Gejala Penyerta pada Balita Diare dengan Infeksi Enteropathogenic Escherichia Coli (Epec) di Puskesmas Rawat Inap Kota Pekanbaru

Enteropathogenic Escherichia coli (EPEC) is a major cause of diarrhea in children below 5 years of age in the developing countries. The present study to detect the symptoms EPEC from childhood diarrhea has been done on April 2014 until October 2014. A total of 47 fecal specimens were collected from five hospitality primary health care in Pekanbaru and examination has been done in Microbiology Laboratory of Medical Faculty Riau University. The clinical manifestations are obtained is fever (57.45%), vomiting (46.80%), mucoid stools (36.17%), no symptoms (17.20%) and mild-moderate dehydration (74.46%). Results found that from all of the fecal specimen, 2 (4.35%) samples were positive EPEC. The infants with diarrhea who had positive EPEC experiencing fever and moderate dehydration

Implikasi Pendidikan Suami dan Perencanaan Persalinan Ibu di Salatiga

The implications of husband\u27s education on expectant mother\u27s delivery planning in SalatigaPurposeThe purpose of this paper was to determine the implications of husband\u27s education on expectant mother\u27s delivery planning. MethodsThe research was a survey study with a cross-sectional design. The samples were 267 pregnant woman in the third trimester in Salatiga city whose checkups were recorded in the register of pregnant women in all Salatiga primary health centers. Sampling used simple random sampling. The data were collected from August to September 2015 by interviewing patients at home. The analyses were performed using logistic regression and Chi-square tests. ResultsFrom 267 respondents, a total of 85.4% had well planned deliveries. The analysis showed that there was significant correlation in the variable of husband\u27s education OR = 2.62 (95% CI = 1.20-5.58; p = 0.0061) with the potential confounder test result showing husband\u27s knowledge had a value of Crude OR = 2.62 and M-H of OR = 2.32 with a value change of 12.21%. This finding shows that the husband\u27s knowledge variable has an influence on the correlation of husband\u27s education toward the planning of delivery of pregnant women in Salatiga. ConclusionFindings showed that the higher husband\u27s education level, the better the maternity planning of pregnant women. The multiparous parity had a better maternity planning then primiparous parity and pregnant women with a high risk factor status will make better maternity plans than those with low-risk status. It is expected for pregnant women and their husbands to be more active in seeking information about P4K

Enablement by single-use technology of production of two billion vaccine doses of adenovirus-vectored vaccine in under a year

Manufacturing of the simian adenovirus-vectored vaccine ChAdOx1 nCoV-19 (AZD1222, Vaxzevria) has played an important role in control of the COVID-19 pandemic. More than two billion doses have been produced, with the majority both made and used in low and middle income countries. This has been enabled by a programme of early technology transfer to multiple drug substance production sites, occurring in parallel with process development. The University of Oxford was transferring technology to five sites by March 2020, and AstraZeneca subsequently extended the drug substance manufacturing network to 12 countries. This innovative approach was possible only as a result of single-use technology (SUT), and the presentation will provide a case study of the application of such technology to pandemic response. Pre-pandemic research in the Jenner Institute had developed a potentially scalable adenovirus manufacturing process, prioritising simplicity and end-to-end single-use product contact materials to facilitate future technology transfer. From February 2020, this was aggressively scaled up, reaching 200L by April and 1000L by June. In most respects the process scaled linearly, with small-scale work largely predictive of parameters which were successful at large scale. In parallel, process optimisations targeted further simplification. This simple SUT-based process has been the critical factor enabling distributed manufacturing of a novel product type in existing facilities. Several of the facilities contributing to the production (including those in LMICs and the one which has contributed most to global output) had no previous experience of viral vector manufacture, yet were able to rapidly and effectively on-board the process and. Use of shared SUT has also assisted product comparability across the network. SUT has thus played a pivotal role in both scale-up and scale-out, allowing manufacturing to reach a scale we believe to be unprecedented for any viral vector, and making a major contribution to equity of access to COVID-19 vaccines

Tackling a capacity bottleneck to permit large-scale downstream processing of an adenovirus-vectored vaccine

We recently described the strategy by which the University of Oxford and AstraZeneca collaboratively scaled up production of our adenovirus-vectored COVID-19 vaccine, using a productive fed batch process and distributed manufacturing approach in twelve countries around the world. Here we will focus on the development of the downstream process used to make this vaccine. In early development, the first tangential flow filtration step in our previously developed process was noted to be a potential obstacle for scale-up beyond 200L. By removing this first tangential flow filtration step, we established a simple purification process capable of handling the increasing quantities and concentrations of viral titers which are becoming a bottleneck for many adenoviral vector manufacturing processes. Product quality was in line with regulatory expectations. This strategy has enabled 2 billion doses of the Oxford/AstraZeneca vaccine to be produced by November 2021, with the majority made and used in low- and middle-income countries

