Implementasi Teknik Maze Untuk Mengembangkan Kreativitas Dan Kemampuan Kognitif Anak Kelompok B2 TK Shanti Kumara III Sempidi Mengwi Badung

Penelitian ini bertujuan untuk meningkatkan kreativitas dan kemampuan kognitif anak pada kelompok B2 TK Shanti Kumara III Sempidi Mengwi Badung. Pelaksanaan penelitian didasarkan pada kelompok observasi awal yang menunjukkan bahwa krativitas anak masih rendah. Oleh karena itu, diperlukan penerapan teknik maze untuk meningkatkan kreativitas anak. Subjek penelitian adalah 26 anak TK Shanti Kumara III Sempidi Mengwi Badung. Analisis data menggunakan teknik deskripsi kuantitatif. Hasil penelitian menunujukkan bahwa kualitas kreativitas dan kemampuan kognitif anak melalui penerapan teknik maze pada anak mengalami peningkatan. Secara rinci dapat dilihat dari 1) skor kemampuan kognitif anak meningkat di siklus I sampai dengan siklus II sebesar 46,15% dan 2) skor kreativitas anak meningkat di siklus I sampai dengan siklus II sebesar 53,85%. Berdasarkan penelitian tersebut Penerapan teknik maze dapat digunakan sebagai salah satu alternatif teknik yang menarik dalam pembelajaran di TK untuk meningkatkan kreativitas anak.Kata Kunci : kemampuan kognitif, kreativitas, teknik maze This research aims at improving children's creativity and cognitive skill of B2 Group at TK Shanti Kumara III Sempidi Mengwi Badung. The research was based on pre-observation which showed that the children's creativity was low. Thus, maze technique was needed to improve children's creativity. The subject was 26 children at Shanti Kumara III Kindergarten Sempidi Mengwi Badung. Data analysis using quantitative descriptive technique. The result of the research shows that 1) cognitive skill of children increased on cycle I and was continued until cycle II of 46.15%, 2) creativity score of children also increased on cycle I and was continued until cycle II of 53.85%. Based on those results, it is concluded that the implementation of Maze Technique can be used effectively as an interesting alternative technique in kindergarten learning process to improve children creativity

Tuberculosis in children in India-II: Chemotherapy for tuberculosis

Tubercle bacilli readily become resistant to the common drugs, and resistant bacilli are more likely to proliferate if they are present in the patient at the start of treatment. So always use more than one drug. The only possible exception is prophylaxis for an asymptomatic case with a normal X-ray. CAUTION! (1) Never give intermittent (twice or thrice weekly) treatment unless every dose can be supervised by a health worker. Daily treatment is usually mandatory. (2) When you give more than one drug, give them both at the same time, so that high blood levels coincide; do not give one drug daily and the other drug less often. THE DOSES of the commonly used drugs for daily and intermittent treatment in children and adults are: lsoniazid (H) 5 mg/kg/24 hours if he is moderately ill and 10 mg/kg/24 hours if he is severely ill. The dose for a twice weekly course is 15 mg/kg. CAUTION! Opinions on the dose of isoniazid vary. Some consider 10 mg/kg/24 hours too much for an Indian child and always give 5 mg. Rifampicin (R) 10 mg/kg/24 hours, or 10 mg/kg twice weekly. Pyrazinamide (Z) 35 mg/kg/24 hours, 75 mg/kg twice weekly or 50 mg/kg thrice weekly, is an important drug for short course treatment, so try to include it whenever it is mentioned in the regimes below. Streptomycin (S) 10-20 mg/kg/24 hours, or 40 mg/kg twice weekly, to a total of not more than 0.75 g. Streptomycin is painful, so avoid it if you can. If you give it, inject in different places each day, because repeated injections into the same site are painful. Ethambutol (E) 25 mg/kg/24 hours for 2 months, then 15 mg/kg/24 hours. Avoid ethambutol in younger children (under 12); they are unable to complain of the early symptoms of retrobulbar neuritis (blindness). Thiacetazone (T) 4 mg/kg/24 hours to a maximum Of 150 mg; unsuitable for intermittent treatment

