Immediate Effect of Elastic Taping Application on Gait Functional Ability in Patients with Stroke

Background: The typical consequence of a stroke is the limitation in walking ability. In stroke patients, there is a disruption of mobilization, including walking. Stroke patients exhibit abnormal walking patterns as compensation for muscular weakness. Elastic taping known to increase functional movement through increased muscle strength In addition; elastic taping helps maintain muscle coordination of agonists, synergists, and antagonists. Objective: Determine the immediate effect of elastic tape on the gait functional ability in post stroke patient with ankle dorsiflexor muscle weakness. Method: This research is an experimental pre-post study. The total subjects are 11 patients with hemiparesis following stroke. The gait speed, step length and stride length measured by gait analysis lab with CMAX gait software, before and after the elastic tape application for 30 minutes. Leukotape K® was applied with facilitation technique on the anterior tibial and extensor digitorum longus, from the origin to the insertion with 100% of stretch. Result: The gait speed and step length on healthy side after 30 minutes elastic tape increased when compared with the pre-application value (p>0.05). Conclusion: There is an increment of gait speed and step length on healthy side in post-stroke patients with ankle dorsiflexor weakness after 30 minutes elastic taping application. Elastic taping may be beneficial in treating gait functional disturbances in post-stroke patients

Amputasi Ekstremitas Atas Akibat Luka Bakar Listrik : Laporan Kasus

Amputation is a surgery that involves removing part or all of a limb or some abnormal growths from the body. The prevalence of amputations was approximately 1.6 million in 2005 in the United States and will double to 3.6 million in 2050. The main cause of upper extremity amputation is trauma, which is around 80%, especially in young adults with an incidence of amputation due to electrical burn injuries of around 2% (mainly transradial and transhumeral). The effects of an electric current depend on the type of current, voltage, tissue resistance, current strength, the path the current takes through the body, duration of contact, and individual susceptibility. Individuals undergoing upper extremity amputations need comprehensive rehabilitation by physiatrists, physiotherapists, occupational therapists, prosthetists, and psychologists. An appropriate rehabilitation program and a comfortable prosthesis (including maintenance of limb length) aim at prosthesis reconstruction. In addition to rehabilitation programs, appropriate amputation techniques can also facilitate individuals in the functional recovery process.Amputasi adalah pembedahan yang melibatkan pemotongan sebagian atau seluruh anggota badan atau beberapa hasil pertumbuhan abnormal dari tubuh. Prevalensi amputasi sekitar 1,6 juta pada tahun 2005 di Amerika Serikat dan akan meningkat dua kali lipat sebesar 3,6 juta pada tahun 2050. Penyebab utama amputasi ekstremitas atas adalah trauma yaitu sekitar 80% terutama pada orang dewasa muda dengan insiden amputasi akibat trauma luka bakar listrik sekitar 2% (terutama transradial dan transhumeral). Efek arus listrik bergantung pada jenis arus, voltase, daya tahan jaringan, kekuatan arus, jalur yang dilalui arus melalui tubuh, durasi kontak, dan kerentanan individu. Individu yang menjalani amputasi ekstremitas atas membutuhkan rehabilitasi secara komprehensif oleh dokter, fisioterapis, terapis okupasi, ahli prostesis, dan psikolog. Program rehabilitasi yang tepat dan prostesis yang nyaman (termasuk pemeliharaan panjang ekstremitas) bertujuan pada rekonstruksi prostesis. Selain program rehabilitasi, teknik amputasi yang tepat juga dapat memfasilitasi individu pada proses pemulihan secara fungsional

