Ulkus Diabetikum Pada Wanita Dengan Pola Hidup Yang Buruk Pada Penderita Dm Tipe II Dan Hipertensi Grade II

Latar belakang. Diabetes Melitus (DM) merupakan masalah kesehatan yang perlu mendapatkan penanganan yang seksama. Prevalensi DM semakin tahun semakin meningkat, terutama pada kelompok yang berisiko tinggi untuk mengalami penyakit DM. Kasus. Ny. H, 58 tahun datang dengan keluhan luka pada kaki kanan sejak 3 minggu yang lalu. Pasien telah menderita kencing manis sejak 5 tahun yang lalu dan jarang kontrol. Riwayat pola hidup jarang berolahraga, makan karbohidrat dalam jumlah banyak, terutama nasi, serta sering mengkonsumsi makanan dan minuman yang mengandung banyak gula, baik gula alami maupun pemanis buatan. Tekanan darah 180/90mmHg, ekstremitas terdapat ulkus diabetikum pada regio pedis dextra. Hemoglobin 10,4 gr/dl, LED 45%, leukosit 12.700/µl, Gula Darah Sewaktu 400 mg/dl, Gula Darah Nocturnal 202 mg/dl, Gula Darah 2 jam Post Prandial 233 mg/dl. Diagnosis. Ulkus diabetikum dengan diabetes mellitus tipe 2 dan hipertensi grade II dan pola hidup buruk. Pasien ditatalaksana dengan infus Ringer Lactate (makro) 20 tetes/menit, ceftriaxon 1gr/12 jam, metronidazole/8 jam, Glibenclamide 3x500mg, ketorolac 30mg/8 jam, Captopril 3x12,5 mg, diet rendah garam, diet rendah karbohidrat, ganti balutan luka setiap 2 hari. Simpulan. Ulkus diabetikum dan hipertensi pada pasien ini dipengaruhi oleh pola hidup yang buruk. [Medula Unila.2014;2(1) : 8-13

Knowledge of dental academics about the COVID-19 pandemic: a multi-country online survey.

BACKGROUND: COVID-19 is a global pandemic affecting all aspects of life in all countries. We assessed COVID-19 knowledge and associated factors among dental academics in 26 countries. METHODS: We invited dental academics to participate in a cross-sectional, multi-country, online survey from March to April 2020. The survey collected data on knowledge of COVID-19 regarding the mode of transmission, symptoms, diagnosis, treatment, protection, and dental treatment precautions as well as participants' background variables. Multilevel linear models were used to assess the association between dental academics' knowledge of COVID-19 and individual level (personal and professional) and country-level (number of COVID-19 cases/ million population) factors accounting for random variation among countries. RESULTS: Two thousand forty-five academics participated in the survey (response rate 14.3%, with 54.7% female and 67% younger than 46 years of age). The mean (SD) knowledge percent score was 73.2 (11.2) %, and the score of knowledge of symptoms was significantly lower than the score of knowledge of diagnostic methods (53.1 and 85.4%, P <  0.0001). Knowledge score was significantly higher among those living with a partner/spouse than among those living alone (regression coefficient (B) = 0.48); higher among those with PhD degrees than among those with Bachelor of Dental Science degrees (B = 0.48); higher among those seeing 21 to 30 patients daily than among those seeing no patients (B = 0.65); and higher among those from countries with a higher number of COVID-19 cases/million population (B = 0.0007). CONCLUSIONS: Dental academics had poorer knowledge of COVID-19 symptoms than of COVID-19 diagnostic methods. Living arrangements, academic degrees, patient load, and magnitude of the epidemic in the country were associated with COVD-19 knowledge among dental academics. Training of dental academics on COVID-19 can be designed using these findings to recruit those with the greatest need

Behavior change due to COVID-19 among dental academics-The theory of planned behavior: Stresses, worries, training, and pandemic severity

Objective: COVID-19 pandemic led to major life changes. We assessed the psychological impact of COVID-19 on dental academics globally and on changes in their behaviors. Methods: We invited dental academics to complete a cross-sectional, online survey from March to May 2020. The survey was based on the Theory of Planned Behavior (TPB). The survey collected data on participants’ stress levels (using the Impact of Event Scale), attitude (fears, and worries because of COVID-19 extracted by Principal Component Analysis (PCA), perceived control (resulting from training on public health emergencies), norms (country-level COVID-19 fatality rate), and personal and professional backgrounds. We used multilevel regression models to assess the association between the study outcome variables (frequent handwashing and avoidance of crowded places) and explanatory variables (stress, attitude, perceived control and norms). Results: 1862 academics from 28 countries participated in the survey (response rate = 11.3%). Of those, 53.4% were female, 32.9% were <46 years old and 9.9% had severe stress. PCA extracted three main factors: fear of infection, worries because of professional responsibilities, and worries because of restricted mobility. These factors had significant dosedependent association with stress and were significantly associated with more frequent handwashing by dental academics (B = 0.56, 0.33, and 0.34) and avoiding crowded places (B = 0.55, 0.30, and 0.28). Low country fatality rates were significantly associated with more handwashing (B = -2.82) and avoiding crowded places (B = -6.61). Training on public health emergencies was not significantly associated with behavior change (B = -0.01 and -0.11). Conclusions: COVID-19 had a considerable psychological impact on dental academics. There was a direct, dose-dependent association between change in behaviors and worries but no association between these changes and training on public health emergencies. More change in behaviors was associated with lower country COVID-19 fatality rates. Fears and stresses were associated with greater adoption of preventive measures against the pandemic