Tuberculosis in children in India-I

Tuberculosis is different in children. It involves many organs, instead of being the predominantly respiratory disease that it usually is in adults. Fortunately, it readily responds to treatment–if you diagnose it early enough and treat it for long enough! This is the problem. Unfortunately, tuberculosis causes such non-specific symptoms and signs, and you are so seldom able to isolate bacilli, that you may never be sure of the diagnosis. Even experts sometimes disagree. In India particularly, it is a disease of the poorest of the poor, but even in them it causes only a small proportion of their burden of morbidity. The great problem is to reach those infected. Of every thousand Indians, seven children and about twenty adults have active tuberculosis, and five of these adults are sputum positive. Only about half the 9 million in the community at any one time are ever diagnosed, and of these only about 13% complete their treatment, so there is a huge pool of infectious cases, half a million of whom die each year. Fortunately, the incidence of tuberculosis among children reporting to hospital is slowly decreasing, probably largely due to improved coverage with BCG

A proprietary alpha-amylase inhibitor from white bean (Phaseolus vulgaris): A review of clinical studies on weight loss and glycemic control

Obesity, and resultant health hazards which include diabetes, cardiovascular disease and metabolic syndrome, are worldwide medical problems. Control of diet and exercise are cornerstones of the management of excess weight. Foods with a low glycemic index may reduce the risk of diabetes and heart disease as well as their complications. As an alternative to a low glycemic index diet, there is a growing body of research into products that slow the absorption of carbohydrates through the inhibition of enzymes responsible for their digestion. These products include alpha-amylase and glucosidase inhibitors. The common white bean (Phaseolus vulgaris) produces an alpha-amylase inhibitor, which has been characterized and tested in numerous clinical studies. A specific and proprietary product named Phase 2® Carb Controller (Pharmachem Laboratories, Kearny, NJ) has demonstrated the ability to cause weight loss with doses of 500 to 3000 mg per day, in either a single dose or in divided doses. Clinical studies also show that Phase 2 has the ability to reduce the post-prandial spike in blood glucose levels. Experiments conducted incorporating Phase 2 into food and beverage products have found that it can be integrated into various products without losing activity or altering the appearance, texture or taste of the food. There have been no serious side effects reported following consumption of Phase 2. Gastro-intestinal side effects are rare and diminish upon extended use of the product. In summary, Phase 2 has the potential to induce weight loss and reduce spikes in blood sugar caused by carbohydrates through its alpha-amylase inhibiting activity

MKS3/TMEM67 mutations are a major cause of COACH syndrome, a joubert syndrome related disorder with liver involvement

The acronym COACH defines an autosomal recessive condition of Cerebellar vermis hypo/ aplasia, Oligophrenia, congenital Ataxia, Coloboma and Hepatic fibrosis. Patients present the “molar tooth sign”, a midbrain-hindbrain malformation pathognomonic for Joubert Syndrome (JS) and Related Disorders (JSRDs). The main feature of COACH is congenital hepatic fibrosis (CHF), resulting from malformation of the embryonic ductal plate. CHF is invariably found also in Meckel syndrome (MS), a lethal ciliopathy already found to be allelic with JSRDs at the CEP290 and RPGRIP1L genes. Recently, mutations in the MKS3 gene (approved symbol TMEM67), causative of about 7% MS cases, have been detected in few Meckel-like and pure JS patients. Analysis of MKS3 in 14 COACH families identified mutations in 8 (57%). Features such as colobomas and nephronophthisis were found only in a subset of mutated cases. These data confirm COACH as a distinct JSRD subgroup with core features of JS plus CHF, which major gene is MKS3, and further strengthen gene-phenotype correlates in JSRDs

EpiNet as a way of involving more physicians and patients in epilepsy research: Validation study and accreditation process