ANALISIS FAKTOR RISIKO KEJADIAN PREEKLAMPSIA PADA IBU HAMIL YANG BERSALIN DI RSUD SAWERIGADING PALOPO

Preeclampsia is one of the most common causes of death in pregnant women in addition to bleeding and infection. The purpose of this study was to analyze the risk factors associated with the incidence of preeclampsia in pregnant women who gave birth at Sawerigading Hospital Palopo. The method used in this study is an analytical observational method with a case control approach. The population was taken from pregnant women who gave birth at Sawerigading Hospital Palopo in the period January 2019 - October 2020. The sample selected used a simple random sampling technique with a total sample of 90 samples consisting of 45 case groups and 45 control groups according to the criteria. The data were univariately analyzed, and the chi-square test was 2x2 table with a significance level of sig p 0.05 and logistic regression test. Based on the results of the analysis, it was found that the variables of maternal age during pregnancy (p=0.803), gravida status (p=1,000), history of preeclampsia in Family history (p=0.557), and chronic history (p=0.153) did not have a significant relationship with the incidence of preeclampsia in pregnant women who gave birth at Sawerigading Hospital Palopo. The most dominant risk factor for the incidence of preeclampsia in pregnant women giving birth at Sawerigading Hospital Palopo is obesity (OR 5,632)

HIV care decentralization in lower- and middle-income countries: outcomes, costs, and cost effectiveness

© 2018 Dr Arie RahadiDecentralized provision of HIV care continuum – from diagnosis to chronic antiretroviral treatment (ART) – at primary health care facilities (PHCFs) is a critical step towards realizing optimal care coverage in national programs of lower- and middle-income countries (LMICs). Whether such a model of provision is justified depends on considerations of effectiveness, program costs, and cost-effectiveness. This research project aims to: a) examine the effectiveness of decentralized provision of HIV testing and counseling (HTC), pre-ART (ART initiation), and long-term ART care relative to hospital provision with the following outcomes: • Cascade of service receipt in HIV testing and counseling (HTC); • The timeliness of ART initiation by baseline CD4 count and clinical stage; • Treatment adherence during ART care. b) estimate and compare ART program costs of decentralized care at PHCFs and those of hospital care; c) estimate the cost-effectiveness of decentralized provision of routine, chronic ART care relative to hospital (centralized) provision. Data from national surveys and reviews of published studies in Indonesia and sub-Saharan Africa were analyzed using multivariate statistics, meta-analysis, and model-based cost-effectiveness analysis. In HTC, pregnant women were equally likely to receive a full HTC procedure, up to post-test counseling, at both hospitals and PHCFs in four high-prevalence countries (Lesotho, Malawi, Zambia, and Zimbabwe), with a positive implication for motivating regular HTC. In pre-ART care; CD4 counts at ART initiation increased over the calendar time for both hospital and PHCF patients, with fewer patients experiencing a late HIV stage. In ART care, hospital and PHCF patients exhibited at least similar adherence to ART, indicating a non-inferior performance of decentralized provision in Indonesia. In program costs, the average cost of providing ART care for PHCF patients was not lower than hospital provision in four sub-Saharan African countries (Rwanda, Malawi, Zambia, and Ethiopia), except in Ethiopia. Cost differences were largely attributable to differential prescribing of ART regimens between facility types and minimized with a switch to the recommended regimens. In terms of cost-effectiveness, decentralizing stable ART patients from hospitals to PHCFs for routine care (down-referral) was found to be cost-effective in Ethiopia. Economically, the extra program cost represents an affordable investment to advance the performance of the existing decentralization programming and population health. HIV care decentralization redistributes the care burden across the health system without compromising patient outcomes and favorable cost-effectiveness implications. Program expansion beyond decentralization and facility-based provision may be necessary to attain optimal coverage of HIV care in many LMICs. Identifying the optimal model of decentralization for given set of program characteristics is a key research area in the direction of optimizing program outcomes and efficiency

