0.475 and 0.857 respectively. In this study, no side effects were found in either group between 15 second and 60 second boluses.\u0000Conclusion: There were no significant hemodynamic changes in both test groups (15 second and 60 second boluses), at 1, 3, 5, 10 and 15 minutes.","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127380548","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}
Pub Date : 2022-12-30DOI: 10.47353/jsocmed.v1i3.14
Muhammad Ramadhan Hasibuan, A. Lubis, D. W. Wijaya
Introduction: Excessive saliva production can becomes an airway problem in conditions of decreased consciousness where there is impaired swallowing function. It increases the risk of aspiration of saliva into the airways that can result in choking. The use of premedication drugs to reduce the incidence of drug-induced hypersalivation can be done as a prevention. The anticholinergic drug class is the drug of choice for the management of hypersalivation in general anesthesia patients who have been given ketamine and ether. Ketamine as a sedating agent will provide a side effect of hypersalivation, where hypersalivation can cause laryngospasm or aspiration, as a form of prevention, anticholinergic drugs such as atropine can be given. The aim of this research was to compare the effect of antisialagogue on the administration of atropine sulfate at a dose of 0.25 mg and 0.5 mg in intravenous general anesthesia patients without ETT with ketamine at Haji Adam Malik General Hospital Medan and Putri Hijau Hospital Medan. Method: This study used a double blind RCT design. A total of 60 patients with intravenous general anesthesia without ETT with ketamine (1-2 mg/kg BW) were divided into 2 groups of Atropine Sulfas doses (0.25 and 0.5 mg) then the total salivary volume of each patient was measured and analyzed. Results: There was a significant difference between the treatment groups of 0.25 mg and 0.5 mg in the volume of saliva that had been collected (P-value = 0.008). Conclusion: There was a significant comparison between the use of 0.25 mg and 0.5 mg atropine in patients at Haji Adam Malik Hospital and Putri Hijau Hospital Medan.
在意识下降、吞咽功能受损的情况下，唾液分泌过多会成为气道问题。它会增加唾液吸入气道的风险，从而导致窒息。用药前使用药物来减少药物性唾液过多的发生率是可以预防的。抗胆碱能类药物是治疗给予氯胺酮和乙醚的全身麻醉患者唾液过多的首选药物。氯胺酮作为镇静剂会产生唾液分泌过多的副作用，唾液分泌过多会引起喉痉挛或误吸，作为预防的一种形式，可以使用抗胆碱能药物，如阿托品。本研究的目的是比较抗喉剂对棉兰Haji Adam Malik综合医院和Putri Hijau医院无氯胺酮ETT静脉全麻患者0.25 mg和0.5 mg硫酸阿托品给药的影响。方法:采用双盲随机对照试验设计。采用氯胺酮(1 ~ 2 mg/kg BW)静脉全麻非ETT患者60例，分为阿托品磺胺类药物剂量(0.25、0.5 mg) 2组，测定并分析各组患者的总唾液体积。结果:0.25 mg与0.5 mg处理组唾液采集量差异有统计学意义(p值= 0.008)。结论:棉兰Haji Adam Malik医院和Putri Hijau医院的患者使用0.25 mg和0.5 mg阿托品有显著性差异。
{"title":"Antisialogogue Effect of Atropine Sulfate at Dosages of 0.25 Mg and 0.5 Mg Under General Anesthesia with Ketamin","authors":"Muhammad Ramadhan Hasibuan, A. Lubis, D. W. Wijaya","doi":"10.47353/jsocmed.v1i3.14","DOIUrl":"https://doi.org/10.47353/jsocmed.v1i3.14","url":null,"abstract":"Introduction: Excessive saliva production can becomes an airway problem in conditions of decreased consciousness where there is impaired swallowing function. It increases the risk of aspiration of saliva into the airways that can result in choking. The use of premedication drugs to reduce the incidence of drug-induced hypersalivation can be done as a prevention. The anticholinergic drug class is the drug of choice for the management of hypersalivation in general anesthesia patients who have been given ketamine and ether. Ketamine as a sedating agent will provide a side effect of hypersalivation, where hypersalivation can cause laryngospasm or aspiration, as a form of prevention, anticholinergic drugs such as atropine can be given. The aim of this research was to compare the effect of antisialagogue on the administration of atropine sulfate at a dose of 0.25 mg and 0.5 mg in intravenous general anesthesia patients without ETT with ketamine at Haji Adam Malik General Hospital Medan and Putri Hijau Hospital Medan.