open185siObjective: EpiNet was established to encourage epilepsy research. EpiNet is used for multicenter cohort studies and investigator-led trials. Physicians must be accredited to recruit patients into trials. Here, we describe the accreditation process for the EpiNet-First trials. Methods: Physicians with an interest in epilepsy were invited to assess 30 case scenarios to determine the following: whether patients have epilepsy; the nature of the seizures (generalized, focal); and the etiology. Information was presented in two steps for 23 cases. The EpiNet steering committee determined that 21 cases had epilepsy. The steering committee determined by consensus which responses were acceptable for each case. We chose a subset of 18 cases to accredit investigators for the EpiNet-First trials. We initially focused on 12 cases; to be accredited, investigators could not diagnose epilepsy in any case that the steering committee determined did not have epilepsy. If investigators were not accredited after assessing 12 cases, 6 further cases were considered. When assessing the 18 cases, investigators could be accredited if they diagnosed one of six nonepilepsy patients as having possible epilepsy but could make no other false-positive errors and could make only one error regarding seizure classification. Results: Between December 2013 and December 2014, 189 physicians assessed the 30 cases. Agreement with the steering committee regarding the diagnosis at step 1 ranged from 47% to 100%, and improved when information regarding tests was provided at step 2. One hundred five of the 189 physicians (55%) were accredited for the EpiNet-First trials. The kappa value for diagnosis of epilepsy across all 30 cases for accredited physicians was 0.70. Significance: We have established criteria for accrediting physicians using EpiNet. New investigators can be accredited by assessing 18 case scenarios. We encourage physicians with an interest in epilepsy to become EpiNet-accredited and to participate in these investigator-led clinical trials.openBergin P.S.; Beghi E.; Sadleir L.G.; Brockington A.; Tripathi M.; Richardson M.P.; Bianchi E.; Srivastava K.; Jayabal J.; Legros B.; Ossemann M.; McGrath N.; Verrotti A.; Tan H.J.; Beretta S.; Frith R.; Iniesta I.; Whitham E.; Wanigasinghe J.; Ezeala-Adikaibe B.; Striano P.; Rosemergy I.; Walker E.B.; Alkhidze M.; Rodriguez-Leyva I.; Ramirez Gonzalez J.A.; D'Souza W.J.; Calle A.; Palacios C.; Cairns A.; Carney P.; Craig D.; Gill D.; Gupta S.; Lander C.; Laue-Gizzi H.; Hitchens N.; Kiley M.; Lawn N.; Reyneke E.; Riney K.; Tan M.; Tan M.; Thieban M.; Wong C.; van Rijckevorsel G.; Ferrari Strang A.G.; Gifoni A.; Helio L.; Monnerat B.; Brna P.; Donner E.; Jacques S.; Jette N.; McLachlan R.; Mohamed I.; Tran T.P.Y.; Bo X.; Fan S.; Guang Y.; Li M.; Wang K.; Zhang S.; Ladino L.; Christensen J.; Kӧlmel M.S.; Nikanorova M.; Uusitalo A.; Vieira P.; Auvin S.; Ediberidze T.; Gogatishvili N.; Jishkariani T.; Dennig D.; Grimmer A.; Michaelis R.; Schubert-Bast S.; Stephani C.; Stodieck S.; Vollbrandt M.; Zellner A.; Zafeiriou D.; Fogarasi A.; Halasz P.; Chaurasia R.N.; Jain S.; Nair R.; Passi P.; Rajadhyaksha S.; Sattaluri S.J.; Shah H.; Udani V.; Costello D.; Aguglia U.; Bartocci A.; Benna P.; Ferlazzo E.; Laino D.; Spalice A.; Zanchi C.; Ali A.; Lim K.S.; Ramirez A.; Anderson