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Relationship Between Old Menstruation with Hemoglobin Levels in Student Faculty of Medicine Universitas Muslim Indonesia Bacth 2016

Hemoglobin is an important component in the blood. If the blood lacks hemoglobin or the amount of hemoglobin in the blood is less than the normal amount, then the body will have anemia. The purpose of this study was to determine the relationship between menstrual periods with hemoglobin levels in female students. This research is a descriptive analytic research, cross-sectional approach, using total sampling technique. Sample amounted to 99 people in Faculty of Medicine UMI. Data collection was done by using questionnaire and measuring respondent hemoglobin. Data analysis using spearman test. There were 49 female students (49.5%) who had normal menstrual period with normal hemoglobin level (≥12). There were 38 female (38.4%) students who had normal menstrual period with low hemoglobin level (&lt; 12), there were three female students (3.0%) who had hypermenorrhoea or abnormal menstrual periods with normal hemoglobin (≥12), and 9 9.1% women who had abnormal menstruation (hypermorrhoea) with hemoglobin low (&lt;12), and no female students had hypomenorrhoea. Based on result of analysis of test of relationship obtained value p = 0,042 (smaller than value α = 0,05). The conclusion that can be taken is there is a significant relationship between the length of menstruation with hemoglobin level in student of Faculty of Medicine UMI bacth 2016

Keragaman Dan Kelimpahan Ikan Pada Rumah Ikan (Fish Apartement) Dan Terumbu Buatan (Artificial Reef) Domus Coronarius Circularis Di Bangsring Underwater, Kabupaten Banyuwangi

Bangsring Underwater merupakan perairan yang memiliki sumberdaya hayati laut yang melimpah. Kegiatan konservasi seperti penurunan terumbu buatan di perairan ini sedang gencar dilakukan. Kegiatan konservasi ini bertujuan untuk meningkatkan sumberdaya perikanan di perairan bangsring seperti terumbu karang dan ikan. Terdapat dua jenis terumbu karang buatan yang turunkan di perairan bangsring yaitu Fish Apartment dan Domus Coronarius Circularis. Kedua terumbu karang tersebut berada di kedalaman sekitar 10 – 15 meter pada dasar laut yang memiliki topografi dengan sudut kemiringan 150. Penelitian dilaksanakan pada bulan Maret - Mei 2021 di Perairan Bangsring Underwater dan berada di area sekitar rumah apung. Pengamatan ini dilakukan menggunakan metode Underwater Visual Census (UVC) dengan metode transek sabuk, dimana pengambilan data dilakukan pada pagi hari dalam waktu bersamaan di kedua stasiun dan secara berulang dalam jangka waktu tiga bulan. Spesies yang ditemukan di identifikasi menggunakan coral reef guide. Pada hasil penilitian ini tercatat 1.420 ekor, yang tediri dari beberapa Famili seperti; Pomacentridae, Lutjanidae, Serranidae, Siganidae, Chaedontidae, Scaridae, Carangidae, Scorpaenidae, Mullidae, Aulostomidae, Zanclidae, Gobiidae, Haemulidae, Caesionidae. Spesies yang ditemukan berjumlah 40 spesies yang berbeda. Spesies yang ditemukan diantaranya Caranx sexfasciastus dan Dascyllus reticulatus. Pada Domus Coronarius Circularis ditemukan 35 spesies ikan yang berbeda dengan jumlah individu 726 ekor. Sedangkan, pada Fish Apartment ditemukan 23 spesies ikan dengan jumlah individu 694 ekor. Ikan yang memiliki jumlah akumulatif tertinggi adalah spesies Caranx sexfasciastus dengan jumlah 235 ekor. Sedangkan pada Fish Apartment jumlah individu tertinggi adalah spesies Dascyllus reticulatus dengan jumlah 162 ekor. Komposisi Jenis Ikan pada Domus Coronarius Circularis tertinggi adalah Ikan target sebesar 47,4%. Sedangkan Komposisi Jenis Ikan pada Fish Apartment tertinggi adalah Ikan Major Grup sebesar 71,2%. Indeks Keanekaragaman Ikan tertinggi pada Domus Coronarius Circularis adalah 0.36 pada Jenis Ikan Mayor Grup. Sedangkan Indeks Keanekaragaman Ikan tertinggi pada Fish Apartment adalah 0.34 pada Jenis Ikan Target. Berdasarkan nilai Keanekaragaman (H’), pada kedua stasiun tersebut termasuk kategori rendah (nilai H’< 2,0). Indeks Keseragaman (E) pada kedua lokasi tersebut termasuk dalam kategori rendah yaitu sekitar 0,05 – 0,1 dimana (0,00 < E < 0,5). Pada Domus Coronarius Circularis di dominansi oleh Ikan Target dengan nilai 0.223 dan termasuk dalam kategori rendah (0,00 < D < 0,5). Sedangkan, pada Fish Apartment di dominansi oleh Ikan Major Grup dengan nilai 0.507 dan termasuk dalam kategori sedang (0.50 < D < 0.75)