\u0000Method: This study used a double blind RCT design. A total of 60 patients with intravenous general anesthesia without ETT with ketamine (1-2 mg/kg BW) were divided into 2 groups of Atropine Sulfas doses (0.25 and 0.5 mg) then the total salivary volume of each patient was measured and analyzed.\u0000Results: There was a significant difference between the treatment groups of 0.25 mg and 0.5 mg in the volume of saliva that had been collected (P-value = 0.008).\u0000Conclusion: There was a significant comparison between the use of 0.25 mg and 0.5 mg atropine in patients at Haji Adam Malik Hospital and Putri Hijau Hospital Medan.","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133636519","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}
Pub Date : 2022-12-30DOI: 10.47353/jsocmed.v1i3.18
M. Taufik, D. W. Wijaya, A. Lubis
Introduction: The SARS-CoV-2 epidemic is sweeping the world with several waves of infections continuing. In some COVID-19 patients, this condition can develop into ARDS (acute respiratory distress syndrome) which requires ICU care with a mortality rate of 50-65 and the need for mechanical ventilation reaches 97%. The aim of this research was to know characteristics of COVID-19 patients to predict mortality in the Negative Pressure Isolation Room COVID 19 ICU at H. Adam Malik General Hospital Method: Retrospective research method with secondary data sources of COVID-19 Negative Pressure Isolation Room ICU (RITN) patients at RSUP H. Adam Malik Medan for the period May 2021 – July 2021.The data collected was in the form of patient data including name, gender, age, medical record number, comorbidities, NLR, D-Dimer, Fibrinogen, PF ratio, use of oxygen supplementation, and length of ICU stay. Chi Square statistical analysis was used for categorical data, while the T-test or Mann Whitney was used for numerical data. Then between the variables an ANOVA test was carried out to assess the comparison of clinical characteristics with mortality. Results: The results of this study indicate a higher mortality rate in women41 people (57.7%), 56-65 years age group 26 people (36.6%), patients using ventilators 51 people (71.8%), comorbid hypertension 33 people (46.5%) ), Moderate PF Ratio were 44 people (62%) and Length of stay <10 days were 55 people (77.5%). The mean fibrinogen value in COVID-19 patients who died was 658.96 ± 674.98, as well as the D-dimer value of 658.96 ± 674.98 and NLR of 11.06 ± 3.23 which showed a significant increase compared to patients Survivors of COVID-19 (p<0.05). Conclusion: A significant relationship was found between gender, age, breathing apparatus, D-dimer, Fibrinogen, NLR and length of stay with mortality of COVID-19 patients treated in the COVID Negative Pressure Room (RITN) ICU
SARS-CoV-2疫情正在席卷全球，几波感染仍在继续。在一些COVID-19患者中，这种情况可发展为ARDS(急性呼吸窘迫综合征)，需要ICU护理，死亡率为50-65，机械通气需求达到97%。本研究的目的是了解H. Adam Malik综合医院负压隔离室COVID-19 ICU患者的特征，以预测其死亡率。方法:回顾性研究方法，采用二手数据来源的RSUP H. Adam Malik Medan医院2021年5月至2021年7月期间COVID-19负压隔离室ICU (RITN)患者。收集的数据采用患者资料的形式，包括姓名、性别、年龄、病历号、合并症、NLR、d -二聚体、纤维蛋白原、PF比、补氧使用情况、ICU住院时间。分类资料采用卡方统计分析，数值资料采用t检验或Mann Whitney检验。然后在变量之间进行方差分析，以评估临床特征与死亡率的比较。结果:本组患者死亡率较高:女性41例(57.7%)，56 ~ 65岁26例(36.6%)，使用呼吸机51例(71.8%)，合并高血压33例(46.5%)，中度PF率44例(62%)，住院时间<10天55例(77.5%)。死亡患者的平均纤维蛋白原值为658.96±674.98,d -二聚体值为658.96±674.98,NLR为11.06±3.23，与存活患者相比均有显著升高(p<0.05)。结论:性别、年龄、呼吸器、d -二聚体、纤维蛋白原、NLR、住院时间与COVID-19负压室(RITN) ICU收治的COVID-19患者死亡率有显著相关
