International Journal of Integrated Health Sciences
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Feasibility, Safety, and Efficacy of Segmental Spinal Anesthesia with Predominantly Isobaric Levobupivacaine: A Tertiary Care Hospital Study
Get PDFObjective: To assess feasibility, safety, and efficacy of segmental spinal anesthesia with isobaric levobupivacaine in patients undergoing various abdominal and lower limb surgeries. Methods: This was a prospective cohort study conducted at the Department of Anesthesiology and Critical Care of Kota Heart Institute and group of hospitals in India. The study involved 100 patients undergoing various abdominal and lower limb surgeries under segmental spinal anesthesia (SSA). Isobaric levobupivacaine 0.5% with fentanyl 20-25 μg or dexmedetomidine 5-10 as adjuvant or hypobaric levobupivacaine 0.167% was injected in intervertebral space depending on the surgery. Hemodynamic parameters, postoperative pain level, and adverse effects were analyzed with a p-value less than 0.05 was considered statistically significant.Results: An overall male predominance was observed with a 1:0.515 male-to-female ratio. The most affected age group was 41-50 years (37%), with a mean age of 44.51 ± 11.72 years. ASA classification indicated 34% of patients in ASA I, 40% in ASA II, 24% ASA III and 2% in ASA IV . The primary surgery was laparoscopic cholecystectomy (26%) in normal risk group and orthopedic in high-risk group(20%). Postoperative pain assessment showed mean VAS scores ranging from 1.92 to 3.42 at different time intervals. Common adverse effects were hemodynamic instability (13%), shoulder tip pain (33%), PONV (3%), headache (6%), pruritis (2%) and urinary retention (1%). The hemodynamic instability showed less incidence in ASA III/IV category.Conclusion: Segmental spinal anesthesia can be used successfully for abdominal and lower limb orthopedic surgeries in patients of ASA I to ASA IV
Differential White Blood Cell Count and COVID-19 Hospital Length of Stay: A Post-hoc Analysis
Get PDFObjective: To explore the association between differential white blood cell count and hospital length of stay (LOS) in COVID-19 patients.Methods: This study is a post-hoc analysis of two prospective cohort studies involving hospitalized COVID-19 patients who received standard therapy, including antiviral and supportive treatments at Persahabatan Hospital, Jakarta, Indonesia, during the Delta and Omicron dominant pandemic periods. Baseline differential white blood cell count before initiation of therapy were documented. LOS was categorized as ≤10 days and >10 days.Result: Data from 463 subjects were included with most subjects were males (62.2%) with a median age of 54 (14–93) years. The average LOS for subjects was 12.7 (12.1–13.4) days. Bivariate tests showed that lymphocytes, neutrophils, monocytes, neutrophil-lymphocyte ratio (NLR), and neutrophil-monocyte ratio (NMR) had significant association (p 8.35 × 10^3/µL) at admission may predict shorter hospitalization (<10 days).Conclusion: Monocyte count may serve as a potential marker for length of stay in COVID-19 patients, offering key insights for optimizing patient management and resource allocation
Nutrition Education Effect in Increasing Knowledge and Ability to Interpret Nutrition Facts in Adolescents
Get PDFObjective: To evaluate the effectiveness of nutrition education on the understanding and proficiency in interpreting nutrition labels among adolescents aged 16-18 years..Methods: This quantitative study adopted quasi-experimental and control group designs with a pre-test and post-test approach. The sample size included 60 participants, divided into 2 equal groups, receiving education through lecture method and leaflets, respectively. The intertervention was conducted one day in group 1 and group 2, respectively. Sample selection was conducted using a simple random sampling method. Data were collected through a knowledge questionnaire and details on reading ability were obtained using an interpreting ability checklist through pre-tests and post-tests conducted at the same day. The retrieved data were analyzed using the Wilcoxon Signed Rank Test and the Mann-Whitney U Test (α=0.05).Results: Nutrition education is shown to enhance the understanding (p-value=0,026) and proficiency of students in interpreting nutrition facts (p-value=0,064).Conclusion: Nutrition education had a positive impact on the understanding and skill of adolescents in reading nutrition facts. Thus, developing educational materials that can be readily applied in daily life will help consumers in making more nutritionally informed choices when selecting packaged foods
Detection of Leptospira sp. Bacteria and Factors Related to the Incidence of Leptospirosis in Semarang City