EFEK SEGERA APLIKASI ELASTIC TAPING TERHADAP KEMAMPUAN FUNGSIONAL GAIT PADA PASIEN PASCA STROKE

Latar Belakang: Konsekuensi klinis stroke adalah keterbatasan dalam kemampuan berjalan. Pada pasien stroke terjadi gangguan mobilisasi, termasuk berjalan. Pasien stroke menunjukkan pola berjalan abnormal sebagai kompensasi terjadinya kelemahan muskuler. Elastic taping diketahui efektif meningkatkan gerakan fungsional melalui peningkatan kekuatan otot. Selain itu pula, elastic taping membantu menjaga koordinasi otot agonis, sinergis, dan antagonis melalui kontrol tonus otot Tujuan: Membuktikan efek segera penggunaan elastic taping pada otot dorsiflexor ankle terhadap kemampuan fungsional gait pada subyek pasca stroke Metode: Penelitian eksperimental satu kelompok pre-post study. Jumlah total subyek 11 pasien dengan hemiparesis pasca stroke. Gait speed, step length dan stride length diukur melalui laboratorium analisis gait dengan perangkat lunak CMAX gait, dilakukan sebelum dan setelah 30 menit aplikasi elastic taping. Leukotape K® digunakan dengan teknik fasilitasi pada otot tibialis anterior dan extensor digitorum longus, dari origo ke insertion dengan regangan 100%. Hasil: Gait speed dan step length pada sisi sehat meningkat bila dibandingkan dengan sebelum aplikasi elastic taping (p>0.05). Kesimpulan: Terdapat peningkatan gait speed dan step length tungkai sisi sehat pada pasien pasca stroke dengan kelemahan ankle dorsiflexor setelah 30 menit aplikasi elastic taping. Elastic taping dapat berguna dalam menangani gangguan fungsional berjalan pada pasien pasca stroke

Hubungan Antara Perokok Pasif Pada Kehamilan Dengan Bayi Berat Lahir Rendah di RSUD H. Padjonga Dg. Ngalle Takalar Tahun 2019

Introduction: A newborn who weighs less than 2,500 grams at delivery is considered low birth weight (LBW). There are many factors that can influence the determinants of LBW. One of the multifactorial is pre-natal exposure to tobacco smoke from the partner or environment in pregnant women (passive smokers) which provides negative effects for both the mother and the fetus. This study aims to determine the relationship between passive smoking during pregnancy and LBW at RSUD H. PadjonganDg. Ngalle Takalar in 2019. Methods: The research is an observational analysis with a case-control approach. The population in this study is all mothers who gave birth to babies in the delivery room at RSUD H. PadjonganDg. Ngalle Takalar had 139 mothers who gave birth from January to December 2019. The sampling technique in this study used purposive sampling Results: The results showed the pregnant woman's environment who was most often exposed to cigarette smoke with LBW (<0.05), Cigarette smoke exposure in the home with LBW (<0.05), Cigarette smoke exposure in the outdoor environment with LBW (<0.05), Pregnant women who were exposed to cigarette smoke in one week with LBW(<0.05), Frequency of time pregnant women were exposed to cigarette smoke in one day with LBW(<0.05). Conclusion: There is a significant relationship between passive smoking during pregnancy and low birth weight (LBW). Keywords: Passive smoking; pregnancy; low birth weightPendahuluan: Berat lahir rendah (BBLR) adalah berat bayi saat lahir kurang dari 2.500 gram. Ada banyak faktor yang dapat mempengaruhi penentu BBLR. Salah satu faktor multifaktorial adalah paparan pre-natal terhadap asap tembakau dari pasangan atau lingkungan pada ibu hamil (perokok pasif) yang memberikan dampak negatif bagi ibu dan janin. Penelitian ini bertujuan untuk mengetahui hubungan antara perokok pasif selama kehamilan dan BBLR di RSUD H. PadjonganDg. Ngalle Takalar pada tahun 2019. Metode: Penelitian ini merupakan penelitian korelasional deskriptif dengan desain pendekatan retrospektif. Populasi dalam penelitian ini adalah semua ibu yang melahirkan bayi di ruang bersalin RSUD H. PadjonganDg. Ngalle Takalar dengan total 139 ibu yang melahirkan dari bulan Januari hingga Desember 2019. Teknik sampling pada penelitian ini menggunakan metode accidental sampling, dengan total sampel 60 orang dan hasil diolah menggunakan SPSS dengan uji Chi square. Hasil: Hasil penelitian menunjukkan lingkungan ibu hamil yang paling sering terpapar asap rokok dengan BBLR (<0,05), Paparan asap rokok di rumah dengan BBLR (<0,05), Paparan asap rokok di lingkungan luar rumah dengan BBLR (<0,05), Ibu hamil yang terpapar asap rokok dalam satu minggu dengan BBLR (<0,05), Frekuensi waktu ibu hamil terpapar asap rokok dalam satu hari dengan BBLR (<0,05). Kesimpulan: Ada hubungan yang signifikan antara perokok pasif selama kehamilan dan berat lahir rendah (BBLR)