{"title":"The Relationship Between The Characteristics of COVID-19 Patients To Predict Mortality in The COVID-19 ICU Special Care","authors":"M. Taufik, D. W. Wijaya, A. Lubis","doi":"10.47353/jsocmed.v1i3.18","DOIUrl":"https://doi.org/10.47353/jsocmed.v1i3.18","url":null,"abstract":"Introduction: The SARS-CoV-2 epidemic is sweeping the world with several waves of infections continuing. In some COVID-19 patients, this condition can develop into ARDS (acute respiratory distress syndrome) which requires ICU care with a mortality rate of 50-65 and the need for mechanical ventilation reaches 97%. The aim of this research was to know characteristics of COVID-19 patients to predict mortality in the Negative Pressure Isolation Room COVID 19 ICU at H. Adam Malik General Hospital\u0000Method: Retrospective research method with secondary data sources of COVID-19 Negative Pressure Isolation Room ICU (RITN) patients at RSUP H. Adam Malik Medan for the period May 2021 – July 2021.The data collected was in the form of patient data including name, gender, age, medical record number, comorbidities, NLR, D-Dimer, Fibrinogen, PF ratio, use of oxygen supplementation, and length of ICU stay. Chi Square statistical analysis was used for categorical data, while the T-test or Mann Whitney was used for numerical data. Then between the variables an ANOVA test was carried out to assess the comparison of clinical characteristics with mortality.\u0000Results: The results of this study indicate a higher mortality rate in women41 people (57.7%), 56-65 years age group 26 people (36.6%), patients using ventilators 51 people (71.8%), comorbid hypertension 33 people (46.5%) ), Moderate PF Ratio were 44 people (62%) and Length of stay <10 days were 55 people (77.5%). The mean fibrinogen value in COVID-19 patients who died was 658.96 ± 674.98, as well as the D-dimer value of 658.96 ± 674.98 and NLR of 11.06 ± 3.23 which showed a significant increase compared to patients Survivors of COVID-19 (p<0.05).\u0000Conclusion: A significant relationship was found between gender, age, breathing apparatus, D-dimer, Fibrinogen, NLR and length of stay with mortality of COVID-19 patients treated in the COVID Negative Pressure Room (RITN) ICU","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125073590","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}
Pub Date : 2022-12-30DOI: 10.47353/jsocmed.v1i3.12
Muhammad Harmen Reza Siregar, E. R. Daulay, R. Hasan
Background: Early diagnosis of acyanotic congenital heart disease could lead to early referral and treatment before the onset of irreversible sequelae. Despite the development of modern imaging methods, conventional chest radiographs remain an important component of diagnostic process in pediatric cardiology. The aim of this study is to determine the accuracy of the results of chest X-ray examination with echocardiography results in patients with suspected acyanotic congenital heart disease at H. Adam Malik General Hospital Medan in 2019-2020. Methods: This study was a retrospective cross-sectional analytical observational study with a diagnostic test design to compare the sensitivity and specificity of conventional chest radiography compared with echocardiography of patients with suspected acyanotic CHD with shunts. The sample population was all children <18 years with suspicion of cyanotic CHD who came for treatment at H. Adam Malik Hospital Medan in the period January 2019 - December 2020. The study used data from medical records at H. Adam Malik Hospital Medan. The collected data is then analysed for diagnostic tests. Results: This study had a sample of 64 people with the highest proportion of samples being women, the average age was 67.9±54.1 months, and the results of echocardiography of the ductus arteriosus were persistent. The results of the diagnostic test showed a sensitivity of 78% and specificity of 80%, 95% PPV value and 40% NPV value, LR+ 3.8 and LR- 0.2. Conclusions: chest X-ray is adequate as a diagnostic tool in acyanotic congenital heart disease with left-to-right shunt. Clinical suspicion accompanied by chest X-ray results suggesting acyanotic congenital heart disease should be further assessed.