Perceived Preparedness of Dental Academic Institutions to Cope with the COVID-19 Pandemic: A Multi-Country Survey

Dental academic institutions are affected by COVID-19. We assessed the perceived COVID-19 preparedness of these institutions and the characteristics of institutions with greater perceived preparedness. An international cross-sectional survey of dental academics was conducted from March to August 2020 to assess academics’ and institutional attributes, perceived preparedness, and availability of infection prevention and control (IPC) equipment. Principal component analysis (PCA) identified perceived preparedness components. Multilevel linear regression analysis assessed the association between perceived preparedness and fixed effect factors (academics’ and institutions’ attributes) with countries as random effect variable. Of the 1820 dental academics from 28 countries, 78.4% worked in public institutions and 75.2% reported temporary closure. PCA showed five components: clinic apparel, measures before and after patient care, institutional policies, and availability of IPC equipment. Significantly less perceived preparedness was reported in lower-middle income (LMICs) (B = −1.31, p = 0.006) and upper-middle income (UMICs) (B = −0.98, p = 0.02) countries than in high-income countries (HICs), in teaching only (B = −0.55, p &lt; 0.0001) and in research only (B = −1.22, p = 0.003) than teaching and research institutions and in institutions receiving ≤100 patients daily than those receiving &gt;100 patients (B = −0.38, p &lt; 0.0001). More perceived preparedness was reported by academics with administrative roles (B = 0.59, p &lt; 0.0001). Academics from low-income countries (LICs) and LMICs reported less availability of clinic apparel, IPC equipment, measures before patient care, and institutional policies but more measures during patient care. There was greater perceived preparedness in HICs and institutions with greater involvement in teaching, research, and patient care

Genome-wide association study confirm major QTL for backfat fatty acid composition on SSC14 in Duroc pigs

Background: Fatty acid composition contributes importantly to meat quality and is essential to the nutritional value of the meat. Identification of genetic factors underlying levels of fatty acids can be used to breed for pigs with healthier meat. The aim of this study was to conduct genome-wide association studies (GWAS) to identify QTL regions affecting fatty acid composition in backfat from the pig breeds Duroc and Landrace. Results: Using data from the Axiom porcine 660 K array, we performed GWAS on 454 Duroc and 659 Landrace boars for fatty acid phenotypes measured by near-infrared spectroscopy (NIRS) technology (C16:0, C16:1n-7, C18:0, C18:1n-9, C18:2n-6, C18:3n-3, total saturated fatty acids, monounsaturated fatty acids and polyunsaturated fatty acids). Two QTL regions on SSC4 and SSC14 were identified in Duroc for the de novo synthesized fatty acids traits, whereas one QTL on SSC8 was detected in Landrace for C16:1n-7. The QTL region on SSC14 has been reported in previous studies and a putative causative mutation has been suggested in the promoter region of the SCD gene. Whole genome re-sequencing data was used for genotype imputation and to fine map the SSC14 QTL region in Norwegian Duroc. This effort confirms the location of the QTL on this chromosome as well as suggesting other putative candidate genes in the region. The most significant single nucleotide polymorphisms (SNPs) located on SSC14 explain between 55 and 76% of the genetic variance and between 27 and 54% of the phenotypic variance for the de novo synthesized fatty acid traits in Norwegian Duroc. For the QTL region on SSC8 in Landrace, the most significant SNP explained 19% of the genetic variance and 5% of the phenotypic variance for C16:1n-7. Conclusions: This study confirms a major QTL affecting fatty acid composition on SSC14 in Duroc, which can be used in genetic selection to increase the level of fatty acid desaturation. The SSC14 QTL was not segregating in the Landrace population, but another QTL on SSC8 affecting C16:1n-7 was identified and might be used to increase the level of desaturation in meat products from this breed