HIV‑related stigma and discrimination among health care workers during early program decentralization in rural district Gunungkidul, Indonesia: a cross‑sectional study

Background Expanding HIV services by decentralizing provision to primary care raises a possible concern of HIV-related stigma and discrimination (SAD) from health care workers (HCWs) as new service points gain experience in HIV care delivery during early implementation. We surveyed indicators and examined the correlates of HIV-related SAD among HCWs in a decentralizing district of rural Gunungkidul, Indonesia. Methods We conducted a cross-sectional survey on a random stratified sample of 234 HCWs in 14 public health facilities (one district hospital, 13 primary health centers [PHC]) during the second year of decentralization roll-out in the district. We computed the prevalence of SAD indicators and used multivariable logistic regression to identify the correlates of these SAD indicators. Results The prevalence of SAD among HCWs was similarly high between hospital and PHC HCWs for fear of HIV transmission (~71%) and perceived negative image of PHIV (~75%). Hospital HCWs exhibited somewhat lower avoidance of service duties (52.6% vs. 63.7%; p = 0.088) with weak evidence of a difference and significantly higher levels of discriminatory practice (96.1% vs. 85.6%; p = 0.009) than those working in PHCs. Recent interactions with PLHIV and receipt of training lowered the odds of fear of HIV transmission (p <0.021). However, the odds of avoiding care duties increased with receipt of training (p =0.003) and decreased for hospital HCWs (p = 0.030). HIV knowledge lowered the odds of discriminatory practice (p = 0.002), but hospital facility and nurse/midwife cadres were associated with increased odds of discriminatory practices (p <0.021). No significant correlate was found for perceived negative image of PLHIV. Conclusion HIV-related SAD among HCWs can be prevalent during early decentralization, highlighting the need for timely or preparatory interventions with a focus on building the capacity of hospital and non-physician workforce for positive patient-provider interactions when delivering HIV care

Impart: findings from a prison‐based model of HIV assisted partner notification in Indonesia

Abstract Introduction Assisted partner notification (APN) safely and effectively increases partner awareness of HIV exposure, testing and case identification in community settings. Nonetheless, it has not been specifically developed or evaluated for use in prison settings where people with HIV often are diagnosed and may have difficulty contacting or otherwise notifying partners. We developed Impart, a prison‐based APN model, and evaluated its efficacy in Indonesia to increase partner notification and HIV testing. Methods From January 2020 to January 2021, 55 incarcerated men with HIV were recruited as index participants from six jail and prison facilities in Jakarta in a two‐group randomized trial comparing the outcomes of self‐tell notification (treatment as usual) versus Impart APN in increasing partner notification and HIV testing. Participants voluntarily provided names and contact information for sex and drug‐injection partners in the community with whom they had shared possible HIV exposure during the year prior to incarceration. Participants randomized to the self‐tell only condition were coached in how to notify their partners by phone, mail or during an in‐person visit within 6 weeks. Participants randomized to Impart APN could choose between self‐tell notification or anonymous APN by a two‐person team consisting of a nurse and outreach worker. We compared the proportion of partners in each group who were notified of exposure by the end of 6 weeks, subsequently tested and HIV diagnosed. Results Index participants (n = 55) selected 117 partners for notification. Compared to self‐tell notification, Impart APN resulted in nearly a six‐fold increase in the odds of a named partner being notified of HIV exposure. Nearly two thirds of the partners notified through Impart APN (15/24) completed HIV testing within 6 weeks post notification compared to none of those whom participants had self‐notified. One‐third of the partners (5/15) who completed HIV testing post notification were diagnosed as HIV positive for the first time. Conclusions Voluntary APN can be successfully implemented with a prison population and within a prison setting despite the many barriers to HIV notification that incarceration presents. Our findings suggest that the Impart model holds considerable promise to increase partner notification, HIV testing and diagnosis among sex and drug‐injecting partners of HIV‐positive incarcerated men