背景:无氰型先天性心脏病的早期诊断可以在不可逆后遗症发作前进行早期转诊和治疗。尽管现代成像方法的发展，传统的胸部x线片仍然是儿科心脏病诊断过程的重要组成部分。本研究的目的是确定2019-2020年棉兰H. Adam Malik总医院疑似无肺型先天性心脏病患者胸部x线检查合并超声心动图结果的准确性。方法:本研究是一项回顾性横断面分析性观察研究，采用诊断试验设计，比较常规胸片与超声心动图对疑似无肺型冠心病合并分流患者的敏感性和特异性。样本人群为2019年1月至2020年12月期间在棉兰H. Adam Malik医院接受治疗的所有怀疑患有紫绀型冠心病的<18岁儿童。该研究使用了棉兰H. Adam Malik医院的医疗记录数据。然后对收集到的数据进行分析，用于诊断测试。结果:本研究样本64例，女性比例最高，平均年龄67.9±54.1个月，动脉导管超声心动图结果持久。诊断结果敏感性78%，特异性80%，PPV值95%，NPV值40%，LR+ 3.8, LR- 0.2。结论:胸片可作为无氰先天性心脏病左向右分流的诊断工具。临床怀疑伴胸片结果提示无氰先天性心脏病应进一步评估。
{"title":"Role of Chest Radiograph in Diagnosis of Acyanotic Congenital Heart Disease","authors":"Muhammad Harmen Reza Siregar, E. R. Daulay, R. Hasan","doi":"10.47353/jsocmed.v1i3.12","DOIUrl":"https://doi.org/10.47353/jsocmed.v1i3.12","url":null,"abstract":"Background: Early diagnosis of acyanotic congenital heart disease could lead to early referral and treatment before the onset of irreversible sequelae. Despite the development of modern imaging methods, conventional chest radiographs remain an important component of diagnostic process in pediatric cardiology. The aim of this study is to determine the accuracy of the results of chest X-ray examination with echocardiography results in patients with suspected acyanotic congenital heart disease at H. Adam Malik General Hospital Medan in 2019-2020. \u0000Methods: This study was a retrospective cross-sectional analytical observational study with a diagnostic test design to compare the sensitivity and specificity of conventional chest radiography compared with echocardiography of patients with suspected acyanotic CHD with shunts. The sample population was all children <18 years with suspicion of cyanotic CHD who came for treatment at H. Adam Malik Hospital Medan in the period January 2019 - December 2020. The study used data from medical records at H. Adam Malik Hospital Medan. The collected data is then analysed for diagnostic tests. \u0000Results: This study had a sample of 64 people with the highest proportion of samples being women, the average age was 67.9±54.1 months, and the results of echocardiography of the ductus arteriosus were persistent. The results of the diagnostic test showed a sensitivity of 78% and specificity of 80%, 95% PPV value and 40% NPV value, LR+ 3.8 and LR- 0.2. \u0000Conclusions: chest X-ray is adequate as a diagnostic tool in acyanotic congenital heart disease with left-to-right shunt. Clinical suspicion accompanied by chest X-ray results suggesting acyanotic congenital heart disease should be further assessed.","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"276 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115433340","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}
Pub Date : 2022-12-30DOI: 10.47353/jsocmed.v1i3.15
I. Ghozali, Tasrif Hamdi, Yusmaidi, John Frans Sitepu
Introduction: Laparoscopy is mostly performed under general anesthesia (GA) but laparoscopy using anesthesia such as thoracic spinal anesthesia (TSA) is mostly performed by some anesthesiologists and it is very useful when compared to GA. Method: This paper presents a case report of the use of TSA in healthy pediatric patients who administered anesthesia with TSA in the T10-T11 interspace, using 1 ml of hyperbaric Bupivacaine 5 mg/ml mixed with: 1 ml of Levobupivacaine isobaric 5 mg/ml, Fentanyl 50 μg, Ketamine 10 mg and Dexmedetomidine 10 μg mixed in 1 syringe. Results: During procedure, hemodynamically stable, no nausea, vomiting, or discomfort. Postoperative recovery process was very smooth, hemodynamically stable, no pain was reported or PDPH (Post Dural Puncture Headache) even though we used a 26G spinal needle. The use of TSA is considered very practical and more economical even though it is still carried out very carefully. Conclusion: This is only one single case report. TSA can be a better choice compare with general anesthesia. Stable hemodynamic during laparoscope and TSA can avoid systemic effect of general anesthesia like cognitive affect after general anesthesia, longer for recovery from anesthesia, nausea, vomiting, poor control pain and high cost.
