Penyusunan Penuntun Praktikum pada Materi Pencemaran di SMA Berdasarkan Uji Kualitas Air Sungai Kapuas

This research has purpose to know water quality in residential districts, market, and butchery in the areas along Kapuas River in Pontianak based on parameter in physics, chemistry, and biology. Form of this research is descriptive with survey method. This research is based on second class water standard according to PP 82 in the year of 2001. The result of sample test in three observation locations shows that the water is worth to be used based on the physics parameter (TDS, TSS and temperature) meanwhile, based on parameter in chemistry (DO, BOD, COD, and pH) and biology (Total Coliform), the water from those locations is unworthy to be used. The result of the research on water quality used in arranging the guidance of the practicum entitled Testing of the content of simple group of Coliform Bacteria in Kapuas River water on material for tenth grade students of senior high school about environmental contamination. Validation of the practicum guidance is done by 7 people as validator with average score of validation about 3,5 or it is worth being used for supporting the learning about environmental contamination material. Keys: water quality, Kapuas River, practicum guidanc

Urinary Incontinence in Elderly

Urinary Incontinence (UI) is dened any involuntary leakage of urine. It is twice as common in women as in men and affects at least 1 in 3 older women. It is not a normal result of aging. Rather it is a medical problem that is often curable and should be treated. Urine is stored in the bladder and emptied via the urethra. During urination, muscles of the bladder wall contract, forcing urine from the bladder into the urethra. Sphincter muscles surrounding the urethra relax thus releasing urine from the body. Incontinence occurs if bladder muscles suddenly contract or sphincter muscles are not strong enough to contain urine. The diagnosis of geriatric urinary incontinence includes evaluation for overow incontinence, functional incontinence and stress incontinence. The treatment goal should be realistic and aim to improve the patient's functional status and quality of life. Best treatment outcomes can only be achieved by a holistic treatment approach

A Study of Association of Mean Platelet Volume and Ischaemic Stroke

Background: Cerebrovascular diseases include some of the most common and devastating disorders. Mean platelet volume (MPV) is a physiological variable of haemostatic importance. Large platelets are more reactive, produce more prothrombotic factors and aggregate more easily.Thus, the detection of large platelets in patients with cerebrovascular diseases would lend support to the idea that platelet volume influences thrombotic large vessel occlusion leading to ischaemic stroke. Here the aim of our study is to correlate the size of pletelet with ischaemic stroke.Subjects and method: This was a case control study carried out in Department of Medicine in Guru Nanak Dev Hospital attached to Govt. Medical college. The study was carried out among 50 patients diagnosed with an acute ischemic stroke and presenting with in 48 hours of onset. Clinical severity was assessed using Modified Rankin‘s scale. Mean Platelet Volume was measured using an automated analyzer. Fifty age and sex matched controls were also recruited and their Mean Platelet Volumes assessed and association was calculated. Results: MPV has got a statistically significant correlation with ischemic stroke with a p value of 0.000 (highly significant) with an average MPV in cases being 8.92±1.03fl compared to controls in which average being 7.67±1.38fl. The range of MPV in cases was 7.40 to 12.80. The range of MPV in control was 4.90 to 10.10. The association of MPV with severity of stroke was determined by comparing the modified Rankin‘s score with corresponding mean values of MPV in each group. MPV – EDTA showed a p value of 0.191 which was statistically insignificant.Conclusion: MPV was significantly higher in patients of ischemic stroke which suggest a association of MPV with ischemic stroke. Further there was no significant association between severity of ischemic stroke and MPV

Original Article Section: Medicine Prevalence of Hepatitis B in Alcoholic Liver Disease

ABSTRACT Background: Alcohol intake is most widely used social drink worldwide. Chemically it is ethyl alcohol which is produced by fermentation. Habitual and regular intake of alcohol causes damage to every system of our body and is associated with HBV, HCV and other viral infections. Methods: In this study involving 194 patients of ALD, we found HBsAg was positive in 4.6% of patients of ALD. Most of the cases had developed cirrhosis and its complications. Results: Of all HBsAg positive patients, 44.4% presented with gastrointestinal bleeding and 44.4% with hepatic encephalopathy. The mean value of SGOT and SGPT were significantly higher in HBsAg positive patients as compared to HBsAg negative patients. Conclusion: The study concluded that alcoholics are more prone to infection with Hepatitis B as compared to non alcoholics and are more prone to develop cirrhosis and its complications

Original Article Section: Medicine The Study of Arrhythmias in the First Week of Myocardial Infarction