N.; Barber A.; Cariga P.; Cleland J.; Child N.; Davis S.; Dayal V.; Dickson C.; Doran J.; Duncan R.; Giri P.; Herd M.; Hutchinson D.; Jones B.; Kao J.; Kilfoyle D.; Mottershead J.; Muir C.; Nolan M.; Pereira J.; Ranta A.; Sadani S.; Simpson M.; Spooner C.; Timmings P.; Walker E.; Wei D.; Willoughby E.; Wong E.; Wu T.; Olusola T.; Mahmud H.; Mogul Z.; Espinoza J.; Vizarreta J.H.; Baeta E.M.; Teotonio R.; Jocic-Jakubi B.; Lukic S.; Korosec M.; Zgur T.; Eguilaz M.G.; Asztely F.; Sithinamsuwan P.; Anderson J.; Auce P.; Desurkar A.; Hamandi K.; Kelso A.; Sanchez V.; Sidra A.; Smith P.; Wehner T.; Winston G.; Andrade E.; Bensalem-Owen M.; Boudreau M.; Caller T.; Chapman K.; Chari G.; Davis K.; Droker B.; El-Hagrassy M.; Eliashiv D.; Eze C.; Heck C.; Kabir A.; Kolesnik D.; Lam A.; Lopez J.; Maamoon T.; Cohen J.M.; Maganti R.; Nwankwo C.; Park K.; Proteasa S.; Sandok E.; Seinfield S.; Toub J.; Wirrell E.; Arbildi M.; Thien T.T.Bergin, P. S.; Beghi, E.; Sadleir, L. G.; Brockington, A.; Tripathi, M.; Richardson, M. P.; Bianchi, E.; Srivastava, K.; Jayabal, J.; Legros, B.; Ossemann, M.; Mcgrath, N.; Verrotti, A.; Tan, H. J.; Beretta, S.; Frith, R.; Iniesta, I.; Whitham, E.; Wanigasinghe, J.; Ezeala-Adikaibe, B.; Striano, P.; Rosemergy, I.; Walker, E. B.; Alkhidze, M.; Rodriguez-Leyva, I.; Ramirez Gonzalez, J. A.; D'Souza, W. J.; Calle, A.; Palacios, C.; Cairns, A.; Carney, P.; Craig, D.; Gill, D.; Gupta, S.; Lander, C.; Laue-Gizzi, H.; Hitchens, N.; Kiley, M.; Lawn, N.; Reyneke, E.; Riney, K.; Tan, M.; Tan, M.; Thieban, M.; Wong, C.; van Rijckevorsel, G.; Ferrari Strang, A. G.; Gifoni, A.; Helio, L.; Monnerat, B.; Brna, P.; Donner, E.; Jacques, S.; Jette, N.; Mclachlan, R.; Mohamed, I.; Tran, T. P. Y.; Bo, X.; Fan, S.; Guang, Y.; Li, M.; Wang, K.; Zhang, S.; Ladino, L.; Christensen, J.; Kӧlmel, M. S.; Nikanorova, M.; Uusitalo, A.; Vieira, P.; Auvin, S.; Ediberidze, T.; Gogatishvili, N.; Jishkariani, T.; Dennig, D.; Grimmer, A.; Michaelis, R.; Schubert-Bast, S.; Stephani, C.; Stodieck, S.; Vollbrandt, M.; Zellner, A.; Zafeiriou, D.; Fogarasi, A.; Halasz, P.; Chaurasia, R. N.; Jain, S.; Nair, R.; Passi, P.; Rajadhyaksha, S.; Sattaluri, S. J.; Shah, H.; Udani, V.; Costello, D.; Aguglia, U.; Bartocci, A.; Benna, P.; Ferlazzo, E.; Laino, D.; Spalice, A.; Zanchi, C.; Ali, A.; Lim, K. S.; Ramirez, A.; Anderson, N.; Barber, A.; Cariga, P.; Cleland, J.; Child, N.; Davis, S.; Dayal, V.; Dickson, C.; Doran, J.; Duncan, R.; Giri, P.; Herd, M.; Hutchinson, D.; Jones, B.; Kao, J.; Kilfoyle, D.; Mottershead, J.; Muir, C.; Nolan, M.; Pereira, J.; Ranta, A.; Sadani, S.; Simpson, M.; Spooner, C.; Timmings, P.; Walker, E.; Wei, D.; Willoughby, E.; Wong, E.; Wu, T.; Olusola, T.; Mahmud, H.; Mogul, Z.; Espinoza, J.; Vizarreta, J. H.; Baeta, E. M.; Teotonio, R.; Jocic-Jakubi, B.; Lukic, S.; Korosec, M.; Zgur, T.; Eguilaz, M. G.; Asztely, F.; Sithinamsuwan, P.; Anderson, J.; Auce, P.; Desurkar, A.; Hamandi, K.; Kelso, A.; Sanchez, V.; Sidra, A.; Smith, P.; Wehner, T.; Winston, G.; Andrade, E.; Bensalem-Owen, M.; Boudreau, M.; Caller, T.; Chapman, K.; Chari, G.; Davis, K.; Droker, B.; El-Hagrassy, M.; Eliashiv, D.; Eze, C.; Heck, C.; Kabir, A.; Kolesnik, D.; Lam, A.; Lopez, J.; Maamoon, T.; Cohen, J. M.; Maganti, R.; Nwankwo, C.; Park, K.; Proteasa, S.; Sandok, E.; Seinfield, S.; Toub, J.; Wirrell, E.; Arbildi, M.; Thien, T. T