{"title":"Single-Shot Thoracic Spinal Anesthesia (TSA) In Pediatric Patient Under Laparoscopic Cholecystectomy: A Case Report","authors":"I. Ghozali, Tasrif Hamdi, Yusmaidi, John Frans Sitepu","doi":"10.47353/jsocmed.v1i3.15","DOIUrl":"https://doi.org/10.47353/jsocmed.v1i3.15","url":null,"abstract":"Introduction: Laparoscopy is mostly performed under general anesthesia (GA) but laparoscopy using anesthesia such as thoracic spinal anesthesia (TSA) is mostly performed by some anesthesiologists and it is very useful when compared to GA. \u0000Method: This paper presents a case report of the use of TSA in healthy pediatric patients who administered anesthesia with TSA in the T10-T11 interspace, using 1 ml of hyperbaric Bupivacaine 5 mg/ml mixed with: 1 ml of Levobupivacaine isobaric 5 mg/ml, Fentanyl 50 μg, Ketamine 10 mg and Dexmedetomidine 10 μg mixed in 1 syringe. \u0000Results: During procedure, hemodynamically stable, no nausea, vomiting, or discomfort. Postoperative recovery process was very smooth, hemodynamically stable, no pain was reported or PDPH (Post Dural Puncture Headache) even though we used a 26G spinal needle. The use of TSA is considered very practical and more economical even though it is still carried out very carefully. \u0000Conclusion: This is only one single case report. TSA can be a better choice compare with general anesthesia. Stable hemodynamic during laparoscope and TSA can avoid systemic effect of general anesthesia like cognitive affect after general anesthesia, longer for recovery from anesthesia, nausea, vomiting, poor control pain and high cost.","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115355163","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}
Pub Date : 2022-12-30DOI: 10.47353/jsocmed.v1i3.17
Adhika Syaputra, D. W. Wijaya, A. Hanafie
Introduction: Sepsis and septic shock are major health problems, affecting millions of people worldwide and a leading cause of death. Administration of broad-spectrum empiric antibiotics as a one hour sepsis bundle treatment is associated with antimicrobial resistance which has various adverse effects and reduces the quality of health services. The aim of this research was to determine the pattern of empiric antibiotic use in the management of one hour bundle of sepsis at Haji Adam Malik General Hospital Medan. Method: This study used a descriptive method from November 2022 to December 2022 in the Emergency Room (ER), Medical Inpatient Room, Surgical Inpatient Room, and Adult Intensive Care Unit (ICU) of Haji Adam Malik General Hospital Medan. This study used a consecutive sampling technique to recruit 42 sepsis patients who were given a one hour bundle of sepsis according to the inclusion and exclusion criteria. This descriptive analysis was used to determine the characteristics of the sample, namely age, sex, culture results, and antibiotic sensitivity test results. Results: The most common use of antibiotics in the one hour bundle sepsis strategy was ceftriaxone 1 gram in 20 patients (47.6%), Ampicillin-Sulbactam 1.5 grams in 10 patients (23.8%), Levofloxacin 750 mg in 6 patients (14.3%), Meropenem 1 gram in 4 patients (9.5%), and Ciprofloxacin 200 mg in 2 patients (4.8%). Conclusion: Antibiotic administration time is less than 1 hour in the one hour bundle strategy carried out in the ER. Most of the antibiotics given are in accordance with the antibiotic sensitivity test results, but there are still some patients who still experience resistance to the antibiotics.given so it is important to always or immediately carry out culture and sensitivity tests on patients so that the antibiotics given can be more optimal
败血症和感染性休克是影响全世界数百万人的主要健康问题，也是导致死亡的主要原因。广谱经验性抗生素作为一小时脓毒症一揽子治疗与抗菌素耐药性有关，这具有各种不良影响并降低卫生服务质量。本研究的目的是确定棉兰哈吉亚当马利克综合医院一小时脓毒症管理中经验性抗生素使用的模式。方法:本研究采用描述性方法，于2022年11月至2022年12月在棉兰Haji Adam Malik综合医院急诊室(ER)、内科住院室、外科住院室和成人重症监护病房(ICU)进行。本研究采用连续抽样技术，招募42例脓毒症患者，根据纳入和排除标准给予1小时脓毒症治疗。该描述性分析用于确定样本的特征，即年龄、性别、培养结果和抗生素敏感性试验结果。结果:1小时束脓毒症策略中使用最多的抗生素是头孢曲松1 g 20例(47.6%)，氨苄西林-舒巴坦1.5 g 10例(23.8%)，左氧氟沙星750 mg 6例(14.3%)，美罗培南1 g 4例(9.5%)，环丙沙星200 mg 2例(4.8%)。结论:急诊采用一小时捆绑策略，抗生素给药时间小于1小时。大多数抗生素的使用是根据抗生素敏感性试验结果进行的，但仍有一些患者对抗生素产生耐药性。因此，经常或立即对患者进行培养和敏感性试验是很重要的，这样所给的抗生素才能更理想