Marfan Syndrome in Semarang: report of two cases

Marfan Syndrome is a heritable connective tissue disorders, mostly caused by mutations in fibrillin-1 gene. In major cases, this syndrome is inherit in autosomal dominant manner, with~25% cases are caused by de novo mutations. Affected persons showed varying patterns of organ involvement including the ocular, skeletal, cardiovascular, pulmonary, dura and skin, in which aortic dissection become the most common cause of mortality. High variability in phenotypic expressions between and within families were also observed in this syndrome. Two cases of Marfan Syndrome in whom mutation analysis in FBN1 gene have been performed, showed two novel mutations. The first case was a 7-years old boy with a de novo missense mutation in exon 28 of FBN1 gene, c.3545G>A [p.C1182T]. The patient presented with lens dislocation, aortic dilatation, mitral valve prolapsed, pectus carinatum and dolichostenomelia. The second case was a familial Marfan Syndrome. The proband was a 32-years old man with a nonsense mutation in exon 15 of FBN1 gene, c.1924G>T [p.Gly642X]. He presented with tall stature, increased arm span and height ratio, bilateral high myopia, arachnodactily, positive thumb signs and wrist signs, joint laxity of articulatio genu, history of spontaneous pneumothorax, and finally passed away because of aortic dissection. His mother, two sisters and brother were clinically Marfan Syndrome, and will be further described. The variability in phenotypes and disorders severity should be better considered. The presence of Marfan Syndrome affected person in a family should be followed by further investigation in other family members to conclude the inheritance manner. DNA analysis is important for diagnostic establishment and knowing the recurrence risk in the next generation. Early recognition in affected status will lead to early prevention to complications that may follow. Comprehensive management including genetic counseling thus needed for Marfan Syndrome patients and their family members

Reformasi Lingkungan Cina Studi Kasus: Shenzhen Special Economic Zone

China in the few last decades has undergone a rapid economic transformation. Establishment of Special Economic Zones in the late 70 was a major key point in this transformation. A massive industrial progress in those SEZs including Shenzhen, has led the rise of China�s economic power. But it also comes with a prize of environmental degradation. Shenzhen as a lead and model city in environmental protection have to change its regulation and strategy to tackle this new challenge. Using Ecological Modernization Theory we can see how Shenzhen government, enterprise, and civil society together gone through environmental reform toward more sustainable development. Decentralization and flexibility of Shenzhen�s government is important factor in Ecological Modernization Theory, along with technological innovation, and changing role of enterprise & civil society. Environmental reformation in Shenzhen is far from perfect but it is still transforming and developing, despite all of the obstacles

JEPANG DALAM POLITIK REDD+ DI INDONESIA : TINJAUAN KONSTRUKTIVIS

This research aims to analyzing of political judgment that construct Japan action in carry out their REDD+ political in Indonesia and it formed framework of Japan basis motivation in cooperation IJ-REDD+ toward Indonesia. This is considered from constructive theory based on Reus-Smith, it�s linked to four reason or political judgment underlie step of action by Japan as an actor social, those are ideographic, purposive, ethical and instrumental. Finding of analysis, four reason of political judgment will explain how the ideas able to transform to be norm and then it influencing behavior and structure of Japan nation (government) to formulate environmental policy toward REDD+ in their own country and it started in cooperation REDD+ project form in Indonesia by through JICA organization. Acceptance toward its norm is connected to Japan effort to identification itself then compose their interest in cooperation. This research concludes process of Japan involvement in carry out their REDD+ political in Indonesia can�t be separated from Japan identity as environmental friendly country that composed by social structure and Japanese norm adhered, then compose purposing of Japan motivation related to cooperation implementation itself. In social interaction and in expectation able to explain the dimension connection toward identity, motivation and how relation can be important contributing in international environmental policy stud

ALASAN UNI EROPA DALAM MEMPERTAHANKAN KEBIJAKAN SUBSIDI PERIKANAN PASCA REFORMASI COMMON FISHERIES POLICY (CFP) TAHUN 2002

After the reform of Common Fisheries Policy (CFP) in 2002, the European Union issued fisheries subsidies with the original purpose to keep the water�s environment and European marine resources. However, this policy actually have an impact on the environmental damage such as overfishing that threatens fish stocks in European waters, food security, long-term economic, and political integration of the European Union in the future. Fisheries subsidies become a controversial policy because it proved with the negative impact on the environment. By looking at the political processes in three pillars of the European Union as a supranational state reflection: European Commission, European Parliament and Council of the European Union, resulted a decision that fisheries subsidies will continue with allocate fund 6.5 billion euro start from 2014 until 2020. Some countries support this policy as beneficial subsidies, but the others countries argue that subsidies is a blind spent. Conflicts of the member state�s interest behind the fisheries subsidies and the political dynamics background become focus of the research to find out the reasons and justification of the European Union to still maintain fisheries subsidies