Get PDFObjective: The Case Fatality Rate (CFR) of Leptospirosis in Semarang City has shown a tendency to increase from 2019 to 2022. In 2022, there were 30 cases reported, with 8 deaths (CFR 27%). The purpose of this study was to detect Leptospira sp. bacteria in rats and analyze the risk factors for leptospirosis in Semarang City.Methods: This study employed an observational approach with a Case-Control Study design. The research was conducted in Semarang City from November to December 2023. Non-random sampling techniques were used, specifically the total sampling method, resulting in a sample size of 45 case groups and 45 control groups. Bivariate analysis was performed using the Chi-square test, with a significance level set at <0.05.Results: Based on the Chi-Square test results, the following variables were found to be associated with the incidence of leptospirosis in Semarang City: the presence of rats (p<0.0001), the presence of Leptospira sp. bacteria (p<0.0001), house conditions (p=0.260), sewer condition (p<0.0001), presence of pets (p=0.001), condition of landfills (p=0.001), presence of vegetation (p=0.005), temperature (p=0.299), humidity (p=0.495), lighting (p=0.023), history of wounds (p=0.001), and knowledge level (p=0.025).Conclusion: The risk factors for leptospirosis in Semarang City include the presence of rats, the presence of Leptospira sp. bacteria, sewer conditions, the presence of pets, conditions of landfills, the presence of vegetation, lighting, history of injury, and level of knowledge
Analysis of the Relationship between Age and Immunization Completeness with Measles Incidence in the City of Medan in 2022
No full textObjective: To analyze the relationship between age and immunization completeness and the occurrence of measles in Medan City in 2022.Methods: This study is quantitative research with a case-control study design. The respondents in this study are the entire population of Medan City. The sample size for this research is 96 respondents, with 48 in the case group and 48 in the control group, all recorded in the measles case report at the Health Department of Medan City in 2022. The study was conducted from January to July 2023.Results: Forty respondents in this study belonged to the toddler group, and most of whom had an incomplete immunization history. Based on chi-square analysis, a significant relationship was found between age and the occurrence of measles (p-value < 0.05), as well as between immunization completeness and the occurrence of measles (p-value < 0.05) with an odds ratio (OR) of 11.0. This means that respondents who are not immunized are 11 times more likely to experience measles compared to those who are immunized. Respondents with incomplete immunization are also 11 times more likely to experience measles compared to those with complete immunization.Conclusion: There is a significant relationship between age and immunization completeness and the occurrence of measles. Respondents with an incomplete immunization history are at 11 times higher risk of experiencing measles compared to those with a complete immunization history. For future research, it is recommended to increase the number of study respondents and further explore and expand on risk factors such as the history of contact with measles cases in the city of Medan
Subclinical Left Ventricular Dysfunction Prevention in Breast Cancer Patients after FAC Chemotherapy: A Carvedilol Trial
Get PDFObjective: To assess the cardioprotective effects of Carvedilol in preventing subclinical left ventricular dysfunction (SLVD) in breast cancer patients after completing FAC chemotherapy.Methods: This prospective study employed a quasi-experimental clinical trial conducted from September 2018 to May 2019. Breast cancer patients receiving FAC chemotherapy were divided into two groups: intervention (IG) and control (CG). The IG received Carvedilol 6.25 mg b.i.d., which was increased every three weeks until reaching a tolerated dose. The study evaluated changes in left ventricular global longitudinal strain (GLS) and the incidence of SLVD (GLS reduction ≥15% and GLS >-18%) 24 weeks after initiating the FAC regimen.Result: Of the 81 women enrolled in the study, 31 were in the IG. No significant changes in GLS were observed during or after completing FAC chemotherapy in the IG, whereas the CG showed contradictory results. At the end of the follow-up period, the delta GLS reduction was lower in the IG (0.7; 95% CI -0.60, 3.60) compared to the CG (3.00; 95% CI -2.16, 4.19), with a p-value of 0.035. Similarly, the percentage reduction in GLS was 3.6% in the IG and 14.29% in the CG, resulting in a p-value of 0.05. The incidence rate of SLVD (GLS reduction ≥15% and GLS > -18%) was lower in the IG (41.9% and 25.8%) than in the CG (58% and 48%).Conclusion: Carvedilol may have a cardioprotective effect in preventing the incidence of SLVD, as evaluated by GLS reduction and changes, in women with breast cancer after completing a full cycle of the FAC regimen