{"title":"Patterns of Antibiotic Use in The One Hour Bundle Treatment of Sepsis","authors":"Adhika Syaputra, D. W. Wijaya, A. Hanafie","doi":"10.47353/jsocmed.v1i3.17","DOIUrl":"https://doi.org/10.47353/jsocmed.v1i3.17","url":null,"abstract":"Introduction: Sepsis and septic shock are major health problems, affecting millions of people worldwide and a leading cause of death. Administration of broad-spectrum empiric antibiotics as a one hour sepsis bundle treatment is associated with antimicrobial resistance which has various adverse effects and reduces the quality of health services. The aim of this research was to determine the pattern of empiric antibiotic use in the management of one hour bundle of sepsis at Haji Adam Malik General Hospital Medan.\u0000Method: This study used a descriptive method from November 2022 to December 2022 in the Emergency Room (ER), Medical Inpatient Room, Surgical Inpatient Room, and Adult Intensive Care Unit (ICU) of Haji Adam Malik General Hospital Medan. This study used a consecutive sampling technique to recruit 42 sepsis patients who were given a one hour bundle of sepsis according to the inclusion and exclusion criteria. This descriptive analysis was used to determine the characteristics of the sample, namely age, sex, culture results, and antibiotic sensitivity test results.\u0000Results: The most common use of antibiotics in the one hour bundle sepsis strategy was ceftriaxone 1 gram in 20 patients (47.6%), Ampicillin-Sulbactam 1.5 grams in 10 patients (23.8%), Levofloxacin 750 mg in 6 patients (14.3%), Meropenem 1 gram in 4 patients (9.5%), and Ciprofloxacin 200 mg in 2 patients (4.8%).\u0000Conclusion: Antibiotic administration time is less than 1 hour in the one hour bundle strategy carried out in the ER. Most of the antibiotics given are in accordance with the antibiotic sensitivity test results, but there are still some patients who still experience resistance to the antibiotics.given so it is important to always or immediately carry out culture and sensitivity tests on patients so that the antibiotics given can be more optimal","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126840783","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}
Pub Date : 2022-12-30DOI: 10.47353/jsocmed.v1i3.11
F. Hermanto, Rispa Saeful Mu'tamar
Introduction: This pandemic has forced humans to look for solutions and alternatives to survive in various fields. Adaptation habit new (new normal) is a concepts that are applied so that humans still can operate activity without must sacrifice his safety and health. one applied concept in field education is with application online learning adopted by all level and type education around the world. Online learning is considered give solutions for the learning process still permanent can conducted in the midst of the COVID-19 pandemic . Method: With the Covid-19 pandemic, the task of educators in teaching students has become more difficult. It takes innovation and a more intense focus as well as great support from the Government, educational institutions, educators and parents to help the learning process for students well even in the conditions of the Covid-19 pandemic.The purpose of this study is to see how much influence online learning has on Compass Course Learning and the steering system during the Covid-19 Pandemic at the Malahayati Polytechnic so that educational institutions can make learning and coaching strategies that are more effective, measurable and continuous during the Covid-19 pandemic. The research method used is to use method type study descriptive with approach qualitative. Results: The presence of the Covid-19 pandemic that occurred in early 2020 to date has changed the pattern of life of people around the world, including Indonesia. With the Covid-19 pandemic, people are encouraged and even the government has issued a ban not to congregate, especially in public places. This also has an impact on new policies in the world of education, one of which is a prohibition on holding face-to-face learning in all schools and canceling all activities in schools. Conclusion: the average score obtained by the cadets of class IX semester II in the Compass and steering system courses on theory and practice scores an average of above 88, which means that all cadets get an A grade