Indeks Nilai Penting Lamun (Seagrass) di Kawasan Taman Nasional Baluran, Kabupaten Situbondo, Jawa Timur

Ekosistem padang lamun memiliki banyak fungsi dan peranan penting di perairan. Meskipun ekosistem lamun memiliki peran yang sangat krusial di perairan, akan tetapi banyak ancaman yang menyebabkan penurunan luasan padang yang memiliki kaitan dengan kondisi kesehatan padang lamun. Masalah utama yang mengakibatkan kerusakan ekosistem lamun di seluruh dunia adalah aktivitas manusia seperti reklamasi, pengerukan, penambangan pasir, pencemaran air, dan pembuangan limbah. Penelitian ini bertujuan untuk mengetahui kondisi kesehatan dan indeks nilai penting (INP) lamun di Kawasan Perairan Taman Nasional Baluran, Situbondo, Jawa Timur. Taman Nasional Baluran yang menjadi salah satu destinasi wisata dan kegiatan perikanan menjadikan ancaman tersendiri bagi ekosistem yang ada di dalamnya salah satunya lamun apabila tidak dikelola dengan baik. Kurangnya pengetahuan masyarakat mengenai lamun memperparah keadaan sehingga kurangnya upaya untuk menjaga dan melestarikan ekosistem ini. Penelitian ini dilaksanakan pada bulan Mei-Juli 2022 di delapan perairan meliputi Perairan Bama, Kajang, Kakapa, Simacan, Sirondo, Lempuyang, Air Karang, dan Trisik yang berada di Taman Nasional Baluran. Penelitian ini merupakan penelitian deskriptif dengan menggunakan metode purposive sampling. Pengambilan data lapang terdiri atas parameter kualitas perairan, persentase tutupan jenis, kerapatan jenis, dan frekuensi jenis lamun. Paramater kualitas perairan yang diukur meliputi suhu, pH, salinitas, DO, kecepatan arus, dan kecerahan. Pengambilan data lamun mengacu pada Coremap LIPI dengan kuadran transek berukuran 50x50 cm dan dibagi empat bagian. Garis transek ditarik sejauh 100 meter tegak lurus garis pantai atau menyesuaikan luas hamparan padang lamun di lokasi penelitian. Jarak peletakan antar kuadran adalah 10 meter dan jarak antar garis transek adalah 50 meter. Hasil pengukuran parameter perairan menunjukkan rata-rata normal dan sesuai dengan baku mutu Kepmen LH no. 51 tahun 2004, kecuali pH namun masih termasuk dalam perairan yang produktif. Berdasarkan hasil tersebut, kondisi lokasi penelitian tergolong perairan yang baik untuk lamun dapat hidup dan tumbuh. Hasil identifikasi didapatkan 7 spesies lamun yaitu Enhalus acoroides, Thalassia hemprichii, Cymodocea rotundata, Halodule pinifolia, Halodule uninervis, Syringodium isoetifolium, dan Halophila ovalis. Hasil penelitian mengenai kondisi kesehatan lamun di Taman Nasional Baluran didapatkan nilai sebesar 59,46± 5,75 % yang berarti dalam kondisi kurang sehat dengan kategori tutupan sedang menurut Kepmen LH No. 200 tahun 2004 dan Coremap LIPI. Halodule pinifolia merupakan spesies dengan peranan paling kecil di Kawasan Perairan TN Baluran karena memiliki indeks nilai penting terendah. Enhalus acoroides merupakan jenis lamun yang memiliki indeks nilai penting tertinggi dengan nilai 93.25 %. Berdasarkan hasil tersebut Enhalus acoroides merupakan spesies yang memiliki peranan paling dominan, paling mampu beradaptasi dengan lingkungan, dan memiliki tingkat ketahanan tinggi di Kawasan Perairan Taman Nasional Baluran