Feasibility and antihypertensive effect of replacing regular salt with mineral salt -rich in magnesium and potassium- in subjects with mildly elevated blood pressure

<p>Abstract</p> <p>Background</p> <p>High salt intake is linked to hypertension whereas a restriction of dietary salt lowers blood pressure (BP). Substituting potassium and/or magnesium salts for sodium chloride (NaCl) may enhance the feasibility of salt restriction and lower blood pressure beyond the sodium reduction alone. The aim of this study was to determine the feasibility and effect on blood pressure of replacing NaCl (Regular salt) with a novel mineral salt [50% sodium chloride and rich in potassium chloride (25%), magnesium ammonium potassium chloride, hydrate (25%)] (Smart Salt).</p> <p>Methods</p> <p>A randomized, double-blind, placebo-controlled study was conducted with an intervention period of 8-weeks in subjects (n = 45) with systolic (S)BP 130-159 mmHg and/or diastolic (D)BP 85-99 mmHg. During the intervention period, subjects consumed processed foods salted with either NaCl or Smart Salt. The primary endpoint was the change in SBP. Secondary endpoints were changes in DBP, daily urine excretion of sodium (24-h dU-Na), potassium (dU-K) and magnesium (dU-Mg).</p> <p>Results</p> <p>24-h dU-Na decreased significantly in the Smart Salt group (-29.8 mmol; p = 0.012) and remained unchanged in the control group: resulting in a 3.3 g difference in NaCl intake between the groups. Replacement of NaCl with Smart Salt resulted in a significant reduction in SBP over 8 weeks (-7.5 mmHg; p = 0.016). SBP increased (+3.8 mmHg, p = 0.072) slightly in the Regular salt group. The difference in the change of SBP between study groups was significant (p < 0.002).</p> <p>Conclusions</p> <p>The substitution of Smart Salt for Regular salt in subjects with high normal or mildly elevated BP resulted in a significant reduction in their daily sodium intake as well as a reduction in SBP.</p> <p>Trial Registration</p> <p>ISRCTN: <a href="http://www.controlled-trials.com/ISRCTN01739816">ISRCTN01739816</a></p

Infecções em dispositivos neurológicos implantáveis em crianças e adolescentes

OBJETIVO: Determinar a freqüência, as causas, o sítio específico e as manifestações clínicas e laboratoriais das infecções em crianças e adolescentes após a implantação de dispositivos neurológicos (DVP) no Hospital Governador João Alves Filho (Aracaju SE). MÉTODO: Estudo prospectivo, observacional, não controlado de 50 pacientes, submetidos a DVP (58 procedimentos), no período de janeiro de 2003 a outubro de 2004. RESULTADOS: Observaram-se taxas de infecção por procedimento de 27,6%, taxas de infecção de índice cirúrgico zero, 1 e 2 de 25,7% e 30,4%, respectivamente (NNIS-CDC). A infecção de sítio cirúrgico foi a principal complicação com 50% das infecções. CONCLUSÃO: Taxa de infecção por procedimento, paciente e índice de risco cirúrgico mostraram-se elevadas. Não houve significância estatística com relação à idade, etiologia da hidrocefalia, ao tipo de procedimento (derivação primária e reinserção), tempo de internação pré-operatória, duração da cirurgia, antibioticoprofilaxia, cateter SNC prévio e índice de risco cirúrgico. _________________________________________________________________________________________ ABSTRACT: OBJECTIVE: To determine frequency, etiology, site and clinical and laboratory findings of ventriculoperitoneal shunt (VPS) infections in children and adolescents with hydrocephalus managed in Hospital Governador João Alves Filho, Aracaju SE, Brazil. METHOD: A non-controlled prospective observational study comprising 50 patients that underwent VPS (58 procedures) from January/2003 to October/2004. RESULTS: Infection rate per procedure was 27.6%; surgical risk index (NNISS-CDC) 0 and 1-2 were 25.7% and 30.4% respectively; surgical site infection was the main complication with 50% of the cases. CONCLUSION: Infection rates per procedure, per patient, and per surgical risk index were high. No statistical differences were found related to the following: age, etiology of hydrocephalus, type of procedure, pre-operative length of stay, duration of procedure, antibiotic prophylaxis, previous central nervous system catheter, and surgical risk index