{"title":"The Effect of Online Learning on Compass And Steering System Learning at Politeknik Pelayaran Malahayati in The conditions of The Covid-19 Pandemic","authors":"F. Hermanto, Rispa Saeful Mu'tamar","doi":"10.47353/jsocmed.v1i3.11","DOIUrl":"https://doi.org/10.47353/jsocmed.v1i3.11","url":null,"abstract":"Introduction: This pandemic has forced humans to look for solutions and alternatives to survive in various fields. Adaptation habit new (new normal) is a concepts that are applied so that humans still can operate activity without must sacrifice his safety and health. one applied concept in field education is with application online learning adopted by all level and type education around the world. Online learning is considered give solutions for the learning process still permanent can conducted in the midst of the COVID-19 pandemic . \u0000Method: With the Covid-19 pandemic, the task of educators in teaching students has become more difficult. It takes innovation and a more intense focus as well as great support from the Government, educational institutions, educators and parents to help the learning process for students well even in the conditions of the Covid-19 pandemic.The purpose of this study is to see how much influence online learning has on Compass Course Learning and the steering system during the Covid-19 Pandemic at the Malahayati Polytechnic so that educational institutions can make learning and coaching strategies that are more effective, measurable and continuous during the Covid-19 pandemic. The research method used is to use method type study descriptive with approach qualitative. \u0000Results: The presence of the Covid-19 pandemic that occurred in early 2020 to date has changed the pattern of life of people around the world, including Indonesia. With the Covid-19 pandemic, people are encouraged and even the government has issued a ban not to congregate, especially in public places. This also has an impact on new policies in the world of education, one of which is a prohibition on holding face-to-face learning in all schools and canceling all activities in schools. \u0000Conclusion: the average score obtained by the cadets of class IX semester II in the Compass and steering system courses on theory and practice scores an average of above 88, which means that all cadets get an A grade","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123596974","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}
B. Lubis, P. Amelia, M. Akil, Vincent Viandy, Adeline S. Winata, Yohanes WH George
Background: Currently, there is no standardized approach to managing critically ill COVID-19 patients with acute kidney injury and ST-elevation myocardial infarction. Continuous renal replacement therapy is a routinely used technique in managing critical patients in the intensive care unit. This procedure is applicable in patients with unstable hemodynamic, renal, or non-renal indications, such as removing the excess urea and creatinine from patients with acute kidney injury or clearing the tumor necrosis factor from patients with systemic inflammations. Method: This was a retrospective case report, after analysis of patient clinical data. The patient provided written informed consent to publish their case details and any accompanying images. The study protocol complies with the requirements of the institute’s committee of Haji Adam Malik Hospital, Medan, Indonesia. Results: This report presents a case of ST-Elevation myocardial infarction with COVID-19 infection and acute kidney injury who successfully managed by percutaneous coronary intervention and continuous renal replacement therapy. This patient was prepared for percutaneous coronary intervention and intubated with consideration of strict infection control. To improve the outcomes, we performed continuous renal replacement therapy with continuous venovenous hemodiafiltration mode. The patient improved with a stable hemodynamic and better renal function after 24 hours of continuous renal replacement therapy. Conclusion: Early continuous renal replacement therapy might be beneficial in treating COVID-19 patients with AKI, who previously underwent percutaneous coronary intervention for ST-elevation myocardial infarction.