Tacrolimus Therapy Among Steroid-Resistant Nephrotic Syndrome Children: A Preliminary Study in West Java, Indonesia
Get PDFObjective: To explore the outcomes of Tac therapy for Steroid-Resistant Nephrotic Syndrome (SRNS) and its implication in reducing the number of CKD events.Methods: An open, prospective, cohort study was conducted at a tertiary hospital in Bandung, West Java, Indonesia. Children (age 1–18 years old) with steroid and cyclophosphamide resistant nephrotic syndrome were enrolled in this study. Blood pressure, urinary protein, serum ureum, and creatinine levels were measured every month, Tac and soluble urokinase plasminogen activator receptor (supaR) levels were assessed at the 0, third, and sixth months.Results: Ten of fifteen subjects enrolled in this study got better within 3–6 months with a trend of decreasing suPAR level and proteinuria, as well as stable blood pressure and serum creatinine and ureum level. During treatment, no side effects of the subjects were found with the Tac level maintain safely.Conclusion: Tac is an effective and safe agent in treating SRNS, especially for those do not respond well to an alkylating agent
Effect of Eye Exercises on Computer Vision Syndrome among Medical Students of Universitas Sumatera Utara, Indonesia
Get PDFObjective: To determine the effect of eye exercises on Computer Vision Syndrome among batch 2019 medical students of the Faculty of Medicine, Universitas Sumatera Utara, and Indonesia.Methods: This study used analytical true experimental with a Pretest-Posttest Control Group Design. Sample consisted of 86 respondents who were divided into two groups: control and experimental (intervention) groups. Each group consisted of 43 respondents who were sampled randomly using the simple random sampling technique. Data were collected through the Computer Vision Syndrome Questionnaire (CVS-Q) and analyzed using a statistical software application with a p-value of < 0.05 considered significant.Results: A decrease in the score of Computer Vision Syndrome in the experimental (intervention) group after the eye exercise was observed with a p-value of 0.001 (<0.05). Conclusion: Eye exercise has an effect on the Computer Vision Syndrome.
Adenosine Deaminase as Inflammatory Marker in Type II Diabetes Mellitus
Get PDFObjective: To evaluate the enzymatic activity of Adenosine Deaminase in type II diabetes mellitus (T2DM).Methods: This study was conducted on 60 clinically diagnosed type II diabetes mellitus patients, with 60 healthy subjects as the control group. Subjects were enrolled in the study only after their written consent was obtained. The inclusion of diabetes mellitus cases (DM) was conducted as per the WHO guidelines. Estimation of enzymatic activity of serum ADA was performed by Kinetic method using a commercial kit.Result: The observed serum ADA activity in DM patients was 48.34 ± 21.05 U/L, which was significantly higher in comparison to healthy controls (25.02 ± 5.78 U/L). The serum activity raised in about 80% of patients and they had higher values above the reference activity of 30 U/L. The increased activity of ADA among the diabetic subjects indicates inflammatory changes in these individuals.Conclusion: It is possible that in the coming years, a new therapeutic strategy based on anti-inflammatory properties with beneficial effects on diabetic complications can be translated into real clinical treatments
Outcome of Posterior Cruciate Ligament Avulsion Fractures from Tibial Attachment Treated by Open Reduction and Internal Fixation
Get PDFObjectives: To analyze the clinical and functional outcomes of posterior cruciate ligament avulsion fractures treated by open reduction and internal fixation from tibial attachment.Methods: This observational study was conducted at the orthopedics department of a tertiary care medical college. Forty adult patients with PCL avulsion fractures were included in this study based on predefined inclusion and exclusion criteria. All patients were treated by open reduction and internal fixation. Patients were followed up for one year. The Lysholm scale and knee society score were used to assess functional outcomes. A p-value less than 0.05 was considered to be statistically significant.Results: Overall, 34 (75 %) males and 6 (15%) females participated in this study with an M: F ratio of 1:0.17. The mean age of affected patients was 37.3 +/- 7.34 years. Out of 40 patients, 29 (72.50%) patients sustained fractures secondary to road traffic accidents, while 7 (17.50%) had sports-related injuries. There was a highly significant improvement in the Lysholm and Knee Society scores from the time of presentation to the final follow-up (P<0.0001). Only 1 (2.5%) patient developed residual joint instability as evidenced by the drawer test result.Conclusion: Patients with posterior cruciate ligament avulsion fracture treated by Open reduction and internal fixation were found to have excellent results in terms of functional outcomes