ABSTRACT Background: Cardiac arrhythmias are quite common in the setting of acute myocardial infarction. Ninety percent of patients with acute myocardial infarction (AMI) have some cardiac rhythm abnormality, and 25% have cardiac conduction disturbance within 24 hours of infarct onset. These are tachyarrhythmias, ventricular arrhythmias, and atrioventricular block. A good correlation exists between the site of infarct and type of arrhythmias. Sinus bradycardia, sinoatrial escape rhythms, Wenkebach type and complete heart block are usually associated with inferior wall myocardial infarction (IWMI). Atrial premature contraction (APC) and ventricular premature contraction (VPC) are usually seen in anterior wall myocardial infarction (AWMI). Methods: The present cross-sectional study was conducted on 100 consecutive cases of acute myocardial infarction with arrhythmias attending as indoor emergency patients of Guru Nanak Dev Hospital attached to Government Medical College, Amritsar were included. History, clinical examination and required investigations including lipid profile, blood sugars, electrolytes, CPK-MB, ECG, and 2D-Echo were done. Results: Out of the hundred patients in the study, males (57%) outnumbered females (43%). Most of the patients were found in the age group of 51-60 years (34%). Smoking was the most significant risk factor (38%), followed by diabetes mellitus (35%), hypertension (30%) and prior ischemic heart disease (28%). The majority (56%) of the patients had anterior wall myocardial infarction (AWMI), followed by IWMI (24%), IWMI + RVMI (13%) and AWMI + IWMI (7%). Most of the arrhythmias (62%) developed during initial 24 hours of admission, while 27% in next 24 hours and 11% after 48 hours of admission to hospital. The most common arrhythmia observed was VPC (50%), followed by sinus tachycardia (48%), sinus bradycardia (16%), accelerated idioventricular rhythm (9%), 3rd degree heart block (7%), ventricular tachycardia (6%), 1st degree Heart Block (5%), 2nd degree Heart block (5%), ventricular fibrillation (4%), APC (4%) and AF (1%). Maximum incidence of VPC, sinus tachycardia, ventricular tachycardia (VT) and ventricular fibrillation (VF) were recorded in AWMI, while the maximum incidence of sinus bradycardia and AV block were observed in IWMI. Mortality was more common in patients developing arrhythmias specifically VT, VF and heart blocks especially 2nd-degree heart block and 3rd-degree heart block. Conclusion: Most of the patients with acute myocardial infarction develop some kind of arrhythmias which is an important cause of morbidity in these patients, develop during the initial 24 hours of admission to the hospital. Most common arrhythmias observed were VPC, followed by sinus tachycardia, AV block, bundle branch block, sinus bradycardia, VT, and VF. VPC, sinus tachycardia, VT, and VF were more common in AWMI, while sinus bradycardia and AV block were more common in IWMI. Diligent monitoring for arrhythmias and appropriate treatment can be life saving

Lung Abscess – Missed, then Found!

Lung abscess, a liquefactive necrosis of the lung tissue, presents as an air-fluid level in a cavity on chest X-ray. But sometimes it can entirely be missed on chest X-rays and can cause delay in diagnosis and so appropriate management. In such situations, computed tomography of chest can clinch the diagnosis. We are presenting here such a situation where lung abscess was detected on CT chest, whereas the chest radiography totally missed it

Vertigo in Elderly – Common but Complicated

Dizziness and its subtype vertigo are common complaints occurring in all age groups after teenage but, it become a major health problem in elderly because of the frequency with which it affects the elder population and leads to direct and indirect consequences. Causes of vertigo in the elderly are not totally different from young population but to some extent they are different too. In elderly, the causation of dizziness and vertigo is interplay multiple factors, so its diagnosis and management differs from other age groups. This review is aimed at highlighting the special aspects of dizziness and vertigo in the elderly

Idiopathic clubbing: A case report

Clubbing of the fingers and toes has been recognized as a clinical manifestation of intra thoracic disease from the earliest times. Hippocrates particularly described the condition as occurring with advanced phthisis and empyema and emphasized the importance of the changes as diagnostic of purulent pleural effusion. Many subsequent authors have described clubbing of the fingers associated with chronic disease of the heart or lungs, but it is still rare in medical literature to find the condition mentioned as being of primary origin. We here present the case of 24 years old female having developed clubbing of all fingers that had no found secondary cause after an extensive search and so thought to be of primary origin

Original Article Section: Surgery Port Site Chronic Sinuses -A Wisdom of 5 Years and 50 Cases

ABSTRACT Background: Laparoscopic surgery has now become an accepted method of minimal invasion of human anatomy but the dreaded problem of port site complications especially the chronic sinuses has rejuvenated the proponents of open techniques. The scope of laparoscopy widened from diagnostic purposes to resecting large tumors in almost all the systems of the body. As the time progressed, the problems associated with use of long instruments and dexterity of movements started creeping in. The vision, which was analogue, to start with, became 3D digital and with the introduction of robotic arm, the problem of dexterity was addressed to some extent. One thing that persisted right through so much of technical development was the problem of infection and sinuses and the enormity of this issue can be gauged by its evergrowing number. Methods: Although minimal invasive surgery is here to stay for all intent and purposes, we have decided to study 50 cases of chronic port site sinuses treated and followed up for 5 years in various wards of department of surgery in Guru Nanak Dev Hospital, Amritsar. In this study the authors present their experience and rationale regarding various factors like age and sex distribution, site of infection, results of microscopy and culture/sensitivity, treatment given (both surgical and non surgical), response time and prognosis. Results: In the cases where there was discharge culture of the pus yielded skin and soft tissue infections like staphylococcus, streptococcus, pseudomonas, E. coli and klebsiella. Out of 50, 20 cases were treated by appropriate antibiotics after culture sensitivity and quinolones.Conclusion: From the above discussion and flow chart, it can be safely concluded that atypical mycobacteria and some of the anaerobes remain the main offending agents

Polycystic Kidney Disease – A cause for Low backache

Polycystic kidney disease is one of the common inherited diseases affecting the renal system, though it can be an acquired condition too. It can present as wide variety of symptoms and can also be incidental finding on abdominal imaging done for some other purpose. Polycystic kidney disease can be missed for a long duration if a strong suspicion is not there in the mind of physician based on the in detail knowledge of this condition. We here are presenting a short case report of a middle aged female who was having polycystic kidney disease but diagnosed considerably late