背景:目前，COVID-19危重患者合并急性肾损伤和st段抬高型心肌梗死的管理尚无标准化的方法。持续肾替代治疗是在重症监护病房管理危重病人的常规技术。该程序适用于血流动力学不稳定、肾脏或非肾脏指征的患者，如清除急性肾损伤患者体内多余的尿素和肌酐，或清除系统性炎症患者体内的肿瘤坏死因子。方法:回顾性分析患者的临床资料。患者提供书面知情同意，以公布其病例细节和任何随附图片。本研究方案符合印尼棉兰Haji Adam Malik医院的研究所委员会的要求。结果:报告1例st段抬高型心肌梗死合并COVID-19感染并发急性肾损伤，经经皮冠状动脉介入治疗和持续肾替代治疗成功。考虑到严格的感染控制，该患者准备进行经皮冠状动脉介入治疗和插管。为了改善预后，我们采用持续静脉-静脉血液滤过模式进行持续肾替代治疗。经过24小时的持续肾脏替代治疗，患者血流动力学稳定，肾功能改善。结论:早期持续肾脏替代治疗可能有利于治疗COVID-19合并AKI的患者，这些患者之前曾因st段抬高型心肌梗死接受过经皮冠状动脉介入治疗。
{"title":"Early Continuous Renal Replacement Therapy In Patients With St-Elevation Myocardial Infarction And Covid-19 After Percutaneous Coronary Intervention: A Case Report","authors":"B. Lubis, P. Amelia, M. Akil, Vincent Viandy, Adeline S. Winata, Yohanes WH George","doi":"10.47353/jsocmed.v1i2.2","DOIUrl":"https://doi.org/10.47353/jsocmed.v1i2.2","url":null,"abstract":"Background: Currently, there is no standardized approach to managing critically ill COVID-19 patients with acute kidney injury and ST-elevation myocardial infarction. Continuous renal replacement therapy is a routinely used technique in managing critical patients in the intensive care unit. This procedure is applicable in patients with unstable hemodynamic, renal, or non-renal indications, such as removing the excess urea and creatinine from patients with acute kidney injury or clearing the tumor necrosis factor from patients with systemic inflammations. \u0000Method: This was a retrospective case report, after analysis of patient clinical data. The patient provided written informed consent to publish their case details and any accompanying images. The study protocol complies with the requirements of the institute’s committee of Haji Adam Malik Hospital, Medan, Indonesia. \u0000Results: This report presents a case of ST-Elevation myocardial infarction with COVID-19 infection and acute kidney injury who successfully managed by percutaneous coronary intervention and continuous renal replacement therapy. This patient was prepared for percutaneous coronary intervention and intubated with consideration of strict infection control. To improve the outcomes, we performed continuous renal replacement therapy with continuous venovenous hemodiafiltration mode. The patient improved with a stable hemodynamic and better renal function after 24 hours of continuous renal replacement therapy. \u0000Conclusion: Early continuous renal replacement therapy might be beneficial in treating COVID-19 patients with AKI, who previously underwent percutaneous coronary intervention for ST-elevation myocardial infarction.","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125215410","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}
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